2022-05-13T07:02:49-05:00 2021-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-07-01 460360899 Monument Health Network Inc MONU 6057559130 PO Box 6000 Rapid City SD 577096000 Mark Thompson CFO 6057559130 2022-05-12 1 Mark Thompson 999009999 Kim Hunwardsen CPA P00484560 6122536500 2022-05-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Paulette Davidson PO Box 6000 Rapid City SD 577096000 184198809 0 X https://monument.health/ X 1981 SD Monument Health Network is dedicated to improving the health of individuals and our communities. 11 7 1297 145 69374 0 518333 3526653 172654227 180638216 -23681 13 21916 22353 173170795 184187235 155940 0 0 0 98540471 104979192 0 0 0 71081692 79493082 169778103 184472274 3392692 -285039 148333045 114799210 93662816 60375017 54670229 54424193 X Our vision at Monument Health Network is to be one team, to listen, to be inclusive, and to show we care. Monument Health Network is dedicated to improving the health of individuals and our communities. 0 0 109288514 118805678 Monument Health Network (MHN) owns the following acute care hospitals (including physician clinics) and senior care facilities; Monument Health Custer Hospital (CAH)/ Monument Health Custer Senior Care, Monument Health Lead-Deadwood Hospital, Monument Health Spearfish Hospital and Monument Health Sturgis Hospital / Monument Health Sturgis Senior Care. MHN also owns, leases and operates provider based physician clinics in Belle Fourche, Spearfish, Lead, Sturgis & Custer. In addition, MHN operates free standing clinics in Hot Springs, Buffalo, and Newcastle & Upton, Wyoming. Together, these facilities provide common access to compassionate, quality, advanced health care through its numerous healing environments to the greater Black Hills region. 9836174 42971166 SPH Surgical ServicesSpearfish Monument Hospital's surgery department offers the following surgical specialties: Orthopedics, OB/GYN, General Surgery, ENT, Podiatry, Dermatology and Ophthalmology. 7948298 9980933 SPH 10th Street Primary CareSpearfish Monument Hospital's Medical Clinic is a hospital outpatient department providing primary care. It has a total of 47.89 full time equivalents. This hospital outpatient department had 44,662 encounters throughout the year. 6359038 6159964 SPH Orthopedic SurgerySpearfish Monument Hospital's Orthopedic Clinic is a surgery department offering general surgery and orthopedic surgery using state-of-the-art surgical methods using the most advanced equipment. The primary focus is on total joints: knee, hip and shoulder. 6359038 6159964 133432024 1 0 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 99 0 1 1297 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 7 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X X Mark Thompson 6057559127 PO Box 6000 Rapid City SD 577096000 Paulette Davidson President and CEO 10.65 49.35 X X 0 1194256 204200 Heather Brewer MD Board member/Employed Physician 40.00 0.00 X 732549 0 85919 Christopher Gasbarre DO Board Member/ Employed Physician 40.91 0.00 X 594500 0 79440 Lee B Bailey MD Board Member/ Employed Physician 40.67 0.00 X 418958 0 73476 Robert Haivala Vice Chairman 1.83 0.02 X X 0 0 0 Steven Williams Chair 0.71 0.00 X X 0 0 0 Pat Kurttenbach Board member 0.38 0.00 X 0 0 0 Kathryn Johnson Board member From 07/20 0.67 0.00 X 0 0 0 Dan Leikvold Board member From 07/20 0.67 0.00 X 0 0 0 Clinton Walker Board member 0.86 0.00 X 0 0 0 Paul Bisson Board member 0.26 0.00 X 0 0 0 Mark A Thompson CFO/Treasurer 9.77 45.23 X 0 567052 94448 Teresa Burroff General Counsel, Secretary 9.77 45.23 X 0 491229 58138 Stephanie Lahr MD CIO & CMIO 9.77 45.23 X 0 495146 80097 Brad Archer MD Chief Medical Officer 9.77 45.23 X 0 684327 101882 Thomas Worsley President Spearfish Market 55.00 0.00 X 405444 0 55124 Nicole Kerkenbush Chief Performance Officer 9.77 45.23 X 0 385368 38086 Mark Schmidt President Custer, Lead-Deadwood Markets 55.00 0.00 X 309247 0 51261 Mark Schulte President - Sturgis 55.00 0.00 X 281138 0 55528 Ray Jensen MD Physician - Orthopedic Surgery 40.00 0.00 X 1539383 0 130061 Garrett Cox MD Physician - Radiologist 40.00 0.00 X 946203 0 100859 Richard Little MD Physician - Orthopedic Surgery 40.00 0.00 X 1093096 0 102873 Andrew VanOsdol MD Physician - Surgery 40.00 0.00 X 871014 0 87235 Jessica DonnerMD Physician -clinical care 40.00 0.00 X 716464 0 73555 Tresha Moreland Former VP Human Resources 0.00 0.00 X 0 256546 931 Mary Masten General Counsel, Emeritus 3.55 16.45 X 0 103179 12951 7907996 4177103 1486064 143 1 1 0 Medefis 10826 Old Mill Rd 101 Omaha NE 68105 Contract Labor 2808279 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Contract Labor 1465002 Morrison Management Specialist Inc PO Box 102289 Atlanta GA 30368 Professional Services 1394072 Crothall Healthcare 13028 Collection Center Dr Chicago IL 60693 Professional Services 790347 Health Carousel LLC PO Box 714216 Cincinnati OH 45271 Contract Labor 435334 53 3140300 386353 3526653 Acute Care Hospital IP and OP 623000 97884910 97884910 Physician Clinics 621110 63338735 63338735 Long Term Care Facilities 623000 8238278 8238278 11176293 11106919 69374 180638216 13 13 33927 11574 22353 22353 22353 184187235 180568842 69374 22366 2518296 1560587 957709 80476636 70941083 9535553 2123663 1839286 284377 14896219 9270457 5625762 4964378 4320865 643513 44739 157 44582 21709 21709 9756306 6706472 3049834 152715 5333 147382 3193779 2178530 1015249 855875 725695 130180 5229434 2685609 2543825 282270 249201 33069 875460 875299 161 6966781 6367995 598786 666317 211812 454505 Miscellaneous 30401367 5011720 25389647 Medical Supplies 20588302 20089233 499069 458028 392690 65338 184472274 133432024 51040250 0 X 205269 1183866 20050923 23613379 2330716 2606485 922574 911271 136126859 66376041 68886208 69750818 1379570 427453 54656 54656 54503129 16251282 148333045 114799210 50662584 16940712 43000232 43434305 93662816 60375017 X 54380577 54083542 289652 340651 54670229 54424193 148333045 114799210 -285039 39003 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 21709 21709 0 Part II-B, Line 1: Annual dues are paid to the South Dakota Association of Healthcare Organizations. A portion of the dues are applicable to lobbying activities. For calendar year 2021 dues, which were paid in fiscal year 2021, in the amount of $68,291, 15.21% was used for lobbying purposes. In addition, annual dues were paid to the American Hospital Association, a portion of which is applicable to lobbying activities. For calendar year 2021 dues, which were paid in fiscal year 2021, in the amount of $44,297, 25.56% was used for lobbying purposes. 