2025-05-15T07:36:17-05:00 2024-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-07-01 460360899 Monument Health Network Inc MONU 6057559130 PO Box 6000 Rapid City SD 577096000 Austin Willuweit CFO 6057559130 2025-05-14 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-05-14 2023 2025-03-06 01:10:19Z Paulette Davidson PO Box 6000 Rapid City SD 577096000 220051666 0 X https://monument.health/ X 1981 SD Improving the health of individuals and our communities. 9 5 1291 62 178961 0 701010 1030788 209936272 218968659 1539 17671 24163 25196 210662984 220042314 383756 5100 0 0 112210005 113758500 0 0 0 88166093 91786200 200759854 205549800 9903130 14492514 138921164 160854015 61642588 69300423 77278576 91553592 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 164947766 5100 218789698 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 Care Center - Sturgis. MHN also owns, leases and operates provider based physician clinics in Belle Fourche, Spearfish, Lead-Deadwood, Hill City, Sturgis & Custer. In addition, MHN operates free standing clinics in Hot Springs and Buffalo. Together, these facilities provide common access to compassionate, quality, advanced health care through its numerous healing environments in the greater Black Hills region. 164947766 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 110 0 1 1291 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 5 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X X Austin Willuweit 6057559127 PO Box 6000 Rapid City SD 577096000 Paulette Davidson President and CEO 9.06 50.94 X X 0 1727313 253482 Ray Jensen MD Physician - Orthopedic Surgery 40.00 0.00 X 1828915 0 144747 Andrew VanOsdol MD Physician - Surgery 40.00 0.00 X 1041404 0 110800 Christopher Milnes MD Physician - Radiologist 40.00 0.00 X 993291 0 90244 Wesley Badger Physician -Surgery 40.00 0.00 X 977339 0 81081 Garrett Cox Physician - Radiologist 40.00 0.00 X 913713 0 109034 Brad Archer MD Chief Medical Officer 8.30 46.70 X 0 876666 124753 Mark A Thompson CFO/CBDO From 01/2024 8.30 46.70 X 0 868581 49983 Thomas Worsley Pres Spearfish Hosp/Hills Markets 55.00 0.00 X 568278 0 91157 Patrick Woodard Chief Healthcare Infor. Officer 8.30 46.70 X 0 565975 65925 Heather Brewer MD Board member/Employed Physician 40.87 0.00 X 533301 0 86595 Mark Schulte VP Rapid city market 0.00 40.00 X 0 364167 61453 Jason Knudson Board Member/Employed Physician 40.58 0.00 X 352432 0 71517 Mark Schmidt Pres Sturgis, Lead-Deadwood Market 55.00 0.00 X 352841 0 51319 Austin Willuweit VP Finance/CFO from 01/2024 8.30 46.70 X 0 340040 60239 Barbara Hespen Pres Custer Market/System CNO 46.59 8.41 X 276143 0 52663 Charles Lewis DO Board Member/Employed Physician 40.29 0.00 X 255264 0 19951 Nicole Kerkenbush Former-CNPO/Performance Officer 8.30 46.70 X 0 203850 17642 Kathryn Johnson Board member-Chair 1.19 0.00 X X 0 0 0 Steven Williams Board Member Until 12/2023 0.29 0.00 X 0 0 0 Dan Liekvold Board member 0.29 0.00 X 0 0 0 Kenneth Meirose Board Member 0.83 0.00 X 0 0 0 Fred Lamphere Board member 0.29 0.00 X 0 0 0 John Williams Board member From 12/2023 0.38 0.00 X 0 0 0 8092921 4946592 1542585 176 1 1 0 Travel Nurse Across American LLC 5020 Northshore Drive North Little Rock AR 72118 Contract labor 5517972 Morrison Management Specialists Inc PO Box 102289 Atlanta GA 30368 Professional services 2628920 Scull Construction Service Inc 803 Industrial Ave Rapid City SD 57702 Construction 1978258 Engineers-Architects PC 3100 DeMers Avenue Grand Forks ND 58201 Professional services 1289531 Weatherby Medical Staffing PO Box 972633 Dallas TX 75397 Contract labor 1231152 55 986964 43824 1030788 Acute Care Hospital IP and OP 623000 152352093 152352093 Physician Clinics 621110 52443673 52443673 Long Term Care Facilities 623000 4826499 4826499 9346394 9167433 178961 218968659 17671 17671 34548 9352 25196 25196 25196 220042314 218789698 178961 42867 5100 5100 2309516 1095787 1213729 90193784 82728390 7465394 1987628 1801139 186489 13701807 12416235 1285572 5565765 5012987 552778 96813 96813 69850 69850 19346 19346 12611379 12375393 235986 115139 2799 112340 5681980 5044411 637569 1215579 1018866 196713 5862780 3487523 2375257 376370 334621 41749 917045 917045 3457532 3023411 434121 803475 265832 537643 Medical Supplies 30674531 30525383 149148 Interco supplies/servic 29055225 4820854 24234371 Miscellaneous 829156 71990 757166 205549800 164947766 40602034 0 X 4924404 353007 24650265 35257955 3220393 2805944 859689 942882 150770373 85740954 63622032 65029419 1497372 1751101 28698 54656 54656 40063655 54659051 138921164 160854015 18109740 25556044 43532848 43744379 61642588 69300423 X 76888282 91138086 390294 415506 77278576 91553592 138921164 160854015 X 14492514 25274 -242772 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 19346 19346 0 Part II-B, Line 1: Annual dues were paid to the South Dakota Association of Healthcare Organizations. A portion of the dues are applicable to lobbying activities. For calendar year 2024 dues, which were paid in fiscal year 2024, in the amount of $88,440, 5.5% was used for lobbying purposes. Annual dues were paid to the American Hospital Association, a portion of which is applicable to lobbying activities. For calendar year 2024 dues, which were paid in fiscal year 2024, in the amount of $45,256, 32% was used for lobbying purposes. 