2023-10-05T11:29:32-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 8390 EAST CRESCENT PARKWAY SUITE 300 GREENWOOD VILLAGE CO 80111 990 2022-01-01 830279242 WYOMING MEDICAL CENTER INC WYOM 6027474000 2901 NORTH CENTRAL AVENUE 160 PHOENIX AZ 85012 STACI DICKERSON EVP, CFO 6027474000 2023-09-27 1 STACI DICKERSON XXX-XX-XXXX 1 KURT BENNION CPA P01469618 3037795710 2023-09-27 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PETER S FINE 2901 NORTH CENTRAL AVENUE 160 PHOENIX AZ 85012 236755225 0 X SEE SCHEDULE O X 1986 WY ASSIST BANNER HEALTH (BH) COMPLETE ITS MISSION TO MAKE HEALTH CARE EASIER, SO LIFE CAN BE BETTER BY PROVIDING INTEGRATED AND COORDINATED CARE AND POPULATION HEALTH MANAGEMENT. 3 0 0 86 1206452 667662 2910626 3714216 276016500 232416952 144404 79831 681115 544226 279752645 236755225 24500 25835 0 0 135000482 91843210 0 0 0 129437804 140473292 264462786 232342337 15289859 4412888 279059082 250080113 91130981 63082634 187928101 186997479 X ASSIST BANNER HEALTH (BH) COMPLETE ITS MISSION TO MAKE HEALTH CARE EASIER, SO LIFE CAN BE BETTER BY PROVIDING INTEGRATED AND COORDINATED CARE AND POPULATION HEALTH MANAGEMENT. 0 0 164498731 25835 231210500 GUIDED BY AND DEEPLY DEVOTED TO THE NONPROFIT MISSION: "MAKING HEALTH CARE EASIER, SO LIFE CAN BE BETTER," WYOMING MEDICAL CENTER (WYMC), IS COMMITTED TO PROVIDING A WIDE RANGE OF QUALITY CARE, BASED ON THE NEEDS OF THE COMMUNITY. LOCATED IN THE COUNTY SEAT OF CASPER WYOMING, THE SECOND MOST POPULOUS CITY IN WYOMING, THE LEVEL TWO TRAUMA CENTER SERVES AS A REGIONAL REFERRAL CENTER AND PRIMARY FACILITY FOR NATRONA COUNTY RESIDENTS. WYMC PROVIDES A WIDE RANGE OF QUALITY CARE SERVICES INCLUDING CARDIOLOGY, WOMEN AND INFANTS' SERVICES, PEDIATRICS, BARIATRICS, SURGERY, IMAGING, NEUROLOGY, ONCOLOGY, REHABILITATION, AND ENDOCRINOLOGY. (CONTINUED IN SCHEDULE O)WYMC HAS A STRONG HISTORY OF DEDICATION TO ITS COMMUNITY AND PROVIDING CARE TO UNDERSERVED POPULATIONS AND CONTINUES TO HELP IDENTIFY ADDITIONAL OPPORTUNITIES TO BETTER CARE FOR POPULATIONS WITHIN THE COMMUNITY WHO HAVE SPECIAL OR UNMET NEEDS.WYMC IS DEDICATED TO STRENGTHENING PATIENT CARE THROUGH A CONTINUOUS FOCUS ON IMPROVING PATIENT OUTCOMES AND SERVICE, DEVELOPMENT AND TRAINING OF AN ENGAGED WORKFORCE, USE OF INNOVATIVE TECHNOLOGIES, AND EXPANSION OF SERVICES TO MEET COMMUNITY NEEDS. PEOPLE HAVE ALWAYS COME FIRST AND WHETHER WELCOMING NEWBORNS, OR PROVIDING CARE FOR THRIVING IN LATER YEARS, OUR PATIENTS PROVIDE THE MOTIVATION THAT KEEPS US MOVING FORWARD. AT ALL STAGES IN LIFE, WYMC MEETS THE HEALTH AND MEDICAL NEEDS OF ITS PATIENTS THROUGH COMPASSIONATE PROFESSIONALS AND OUTSTANDING SERVICE. WYMC'S REACH PROVIDES PATIENTS WITH ACCESS TO THESE SERVICES BE IT FROM A HOSPITAL BED, MOBILE WEB SITE, VIRTUAL TELEHEALTH SPACE, OR PHYSICAL PRESENCE IN A CLINIC OR PHYSICIAN'S OFFICE. WYMC MEETS THE PATIENT WHERE THEY ARE AND AT THEIR DESIRED LOCALE. WYMC'S MISSION IS "MAKING HEALTH CARE EASIER, SO LIFE CAN BE BETTER. AND AS A NONPROFIT ORGANIZATION, WE EXIST TO SUPPORT OUR CHARITABLE MISSION OF PROVIDING EXCELLENT HEALTH CARE SERVICES TO THE COMMUNITIES WE SERVE, RATHER THAN GENERATING INCOME FOR INVESTORS OR STOCKHOLDERS. EVERY DOLLAR WE EARN IS REINVESTED INTO NEW EQUIPMENT, NEW OR EXPANDING PATIENT CARE SERVICES, NEW PHYSICIAN SERVICES, MODERN TECHNOLOGIES, MAINTAINING EXISTING EQUIPMENT AND FACILITIES, AND EMPLOYEES. WYMC PRESERVES THE DIGNITY OF EVERYONE REGARDLESS OF RACE, CREED, SEX, SEXUAL ORIENTATION, GENDER IDENTITY, AGE, SOCIAL STATUS, OR ABILITY TO PAY FOR SERVICES RENDERED AND OPERATES IN A COST-EFFECTIVE AND FINANCIALLY RESPONSIBLE MANNER TO ENSURE THAT ALL RECEIVE THE EXCELLENT PATIENT CARE THEY DESERVE. FULFILLMENT OF THE WYMC MISSION AND EXEMPT PURPOSE IS ACCOMPLISHED IN PART BY PROVIDING PATIENTS FINANCIAL ASSISTANCE AND CHARITY CARE, AS WELL AS COMMUNITY BENEFIT PROGRAMS AND SERVICES (SEE SCHEDULE H). NOTABLE 2022 COMMUNITY BENEFIT ACTIVITIES INCLUDE:COMMUNITY EDUCATION - WYMC HAS SET ITS SIGHTS ON IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES AND FOCUSES ON PROVIDING THE BEST POSSIBLE CARE TO PATIENTS. IN THIS PROCESS, WYMC RECOGNIZES DELIVERING EXCELLENT CARE IS MORE THAN CLINICAL TREATMENT. WYMC IS COMMITTED TO PROVIDING EDUCATION IN ALL THE COMMUNITIES IT SERVES AND DOING ITS PART TO KEEP WYMC COMMUNITIES STRONG AND HEALTHY. AREA RESIDENTS AND COMMUNITY MEMBERS HAD ACCESS TO IN-PERSON AND ONLINE EDUCATIONAL OPPORTUNITIES INCLUDING CLASSES, SYMPOSIUMS, PRESENTATIONS, AND FORUMS AIMED AT COMMUNITY HEALTH AWARENESS. TOPICS INCLUDED DISCUSSIONS SPECIFIC TO VARIOUS DISEASES AND DISEASE PREVENTION TECHNIQUES, HOLISTIC THERAPIES, WELLNESS, CAREGIVER SUPPORT AND SAFETY. COVID 19 - WYMC FOCUSES ON EMERGENCY PREPAREDNESS YEAR-ROUND TO BE ABLE TO RESPOND TO ANY PUBLIC HEALTH CRISIS AND THE ARRIVAL OF THE COVID-19 PANDEMIC TO THE U.S. PUT THOSE PLANS INTO IMMEDIATE ACTION. SINCE THEN, WYMC HAS BEEN EVER PRESENT, PROVIDING QUALITY-CARE AND ACCESS AND LEADING THE WAY IN OUR COMMUNITIES. PROFOUNDLY ALTERED BY THE GLOBAL PANDEMIC AND AMID THE COVID-19 CHALLENGES, THE IMPORTANCE OF HIGH-QUALITY, ACCESSIBLE HEALTH CARE WAS NEVER MORE EVIDENT AND IN THE ENDEMIC ERA, WYMC CONTINUES TO STEADFASTLY FOCUS ON CARING FOR OUR DIVERSE COMMUNITIES INCLUDING SAFE TESTING, VACCINATIONS, EDUCATION, PROTECTION, AND CARE. WYMC HEALTH CONTINUALLY WORKS TO DEVELOP AND IMPLEMENT PRACTICES TO ENSURE THE SAFETY OF PATIENTS AND HEALTH CARE WORKERS ACROSS ITS SIX-STATE SERVICE AREA; CONSTANTLY REVIEWING AND ENHANCING MEASURES. THE IMPORTANCE OF HEALTH CARE WORKER AND PATIENT SAFETY IS PARAMOUNT WITH AN OVERARCHING MESSAGE - WYMC IS A SAFE PLACE - FOR CARE AND WORK. SAFETY EDUCATION - AT WYMC WE WANT TO HELP KEEP OUR PATIENTS AND FAMILIES SAFE AT HOME, REST, OR PLAY AND SAFETY IS THE FOREMOST PRIORITY AT OUR FACILITIES. AS PART OF OUR EFFORTS, WE OFFER SAFETY EDUCATION RELATED TO HANDWASHING, FARM, RECREATION, WATER, HOLIDAY, POISON PREVENTION, AND SUMMER SAFETY ALONG WITH N FREE GUIDES TO HELP INDIVIDUALS AND FAMILIES PREPARE FOR ANY KIND OF EMERGENCY. HEALTH CARE SUPPORT SERVICES PUBLIC AHCCCS/MEDICAID PROGRAM ENROLLMENT ASSISTANCE AND CARE COORDINATION VALUED AT $5,0004.0 MILLION PROVIDED TO INDIVIDUALS IN NEED. LODGING AND TRANSPORTATION INDIVIDUALS PROVIDED LODGING AND TRANSPORTATION ASSISTANCE MORE THAN $15,000. PATIENT WELLNESS AT WYMC HEALTH, WE ARE COMMITTED TO HELPING PERSONS BE THE HEALTHIEST THEY CAN BE, AND WE OFFER MANY WAYS TO LEARN HOW TO MAINTAIN OR IMPROVE YOUR HEALTH. IN 2022 COMMUNITY EDUCATION AND WELLNESS ACTIVITIES WERE VALUED AT $1.0 MILLION. PHARMACY EDUCATION AS PART OF COMMUNITY SERVICE, WYMC PROVIDED APPROXIMATELY $272,000 FOR THE TRAINING OF FUTURE PHARMACISTS.FUNDED DISCHARGE PROGRAM - INITIATIVE TO PROVIDE POST-DISCHARGE SERVICES TO THE VULNERABLE AND UNDERSERVED. IMPROVES THE HEALTH OF THE COMMUNITY BY PROVIDING ACCESS TO AND RESOURCES FOR POST-DISCHARGE CARE WHICH LEVERAGES' THE PATIENT'S RECOVERY OPTIONS, HELPS MINIMIZE RETURN VISIT, AND ADDRESSES ACCESS TO CARE. APPROXIMATELY $13,000 PROVIDED TO NEEDY COMMUNITY RESIDENTS FOR POST DISCHARGE CARE. AMBULANCE AND EVACUATION SERVICES - AMBULANCE AND EMERGENCY EVACUATION SERVICES ARE PROVIDED TO ARIZONA AND WESTERN REGION COMMUNITIES. WITHOUT THIS SUBSIDY AND SERVICE, LOCALITIES WOULD BE RESPONSIBLE FOR THESE SERVICES VALUED AT $52 THOUSND6.6 MILLION.BEHAVIORAL HEALTH - MENTAL AND EMOTIONAL WELLBEING IS JUST AS IMPORTANT AS PHYSICAL HEALTH AND THE WYMC BEHAVIORAL HEALTH INSTITUTE DEVOTE, $3.0 MILLION IN 2022 TO THE MENTAL HEALTH NEEDS OF THE COMMUNITIES SERVED. FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS - WYMC IS COMMITTED TO ASSISTING FINANCIALLY AND THROUGH IN-KIND CONTRIBUTIONS TO INDIVIDUALS AND THE COMMUNITY AT LARGE. WORKFORCE ENHANCEMENT - WYMC ACTIVELY RECRUITED PHYSICIANS TO SERVE IN FEDERAL MEDICALLY UNDERSERVED AREAS. IN 2022, APPROXIMATELY $317,000 WAS INVESTED TO ENHANCE COMMUNITY WORKFORCE. 