152792 39003 191795 156625 -3833 152792 143471 13154 156625 146585 -3114 143471 121703 24882 146585 0.00000 0.52140 0.47860 0 1 0 9809704 9809704 79078853 34660509 44418344 1145168 992169 152999 44285453 30723363 13562090 1807681 1807681 69750818 Intercompany Receivables 16251282 16251282 Due To Related Parties 43434305 43434305 X Part V, Line 4: Endowed funds are permanently restricted from use and are held in an interest bearing account. The interest earned may be used by the organization at its discretion. Part X, Line 2: References to "Monument Health" apply to all entities controlled by Monument Health, Inc. and its subsidiaries. This includes the reporting entity. Monument Health believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. Monument Health would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 250.000000000000 1 X 300.000000000000 1 1 0 1 1 1953515 1953515 0.01060 14530638 10393581 4137057 0.02240 16484153 10393581 6090572 0.03300 15 2437442 2437442 0.01320 2 27496 27496 0.00010 13914324 9639166 4275158 0.02320 1 6981 6981 0.00000 18 16386243 9639166 6747077 0.03650 18 32870396 20032747 12837649 0.06950 1 843 843 0.00000 1 675 675 0.00000 2 1518 1518 0.00000 1 10608275 0 46999886 46325493 674393 X 1 1 4 1 Monument Health Spearfish Hospital 1440 N Main Street Spearfish SD 57783 www.monument.health 10566 X X X 6 Provider-based clinics A 2 Monument Health Custer Hospital 1039 Montgomery Street Custer SD 57730 www.monument.health 47660 X X X X 2 Provider-based clinics A 3 Monument Health Sturgis Hospital 949 Harmon Street Sturgis SD 57785 www.monument.health 10567 X X X X 1 Provider-based clinic A 4 Monument Health Lead-Deadwood Hospital 61 Charles Street Deadwood SD 57732 www.monument.health 10535 X X X X 1 Provider-based clinic A Facility Reporting Group - A 0 0 1 X X X X X X X X X 18 1 1 0 1 X See Section C, Line 7d X X 1 18 1 See Section C, Line 7d 0 1 X 250.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X See Section C, Line 16a-c X See Section C, Line 16a-c X See Section C, Line 16a-c X X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Monument Health Spearfish Hospital, - Facility 2: Monument Health Custer Hospital, - Facility 3: Monument Health Sturgis Hospital, - Facility 4: Monument Health Lead-Deadwood Hospital Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Reminder emails were sent as needed to increase participation. A total of 134 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Monument Health service area. Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 6a: The Community Health Needs Assessment was undertaken by Monument Health, including: Monument Health Rapid City Hospital, Same Day Surgery Center, Monument Health Network (Monument Health Spearfish Hospital, Monument Health Sturgis Hospital, Monument Health Lead-Deadwood Hospital, and Monument Health Custer Hospital). Under a management contract with Monument Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 7d: https://monument.health/about-us/community-health-needs-assessment/ Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 11: During FY21, Monument Health focused on the following four priority areas identified through the most recent Community Health Needs Assessment: Cancer, Heart Disease and Stroke, Diabetes and Mental Health. Work was also dedicated to COVID-19 initiatives across the health system. Teams comprised of representatives from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and the community worked on the priority areas selected for each facility's Community Health Improvement Plan.Cancer- Began construction on the expansion of the Cancer Care Institute in March 2021. The new location will more than double the space of the existing facility to expand radiation and medical oncology, expand infusion services, and add comprehensive brachytherapy services and integrated services.- Expanded patient services including Breast Survivorship Visits, Advanced Radiation Brachy Treatments, and implementation of the first phase of the Genetics Navigator Platform for cancer screenings.- Adopted South Dakota 2021-2025 Comprehensive Cancer Plan's goals, priorities and tactics throughout Monument Health. Actively contributed to the program with representation and project leaders. - Implemented telehealth and tele-video visits to support cancer patients throughout the COVID-19 pandemic. - Participated in the American Society of Clinical Oncology survey for COVID-19 in Oncology Registry, which collects information about patterns of symptoms and severity of COVID-19 infection, how COVID-19 influences the delivery of cancer care, and how patient cancer and COVID-19 outcomes are affected.- Utilized the Mayo Clinic Care Network to collaborate on individual patient cancer care to provide patients with care close to home. - Provided cancer education at community events including Judd Hoos Charity Concert for Cancer, Rush Hocky Fights Cancer, Custer Mammo or Bust Run Walk, Deadwood Days of 76 Rodeo, and the Tough Enough to Wear Pink program throughout Black Hills Stock Show and Rodeo Rapid City.Heart Disease and Stroke- Hosted and participated in events to increase awareness of Heart Disease and Stroke including the American Heart Association Heart Ball (AHA), the AHA Heart Walk and February Freeze run/walk. - Provided blood pressure screenings and education at community events, including one of the largest regional events, the Black Hills Stock Show and Rodeo Rapid City. - Provided education to area providers through the annual Cardiac Symposium, which had to be virtual this year due to COVID-19. This event highlights current heart and stroke topics, advancements in cardiac medicine, lifestyle management and new physicians and advanced practice providers to the community.- Improved the Stroke metric of tissue plasminogen activator door-to-needle time and increased occurrences of Alteplase administration. - Recruited four additional providers for Heart and Vascular Care and Neurology Care.- Provided heart and vascular outreach clinics in Spearfish, Chadron, Alliance, Belle Fourche, Newcastle, Custer, and Hot Springs. - Utilized the Mayo Clinic Care Network to collaborate on care for cardiology and stroke patients, to provide patients with care close to home. Diabetes- Offered virtual options for the Monument Health Diabetes Prevention Program and the Better Choices Better Health program for patients identified by case managers and/or diabetes educators. These programs were offered in partnership with the South Dakota State University Extension Office and South Dakota Foundation for Medical Care.- Pursued Medicare Diabetes Prevention Program supplier status with goal of implementing program mid-2022.