187372 -25274 162098 191358 -3986 187372 191795 -437 191358 152792 39003 191795 156625 -3833 152792 0.00000 0.61690 0.38310 0 1 0 9757287 9757287 80964940 44350029 36614911 51270432 40296097 10974335 8777714 1094828 7682886 65029419 Other receivables 54659051 54659051 Other long term liabilities 43744379 43744379 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 1 1 0 1 1 1123637 1123637 0.00550 15719531 13792609 1926922 0.00940 16843168 13792609 3050559 0.01490 687932 687932 0.00330 2984 2984 0.00000 30347793 19327422 11020371 0.05360 24814 24814 0.00010 31063523 19327422 11736101 0.05700 47906691 33120031 14786660 0.07190 1 2705 2705 0.00000 1 830 830 0.00000 2 3535 3535 0.00000 1 14352731 53722359 56011148 -2288789 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 21 1 1 0 1 X See Section C, Line 7d X X 1 21 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 118 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/community-health-needs-assessment/ Group A-Facility 1 -- Monument Health Spearfish Hospital Part V, Section B, line 11: During fiscal year 2024, Monument Health focused on five priority areas identified through the most recent Community Health Needs Assessment (CHNA): Cancer; Heart Disease and Stroke; Diabetes, Nutrition, Physical Activity and Weight; Mental Health and Substance Abuse; and Access to Medical Services: Right Care, Right Place. Teams from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and community representatives collaborated on implementing the Community Health Improvement Plan (CHIP).Cancer Care InitiativesMonument Health made significant strides in cancer prevention, treatment, and survivorship with three key objectives:Improved patient access and expanded services through the Cancer Care Institute Expansion, increased infusion capacity, reestablished Breast Surgery Program, reinstituted survivorship visits, support groups, and education classes post-COVID, and added Integrative & Complementary Medicine Services.Positioned the Cancer Care Institute for the future by reviewing investments in Oncology pharmacy support through alignment with other ambulatory pharmacy service lines and adding Specialty & Clinical Pharmacists. The organization invested in oncology devices & technological advances including CT and Radiation Oncology Machine upgrades.Increased awareness of cancer resources by implementing South Dakota's Comprehensive Cancer Control Program and building relationships with the Monument Health Foundation, Black Hills Road Trip of Hope, Walking Forward, and American Cancer Society.Heart Disease and Stroke AdvancementsMonument Health maintained stable coronary angiography and Percutaneous Coronary Intervention (PCI) volumes while achieving the lowest number of post-PCI deaths in recorded facility history. Their post-PCI In-Hospital Risk Standardized Mortality rates ranked better than the 90th percentile compared to over 1,700 participating sites. For the 12th consecutive year, Monument Health received the American Heart Association Chest Pain Myocardial Infarction (MI) Platinum Achievement Award.All Acute Myocardial Infarction (AMI) performance composites continued to exceed national averages. Despite a 25% increase in AMI patients, primarily due to more Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) patients, mortality rates remained stable. The AMI In-Hospital Risk Standardized Mortality reached the 90th percentile compared to over 700 participating hospitals. The cardiovascular surgery program continued to grow with excellent results.Stroke care advanced with the development of a Comprehensive Stroke Center staffed by two Interventional Neurologists and an expanded Interventional Radiology (IR) team. Education enriched the knowledge of medical staff and patients about early stroke recognition. Emergency Room stroke protocols were updated across the health system to meet Joint Commission guidelines. A new stroke alert process for Large Vessel Occlusion was developed with the Transfer Center and Emergency Departments. A dysphagia performance