164498731 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 X BANNER HEALTH 6027474000 2901 NORTH CENTRAL AVENUE 160 PHOENIX AZ 85012 MARGO KARSTEN DIVISION PRESIDENT 2.00 48.00 X 0 1036825 313788 DAN WEINMAN VP STRATEGY & PLANNING 2.00 40.00 X 0 706732 180004 LANCE PORTER CEO, LARGE FACILITY 2.00 40.00 X 0 397328 105553 PETER S FINE CEO 2.00 48.00 X 0 8677921 5958340 DENNIS LARAWAY EVP & CHIEF FINANCIAL OFFICER 2.00 48.00 X 0 2565572 505840 MAJORIE BESSEL MD EVP & CHIEF CLINICAL OFFICER 2.00 48.00 X 0 1675989 800391 DONALD NORLAND CHIEF STRATEGY/GROWTH OFFICER 2.00 48.00 X 0 1564909 826897 REBECCA KUHN CHIEF OPERATING OFFICER 2.00 48.00 X 0 1499857 381989 DAVID BIXBY CHIEF LEGAL COUNSEL 2.00 48.00 X 0 1364975 348343 BRENDA SCHAEFER TREASURER VP, CHIEF INVESTMENT OFFICER 2.00 48.00 X 0 615972 150772 ELIZABETH AVANT ASSISTANT SECRETARY 2.00 48.00 X 0 146583 11462 JEANNE EHLEBRACHT SR DIRECTOR CFO LARGE FACILITY (THRU FEB 2022) 40.00 0.00 X 0 395046 2062 AMY PERRY PRESIDENT & COO 2.00 48.00 X 0 1136684 1646638 JEAN F LANCE SECRETARY EVP CHIEF LEGAL OFFICER & GENERAL COUNSEL 2.00 48.00 X 0 700957 430135 JULIE ANN DUBEK EVP & CHIEF HUMAN RESOURCES OFFICER 2.00 40.00 X 0 776968 446651 NAOMI CRAMER CHIEF HUMAN RESOURCES OFFICER 2.00 40.00 X 0 922017 5443 0 24184335 12114308 0 1 1 0 0 3706767 7449 3714216 NET PATIENT REVENUE 621110 225619933 225619933 JV INVESTMENT INCOME 901101 4409051 3773999 635052 NON-PATIENT NON-OPERAT 900099 1183292 1183292 CAFETERIA SALES 722514 680697 633276 47421 REFERENCE LAB REVENUE 621500 523979 523979 232416952 41670 41670 538546 0 538546 538546 538546 38161 0 38161 38161 38161 OTHER NONOPERATING 900099 5680 5680 5680 236755225 231210500 1206452 624057 X 25835 25835 79792343 64613605 15178738 1431033 1158810 272223 6222060 5038450 1183610 4397774 3561194 836580 20103038 20103038 121195 121195 48845 48845 29079894 20058976 9020918 34320 34320 1314007 765702 548305 4287087 60078 4227009 17870237 2833064 15037173 192449 56268 136181 4952491 4952491 15699564 15699564 861827 861827 DRUG & MEDICAL SUPPLIES 43626041 43626041 EQUIPMENT LEASE/RENTAL 1510563 1105733 404830 FOOD 1297624 1113375 184249 PHYSICIAN RECRUITMENT 916137 617861 298276 -1442027 -1650143 208116 232342337 164498731 67843606 0 20240310 13014036 736820 0 55610969 43593529 776472 499814 5637145 7620694 4200527 936797 448071920 298949690 173818904 149122230 5749212 6419044 6600000 2278571 5688723 26595398 279059082 250080113 19159979 18491961 19181057 72417 35114975 27848664 17674970 16669592 91130981 63082634 X 177984228 173705384 9943873 13292095 187928101 186997479 279059082 250080113 X 4412888 -5343510 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 1 45320 0 1 21031 66351 0 PART II-B, LINE 1: WYOMING MEDICAL CENTER SPENT $45,320 IN REIMBURSED EXPENSES RELATED TO DIRECT COMMUNICATIONS WITH LEGISLATORS. WYOMING MEDICAL CENTER ALSO CONTRIBUTED $21,031 IN LOBBYING COSTS THROUGH ITS PAYMENT OF DUES TO THE WYOMING HOSPITAL ASSOCIATION. 13344402 13344402 146018962 101245142 44773820 4757381 4364856 392525 263601405 181310480 82290925 20349770 12029212 8320558 149122230 RIGHT OF USE ASSET 26595398 26595398 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 279752 DUE TO RELATED ORGANIZATIONS 16389840 16669592 1 1 X 1 X 1 X 1 1 1 0 1 1 18794700 18794700 0.08030 24701906 18908846 5793060 0.02470 926742 0 926742 0.00400 44423348 18908846 25514502 0.10900 0 272659 0 272659 0.00120 1711175 0 1711175 0.00730 9679 0 9679 0.00000 1993513 1993513 0.00850 46416861 18908846 27508015 0.11750 316857 0 316857 0.00140 316857 316857 0.00140 1 -1790482 0 74916643 74901130 15513 X 1 1 1 OUTPATIENT RADIOLOGY LLC IMAGING SERVICES 0.50000 0.00000 0.50000 2 CENTRAL WYOMING OUTPATIENT SURGERY CENTER LLC SURGICAL CENTER 0.50000 0.25000 0.25000 3 NORTH PLATTE PATHOLOGY LLC PATHOLOGY SERVICES 0.50000 0.00000 0.50000 1 1 WYOMING MEDICAL CENTER 1233 EAST 2ND STREET CASPER WY 82601 SEE SCHEDULE O 15341 X X X WYOMING MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE LINE 7D X X 1 22 1 SEE LINE 7D 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE LINE 16J X SEE LINE 16J X SEE LINE 16J X X X X X X X 1 X 0 X X X X 1 X 0 0 WYOMING MEDICAL CENTER PART V, SECTION B, LINE 3J: LINE 3A:WYOMING MEDICAL CENTER, A REGIONAL REFERRAL CENTER IS IN NATRONA COUNTY, WYOMING AND INCLUDES A CENTRAL AND EAST CAMPUS. THE CENTRAL CAMPUS IS THE PRIMARY FACILITY FOR NATRONA COUNTY RESIDENTS AND A LEVEL 2 TRAUMA CENTER. THE DEMOGRAPHIC AREA FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS NATRONA COUNTY. NATRONA COUNTY IS IN THE CENTER OF WYOMING AND IS THE SECOND MOST POPULOUS COUNTY IN WYOMING. WYOMING MEDICAL CENTER IS POSITIONED IN THE COUNTY SEAT OF CASPER. THE PRIMARY SERVICE AREA (PSA) INFORMATION FOR WYOMING MEDICAL CENTER INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL AND DOES NOT EXCLUDE LOW-INCOME OR UNDERSERVED POPULATIONS.LINE 3C:IN COMPLIANCE WITH FEDERAL REQUIREMENTS, WYOMING MEDICAL CENTER, AND THE BH CHNA STEERING COMMITTEE PARTNERED WITH PUBLIC HEALTH EXPERTS AS WELL AS RESIDENTS, REPRESENTATIVES, OR LEADERS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS. WORKING COLLABORATIVELY THE HEALTH NEEDS OF RESIDENTS IN NATRONA COUNTY, WYOMING INCLUDING THE PRIMARY SERVICES AREA FOR WYOMING MEDICAL CENTER WERE ASSESSED. LINE 3D:WYOMING MEDICAL CENTER EMPLOYS AN EIGHT-STEP CHNA PROCESS BASED ON BH'S EXPERIENCE FROM PREVIOUS CHNA CYCLES. THE EIGHT- STEP PROCESS CONSISTS OF THE FOLLOWING:1. REVIEW AND EVALUATE PRIOR CHNA REPORT AND ACTION PLANS, REVIEW DATA2. PARTNER WITH COMMUNITY AGENCIES, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS 3. CONDUCT FOCUS GROUP WITH COMMUNITY STAKEHOLDERS AND CONFIRM COMMUNITY PRIORITIES 4. RESEARCH ADDITIONAL HEALTH NEEDS IDENTIFIED 5. PREPARE CHNA REPORT 6. DEVELOP STRATEGIES FOR THE NEXT THREE YEARS7. OBTAIN BH LEADERSHIP AND BOARD OF DIRECTOR APPROVAL 8. POST TO WWW.BANNERHEALTH.COM AND OBTAIN ONGOING COMMUNITY FEEDBACKORGANIZATIONAL STRUCTURE:-EXTERNAL STAKEHOLDERS - A TEAM OF EXTERNAL STAKEHOLDERS IS MADE UP OF INDIVIDUALS AND ORGANIZATIONS EXTERNAL TO WYMC, AND REPRESENT THE UNDERSERVED, UNINSURED, AND MINORITY POPULATIONS IN NATRONA COUNTY AND THE SURROUNDING AREAS. BASED ON THEIR ROLE IN THE PUBLIC HEALTH REALM OF THE HOSPITAL'S SURROUNDING COMMUNITY, THESE STAKEHOLDERS ARE INSTRUMENTAL IN COLLABORATING AROUND IMPROVING OUR COMMUNITIES. EACH STAKEHOLDER IS VESTED IN THE OVERALL HEALTH OF THE COMMUNITY AND BRINGS FORTH A UNIQUE PERSPECTIVE WITH REGARDS TO THE POPULATION'S HEALTH NEEDS.