- Implemented LACES program to improve transition from inpatient to outpatient care. Program focuses on Low Blood Glucose, A1C, Consults, Education and Survival Skills for patients. - Supported local events for Diabetes education including Diabetes Inc. and the Black Hills Dialysis Group. - Provided telephonic and tele-video visits for patients during COVID-19 and explored options to continue post-pandemic.- Held ongoing outreach clinics monthly in the communities of Spearfish, Sturgis, Belle Fourche, Lead/Deadwood, Hot Springs, Hill City, Custer, and Newcastle. Mental Health- Partner with Avera E-care for Psychiatrist and Social Worker or Nurse services by phone and video.- Increased mental health needs assessment coverage in the ED for patient evaluation and therapeutic work. - Continued collaboration with Pennington County Care Campus and provided representation on their Advisory Board. - Held on-site and televisits from Protection & Advocacy for Individuals with Mental Illness Program to provide education on available services.- Offered Alcoholics Anonymous meeting availability to patients within our facilities via streaming due to COVID-19. - Conducted group sessions for the Red Road to Wellbriety addiction program, which aligned with the Tribal Practices and Cultural Beliefs Teen Group. Sessions were held via tele-health due to COVID-19.- Implemented Trauma Informed Care and provided toolkits for Emergency Department and Medical Staff. Caregivers are continuously trained through orientation, monthly meetings, and annual competency. - Expanded the availability of counselors located in our primary care facilities across the Monument Health system. - Recruited additional Psychiatrists and Psychologists. - Continued use of systemwide standard processes for mental health screening of patients identified at risk utilizing the Columbia scale. Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 13h: Must reside within 200 mile radius of the location where the service was received.Presumptive eligibility may be used. Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 16j: A summary of the hospital's financial assistance policy is posted for all patients at various points of entry, including on the facility website, in waiting rooms, and in the admissions office. The policy in its entirety is also available upon request. The financial assistance policy application form was translated into the primary language spoken by limited English proficient populations. This is posted on the website listed for line 16a. Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged financial assistance policy eligible patients gross charges for services that are not covered under the financial assistance policy. Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Reminder emails were sent as needed to increase participation. A total of 134 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Monument Health service area. Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 6a: The Community Health Needs Assessment was undertaken by Monument Health, including: Monument Health Rapid City Hospital, Same Day Surgery Center, Monument Health Network (Monument Health Spearfish Hospital, Monument Health Sturgis Hospital, Monument Health Lead-Deadwood Hospital, and Monument Health Custer Hospital). Under a management contract with Monument Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 7d: https://monument.health/about-us/community-health-needs-assessment/ Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 11: During FY21, Monument Health focused on the following four priority areas identified through the most recent Community Health Needs Assessment: Cancer, Heart Disease and Stroke, Diabetes and Mental Health. Work was also dedicated to COVID-19 initiatives across the health system. Teams comprised of representatives from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and the community worked on the priority areas selected for each facility's Community Health Improvement Plan.Cancer- Began construction on the expansion of the Cancer Care Institute in March 2021. The new location will more than double the space of the existing facility to expand radiation and medical oncology, expand infusion services, and add comprehensive brachytherapy services and integrated services.- Expanded patient services including Breast Survivorship Visits, Advanced Radiation Brachy Treatments, and implementation of the first phase of the Genetics Navigator Platform for cancer screenings.- Adopted South Dakota 2021-2025 Comprehensive Cancer Plan's goals, priorities and tactics throughout Monument Health. Actively contributed to the program with representation and project leaders. - Implemented telehealth and tele-video visits to support cancer patients throughout the COVID-19 pandemic. - Participated in the American Society of Clinical Oncology survey for COVID-19 in Oncology Registry, which collects information about patterns of symptoms and severity of COVID-19 infection, how COVID-19 influences the delivery of cancer care, and how patient cancer and COVID-19 outcomes are affected.- Utilized the Mayo Clinic Care Network to collaborate on individual patient cancer care to provide patients with care close to home. - Provided cancer education at community events including Judd Hoos Charity Concert for Cancer, Rush Hocky Fights Cancer, Custer Mammo or Bust Run Walk, Deadwood Days of 76 Rodeo, and the Tough Enough to Wear Pink program throughout Black Hills Stock Show and Rodeo Rapid City.Heart Disease and Stroke- Hosted and participated in events to increase awareness of Heart Disease and Stroke including the American Heart Association (AHA) Heart Ball, the AHA Heart Walk and February Freeze run/walk. - Provided blood pressure screenings and education at community events, including one of the largest regional events, the Black Hills Stock Show and Rodeo Rapid City. - Provided education to area providers through the annual Cardiac Symposium, which had to be virtual this year due to COVID-19. This event highlights current heart and stroke topics, advancements in cardiac medicine, lifestyle management and new physicians and advanced practice providers to the community.- Improved the Stroke metric of tissue plasminogen activator door-to-needle time and increased occurrences of Alteplase administration. - Recruited four additional providers for Heart and Vascular Care and Neurology Care.- Provided heart and vascular outreach clinics in Spearfish, Chadron, Alliance, Belle Fourche, Newcastle, Custer, and Hot Springs. - Utilized the Mayo Clinic Care Network to collaborate on care for cardiology and stroke patients, to provide patients with care close to home. Diabetes- Offered virtual options for the Monument Health Diabetes Prevention Program and the Better Choices Better Health program for patients identified by case managers and/or diabetes educators. These programs were offered in partnership with the South Dakota State University Extension Office and South Dakota Foundation for Medical Care.