improvement project continued throughout FY24, with mandatory iLearn dysphagia training implemented. Monument Health received the American Heart Association Get with Guidelines Gold Plus Award for Stroke.Diabetes, Nutrition, Physical Activity, and Weight ManagementMonument Health pursued three objectives to improve diabetes care:Increased community awareness of diabetes prevention and management programs by providing screenings and education at 20 different community health fairs, offering certified trainers for the Monument Health Diabetes Prevention Program and Better Choices Better Health programs, and continuing the annual Diabetes Symposium, which attracted over 150 participants.Improved transition from inpatient to outpatient care by streamlining the outpatient referral process with the inpatient Case Management Team, implementing system-wide RN Diabetes rounding, expanding the inpatient Endocrinology team with greater outreach, and partnering with nursing triage services for post-discharge support.Improved patient access for Primary Care and Diagnostic Procedures through ongoing outreach clinics and streamlined Dietetic Services.Mental Health and Substance Abuse ResourcesMonument Health implemented six strategies to increase access and awareness of mental health and substance abuse resources:Established clear direction for substance abuse disorder care by developing consistent care guidelines and aligning programming with national standards to offer a broader spectrum of outpatient services for adults.Developed strategies to mitigate labor challenges by implementing new services to retain staff, clarifying roles for APPs to maximize their use, and developing telemedicine capabilities to expand patient access.Improved therapeutic programming for inpatients through standardized therapeutic objectives and clarified operational reporting structures for therapeutic teams.Defined effective patient flow strategies with standardized guidelines for both inpatient and outpatient services, improved care delivery for geriatric psychiatric patients, and optimized operational setup of outpatient clinics.Defined a strategy for health equity through partnerships with Indian Health Services and Oyate and development of population health research strategies.Met community needs through optimized provider scheduling tools, improved Medicaid funding initiatives, and evaluation of care delivery and billing practices.Access to Medical Services: Right Care, Right PlaceMonument Health increased access to care through several key project activities: Increased visit volume through optimized templates and greater provider availability. Improved scheduling accuracy to route patients to correct providers and reduced rescheduling needs. Enhanced patient retention through referral capture, resulting in additional visits and downstream revenue. Expanded patient acquisition through digital options and conveniences like online scheduling. Increased staff efficiency through standardized workflows and cross-coverage within the Patient Contact Center. Improved provider satisfaction with streamlined workflows and simplified referral processes. Maintained focus on Primary Care recruitment.The Care Access Workplan included four main components:Integrated Team efforts to efficiently use patient and clinician time, assign patients to appropriate care levels quickly, improve communication, and support roles based on licensure.Nurse Triage to prioritize care based on clinical assessment and Schmidt and Thompson protocols, enhance patient experience, and support provider efficiencies.Scheduling Templates with accurate templates and locations, appropriate security, and alignment to provider in-clinic time.Referrals with proactive management of ordered services and close-the-loop follow-up procedures to promote continuity of care.Through these comprehensive efforts across all five priority areas, Monument Health demonstrated its commitment to addressing the most pressing health needs of its communities. 