- BH'S CHNA STEERING COMMITTEE - COMPRISED OF LEADERS FROM THROUGHOUT BH, THESE LEADERS REPRESENT OUR ARIZONA COMMUNITY DELIVERY, WESTER DIVISION, AND RURAL FACILITIES, AS WELL AS OUR ACADEMIC MEDICAL CENTERS. IN COLLABORATION WITH WYOMING MEDICAL CENTER'S LEADERSHIP TEAM AND BH'S STRATEGY PLANNING DEPARTMENT, THE STEERING COMMITTEE IS INSTRUMENTAL IN BOTH THE DEVELOPMENT OF THE CHNA PROCESS AND THE CONTINUATION OF WYOMING MEDICAL CENTER'S AND BH'S COMMITMENT TO PROVIDING SERVICES THAT MEET COMMUNITY HEALTH NEEDS. - CHNA CHAMPIONS - A WORKING TEAM FROM EACH OF BH'S HOSPITALS MEETS MONTHLY TO REVIEW THE ONGOING PROCESS OF COMMUNITY STAKEHOLDER MEETINGS, REPORT CREATION, AND ACTION PLAN IMPLEMENTATION. THIS GROUP CONSISTS OF MEMBERSHIP MADE UP OF CEOS, CNOS, COOS, FACILITY DIRECTORS, QUALITY MANAGEMENT PERSONNEL, VOLUNTEER SERVICES LEADERS, AND OTHER CLINICAL STAKEHOLDERS. PRIMARY DATA:1. CONSISTS OF NEW DATA THAT IS OBTAINED VIA DIRECT MEANS. FOR BH, PRIMARY DATA IS CREATED BY RENDERING HEALTHCARE SERVICES TO PATIENTS; THE DATA INCLUDES INPATIENT, OR OUTPATIENT COUNTS, VISITS, PAYER, ETC. FOR THE CHNA REPORT, PRIMARY DATA WAS ALSO COLLECTED DIRECTLY FROM THE COMMUNITY THROUGH SURVEYS, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. THE PRIMARY DATA FOR THE CHNA ORIGINATED FROM CERNER (BH'S ELECTRONIC MEDICAL RECORD) AND MCKESSON (BH'S COST ACCOUNTING/DECISION SUPPORT TOOL). THESE DATA SOURCES WERE USED TO IDENTIFY THE HEALTH SERVICES CURRENTLY BEING ACCESSED BY THE COMMUNITY AND PROVIDES INDICATORS FOR DIAGNOSIS-BASED HEALTH NEEDS OF THE COMMUNITY. THIS DATA WAS ALSO USED TO IDENTIFY THE PRIMARY SERVICE AREAS (PSA = 75%), INFORM THE STEERING COMMITTEE, AND FACILITY CHAMPIONS ON WHAT THE NEXT STEPS OF RESEARCH AND FOCUS GROUP FACILITATION NEEDED TO ENTAIL. 2. COMMUNITY SURVEY - TO IDENTIFY AND UNDERSTAND COMMUNITY HEALTH NEEDS, A COMMUNITY HEALTH ASSESSMENT SURVEY WAS ADMINISTERED TO COMMUNITY MEMBERS IN WESTERN DIVISION BETWEEN MAY-JULY 2022. SURVEYS WERE INTENDED TO PROVIDE INFORMATION ABOUT PROMINENT HEALTH PROBLEMS FACING THE COMMUNITY. THE SURVEY HAD A TOTAL OF 15 QUESTIONS TO IDENTIFY FACTORS WHICH CONTRIBUTED TO OVERALL QUALITY OF LIFE, MORE IMPORTANT HEALTH ISSUES AND BEHAVIORS, RATING SCALES, AND IMPACT COVID-19 HAD IN THEIR LIFE AND IN THE COMMUNITY. A TOTAL OF 234 SURVEYS WERE COLLECTED FROM OUR WESTERN DIVISION COMMUNITY PARTNERS, 88 FROM OUR WYOMING PARTNERS, AND 58 FROM NATRONA COUNTY. 3. KEY INFORMANT INTERVIEWS - BH CONDUCTED A SERIES OF KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS IDENTIFIED BY FACILITY CHAMPIONS. KEY INFORMANTS REPRESENTED LOCAL HEALTH DEPARTMENTS, FIRE DEPARTMENTS, BEHAVIORAL HEALTH CENTERS, LOCAL COMMUNITY COLLEGES, AND SOCIAL SERVICE DEPARTMENTS. THROUGH A SERIES OF QUESTIONS, KEY INFORMANTS DEFINED THEIR OPINION OF HEALTH AND WHAT QUALITY OF LIFE MEANT, THEY IDENTIFIED TOP COMMUNITY NEEDS, AND DISCUSSED THE IMPACT COVID-19 CONTINUES TO HAVE IN THEIR COMMUNITY. WHILE THE DEFINITION OF HEALTH VARIED PERSON BY PERSON, THE PRIMARY THEME WAS THE ABILITY TO LIVE A SAFE AND PRODUCTIVE LIFE.SECONDARY DATA:WYOMING MEDICAL CENTER'S PROCESS FOR CONDUCTING THEIR CHNA LEVERAGED A MULTI-PHASED APPROACH TO UNDERSTANDING GAPS IN SERVICES PROVIDED TO THE COMMUNITY, AS WELL AS EXISTING COMMUNITY RESOURCES. THE CHNA UTILIZED A MIXED-METHODS APPROACH THAT INCLUDED THE COLLECTION OF SECONDARY OR QUANTITATIVE DATA WITH REVIEW AND INPUT FROM KEY INFORMANTS, AND MEETINGS WITH INTERNAL LEADERSHIP. SECONDARY DATA INCLUDES PUBLICLY AVAILABLE HEALTH STATISTICS AND DEMOGRAPHIC DATA. WITH INPUT FROM STAKEHOLDERS, CHAMPIONS, AND THE STEERING COMMITTEE, ADDITIONAL HEALTH INDICATORS OF SPECIAL INTEREST WERE INVESTIGATED. COMPARISONS OF DATA SOURCES WERE MADE TO THE COUNTY, STATE, AND PSA IF POSSIBLE. DATA ANALYTICS WERE EMPLOYED TO IDENTIFY DEMOGRAPHICS, SOCIOECONOMIC FACTORS, AND HEALTH TRENDS IN THE PSA, COUNTY, AND STATE. DATA REVIEWED INCLUDED INFORMATION AROUND DEMOGRAPHICS, POPULATION GROWTH, HEALTH INSURANCE COVERAGE, HOSPITAL SERVICES UTILIZATION, PRIMARY AND CHRONIC HEALTH CONCERNS, RISK FACTORS, AND EXISTING COMMUNITY RESOURCES. SEVERAL SERVICES OF DATA WERE CONSULTED TO PRESENT THE MOST COMPREHENSIVE PICTURE OF WYOMING MEDICAL CENTER'S PSA'S HEALTH STATUS AND OUTCOMES. LINES 3E AND 3G:BASED ON DATA AND INFORMATION GATHERED THROUGH THE CHNA PROCESS, THE FOLLOWING REPRESENT THE THREE 2022 PRIORITIZE HEALTH NEEDS:1. ACCESS TO CARE 2. CHRONIC DISEASE MANAGEMENT 3. BEHAVIORAL HEALTHLINE 3H:INPUT WAS COLLECTED FROM INDIVIDUALS IN THE COMMUNITY, INCLUDING PUBLIC HEALTH EXPERTS AS WELL AS RESIDENTS, REPRESENTATIVES, OR LEADERS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS. AS NOTED ABOVE SURVEYS AND FOCUS GROUPS WERE CONDUCTED THROUGHOUT 2022 AND RESULTS INCORPORATED INTO THE CHNA. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 5: IN ADDITION TO THE NOTED COMMUNITY OUTREACH AND IN COMPLIANCE WITH FEDERAL REQUIREMENTS, WYOMING MEDICAL CENTER, AND THE BH CHNA STEERING COMMITTEE PARTNERED WITH PUBLIC HEALTH EXPERTS AS WELL AS KEY INFORMANTS, RESIDENTS, REPRESENTATIVES, OR LEADERS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS TO COLLECT AND REVIEW DATA AND FINDINGS. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 7D: THE 2022 CHNA REPORT IS AVAILABLE ONLINE AT WWW.BANNERHEALTH.COM/STAYING-WELL/COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-REPORT AND THE IMPLEMENTATION STRATEGY IS AVAILABLE ONLINE AT WWW.BANNERHEALTH.COM/-/MEDIA/FILES/PROJECT/BH/CHNA-REPORTS/2022/IMPLEMENTATION-STRATEGIES-FOR-POSTING.ASHX. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 11: SIGNIFICANT HEALTH NEED: ACCESS TO CARESTRATEGY #1: INCREASE ACCESS POINTS FOR PRIMARY CARE SERVICES - EMPLOYED ADDITIONAL PRIMARY CARE PROVIDERS AND ADVANCED PRACTICE PROVIDERS TO INCREASE ACCESS TO CARE.STRATEGY #2: INCREASE ACCESS TO AMBULATORY CARE SETTINGS.- GREW ACCESS TO AMBULATORY SERVICES FOR OUR COMMUNITY THROUGH URGENT CARE, AMBULATORY SURGICAL CENTERS, AND PHYSICAL THERAPY.STRATEGY #3: DEPLOY CARE MODELS AND TOOLS THAT IMPROVE AFFORDABILITY OF CARE FOR BH NETWORK MEMBERS. - PROMOTED ACCESS TO BANNER MEDICAL GROUP, TO REDUCE UTILIZATION OF THE EMERGENCY ROOM - IDENTIFIED 22 CORE MEASURES FOR ANNUAL WELLNESS VISITS TO SET QUALITY MEASURES INCLUDING CHRONIC DISEASE MANAGEMENT, CANCER SCREENINGS, AND IMMUNIZATIONS. SIGNIFICANT HEALTH NEED: CHRONIC DISEASE MANAGEMENT (DIABETES/HEART DISEASE/CANCER)STRATEGY #1: CONTINUE TO IMPROVE THE COORDINATION OF CARE FOR PATIENTS WITH CHRONIC DISEASE DIAGNOSIS - UTILIZED PHARMACISTS TO ASSIST IN CHRONIC DISEASE MANAGEMENT VIA TELEPHONE CONSULTATIONS. - OFFER CANCER SCREENINGS THROUGH CLINICS. - PROVIDED EDUCATION AND ASSISTANCE WITH MEDICATION ADHERENCE, INCLUDING COST OF MEDICATION. STRATEGY #2: GROWTH OF PREVENTATIVE CARE AND WELLNESS PROGRAMS IN THE COMMUNITIES WE SERVE. - PROVIDED MEDICARE ADVANTAGE WELLNESS VISITS THROUGH DEPLOYING MDS, NPS, AND PAS. - OFFERED SAME DAY MAMMOGRAPHY ACCESS IN AMBULATORY SETTINGS (HEALTH CENTERS AND IMAGING LOCATIONS). STRATEGY #3: CONTINUED ENHANCEMENT OF MEASUREMENT /OVERSIGHT OF CLINICAL QUALITY MEASURES FOR CHRONIC DISEASE PATIENTS. - DECREASED HYPERTENSION THROUGH AN INCREASE IN CLINICAL MEASURES FOR BP CONTROL. - DECREASED HBA1CS THROUGH AN INCREASE IN CLINICAL MEASURES FOR DIABETIC PATIENTS. - MONTHLY CLINICAL PERFORMANCE MEETINGS FOCUSING ON DIABETES AND HYPERTENSION FOR QUALITY IMPROVEMENT. SIGNIFICANT HEALTH NEED: BEHAVIORAL HEALTHSTRATEGY #1: PROVIDE SERVICES TO INCREASE AWARENESS AND ACCESS TO ADDRESS GENERAL PSYCHIATRIC HEALTH NEEDS. - CONTINUE