- Pursued Medicare Diabetes Prevention Program supplier status with goal of implementing program mid-2022.- Implemented LACES program to improve transition from inpatient to outpatient care. Program focuses on Low Blood Glucose, A1C, Consults, Education and Survival Skills for patients. - Supported local events for Diabetes education including Diabetes Inc. and the Black Hills Dialysis Group. - Provided telephonic and tele-video visits for patients during COVID-19 and explored options to continue post-pandemic.- Held ongoing outreach clinics monthly in the communities of Spearfish, Sturgis, Belle Fourche, Lead/Deadwood, Hot Springs, Hill City, Custer, and Newcastle. Mental Health- Partner with Avera E-care for Psychiatrist and Social Worker or Nurse services by phone and video.- Increased mental health needs assessment coverage in the ED for patient evaluation and therapeutic work. - Continued collaboration with Pennington County Care Campus and provided representation on their Advisory Board. - Held on-site and televisits from Protection & Advocacy for Individuals with Mental Illness Program to provide education on available services.- Offered Alcoholics Anonymous meeting availability to patients within our facilities via streaming due to COVID-19. - Conducted group sessions for the Red Road to Wellbriety addiction program, which aligned with the Tribal Practices and Cultural Beliefs Teen Group. Sessions were held via tele-health due to COVID-19.- Implemented Trauma Informed Care and provided toolkits for Emergency Department and Medical Staff. Caregivers are continuously trained through orientation, monthly meetings, and annual competency. - Expanded the availability of counselors located in our primary care facilities across the Monument Health system. - Recruited additional Psychiatrists and Psychologists. - Continued use of systemwide standard processes for mental health screening of patients identified at risk utilizing the Columbia scale. Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 13h: Must reside within 200 mile radius of the location where the service was received.Presumptive eligibility may be used. Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 16j: A summary of the hospital's financial assistance policy is posted for all patients at various points of entry, including on the facility website, in waiting rooms, and in the admissions office. The policy in its entirety is also available upon request. The financial assistance policy application form was translated into the primary language spoken by limited English proficient populations. This is posted on the website listed for line 16a. Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged financial assistance policy eligible patients gross charges for services that are not covered under the financial assistance policy. Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Reminder emails were sent as needed to increase participation. A total of 134 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Monument Health service area. Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 6a: The Community Health Needs Assessment was undertaken by Monument Health, including: Monument Health Rapid City Hospital, Same Day Surgery Center, Monument Health Network (Monument Health Spearfish Hospital, Monument Health Sturgis Hospital, Monument Health Lead-Deadwood Hospital, and Monument Health Custer Hospital). Under a management contract with Monument Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 7d: https://monument.health/about-us/community-health-needs-assessment/ Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 11: During FY21, Monument Health focused on the following four priority areas identified through the most recent Community Health Needs Assessment: Cancer, Heart Disease and Stroke, Diabetes and Mental Health. Work was also dedicated to COVID-19 initiatives across the health system. Teams comprised of representatives from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and the community worked on the priority areas selected for each facility's Community Health Improvement Plan.Cancer- Began construction on the expansion of the Cancer Care Institute in March 2021. The new location will more than double the space of the existing facility to expand radiation and medical oncology, expand infusion services, and add comprehensive brachytherapy services and integrated services.- Expanded patient services including Breast Survivorship Visits, Advanced Radiation Brachy Treatments, and implementation of the first phase of the Genetics Navigator Platform for cancer screenings.- Adopted South Dakota 2021-2025 Comprehensive Cancer Plan's goals, priorities and tactics throughout Monument Health. Actively contributed to the program with representation and project leaders. - Implemented telehealth and tele-video visits to support cancer patients throughout the COVID-19 pandemic. - Participated in the American Society of Clinical Oncology survey for COVID-19 in Oncology Registry, which collects information about patterns of symptoms and severity of COVID-19 infection, how COVID-19 influences the delivery of cancer care, and how patient cancer and COVID-19 outcomes are affected.- Utilized the Mayo Clinic Care Network to collaborate on individual patient cancer care to provide patients with care close to home. - Provided cancer education at community events including Judd Hoos Charity Concert for Cancer, Rush Hocky Fights Cancer, Custer Mammo or Bust Run Walk, Deadwood Days of 76 Rodeo, and the Tough Enough to Wear Pink program throughout Black Hills Stock Show and Rodeo Rapid City.Heart Disease and Stroke- Hosted and participated in events to increase awareness of Heart Disease and Stroke including the American Heart Association (AHA) Heart Ball, the AHA Heart Walk and February Freeze run/walk. - Provided blood pressure screenings and education at community events, including one of the largest regional events, the Black Hills Stock Show and Rodeo Rapid City. - Provided education to area providers through the annual Cardiac Symposium, which had to be virtual this year due to COVID-19. This event highlights current heart and stroke topics, advancements in cardiac medicine, lifestyle management and new physicians and advanced practice providers to the community.- Improved the Stroke metric of tissue plasminogen activator door-to-needle time and increased occurrences of Alteplase administration. - Recruited four additional providers for Heart and Vascular Care and Neurology Care.