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 118 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/community-health-needs-assessment/ Group A-Facility 2 -- Monument Health Custer Hospital Part V, Section B, line 11: During fiscal year 2024, Monument Health focused on five priority areas identified through the most recent Community Health Needs Assessment (CHNA): Cancer; Heart Disease and Stroke; Diabetes, Nutrition, Physical Activity and Weight; Mental Health and Substance Abuse; and Access to Medical Services: Right Care, Right Place. Teams from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and community representatives collaborated on implementing the Community Health Improvement Plan (CHIP).Cancer Care InitiativesMonument Health made significant strides in cancer prevention, treatment, and survivorship with three key objectives:Improved patient access and expanded services through the Cancer Care Institute Expansion, increased infusion capacity, reestablished Breast Surgery Program, reinstituted survivorship visits, support groups, and education classes post-COVID, and added Integrative & Complementary Medicine Services.Positioned the Cancer Care Institute for the future by reviewing investments in Oncology pharmacy support through alignment with other ambulatory pharmacy service lines and adding Specialty & Clinical Pharmacists. The organization invested in oncology devices & technological advances including CT and Radiation Oncology Machine upgrades.Increased awareness of cancer resources by implementing South Dakota's Comprehensive Cancer Control Program and building relationships with the Monument Health Foundation, Black Hills Road Trip of Hope, Walking Forward, and American Cancer Society.Heart Disease and Stroke AdvancementsMonument Health maintained stable coronary angiography and PCI volumes while achieving the lowest number of post-PCI deaths in recorded facility history. Their post-PCI In-Hospital Risk Standardized Mortality rates ranked better than the 90th percentile compared to over 1,700 participating sites. For the 12th consecutive year, Monument Health received the American Heart Association Chest Pain MI Platinum Achievement Award.All AMI performance composites continued to exceed national averages. Despite a 25% increase in AMI patients, primarily due to more NSTEMI patients, mortality rates remained stable. The AMI In-Hospital Risk Standardized Mortality reached the 90th percentile compared to over 700 participating hospitals. The cardiovascular surgery program continued to grow with excellent results.Stroke care advanced with the development of a Comprehensive Stroke Center staffed by two Interventional Neurologists and an expanded IR team. Education enriched the knowledge of medical staff and patients about early stroke recognition. Emergency Room stroke protocols were updated across the health system to meet Joint Commission guidelines. A new stroke alert process for Large Vessel Occlusion was developed with the Transfer Center and Emergency Departments. A dysphagia performance improvement project continued throughout FY24, with mandatory iLearn dysphagia training implemented. Monument Health received the American Heart Association Get with Guidelines Gold Plus Award for Stroke.Diabetes, Nutrition, Physical Activity, and Weight ManagementMonument Health pursued three objectives to improve diabetes care:Increased community awareness of diabetes prevention and management programs by providing screenings and education at 20 different community health fairs, offering certified trainers for the Monument Health Diabetes Prevention Program and Better Choices Better Health programs, and continuing the annual Diabetes Symposium, which attracted over 150 participants.Improved transition from inpatient to outpatient care by streamlining the outpatient referral process with the inpatient Case Management Team, implementing system-wide RN Diabetes rounding, expanding the inpatient Endocrinology team with greater outreach, and partnering with nursing triage services for post-discharge support.Improved patient access for Primary Care and Diagnostic Procedures through ongoing outreach clinics and streamlined Dietetic Services.Mental Health and Substance Abuse ResourcesMonument Health implemented six strategies to increase access and awareness of mental health and substance abuse resources:Established clear direction for substance abuse disorder care by developing consistent care guidelines and aligning programming with national standards to offer a broader spectrum of outpatient services for adults.Developed strategies to mitigate labor challenges by implementing new services to retain staff, clarifying roles for APPs to maximize their use, and developing telemedicine capabilities to expand patient access.Improved therapeutic programming for inpatients through standardized therapeutic objectives and clarified operational reporting structures for therapeutic teams.Defined effective patient flow strategies with standardized guidelines for both inpatient and outpatient services, improved care delivery for geriatric psychiatric patients, and optimized operational setup of outpatient clinics.Defined a strategy for health equity through partnerships with Indian Health Services and Oyate and development of population health research strategies.Met community