TO PARTNER WITH COMMUNITY OUTPATIENT BEHAVIORAL HEALTH PROVIDERS TO PROVIDE COORDINATED CARE. - ENCOURAGED PATIENTS TO GET INITIAL BEHAVIORAL SCREENINGS IN THE EMERGENCY DEPARTMENT. STRATEGY #2: UTILIZE INTERNAL AND EXTERNAL RESOURCES TO ADDRESS OPIOID ADDICTION IN BH COMMUNITIES. - IMPLEMENTED A SYSTEM WIDE PRIMARY CARE STRATEGY TO IDENTIFY OPIOID USE DISORDER. STRATEGY #3: UTILIZE INTERNAL AND EXTERNAL RESOURCES TO IMPROVE CLINICAL QUALITY FOR SUICIDE, DEPRESSION PATIENTS IN BH COMMUNITIES. - WORKING TO BE A "ZERO SUICIDE" HEALTH SYSTEM, WHERE ALL NON-CLINICAL HOSPITAL EMPLOYEES ARE TRAINED TO QUESTION, PERSUADE, AND RESPOND WHEN INTERACTING WITH A PERSON HAVING A SUICIDAL CRISIS. - PROVIDED DEPRESSION SCREENINGS DURING CLINIC APPOINTMENTS.ADDITIONAL NEEDS IDENTIFIED THROUGH DATA COLLECTION AND COMMUNITY INPUT WERE AGE RELATED HEALTH CONCERNS, AGING PROBLEMS, CANCER, AND ACCESS TO HEALTHY FOODS. IN MANY OF BH'S FACILITIES A HIGH PERCENTAGE OF THE AGED POPULATION IS SERVED, AS A RESULT TACTICS HAVE BEEN DEVELOPED THAT ACKNOWLEDGE AND ADDRESS CONCERNS OF THE AGED POPULATIONS. IT WAS DETERMINED TO GROUP CANCER INTO CHRONIC DISEASE MANAGEMENT AS OPPOSED TO HAVING IT STAND ALONG SIGNIFICANT HEALTH NEED, AS A RESULT A SPECIFIC STRATEGY HAS BEEN DEVELOPED TO EDUCATE AND CREATE ACCESS TO CANCER SCREENINGS. COVID-19 REMAINS AN ONGOING HEALTH CONCERN IN MANY COMMUNITIES. WHILE BH DECIDED TO NOT DEVELOP A SIGNIFICANT HEALTH NEED THAT IS SPECIFIC TO COVID-19, HEALTH PRIORITIES HAVE BEEN DEVELOPED THAT ARE RELATED TO THE EFFECTS OF COVID-19 AND HAVE DEVELOPED TACTICS TO ADDRESS THESE HEALTH PRIORITIES. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION ARE AVAILABLE ONLINE AT WWW.BANNERHEALTH.COM/PATIENTS/BILLING/FINANCIAL-ASSISTANCE. 14 1 - CENTRAL WY OUTPATIENT SURGERY CENTER 1201 E 3RD STREET CASPER WY 82601 SURGICAL CENTER 2 - OUTPATIENT RADIOLOGY 419 S WASHINGTON STREET SUITE 100 CASPER WY 82601 IMAGING SERVICES 3 - WY HEALTH MED GROUP MULTISPECIALTY 419 S WASHINGTON STREET CASPER WY 82601 PHYSICIAN PRACTICE 4 - WY HEALTH MED GROUP MULTISPECIALTY 6650 E 2ND STREET CASPER WY 82609 PHYSICIAN PRACTICE 5 - NORTH PLATTE PATHOLOGY 111 S JEFFERSON STREET CASPER WY 82601 PATHOLOGY SERVICES 6 - SAGE PRIMARY CARE 1020 S CONWELL STREET CASPER WY 82601 PRIMARY CARE CLINIC 7 - MESA PRIMARY CARE 3632 AMERICAN WAY CASPER WY 82604 PRIMARY CARE CLINIC 8 - IMMEDIATE CARE 3632 AMERICAN WAY CASPER WY 82604 QUICK-CARE CLINIC 9 - RESPIRATORY SYMPTOMS SCREENING CLINIC 245 S FENWAY STREET CASPER WY 82601 QUICK-CARE CLINIC 10 - WOUND CARE CENTER 1201 E 3RD STREET CASPER WY 82601 WOUND CARE 11 - WYOMING NEUROSURGERY & SPINE 1020 E 2ND STREET SUITE 201 CASPER WY 82601 NEUROSURGICAL CLINIC 12 - COLE CREEK PRIMARY CARE 6600 E 2ND STREET CASPER WY 82601 PRIMARY CARE CLINIC 13 - WYOMING PAIN CENTER 6600 E 2ND STREET CASPER WY 82601 PAIN MANAGEMENT CLINIC 14 - THE WYOMING ENDOCRINE & DIABETES CLINIC 419 S WASHINGTON STREET SUITE 201 CASPER WY 82601 ENDOCRINE & DIABETES CLINIC PART I, LINE 3C: BH USES FPG. DEDICATED TO PROVIDING QUALITY, NON-DISCRIMINATING HEALTHCARE TO ALL PATIENTS REGARDLESS OF AGE, SEX, SEXUAL ORIENTATION, GENDER PREFERENCE, RACE, RELIGION, DISABILITY, VETERAN STATUS, NATIONAL ORIGIN AND/OR ABILITY TO PAY, DETERMINATIONS ARE MADE BASED UPON BH'S FINANCIAL ASSISTANCE POLICY FOR HOSPITAL PATIENTS. THIS POLICY ESTABLISHES: 1) GENERAL - BH FINANCIAL ASSISTANCE PROGRAMS WHICH, BASED ON HOUSEHOLD INCOME AND THE LEVEL OF MEDICAL EXPENSES, DETERMINE A PATIENT'S QUALIFICATION FOR CHARITY CARE OR DISCOUNTED COVERED SERVICES. ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE PROVIDED FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED AND WHO MEET THE HOUSEHOLD INCOME GUIDELINES AS OUTLINED IN THIS POLICY, OR ARE MEMBERS OF A MEDICALLY INDIGENT HOUSEHOLD. 2) FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS - UNINSURED PATIENTS WILL QUALIFY FOR BH FINANCIAL ASSISTANCE IF: (A) THEIR HOUSEHOLD INCOME IS LESS THAN 400% OF FPL, (B) THEY CANNOT QUALIFY FOR MEDICAID/AHCCCS OR OTHER GOVERNMENT PROGRAM, OR ARE UNABLE TO REASONABLY COMPLETE THE APPLICATION PROCESS FOR SUCH GOVERNMENTAL PROGRAMS, AND (C) THEY COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE (UNLESS DETERMINED TO BE PRESUMPTIVELY ELIGIBLE, AS PROVIDED BELOW), IN ACCORDANCE WITH THE FOLLOWING: FINANCIAL ASSISTANCE-UNINSURED PATIENTS: HOUSEHOLD INCOME --> AMOUNTS CHARGED 200% OF < FPL --> FULL CHARITY 100% DISCOUNT, WRITE-OFF ENTIRE PATIENT ACCOUNT> 201%-300% FPL --> 75% DISCOUNT OFF AGB (I.E., PATIENT OWES 25% OF AGB) > 301%-400% FPL --> 50% DISCOUNT OFF AGB (I.E., PATIENT OWES 50% OF AGB) 3) FINANCIAL ASSISTANCE FOR MEMBERS OF MEDICALLY INDIGENT HOUSEHOLDS. PATIENTS WHO ARE MEMBERS OF MEDICALLY INDIGENT HOUSEHOLDS WILL QUALIFY FOR BH FINANCIAL ASSISTANCE, SUBJECT TO APPLICATION FOR FINANCIAL ASSISTANCE, AS FOLLOWS: A) IF AN UNINSURED PATIENT, THE PATIENT IS RESPONSIBLE FOR 25% OF THE PATIENT LIABILITY (INCLUDING ANY ADJUSTMENT OF THE PATIENT LIABILITY AMOUNT PURSUANT TO APPLICATION OF THE BH FINANCIAL ASSISTANCE POLICY FOR UNINSURED PATIENTS, I.E., IF THE UNINSURED PATIENT IS A MEMBER OF A MEDICALLY INDIGENT HOUSEHOLD WHICH HAS A HOUSEHOLD INCOME OF 400% OF FPL, THE PATIENT WOULD OWE 25% OF THE BAI (WITHOUT REGARD TO THE AMOUNT OF THE BAI). B) IF AN UNDERINSURED PATIENT, THE PATIENT IS RESPONSIBLE FOR 25% OF THE BAI (WITHOUT REGARD TO THE AMOUNT OF THE BAI). PART I, LINE 7: 1) FINANCIAL ASSISTANCE AT COST, MEDICAID AND OTHER MEANS -TESTED GOVERNMENT PROGRAMS - USING THE COST-TO CHARGE METHODOLOGY DETERMINED BY THE COST ACCOUNTING SYSTEM, THE RATIO OF PATIENT CARE COST TO CHARGES OR RELATIVE VALUE UNITS IS APPLIED TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF FINANCIAL ASSISTANCE. THE COST ACCOUNT SYSTEM ADDRESSES ALL PATIENT SEGMENTS AT THE ACUTE CARE FACILITIES. THE COST ACCOUNTING APPLICATION IS NOT IMPLEMENTED AT THE HEALTH CENTERS, PHYSICIAN PRACTICES, HOME CARE, SURGICAL CENTERS, OR OCCUPATIONAL HEALTH. 2) COMMUNITY HEALTH IMPROVEMENT - BH USES THE CBISA, COMMUNITY BENEFIT INVENTORY TOOL TO COORDINATE AND ESTIMATE THE COSTS ASSOCIATED WITH COMMUNITY HEALTH IMPROVEMENT INITIATIVES. 3) HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND RESEARCH - ACTUAL COST LESS REIMBURSEMENTS AS REPORTED IN THE GENERAL LEDGER ARE USED TO VALUE THESE ACTIVITIES, WHICH OPERATED AT A LOSS PROVIDE INVALUABLE SERVICES TO BH COMMUNITIES. 4) CASH AND IN-KIND CONTRIBUTIONS - ACTUAL OR FAIR MARKET VALUE IS USED TO VALUE THESE CONTRIBUTIONS OR ACTIVITIES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE THE WYOMING BEHAVIORAL INSTITUTE AND ENDOCRINE & DIABETES SERVICES. 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 $ -1,790,482. PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY BY PROVIDING NEEDED SPECIALISTS AND PHYSICIANS AS WELL AS DETERMINING WHAT IS NEEDED BY THE RESIDENTS IN THE LOCAL COMMUNITY AND SURROUNDING AREA. WYOMING MEDICAL CENTER SPENT $316,857 IN RECRUITING PHYSICIANS FOR PEDIATRICS, OB/GYN, PRIMARY CARE, RADIOLOGY SERVICES, AND EMERGENCY CARE. PART III, LINE 2: ACCOUNTS ARE DISCOUNTED TO ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED. THOSE AMOUNTS ARE SUBJECT TO BAD DEBT POLICES. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNT ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: BH/WYMC RUNS A PRESUMPTIVE CHARITY ANALYSIS ON ALL ACCOUNTS TO MINIMIZE QUALIFYING PATIENTS BEING CLASSIFIED AS BAD DEBT. BH ESTIMATES THAT LESS THAN 15% OF THE PATIENT ACCOUNTS COMPRISING THE ORGANIZATION'S BAD DEBT MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER BH POLICIES. PART III, LINE 4: FOOTNOTE PER AUDITED FINANCIAL STATEMENTS (PAGE 13): NET PATIENT ACCOUNTS RECEIVABLE FOOTNOTE: NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICES REVENUES HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED INCLUSIVE OF THE ESTIMATED PRICE CONCESSION. PART III, LINE 8: THE MEDICARE COST REPORTS THAT HOSPITALS ARE REQUIRED TO FILE DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY, THE 2022 RESULT IS A MEDICARE SURPLUS OF $15.5K. THIS SITUATION IS NOT ANTICIPATED TO CONTINUE AND A RETURN TO A SHORTFALL POSITION IS PROJECTED AS CALCULATIONS REFLECTED ON THE COST REPORT DO NOT CUSTOMARILY TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE ORGANIZATION AND DIFFERS FROM THE COST REFLECTED ON THE FINANCIAL STATEMENTS. FUTURE MEDICARE SHORTFALLS SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE ABSENT THIS PROGRAM, MANY INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER NEEDS BASED PROGRAMS, BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF THE GOVERNMENT ARE RELIEVED AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: BH'S FINANCIAL ASSISTANCE POLICIES REQUIRE THAT THE ACCOUNTS OF PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE BE WRITTEN OFF EITHER IN FULL OR IN PART, DEPENDING UPON THE LEVEL OF THE FINANCIAL ASSISTANCE FOR WHICH THE PATIENT HAS QUALIFIED. IF THE ACCOUNT IS NOT WRITTEN OFF COMPLETELY, THE REDUCED BALANCE IS TREATED IN THE SAME MANNER AS ACCOUNTS FOR PATIENTS WITHOUT INSURANCE WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. FOR THOSE PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE AND FOR THE PORTION OF THE ACCOUNTS REMAINING AFTER APPLICATION OF THE FINANCIAL ASSISTANCE POLICIES FOR PATIENTS WHO QUALIFY FOR SUCH ASSISTANCE, ACCOUNT COLLECTION PROCESS IS AS FOLLOWS:1) THE PATIENT OR GUARANTOR WILL RECEIVE NO LESS THAN 3 STATEMENTS PRIOR TO THE ACCOUNT BEING PLACED WITH AN OUTSIDE AGENCY.THE PROCESS TAKES 120 DAYS TO COMPLETE. THE ACCOUNT IS OUTSOURCED TO A THIRD-PARTY COLLECTION AGENCY AFTER THE FINAL STATEMENT CYCLE AND RETURNED TO BH AFTER A REASONABLE COLLECTION ATTEMPT. 2) ATTEMPTS ARE MADE TO VERIFY PHYSICAL LOCATION OF PATIENT AND TO DETERMINE IF THE PATIENT MAY BE ELIGIBLE FOR AHCCCS/MEDICAID COVERAGE. 3) ONCE ASSIGNED TO AN OUTSIDE COLLECTION AGENCY, APPROPRIATE DEBT COLLECTION PRACTICES ARE UTILIZED IN DIFFERENT STATES, DEPENDING UPON LOCAL REGULATIONS. THE COLLECTION AGENCY ATTEMPTS TO OBTAIN PAYMENT FROM THE PATIENT BY MEANS OF DIRECT TELEPHONE CONTACT. IF THIS IS UNSUCCESSFUL, FAILURE TO MAKE PAYMENT MAY RESULT IN A REPORT TO A CREDIT AGENCY. PART VI, LINE 2: BH UTILIZES ITS STRATEGY AND PLANNING TEAM TO CONTINUALLY IDENTIFY AREAS IN THE COMMUNITIES BH SERVES WHERE INSTITUTIONAL CLINICAL NEEDS ARE NOT BEING SATISFIED ESPECIALLY FOR THOSE WITHIN UNDERSERVED, UNINSURED AND MINORITY POPULATIONS. IT ALSO LEVERAGES A MULTI-PHASED APPROACH TO UNDERSTANDING GAPS IN SERVICES PROVIDED TO COMMUNITIES SERVED BY HOSPITALS WITHIN THE SYSTEM AS WELL AS COMMUNITY RESOURCES THROUGH A COMBINATION OF POPULATION GROWTH AND CHANGING DEMOGRAPHICS ANALYSIS, DETAILED ANALYSIS OF NATIONAL, STATE AND COUNTY DATA SOURCES, HEALTHCARE SERVICES AVAILABLE THROUGH OTHER HOSPITAL PROVIDERS, PHYSICIAN SUPPLY IN THE BH SERVICE AREAS, NEW AND MORE EFFECTIVE HEALTHCARE SERVICES THAT ARE BECOMING AVAILABLE THAT WOULD ELEVATE THE QUALITY OF HEALTHCARE SERVICES PROVIDED TO BH COMMUNITIES, AND DEMAND PRESSURES EXPERIENCED BY EXISTING BH FACILITIES AND PHYSICIANS.ON A LOCAL BASIS, HOSPITAL MANAGEMENT TEAMS REGULARLY CONSULT WITH COMMUNITY LEADERS AND PARTNERS, LOCAL COMMUNITY-BASED ADVISORY BOARDS, OTHER SERVICE PROVIDERS (INCLUDING FEDERALLY QUALIFIED HEALTH CLINICS) AND BUSINESSES TO IDENTIFY UNMET PHYSICIAN AND HOSPITAL NEEDS. THESE FINDINGS ARE THEN PRIORITIZED BASED ON SYSTEM CAPITAL AND OPERATING RESOURCE AVAILABILITY, FEASIBILITY, AVAILABILITY OF PHYSICIANS TO BE RECRUITED TO THE SERVICE AREA, AND SUSTAINABILITY. BASED UPON THIS PRIORITIZATION, CAPITAL AND OPERATING RESOURCES ARE THEN INTEGRATED INTO THE FACILITY AND SYSTEM BUDGETS AND PLANS. PART VI, LINE 3: POLICIES AND PROCEDURES EXIST TO EDUCATE OUR PATIENTS ON FINANCIAL ASSISTANCE ELIGIBILITY, AND THEY ARE PROVIDED NUMEROUS OPPORTUNITIES FOR EDUCATION ON BH FINANCIAL ASSISTANCE POLICIES. THE FOLLOWING ARE EXAMPLES OF COMMUNICATION/EDUCATION AVAILABLE TO BH PATIENTS:A. SIGNAGE AND COLLATERAL IN BOTH ENGLISH AND SPANISH ARE POSTED PROMINENTLY IN-PATIENT WAITING LOBBIES, INCLUDING THE EMERGENCY DEPARTMENTS, STATING THAT BH HAS FINANCIAL ASSISTANCE PROGRAMS FOR THOSE WHO DO NOT HAVE INSURANCE OR MAY BE UNABLE TO PAY FOR THEIR SHARE OF THE COST OF SERVICES.B. A TOLL-FREE NUMBER IS PROVIDED FOR THE PATIENT'S/FAMILY'S CONVENIENCE.C. AFTER MEDICAL SCREENING, SELF PAY PATIENTS ARE VISITED BY STAFF AND INFORMED OF THE FINANCIAL POLICY. STAFF ALSO ASSISTS POTENTIALLY ELIGIBLE PATIENTS TO APPLY FOR ENROLLMENT FOR MEDICAID/AHCCCS.D. AN INSERT IS INCLUDED IN ALL OF OUR BILLING STATEMENT TO PATIENTS. THE INSERT AGAIN INFORMS PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IN BOTH ENGLISH AND SPANISH AND PROVIDES TOLL-FREE ACCESS.E. DEPARTMENT REPRESENTATIVES AGAIN INFORM PATIENTS OF THE FINANCIAL ASSISTANCE POLICIES DURING THE SELF-PAY COLLECTION PROCESS.F. BH WEBSITE PROVIDES INFORMATION IN BOTH ENGLISH AND SPANISH OF THE AVAILABILITY OF FINANCIAL ASSISTANCE.THROUGHOUT THE PROCESS, STAFF CONTINUES TO ADVISE POTENTIALLY ELIGIBLE PATIENTS OF THE POSSIBILITY OF ENROLLMENT IN MEDICAID/AHCCCS AND OFFER TO ASSIST IN SUCH ENROLLMENT. PART VI, LINE 4: BH'S 33 HOSPITALS, INCLUDING WYMC, OPERATE OR LEASE NURSING HOMES, PHYSICIAN CLINICS, HOME HEALTH AGENCIES, AMBULATORY FACILITIES, AND DURABLE MEDICAL EQUIPMENT SERVICES IN SIX WESTERN STATES WHICH INCLUDE DEMOGRAPHIC AREAS THAT RANGE FROM METROPOLITAN TO REMOTE RURAL AREAS. THE FOLLOWING SETS FORTH PERTINENT DEMOGRAPHIC INFORMATION WITH RESPECT TO THE COMMUNITIES AND AREAS SERVED BY BH FACILITIES:WYOMING1) STATEI) ESTIMATED POPULATION: 581,381II) MEDIAN HOUSEHOLD INCOME: $68,002III) PERCENT OF POPULATION IN POVERTY: 11.40%IV) PERCENT OF UNINSURED PERSONS UNDER AGE 65: 14.80%V) PER CAPITA HEALTHCARE EXPENSE: $10,989VI) TOTAL PERCENT OF UNINSURED IN POPULATION: 8.50%VI) PERCENT OF UNINSURED ADULTS 19-64 LIVING IN POVERTY: 20.30%VII) PERCENT OF UNINSURED NONELDERLY W INCOME BELOW 100% OF FPL: 15.70%VIII) PERCENT OF UNINSURED NONELDERLY W INCOME UP TO 200% OF FPL: 19.60%IX) PERCENT OF POPULATION BELOW 400% OF FPL: 60.80%X) PERCENT OF ADULTS REPORTING FAIR OR POOR HEALTH: 14.10%XI) PERCENT OF ADULTS DIAGNOSED WITH DIABETES: 7.50%XII) PERCENT OF ADULTS DIAGNOSED WITH CARDIOVASCULAR DISEASE: 6.30%XIII) PERCENT OF ADULTS WHO ARE OVERWEIGHT OR OBESE: 31.40%XIV) PERCENT OF ADULTS REPORTING MENTAL ILLNESS IN PAST YEAR: 53.10% PART VI, LINE 5: BH IS GOVERNED BY A COMMUNITY BOARD, DRAWN PRIMARILY FROM THE COMMUNITIES SERVED BY BH. THIS BOARD ESTABLISHES BH' PRIORITIES AND ENSURES THAT IT OPERATES IN A MANNER THAT WILL FURTHER ITS CHARITABLE, NONPROFIT PURPOSE TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. AS A