- Provided heart and vascular outreach clinics in Spearfish, Chadron, Alliance, Belle Fourche, Newcastle, Custer, and Hot Springs. - Utilized the Mayo Clinic Care Network to collaborate on care for cardiology and stroke patients, to provide patients with care close to home. Diabetes- Offered virtual options for the Monument Health Diabetes Prevention Program and the Better Choices Better Health program for patients identified by case managers and/or diabetes educators. These programs were offered in partnership with the South Dakota State University Extension Office and South Dakota Foundation for Medical Care.- Pursued Medicare Diabetes Prevention Program supplier status with goal of implementing program mid-2022.- Implemented LACES program to improve transition from inpatient to outpatient care. Program focuses on Low Blood Glucose, A1C, Consults, Education and Survival Skills for patients. - Supported local events for Diabetes education including Diabetes Inc. and the Black Hills Dialysis Group. - Provided telephonic and tele-video visits for patients during COVID-19 and explored options to continue post-pandemic.- Held ongoing outreach clinics monthly in the communities of Spearfish, Sturgis, Belle Fourche, Lead/Deadwood, Hot Springs, Hill City, Custer, and Newcastle. Mental Health- Partner with Avera E-care for Psychiatrist and Social Worker or Nurse services by phone and video.- Increased mental health needs assessment coverage in the ED for patient evaluation and therapeutic work. - Continued collaboration with Pennington County Care Campus and provided representation on their Advisory Board. - Held on-site and televisits from Protection & Advocacy for Individuals with Mental Illness Program to provide education on available services.- Offered Alcoholics Anonymous meeting availability to patients within our facilities via streaming due to COVID-19. - Conducted group sessions for the Red Road to Wellbriety addiction program, which aligned with the Tribal Practices and Cultural Beliefs Teen Group. Sessions were held via tele-health due to COVID-19.- Implemented Trauma Informed Care and provided toolkits for Emergency Department and Medical Staff. Caregivers are continuously trained through orientation, monthly meetings, and annual competency. - Expanded the availability of counselors located in our primary care facilities across the Monument Health system. - Recruited additional Psychiatrists and Psychologists. - Continued use of systemwide standard processes for mental health screening of patients identified at risk utilizing the Columbia scale. Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 13h: Must reside within 200 mile radius of the location where the service was received.Presumptive eligibility may be used. Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 16j: A summary of the hospital's financial assistance policy is posted for all patients at various points of entry, including on the facility website, in waiting rooms, and in the admissions office. The policy in its entirety is also available upon request. The financial assistance policy application form was translated into the primary language spoken by limited English proficient populations. This is posted on the website listed for line 16a. Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged financial assistance policy eligible patients gross charges for services that are not covered under the financial assistance policy. Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Reminder emails were sent as needed to increase participation. A total of 134 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Monument Health service area. Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 6a: The Community Health Needs Assessment was undertaken by Monument Health, including: Monument Health Rapid City Hospital, Same Day Surgery Center, Monument Health Network (Monument Health Spearfish Hospital, Monument Health Sturgis Hospital, Monument Health Lead-Deadwood Hospital, and Monument Health Custer Hospital). Under a management contract with Monument Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 7d: https://monument.health/about-us/community-health-needs-assessment/ Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 11: During FY21, Monument Health focused on the following four priority areas identified through the most recent Community Health Needs Assessment: Cancer, Heart Disease and Stroke, Diabetes and Mental Health. Work was also dedicated to COVID-19 initiatives across the health system. Teams comprised of representatives from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and the community worked on the priority areas selected for each facility's Community Health Improvement Plan.Cancer- Began construction on the expansion of the Cancer Care Institute in March 2021. The new location will more than double the space of the existing facility to expand radiation and medical oncology, expand infusion services, and add comprehensive brachytherapy services and integrated services.- Expanded patient services including Breast Survivorship Visits, Advanced Radiation Brachy Treatments, and implementation of the first phase of the Genetics Navigator Platform for cancer screenings.- Adopted South Dakota 2021-2025 Comprehensive Cancer Plan's goals, priorities and tactics throughout Monument Health. Actively contributed to the program with representation and project leaders. - Implemented telehealth and tele-video visits to support cancer patients throughout the COVID-19 pandemic. - Participated in the American Society of Clinical Oncology survey for COVID-19 in Oncology Registry, which collects information about patterns of symptoms and severity of COVID-19 infection, how COVID-19 influences the delivery of cancer care, and how patient cancer and COVID-19 outcomes are affected.- Utilized the Mayo Clinic Care Network to collaborate on individual patient cancer care to provide patients with care close to home. - Provided cancer education at community events including Judd Hoos Charity Concert for Cancer, Rush Hocky Fights Cancer, Custer Mammo or Bust Run Walk, Deadwood Days of 76 Rodeo, and the Tough Enough to Wear Pink program throughout Black Hills Stock Show and Rodeo Rapid City.Heart Disease and Stroke- Hosted and participated in events to increase awareness of Heart Disease and Stroke including the American Heart Association (AHA) Heart Ball, the AHA Heart Walk and February Freeze run/walk. - Provided blood pressure screenings and education at community events, including one of the largest regional events, the Black Hills Stock Show and Rodeo Rapid City. - Provided education to area providers through the annual Cardiac Symposium, which had to be virtual this year due to COVID-19. This event highlights current heart and stroke topics, advancements in cardiac medicine, lifestyle management and new physicians and advanced practice providers to the community.