NONPROFIT ENTITY, BH EXISTS TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITIES WE SERVE, NOT TO GENERATE PROFITS. TO THAT END, EVERY DOLLAR EARNED IS REINVESTED IN NEW EQUIPMENT, NEW OR EXPANDED PATIENT CARE SERVICES, NEW TECHNOLOGIES, MAINTAINING EXISTING EQUIPMENT AND FACILITIES AND NEW FACILITIES TO MEET MARKET NEEDS OR TO ENSURE THE LONGTERM SUCCESS OF THE ORGANIZATION.IN PARTICULAR, BH'S HEAVY REINVESTMENT IN CLINICAL SYSTEMS AND HEALTH INFORMATION TECHNOLOGY ENABLES BH TO PROVIDE A UNIFORMLY HIGH QUALITY OF CARE THROUGHOUT THE SYSTEM, INCLUDING BH'S SMALL, RURAL, CRITICAL ACCESS HOSPITALS. PHYSICIANS AND STAFF PRACTICING IN THESE SOLE COMMUNITY PROVIDERS HAVE THE SAME ELECTRONIC HEALTH RECORD SYSTEMS AND COMPUTERIZED PHYSICIAN ORDER ENTRY AND DECISION SUPPORT TOOLS AS ARE UTILIZED IN BH'S LARGEST TEACHING HOSPITAL. IN ADDITION, BY MEANS OF REMOTE MONITORING AND TELEMEDICINE TECHNOLOGIES, THESE SMALL RURAL HOSPITALS HAVE ACCESS TO THE CLINICAL AND OPERATIONAL SUPPORT OF THE ENTIRE SYSTEM, THEREBY BRINGING A LEVEL OF SOPHISTICATED HEALTH CARE TO THESE COMMUNITIES THAT WOULD NOT OTHERWISE BE POSSIBLE.EXCEPT IN LIMITED CIRCUMSTANCES WHERE NECESSARY TO ENSURE THE AVAILABILITY OF CONSISTENT AND EFFICIENT PHYSICIAN SERVICES, BH UTILIZES AN OPEN MEDICAL STAFF MODEL, THEREBY MAKING THE FACILITIES AVAILABLE TO LOCAL PHYSICIANS TO PROVIDE HIGH QUALITY HOSPITAL SERVICES TO OUR COMMUNITIES. IN ADDITION, BH IS AGGRESSIVELY PURSUING AN INTEGRATION STRATEGY INVOLVING NETWORKS OF EMPLOYED AND INDEPENDENT PHYSICIANS CAPABLE OF PROVIDING EFFICIENT, EVIDENCEBASED AND HIGH-QUALITY CLINICAL CARE WITHIN AN INTEGRATED SYSTEM COVERING THE FULL CONTINUUM OF CARE. THIS WILL ENABLE BH TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES WHILE LIMITING THE COSTS OF PROVIDING SUCH CARE. PART VI, LINE 7, REPORTS FILED WITH STATES WY PART VI, LINE 4 (CONTINUED): G. BH AVERAGE1) STATE AVERAGEI) ESTIMATED POPULATION: 9,668,785II) MEDIAN HOUSEHOLD INCOME: $67,632III) PERCENT OF POPULATION IN POVERTY: 10.70%IV) PERCENT OF UNINSURED PERSONS UNDER AGE 65: 10.98%V) PER CAPITA HEALTHCARE EXPENSE: $7,372VI) TOTAL PERCENT OF UNINSURED IN POPULATION: 9.27%VI) PERCENT OF UNINSURED ADULTS 19-64 LIVING IN POVERTY: 24.02%VII) PERCENT OF UNINSURED NONELDERLY W INCOME BELOW 100% OF FPL: 17.93%VIII) PERCENT OF UNINSURED NONELDERLY W INCOME UP TO 200% OF FPL: 21.43%IX) PERCENT OF POPULATION BELOW 400% OF FPL: 59.13%X) PERCENT OF ADULTS REPORTING FAIR OR POOR HEALTH: 13.88%XI) PERCENT OF ADULTS DIAGNOSED WITH DIABETES: 8.70%XII) PERCENT OF ADULTS DIAGNOSED WITH CARDIOVASCULAR DISEASE: 5.80%XIII) PERCENT OF ADULTS WHO ARE OVERWEIGHT OR OBESE: 29.43%XIV) PERCENT OF ADULTS REPORTING MENTAL ILLNESS IN PAST YEAR: 8.60%2) COUNTY AVERAGEI) ESTIMATED POPULATION: 404,900II) MEDIAN HOUSEHOLD INCOME: $59,473III) PERCENT OF POPULATION IN POVERTY: 11.89%IV) PERCENT OF UNINSURED PERSONS UNDER AGE 65: 12.95% 1 PART I, LINE 2: PRIOR TO MAKING A CONTRIBUTION TO ANOTHER ORGANIZATION, WYOMING MEDICAL CENTER'S STAFF CONFIRM THAT THE RECIPIENT IS A QUALIFIED CHARITY OR GOVERNMENT AGENCY OR THAT THE FUNDS WILL BE USED FOR A CHARITABLE PURPOSE. ALL CONTRIBUTIONS ARE FOR GENERAL OPERATING SUPPORT, SO NO FURTHER FOLLOW-UP REGARDING THE USE OF FUNDS IS CONDUCTED. X 1 1 X X X X 0 1 0 0 0 1 1 1 0 PETER S FINE CEO 0 1693064 0 6627363 0 357494 0 5936896 0 21444 0 14636261 0 4395753 DENNIS LARAWAY EVP & CHIEF FINANCIAL OFFICER 0 973581 0 1388473 0 203518 0 483779 0 22061 0 3071412 0 928746 AMY PERRY PRESIDENT & COO 0 1114474 0 0 0 22210 0 1617859 0 28779 0 2783322 0 506544 MAJORIE BESSEL MD EVP & CHIEF CLINICAL OFFICER 0 641373 0 921847 0 112769 0 783112 0 17279 0 2476380 0 589195 DONALD NORLAND CHIEF STRATEGY/GROWTH OFFICER 0 599488 0 873703 0 91718 0 808093 0 18804 0 2391806 0 542230 REBECCA KUHN CHIEF OPERATING OFFICER 0 11671 0 1488178 0 8 0 380753 0 1236 0 1881846 0 939817 DAVID BIXBY CHIEF LEGAL COUNSEL 0 333414 0 938190 0 93371 0 346108 0 2235 0 1713318 0 508871 MARGO KARSTEN DIVISION PRESIDENT 0 506425 0 443940 0 86460 0 289947 0 23841 0 1350613 0 236091 JULIE ANN DUBEK EVP & CHIEF HUMAN RESOURCES OFFICER 0 446301 0 290943 0 39724 0 423579 0 23072 0 1223619 0 0 JEAN F LANCE SECRETARY EVP CHIEF LEGAL OFFICER & GENERAL COUNSE 0 428914 0 248463 0 23580 0 407792 0 22343 0 1131092 0 80147 NAOMI CRAMER CHIEF HUMAN RESOURCES OFFICER 0 57105 0 801910 0 63002 0 2295 0 3148 0 927460 0 506544 DAN WEINMAN VP STRATEGY & PLANNING 0 391668 0 266262 0 48802 0 155717 0 24287 0 886736 0 88911 BRENDA SCHAEFER TREASURER VP, CHIEF INVESTMENT OFFICER 0 348837 0 234673 0 32462 0 139536 0 11236 0 766744 0 88262 LANCE PORTER CEO, LARGE FACILITY 0 235428 0 140867 0 21033 0 82238 0 23315 0 502881 0 20197 JEANNE EHLEBRACHT SR DIRECTOR CFO LARGE FACILITY (THRU FEB 2022) 0 50660 0 100 0 344286 0 1494 0 568 0 397108 0 0 ELIZABETH AVANT ASSISTANT SECRETARY 0 129604 0 16341 0 638 0 4077 0 7385 0 158045 0 0 PART I, LINE 1A THE BH TRAVEL POLICY ALLOWS FOR FIRST-CLASS AIR TRAVEL ON ANY FLIGHT WITHIN THE US AND THE LESSER FARE OF 1ST OR BUSINESS CLASS ON INTERNATIONAL TRAVEL FOR THE CEO. PART I, LINE 4B 1. SERP II - COVERED 1 EXECUTIVE (FINE). THIS NONQUALIFIED PLAN IS HELD IN A RABBI TRUST AT NORTHERN TRUST COMPANY. PAYMENTS ARE PURSUANT TO THE 2017 PLAN WHICH WAS REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE TO DETERMINE REASONABLENESS AND IS PAYABLE AFTER THE EXECUTIVE VESTS ON THE FIFTH ANNIVERSARY OF THE EFFECTIVE DATE OF THIS PLAN (FEBRUARY 28, 2022). THE ONLY CONTRIBUTIONS ALLOWED ARE EMPLOYER CONTRIBUTIONS AND ARE CALCULATED BASED ON ACTUARILY DETERMINED FACTORS. TAXATION OCCURS UPON DISTRIBUTION. 2. EXEC 457(B) - COVERED APPROXIMATELY 243 FORMER AND CURRENT EXECUTIVES. THIS NONQUALIFIED PLAN IS HELD AT FIDELITY INVESTMENTS AND IS 100% VESTED. TAXATION OCCURS UPON DISTRIBUTION. THE ONLY CONTRIBUTIONS ALLOWED ARE EMPLOYER CONTRIBUTIONS. CONTRIBUTIONS ARE CALCULATED BASED ON ACTUARIALLY DETERMINED FACTORS. EMPLOYER CONTRIBUTIONS TO EXEC 457(B) ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). 3. EXEC 457(F) - COVERED APPROXIMATELY 109 FORMER AND CURRENT EXECUTIVES. THIS NONQUALIFIED PLAN IS HELD AT FIDELITY INVESTMENTS. VESTING OCCURS UPON MEETING VESTING REQUIREMENTS (SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE). - AWARDS ARE SUBJECT TO A ROLLING THREE-YEAR VESTING SCHEDULE. EACH ANNUAL AWARD FULLY VESTS ON THE EARLIER OF AGE 65, JANUARY 1 OF THE YEAR WHICH IS THREE YEARS FROM THE YEAR THE AWARD WAS GRANTED, OR AN INVOLUNTARY NOT-FOR-CAUSE EMPLOYMENT TERMINATION. TAXATION OCCURS UPON DISTRIBUTION (IF VESTED). THE ONLY CONTRIBUTIONS ALLOWED ARE EMPLOYER CONTRIBUTIONS. PAYOUT AMOUNTS ARE TAXABLE AND INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). DEPOSIT AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). 