- Improved the Stroke metric of tissue plasminogen activator door-to-needle time and increased occurrences of Alteplase administration. - Recruited four additional providers for Heart and Vascular Care and Neurology Care.- Provided heart and vascular outreach clinics in Spearfish, Chadron, Alliance, Belle Fourche, Newcastle, Custer, and Hot Springs. - Utilized the Mayo Clinic Care Network to collaborate on care for cardiology and stroke patients, to provide patients with care close to home. Diabetes- Offered virtual options for the Monument Health Diabetes Prevention Program and the Better Choices Better Health program for patients identified by case managers and/or diabetes educators. These programs were offered in partnership with the South Dakota State University Extension Office and South Dakota Foundation for Medical Care.- Pursued Medicare Diabetes Prevention Program supplier status with goal of implementing program mid-2022.- Implemented LACES program to improve transition from inpatient to outpatient care. Program focuses on Low Blood Glucose, A1C, Consults, Education and Survival Skills for patients. - Supported local events for Diabetes education including Diabetes Inc. and the Black Hills Dialysis Group. - Provided telephonic and tele-video visits for patients during COVID-19 and explored options to continue post-pandemic.- Held ongoing outreach clinics monthly in the communities of Spearfish, Sturgis, Belle Fourche, Lead/Deadwood, Hot Springs, Hill City, Custer, and Newcastle. Mental Health- Partner with Avera E-care for Psychiatrist and Social Worker or Nurse services by phone and video.- Increased mental health needs assessment coverage in the ED for patient evaluation and therapeutic work. - Continued collaboration with Pennington County Care Campus and provided representation on their Advisory Board. - Held on-site and televisits from Protection & Advocacy for Individuals with Mental Illness Program to provide education on available services.- Offered Alcoholics Anonymous meeting availability to patients within our facilities via streaming due to COVID-19. - Conducted group sessions for the Red Road to Wellbriety addiction program, which aligned with the Tribal Practices and Cultural Beliefs Teen Group. Sessions were held via tele-health due to COVID-19.- Implemented Trauma Informed Care and provided toolkits for Emergency Department and Medical Staff. Caregivers are continuously trained through orientation, monthly meetings, and annual competency. - Expanded the availability of counselors located in our primary care facilities across the Monument Health system. - Recruited additional Psychiatrists and Psychologists. - Continued use of systemwide standard processes for mental health screening of patients identified at risk utilizing the Columbia scale. Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 13h: Must reside within 200 mile radius of the location where the service was received.Presumptive eligibility may be used. Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 16j: A summary of the hospital's financial assistance policy is posted for all patients at various points of entry, including on the facility website, in waiting rooms, and in the admissions office. The policy in its entirety is also available upon request. The financial assistance policy application form was translated into the primary language spoken by limited English proficient populations. This is posted on the website listed for line 16a. Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged financial assistance policy eligible patients gross charges for services that are not covered under the financial assistance policy. Part V, Lines 16a-c All Facilities The Financial Assistance Policy, Application form, and plain language summary are available at https://monument.health/patient-visitor-guide/financial-assistance/ 8 1 - Monument Health Care Center-Custe 1065 Montgomery Street Custer SD 57730 Skilled Long Term Nursing Home 2 - Monument Health Care Center-Sturgis 2140 Junction Ave Sturgis SD 57785 Skilled Long Term Nursing Home 3 - Monument Health Newcastle Clinic 1121 Washington Blvd Newcastle WY 82701 Clinic 4 - Monument Health Hot Springs Clinic 1100 Highway 71 South Suite 101 Hot Springs SD 57747 Clinic 5 - Monument Health Medical Clinic 130 North 15th St Hot Springs SD 57747 Clinic 6 - Monument Health Assisted Living 423 N 10th Street Custer SD 57730 Assisted Living 7 - Monument Health Buffalo Clinic 209 Ramsland Street Buffalo SD 57720 Clinic 8 - Monument Health Upton Clinic 717 Pine Street Upton WY 82730 Clinic Part I, Line 3c: References to "Monument Health" apply to all entities controlled by Monument Health, Inc. This includes the reporting entity.Financial assistance debt reduction write-offs for free or discounted care are based on an income matrix utilizing the current Federal Poverty Level (FPL) income guidelines after satisfying applicable co-pay requirements. The income matrix is updated annually as the FPL guidelines are released. Presumptive eligibility may be used. Part I, Line 6a: Monument Health Network is included in the community benefit report prepared by Monument Health. The organization's community benefit report can be found on its website at https://monument.health/about-us/mission-vision-values/ Part I, Line 7: Ratio of patient care cost to charges is used for the calculation of cost of services provided for lines 7a, 7b and 7g. Actual costs are used for the calculation of costs of services provided for lines 7e and 7f. Part II, Community Building Activities: Monument Health provides numerous community benefit health events and screenings throughout the Black Hills Region. Monument Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Monument Health provides in-kind support and employee volunteers to help support community heath events and activities. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 15 and 16. Part III, Line 8: The Medicare surplus or deficit is derived from the actual payments received from the Medicare program for services provided to patients with Medicare coverage. The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our communities. Part III, Line 9b: The collection policy requires invoking of the financial assistance policy at any time a patient expresses financial difficulty in meeting their debt obligation. Upon invoking the financial assistance policy, all collection activity is suspended. If the patient is approved for charity, then the account is closed out of the collection process and classified as charity. If a patient expresses financial concern but fails to complete the application process, additional notification is sent to the patient prior to re-instituting collection activity. We are following the 501(r) Final Regulations timelines for notifications and collections. Part VI, Line 2: We gather additional data on needed services from patient surveys, advisory councils and patient and family advisory councils. Part VI, Line 3: Financial Assistance Program brochures explaining the policy, a copy of the policy and Financial Assistance applications are available at each point of entry. Signs alerting patients to the availability of Financial Assistance are prominently displayed and a plain language summary describing the Financial Assistance program accompanies one billing statement for hospital services sent to the patient. The Financial Assistance policy, plain language summary and Financial Assistance application are provided free upon request and are also available on the hospital website at www.monument.health. Monument Health contracts with Midland Medical Group (an unrelated entity) to meet with uninsured patients to assist them with finding a funding source or applying for financial assistance; and our self-pay outsource partner also communicates any funding and financial assistance opportunities with our patients. Part VI, Line 4: Monument Health and its affiliates provide health care services to the 360,000 people who live in the Black Hills of South Dakota and the surrounding region, as well as thousands of visitors each year. Monument Health serves a 38-county region comprised of western South Dakota, southeastern Montana, northeastern Wyoming, southwestern North Dakota and northwestern Nebraska. Part VI, Line 5: Monument Health collaborates with agencies and community-wide coalitions to address prioritized health needs within the communities we serve. Monument Health addresses its community's health needs by: 1) Community members serve on governing boards, advisory councils and patient and family member councils; 2) developing new programs and initiatives to address identified health needs: and 3) promoting an understanding of these health needs among other community organizations and within the public itself. Monument Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Monument Health provides in-kind support and employee volunteers to help support community health events and activities. Part VI, Line 6: Monument Health is committed to partnering with the communities it serves to meet the needs of each respective community. Monument Health, Inc. is the parent organization of Monument Health Rapid City Hospital, Inc., Monument Health Network, Inc., and Monument Health Physicians, Inc. These corporations work together to meet the health care needs of the region. 1 1 0 0 0 0 0 1 0 Ray Jensen MD Physician - Orthopedic Surgery 1514183 0 25200 0 0 0 98047 0 32014 0 1669444 0 0 0 Paulette Davidson President and CEO 0 973611 0 201145 0 19500 0 177630 0 26570 0 1398456 0 0 Richard Little MD Physician - Orthopedic Surgery 1027091 0 9200 0 56805 0 72386 0 30487 0 1195969 0 56805 0 Garrett Cox MD Physician - Radiologist 925003 0 21200 0 0 0 74951 0 25908 0 1047062 0 0 0 Andrew VanOsdol MD Physician - Surgery 841814 0 29200 0 0 0 51462 0 35773 0 958249 0 0 0 Heather Brewer MD Board member/Employed Physician 690392 0 9200 0 32957 0 56888 0 29031 0 818468 0 32957 0 Jessica DonnerMD Physician -clinical care 679299 0 5200 0 31965 0 42405 0 31150 0 790019 0 31965 0 Brad Archer MD Chief Medical Officer 0 558270 0 116251 0 9806 0 77388 0 24494 0 786209 0 0 Christopher Gasbarre DO Board Member/ Employed Physician 548260 0 9200 0 37040 0 50409 0 29031 0 673940 0 37040 0 Mark A Thompson CFO/Treasurer 0 453646 0 93906 0 19500 0 66956 0 27492 0 661500 0 0 Stephanie Lahr MD CIO & CMIO 0 390288 0 85358 0 19500 0 47882 0 32216 0 575244 0 0 Teresa Burroff General Counsel, Secretary 0 391448 0 80281 0 19500 0 45944 0 12195 0 549368 0 0 Lee B Bailey MD Board Member/ Employed Physician 377367 0 5200 0 36391 0 41317 0 34065 0 494340 0 36391 0 Thomas Worsley President Spearfish Market 342085 0 47754 0 15605 0 24936 0 30189 0 460569 0 0 0 Nicole Kerkenbush Chief Performance Officer 0 310785 0 55083 0 19500 0 34615 0 3471 0 423454 0 0 Mark Schmidt President Custer, Lead-Deadwood Mark 262022 0 28655 0 18570 0 21073 0 30189 0 360509 0 6866 0 Mark Schulte President - Sturgis 229855 0 26024 0 25259 0 20134 0 35394 0 336666 0 14628 0 Tresha Moreland Former VP Human Resources 0 43121 0 3600 0 209825 0 582 0 349 0 257477 0 0 Mary Masten General Counsel, Emeritus 0 103179 0 0 0 0 0 0 0 12951 0 116130 0 0 Part I, Line 3 The Executive Committee, which is a committee of the Monument Health (parent) Board, reviews and approves base salary and total compensation ranges for all executives within the Monument Health System. Part I, Lines 4a-b Tresha Moreland received a severance payment of $209,825. Monument Health provides a supplemental nonqualified retirement plan and a flexible benefit plan that can include deferred compensation for its executives. The following individuals had amounts deferred into the account as reported in column c on Schedule J: Brad Archer, MD 68,646 Lee Bailey, MD 22,560 Heather Brewer, MD 41,736 Teresa Burroff 36,812 Paulette Davidson 168,300 Jessica Donner, MD 32,871 Chris Gasbarre, MD 37,054 Nicole Kerkenbush 25,500 Ray Jensen, MD 88,915 Stephanie Lahr 38,552 Garrett Cox 65,819 Richard Little, MD 58,411 Andrew VanOsdol 42,330 Thomas Worsley 15,606 Mark Schmidt 11,706 Mark Schulte 10,630 Mark Thompson 46,396 The following individuals had supplemental non-qualified retirement plan amounts included in schedule J, column B(iii) that were previously reported as deferred compensation on Form 990. These amounts are identified in Schedule J, column f. Lee Bailey, MD 36,391 Heather Brewer, MD 32,957 Christopher Gasbarre, DO 37,040 Richard Little, MD 56,805 Mark Schmidt 6,866 Mark Schulte 14,628 Jessica Donner, MD 31,965 Part I, Line 7 Executives and other employees of system entities will be eligible to receive annual incentive awards that are competitive with the incentives offered by the organizations in the system's peer group(s) in accordance with the terms of the Monument Health, Inc. annual incentive plan for selected executives and other employees (incentive plan). In accordance with this plan, the parent board's executive committee reviews and approves all incentive compensation performance measures and all awards, if any. The committee ensures that the total compensation, including incentive awards, is reasonable. Form 990, Part V, Line 1a: All 1099's are issued centrally by Monument Health Rapid City Hospital, Inc., a related organization. Form 990, Part V, Line 2a: Number of employees on W-3: Monument Health Network, Inc. has its own employees, however, compensation is paid