2022 457(F) ACCRUALS: JULIE ANN ALVARADO-DUBEK - $26,267 MARJORIE BESSEL - $71,751 MARGO KARSTEN - $45,033 JEAN LANCE - $15,761 DENNIS LARAWAY - $124,120 DONALD NORDLUND - $66,327 LANCE PORTER - $2,052 BRENDA SCHAEFER - $12,581 DAN WEINMAN - $18,713 2022 457(F) DISTRIBUTIONS: JULIE ANN ALVARADO-DUBEK - $17,127 MARJORIE BESSEL - $89,190 DAVID BIXBY - $73,458 PETER FINE - $326,345 MARGO KARSTEN - $62,265 DENNIS LARAWAY - $175,644 DONALD NORDLUND - $68,337 BRENDA SCHAEFER - $9,556 DAN WEINMAN - $25,534 NAOMI DAWN CRAMER - $62,603 PATRICK RANKIN - $111,895 PART I, LINE 6 THE INDIVIDUALS IDENTIFIED BELOW PARTICIPATE IN A LONG-TERM INCENTIVE PLAN (LTIP) COVERING THREE-YEAR CYCLES FROM 2019-2021, 2020-2022, 2021-2023, AND 2022-2024. THE LTIP WAS DESIGNED AT THE INITIATIVE OF BH BOARD OF DIRECTORS WITH THE ASSISTANCE OF WILLIS TOWERS WATSON, AND ALL COMPONENTS WERE APPROVED BY THE BOARD. THE PLANS' AREAS OF PERFORMANCE TARGETS INCLUDE: STARS RATING IMPROVEMENT, TRANSFORM REVENUE CYCLE, AND BUILD OUR BENCH TO REFLECT COMMUNITIES. AWARDS ARE CALCULATED AS A PERCENTAGE OF BASE SALARY ON THE LAST DAY OF THE THREE-YEAR CYCLE, AND OPPORTUNITY VARIES BY POSITION LEVEL. THE PLAN REQUIRES A THRESHOLD LEVEL OF FINANCIAL PERFORMANCE BEFORE ANY AWARDS CAN BE MADE, AND THE AMOUNT OF THE AWARDS VARIES WITH THE DEGREE OF ACHIEVEMENT OF THE TARGETS. THE MAXIMUM LTIP PAYOUT OPPORTUNITY RANGES FROM 30% TO 255% OF THE BASE SALARY AS OF DECEMBER 31 IN THE LAST YEAR OF THE THREE-YEAR PLAN. AWARDS HAVE BEEN ACCRUED UNDER THE LTIP, BUT NO PAYMENTS ARE MADE UNTIL AFTER YEAR-END AND ACHIEVEMENT IS VERIFIED BY THE BH BOARD COMPENSATION COMMITTEE AND APPROVED BY THE FULL BOARD OF DIRECTORS OF BH. ALL LTIP COMPENSATION PAYMENTS ARE REPORTED IN THE INCENTIVE AND BONUS COMPENSATION SHOWN IN SCHEDULE J, PART II, COLUMN (B)(II). AMOUNTS PAID FOR THE 2019-2021 CYCLE ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B) AS BONUS & INCENTIVE COMPENSATION. AMOUNTS ACCRUED FOR 2022 FOR THE 2020-2022, 2021-2023, AND 2022-2024 CYCLES (TO BE PAID OUT IN 2023, 2024 AND 2025 RESPECTIVELY) ARE REPORTED IN SCHEDULE J, PART II, COLUMN (C) AS DEFERRED COMPENSATION. 2022 LTIP ACCRUALS: DAVID BIXBY - $334,185 PETER FINE - $4,458,029 REBECCA KUHN - $380,273 MARJORIE BESSEL - $699,461 JULIE ANN ALVARADO-DUBEK - $385,459 BRENDA SCHAEFER - $114,755 LANCE PORTER - $70,466 MARGO KARSTEN - $233,857 DENNIS LARAWAY - $347,673 DONALD NORDLUND - $729,566 JEAN LANCE - $379,831 AMY PERRY - $1,610,936 DAN WINMAN - $124,804 2022 LTIP DISTRIBUTIONS: DAVID BIXBY - $508,871 PETER FINE - $3,166,103 REBECCA KUHN - $939,817 MARJORIE BESSEL - $500,005 JULIE ANN ALVARADO-DUBEK - $95,856 BRENDA SCHAEFER - $78,706 LANCE PORTER - $20,197 MARGO KARSTEN - $173,825 DENNIS LARAWAY - $753,102 DONALD NORDLUND - $473,893 JEAN LANCE - $80,147 DAN WINMAN - $88,911 PATRICK RANKIN - $99,873 NAOMI CRAMER - $443,942 BH HAS A MANAGEMENT INCENTIVE PLAN (MIP) WHICH IS BASED ON COMPANY ACHIEVEMENT OF SEVERAL FINANCIAL AND NON-FINANCIAL/CLINICAL QUALITY METRICS THAT ARE ESTABLISHED ANNUALLY BY THE BH BOARD OF DIRECTORS. AWARDS ARE GRANTED AS A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AND VARY WITH THE POSITION LEVEL OF THE PARTICIPATING EMPLOYEE, RANGING FROM 7% TO 110% OF BASE SALARY. IN 2022, THERE WERE 1,420 MIP PARTICIPANTS. THE MIP WAS ACCRUED IN 2022 FOR THE 2022 MIP, AND PAYOUTS ON THE 2021 MIP WERE PAID IN 2022. MIP COMPENSATION IS INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(II). ROCKY MOUNTAIN INFECTIOUS DISEASES DR. MARK DOWELL, FORMER BOARD MEMBER, OWNS 51% 244465 INFECTIOUS DISEASE MEDICAL SERVICES 0 FORM 990, BOX J WEBSITE: WWW.BANNERHEALTH.COM/LOCATIONS/CASPER/WYOMING-MEDICAL-CENTER FORM 990, PART VI, SECTION A, LINE 6 BH, AN ARIZONA NONPROFIT CORPORATION EXEMPT FROM TAX AS AN ENTITY DESCRIBED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER ELECTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER RESERVES THE AUTHORITY TO APPROVE DECISIONS REGARDING THE FOLLOWING MATTERS: STRATEGIC PLAN, OPERATING AND CAPITAL BUDGETS, INSURANCE AND RISK MANAGEMENT, STAFFING, COMPENSATION, BENEFIT PLANS, AND ANY OTHER MATERIAL ACTION TAKEN OUTSIDE OF THE NORMAL COURSE OF BUSINESS. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B BH'S TAX DEPARTMENT (BH TAX) IS RESPONSIBLE FOR OVERSEEING THE PROCESSES FOR PREPARING THE FORM 990. BH TAX TAKES THE LEAD ROLE IN THE PROCESS AND IS CHARGED WITH THE DUTY TO COLLECT THE FINANCIAL AND OTHER INFORMATION NEEDED TO COMPLETE THE FORM 990. THIS INCLUDES COORDINATING WITH OTHER BH DEPARTMENTS, SUCH AS THE LEGAL, PAYROLL, GOVERNMENT RELATIONS, LICENSING, COMMUNITY BENEFIT, COMPENSATION AND BENEFITS, ACCOUNTS PAYABLE, RISK MANAGEMENT, CERTIFICATION, CREDENTIALING, FINANCIAL SERVICES AND TREASURY DEPARTMENTS IN ORDER TO ENSURE THAT THE EXPERTISE OF EACH DEPARTMENT IS UTILIZED IN THE INFORMATION-GATHERING PROCESS. ONCE THE INFORMATION IS GATHERED, IT IS ORGANIZED AND ASSEMBLED INTO AN ORGANIZER BY AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE FORM 990. THE ACCOUNTING FIRM HAS EXPERTISE IN NON-PROFIT HOSPITAL SYSTEMS AND HAS SPECIFIC KNOWLEDGE OF BH'S OPERATIONS AND RETURN COMPLEXITY. ONCE THE INFORMATION GATHERING PROCESS IS COMPLETE, A FIRST DRAFT OF THE FORM 990 IS PREPARED BY THE OUTSIDE ACCOUNTING FIRM AND READIED FOR REVIEW. THE REVIEW PROCESS BEGINS WITH AN INITIAL REVIEW DONE BY BH TAX. DURING THIS REVIEW, A LIST OF QUESTIONS, ISSUES AND ADDITIONAL TASKS IS COMPILED. THIS LIST IS THEN DISSEMINATED TO THE APPROPRIATE BH DEPARTMENTS FOR FURTHER ACTION. ONCE ALL QUESTIONS, ISSUES AND TASKS HAVE BEEN COMPLETED, A SECOND REVIEW BY BH TAX IS AND THE ACCOUNTING FIRM IS DONE. AGAIN, IF APPLICABLE, A LIST OF QUESTIONS, ISSUES AND ADDITIONAL TASKS IS COMPILED. THIS LIST IS THEN DISSEMINATED TO THE APPROPRIATE BH DEPARTMENTS FOR FURTHER ACTION. ONCE THIS SECOND REVIEW PROCESS IS COMPLETED, A FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE CHIEF LEGAL OFFICER & GENERAL COUNSEL AND CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. CHANGES TO THE FORM 990 ARE MADE IF NECESSARY AND APPROVAL IS GRANTED TO SEND THE FORM 990 TO THE BOARD MEMBERS. EACH MEMBER OF THE BOARD IS THEN SENT THE DRAFT FORM 990 ALONG WITH AN EXECUTIVE SUMMARY OF KEY ITEMS REPORTED IN THE FORM 990. ANY ISSUES ARE ADDRESSED AND RESOLVED AND THE FINAL VERSION OF THE FORM 990 IS SIGNED BY THE CFO OR ANOTHER OFFICER IF REQUIRED TO MEET TIMELY FILING REQUIREMENTS. FORM 990, PART VI, SECTION B, LINE 12C PURSUANT TO BH CONFLICT OF INTEREST POLICY, ALL BOARD MEMBERS, OFFICERS AND THE DIRECTOR OF AUDIT SERVICES MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST THAT MAY GIVE RISE TO A CONFLICT OF INTEREST PROMPTLY TO THE BOARD AUDIT COMMITTEE. THE COMMITTEE MUST THEN CONSIDER THE DISCLOSED INTEREST AND EITHER AUTHORIZE THE CONTINUATION OF THE POTENTIAL FINANCIAL INTEREST AND ANY RELATED TRANSACTION WITH APPROPRIATE PROTECTIONS, OR DISAPPROVE OF IT. OTHER BH EMPLOYEES MUST GO THROUGH A SIMILAR PROCESS OF DISCLOSURE TO THEIR RESPECTIVE SUPERVISOR AND TO THE DIRECTOR OF AUDIT SERVICES, WHO MAINTAINS ALL OF THE DISCLOSED FINANCIAL INTERESTS/CONFLICTS. IN ADDITION, ALL BOARD MEMBERS, OFFICERS, VICE PRESIDENTS, AND OTHER SELECTED MEMBERS OF MANAGEMENT, KEY EMPLOYEES AND EMPLOYED PHYSICIANS MUST COMPLETE AN ANNUAL SURVEY THAT IS DISTRIBUTED ELECTRONICALLY UNDER THE SUPERVISION OF THE DIRECTOR OF AUDIT SERVICES. THE SURVEY INCLUDES A QUESTIONNAIRE THAT IS DESIGNED TO IDENTIFY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, AS WELL AS OTHER TRANSACTIONS AND RELATIONSHIPS REQUIRED TO BE DISCLOSED IN THE FORM 990 AND SCHEDULE L. MEMBERS OF EXECUTIVE MANAGEMENT ARE ALSO REQUIRED TO COMPLETE A QUARTERLY QUESTIONNAIRE MANAGED UNDER THE SUPERVISION OF THE DIRECTOR OF AUDIT SERVICES. THIS QUESTIONNAIRE IS PRIMARILY DESIGNED TO IDENTIFY WEAKNESSES IN INTERNAL CONTROLS OR ACCOUNTING, BUT ALSO REQUIRES DISCLOSURE OF ANY KNOWLEDGE BY THE RESPONDING MANAGER OF ANY VIOLATIONS OF BH'S CONFLICT OF INTEREST POLICY. THE DIRECTOR OF AUDIT SERVICES COMPILES A SUMMARY OF THE CONFLICT OF INTEREST DISCLOSURES OBTAINED THROUGH THE ANNUAL SURVEY PROCESS INVOLVING BOARD MEMBERS OR OFFICERS. THIS SUMMARY IS REVIEWED WITH BH'S GENERAL COUNSEL TO DETERMINE THE APPROPRIATE ACTION TO BE TAKEN UNDER CONFLICT OF INTEREST POLICY. IN ADDITION, THE DIRECTOR REVIEWS THE SUMMARY ANNUALLY WITH THE BOARD AUDIT COMMITTEE IN ORDER TO ENSURE THAT ALL DISCLOSED ACTUAL OR POTENTIAL CONFLICTS HAVE BEEN REVIEWED AND PROCESSED APPROPRIATELY UNDER THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 BH UTILIZES A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT DIRECTORS THAT EXERCISES OVERSIGHT OVER ALL ASPECTS OF THE COMPENSATION PAID TO OR FOR THE BENEFIT OF THE CEO AND ALL OTHER SENIOR EXECUTIVES OF BH AND ANY OF ITS AFFILIATES AND ALL OTHER PERSONS WHO CONSTITUTE "DISQUALIFIED PERSONS" WITH RESPECT TO BH UNDER CODE SECTION 4958. THE COMMITTEE: - ASSESSES ANNUALLY THE PERFORMANCE OF THE CEO. - EXERCISES OVERSIGHT OVER ALL ASPECTS OF COMPENSATION FOR THE CEO. - REVIEWS AND DETERMINES THE EXECUTIVE TOTAL COMPENSATION PHILOSOPHY OF BH. - ESTABLISHES THE PERMISSIBLE RANGES OF COMPENSATION FOR SENIOR EXECUTIVES AND DISQUALIFIED PERSONS. - REVIEWS AND APPROVES THE DESIGN OF THE COMPONENTS OF COMPENSATION FOR SENIOR EXECUTIVES AND ANY OTHER DISQUALIFIED PERSONS AND MONITORS COMPLIANCE OF BH WITH THE PHILOSOPHY AND DESIGN COMPONENTS OF EXECUTIVE COMPENSATION. - RECEIVES THE CEO'S REPORT CONCERNING THE OVERALL PERFORMANCE AND DEVELOPMENT ASSESSMENT OF THE SENIOR EXECUTIVES. - ACTS FOR THE BOARD IN THE ENGAGEMENT AND DIRECT OVERSIGHT OF EXTERNAL INDEPENDENT COMPENSATION CONSULTANTS ENGAGED TO PROVIDE ADVICE AND INFORMATION WITH RESPECT TO THE REASONABLENESS AND COMPETITIVENESS OF THE COMPENSATION PAID TO THE CEO, SENIOR EXECUTIVES AND ANY OTHER DISQUALIFIED PERSONS, WHICH CONSULTANT REPORTS DIRECTLY TO THE COMMITTEE. IN ADDITION, THE COMMITTEE HAS ADOPTED THE FOLLOWING BEST PRACTICES WITH RESPECT TO ITS EXECUTIVE COMPENSATION OVERSIGHT FUNCTION: - REVIEWS ALL INCENTIVE PLANS, BENEFIT PLANS AND PROGRAMS THAT APPLY TO EMPLOYEES AND PHYSICIANS. - APPROVES CEO'S RECOMMENDATIONS AS TO THE COMPENSATION OF SENIOR EXECUTIVES. - USES TALLY SHEETS SUMMARIZING ALL COMPONENTS OF THE CEO'S AND SENIOR EXECUTIVES' COMPENSATION, INCLUDING A THREE-YEAR EARNINGS HISTORY AND THE COST OF ALL COMPENSATION (INCLUDING SPECIFICALLY DEFERRED COMPENSATION) AT THE TIME THAT ANY ACTION IS TAKEN WITH RESPECT TO THE CEO'S OR SENIOR EXECUTIVES' COMPENSATION IN ORDER TO ENSURE THAT THE COMMITTEE IS FULLY INFORMED OF THE COMPLETE COMPENSATION PACKAGE BEFORE TAKING ANY SUCH ACTION. - REVIEWS THE ANNUAL FORM 990 DISCLOSURES RELATING TO EXECUTIVE COMPENSATION TO ENSURE THE DISCLOSURES ACCURATELY RECONCILE TO THE COMPENSATION PACKAGES APPROVED BY THE COMMITTEE. THE COMPENSATION COMMITTEE RETAINS AN EXTERNAL INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST THE COMMITTEE. THE COMMITTEE ENGAGES A NATIONALLY RECOGNIZED COMPENSATION CONSULTING FIRM WITH SUBSTANTIAL HEALTHCARE EXPERIENCE. THIS FIRM REVIEWED AND OPINED AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PACKAGE OF THE CEO, SENIOR EXECUTIVE MANAGEMENT, AND OTHER EXECUTIVE MANAGEMENT IDENTIFIED BY THE COMMITTEE AS POTENTIAL DISQUALIFIED PERSONS. THE COMMITTEE ANNUALLY REVIEWS THE RELATIONSHIP BETWEEN BH AND EACH CONSULTANT TO ENSURE THE CONSULTANT'S INDEPENDENCE. IN CONNECTION WITH EACH SUCH EVALUATION, THE COMMITTEE REQUESTS A WRITTEN CERTIFICATION FROM EACH CONSULTANT THAT: - INCLUDES AN INDEPENDENCE ATTESTATION AFFIRMING THAT THE CONSULTANT HAS CONDUCTED ITS OWN INTERNAL ASSESSMENT AND BASED ON SUCH ASSESSMENT AND ITS INTERNAL CONTROLS, CONCLUDED THAT IT HAS PERFORMED ITS SERVICES FOR THE COMMITTEE IN AN INDEPENDENT MANNER AND IS INDEPENDENT AS DEFINED IN THE INTERMEDIATE SANCTION REGULATIONS UNDER CODE SECTION 4958. - CONFIRMS THAT THE CONSULTANT REPORTS TO THE COMMITTEE THROUGH THE CHAIR OF THE COMMITTEE AND THAT ALL CONSULTING ACTIVITY FOR BH CONDUCTED BY SUCH CONSULTANT DURING THE PRECEDING YEAR WAS CONDUCTED WITH THE KNOWLEDGE AND CONSENT OF THE CHAIR OF THE COMMITTEE. - DETAILS THE AMOUNTS PAID BY BH TO THE CONSULTANT IN ITS CAPACITY AS AN EXTERNAL COMPENSATION CONSULTANT TO THE COMMITTEE, AND THE AMOUNTS PAID BY BH, IF ANY, TO THE CONSULTANT AND ITS AFFILIATES FOR ANY OTHER ENGAGEMENTS. WITH THE ASSISTANCE OF THE INDEPENDENT COMPENSATION CONSULTANT, THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE PERFORMANCE OF THE CEO AND RECOMMENDS ADJUSTMENTS TO THE BASE SALARY AS DEEMED APPROPRIATE BASED UPON THE REVIEW, SUBJECT TO CONFIRMATION FROM THE CONSULTANT (WHO ATTENDS SUCH MEETING) THAT THE RECOMMENDATION IS APPROPRIATE AND WILL NOT RESULT IN THE OVERALL COMPENSATION OF THE CEO BECOMING UNREASONABLE. IN ORDER TO ENSURE THAT THE COMPENSATION DECISION IS SUBJECT TO THE ACTION OF INDEPENDENT DIRECTORS, THE BOARD MAY NOT APPROVE A SALARY ACTION DIFFERENT FROM THAT RECOMMENDED BY THE COMPENSATION COMMITTEE WITHOUT THE CONCURRENCE OF THE COMMITTEE. THE CEO ESTABLISHES THE BASE SALARY OF THE EXECUTIVES WHO DIRECTLY REPORT TO HIM, AND THOSE EXECUTIVES IN TURN ESTABLISH THE BASE SALARY OF THOSE INDIVIDUALS WHO REPORT TO THEM. ALL BASE SALARIES ARE, HOWEVER, BASED UPON POSITION-SPECIFIC MARKET DATA PROVIDED BY THE BH COMPENSATION AND BENEFITS DEPARTMENT. THESE RANGES ARE ESTABLISHED IN ACCORDANCE WITH AN EXECUTIVE COMPENSATION PHILOSOPHY THAT IS ESTABLISHED, AND REVIEWED ANNUALLY, BY THE COMPENSATION COMMITTEE. ANNUAL EQUITY ADJUSTMENTS MAY BE MADE UPON APPROVAL OF THE CEO AND BASED UPON SPECIFIC MARKET DATA. THE COMPENSATION COMMITTEE RECEIVES AN ANNUAL REPORT FROM THE COMPENSATION AND BENEFITS DEPARTMENT SHOWING THAT BASE SALARIES ARE BEING MAINTAINED CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY APPROVED BY THE COMMITTEE. AS STATED IN THE RESPONSE TO SCHEDULE J, PART I, LINE 7, THE SIGNIFICANT NON-FIXED COMPONENTS OF THE COMPENSATION OF THE CEO AND OTHER SENIOR MANAGEMENT ARE ESTABLISHED AND MONITORED BY THE COMPENSATION COMMITTEE WITH THE ASSISTANCE OF THE INDEPENDENT COMPENSATION CONSULTANT AND ARE INCLUDED IN THE ANNUAL REASONABLENESS OPINION RENDERED BY THE INDEPENDENT COMPENSATION CONSULTANT. CONTEMPORANEOUS MINUTES ARE KEPT OF ALL MEETINGS OF THE COMPENSATION COMMITTEE AND OF THE ACTIONS OF THE BOARD OF DIRECTORS IN APPROVING THE COMPENSATION OF CEO AND REVIEWING AND MONITORING THE COMPENSATION FOR ALL OTHER SENIOR EXECUTIVES AND TOP MANAGEMENT. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND TAX RETURNS ARE AVAILABLE UPON REQUEST. COPIES ARE MAINTAINED AT EACH ADMINISTRATIVE OFFICE AND IN THE LEGAL AND TAX DEPARTMENTS. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT REQUIRED TO BE MADE AVAILABLE TO THE PUBLIC AND THEREFORE THEY ARE NOT MADE PUBLIC. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 20,058,976. MANAGEMENT AND GENERAL EXPENSES 9,020,918. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,079,894. FORM 990, PART XI, LINE 9: NET ASSET ADJUSTMENT WITH COMPANY MERGER -5,343,510. FORM 990, PART XII, LINE 2C WYOMING MEDICAL CENTER IS NOW INCLUDED IN BH'S AUDITED FINANCIAL STATEMENTS. BH'S BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT. 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