by Monument Health Rapid City Hospital, the common payroll agent. Form 990, Part VI, Section A, line 1 The membership of the Executive Committee of the Corporation shall consist of the following: Chair of the Board of Directors, Vice Chair of the Board of Directors, two other Board members appointed by the Chair, and the Corporation's President. The Chair of the Board of Directors shall serve as the Chair of the Executive Committee. Directors on the Executive Committee shall serve during the term of office they hold which places them on the Executive Committee, or, for the two Chair-appointed members, for a term of one (1) year or until their successors are appointed. The Executive Committee, when the Board of Directors is not in session, shall have and may exercise all of the authority of the Board of Directors, except to the extent, if any, that such authority shall be limited by a motion or resolution of the Board of Directors or that is authority reserved to the Member. It is intended that the powers of the Executive Committee to act for the whole Board be confined to such urgent matters as reasonably should not be deferred until the next regularly-scheduled meeting of the full Board. Form 990, Part VI, Section A, line 2 Paulette Davidson has a business relationship with the following individuals due to being the CEO of the supporting organization that exercises reserve powers over the supported organizations that employ each of these key employees: Teresa Burroff; Stephanie Lahr, MD; Mary Masten; Brad Archer, MD; Tresha Moreland; Mark Thompson; and Nicole Kerkenbush. Form 990, Part VI, Section A, line 6 Monument Health, Inc. is the sole member of Monument Health Network, Inc. Form 990, Part VI, Section A, line 7a Monument Health, Inc., being the sole member of Monument Health Network, Inc., has the ability to appoint or remove all members of Monument Health Network, Inc.'s board. Form 990, Part VI, Section A, line 7b Monument Health, Inc. (MHI) provides compliance, governance, financial, and planning support to its Supported Organizations to best assure the functions and services of the Supported Organizations are coordinated and supported in a manner that furthers the shared charitable mission of the Supported Organizations and MHI, as a whole. Monument Health, Inc. has final authority in significant business decisions affecting the Supported Organizations. Form 990, Part VI, Section B, line 11b The 990 is prepared and reviewed by an independent accounting firm. It is then reviewed internally by finance and legal management. The Form 990 is further reviewed, prior to filing, by the organization's board of directors through a portal to the organization's internal information system, to which each board member has access. Educational sessions have been provided to board members on how to access the portal. Form 990, Part VI, Section B, line 12c As part of the annual disclosure of potential conflicts process, all board members, officers, and management are required to complete an annual disclosure statement on financial interests and conflicting interests. At Board and Board Committee meetings, the meeting agenda includes an initial item "Conflicts of Interest" where the Chair asks members if they have any conflicting interests or financial interests related to an agenda item. If a conflicting or financial interest is disclosed, it is noted in the minutes and there is discussion or determination of whether the disclosure requires the board or committee member to be excused from discussion or action on that agenda item. Board or committee members whose disclosure is found to be a conflict may be invited to speak on the matter by the Chair, but are not permitted to vote on the matter and may be required to leave the meeting during discussion, after they have made any comments invited by the Chair. Failure to comply with the Conflict of Interest policy constitutes grounds for removal from office or membership on the Board or Board Committee and, in the case of all employees, termination of employment. Form 990, Part VI, Section B, line 15a The Executive Committee of Monument Health, Inc (MHI; parent) annually engages an independent third party compensation firm to conduct a review of all executives, Vice President level and above, to determine an appropriate compensation range in which their compensation would be established. The independent compensation consultant provided peer group market comparative data for base salary, total cash compensation, benefits and total compensation for executives. The CEO or her designee determines the actual base salary of the executives within the committee-approved base salary range based on experience and performance, providing the total compensation is within the targeted market percentile, e.g. 50th percentile. Each year, the independent consultant meets with Committee members and presents data upon which the Committee determines all elements of compensation for the member's CEO (base salary, total cash compensation, benefits and total compensation) and reaffirms the organization's executive compensation philosophy, which includes the targeted market percentile for all other executives. Actual compensation is paid by Monument Health Rapid City Hospital and charged to Monument Health, Inc. Form 990, Part VI, Section C, line 19 The Articles of Incorporation of the organization are filed in the office of the Secretary of State of South Dakota and are available to the public from the Office of the Secretary of State. Other documents (Bylaws, conflict of interest policy and financial statements) are not posted for the public but are available or described in other public documents or sites such as offering statements in bond issues or municipal securities rulemaking board's electronic municipal market access (EMMA) data port. Form 990, Part X, Line 20 Monument Health Network, Inc. is part of the Monument Health, Inc. Obligated Group which consists of Monument Health, Inc., Monument Health Rapid City Hospital, Inc., Monument Health Network, Inc., and Monument Health Physicians, Inc. Monument Health Network, Inc. was not allocated any share of the bond issue, and thus does not have an amount on line 20. Monument Health Inc 353 Fairmont Blvd Rapid City SD 57701 201487506 Healthcare SD 501(c)(3) Line 12c, III-FI N/A 0 Monument Health Rapid City Hospital Inc 353 Fairmont Blvd Rapid City SD 57701 460319070 Healthcare SD 501(c)(3) Line 3 Monument Health Inc 0 Monument Health Physicians Inc 353 Fairmont Blvd Rapid City SD 57701 460372454 Healthcare SD 501(c)(3) PF Monument Health Inc 0 Medical & Dental Building 2805 S 5th St Rapid City SD 57701 460339629 Medical Office Bldg SD N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0