needs through optimized provider scheduling tools, improved Medicaid funding initiatives, and evaluation of care delivery and billing practices.Access to Medical Services: Right Care, Right PlaceMonument Health increased access to care through several key project activities: Increased visit volume through optimized templates and greater provider availability. Improved scheduling accuracy to route patients to correct providers and reduced rescheduling needs. Enhanced patient retention through referral capture, resulting in additional visits and downstream revenue. Expanded patient acquisition through digital options and conveniences like online scheduling. Increased staff efficiency through standardized workflows and cross-coverage within the Patient Contact Center. Improved provider satisfaction with streamlined workflows and simplified referral processes. Maintained focus on Primary Care recruitment.The Care Access Workplan included four main components:Integrated Team efforts to efficiently use patient and clinician time, assign patients to appropriate care levels quickly, improve communication, and support roles based on licensure.Nurse Triage to prioritize care based on clinical assessment and Schmidt and Thompson protocols, enhance patient experience, and support provider efficiencies.Scheduling Templates with accurate templates and locations, appropriate security, and alignment to provider in-clinic time.Referrals with proactive management of ordered services and close-the-loop follow-up procedures to promote continuity of care.Through these comprehensive efforts across all five priority areas, Monument Health demonstrated its commitment to addressing the most pressing health needs of its communities. 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 118 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/community-health-needs-assessment/ Group A-Facility 3 -- Monument Health Sturgis Hospital Part V, Section B, line 11: During fiscal year 2024, Monument Health focused on five priority areas identified through the most recent Community Health Needs Assessment (CHNA): Cancer; Heart Disease and Stroke; Diabetes, Nutrition, Physical Activity and Weight; Mental Health and Substance Abuse; and Access to Medical Services: Right Care, Right Place. Teams from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and community representatives collaborated on implementing the Community Health Improvement Plan (CHIP).Cancer Care InitiativesMonument Health made significant strides in cancer prevention, treatment, and survivorship with three key objectives:Improved patient access and expanded services through the Cancer Care Institute Expansion, increased infusion capacity, reestablished Breast Surgery Program, reinstituted survivorship visits, support groups, and education classes post-COVID, and added Integrative & Complementary Medicine Services.Positioned the Cancer Care Institute for the future by reviewing investments in Oncology pharmacy support through alignment with other ambulatory pharmacy service lines and adding Specialty & Clinical Pharmacists. The organization invested in oncology devices & technological advances including CT and Radiation Oncology Machine upgrades.Increased awareness of cancer resources by implementing South Dakota's Comprehensive Cancer Control Program and building relationships with the Monument Health Foundation, Black Hills Road Trip of Hope, Walking Forward, and American Cancer Society.Heart Disease and Stroke AdvancementsMonument Health maintained stable coronary angiography and PCI volumes while achieving the lowest number of post-PCI deaths in recorded facility history. Their post-PCI In-Hospital Risk Standardized Mortality rates ranked better than the 90th percentile compared to over 1,700 participating sites. For the 12th consecutive year, Monument Health received the American Heart Association Chest Pain MI Platinum Achievement Award.All AMI performance composites continued to exceed national averages. Despite a 25% increase in AMI patients, primarily due to more NSTEMI patients, mortality rates remained stable. The AMI In-Hospital Risk Standardized Mortality reached the 90th percentile compared to over 700 participating hospitals. The cardiovascular surgery program continued to grow with excellent results.Stroke care advanced with the development of a Comprehensive Stroke Center staffed by two Interventional Neurologists and an expanded IR team. Education enriched the knowledge of medical staff and patients about early stroke recognition. Emergency Room stroke protocols were updated across the health system to meet Joint Commission guidelines. A new stroke alert process for Large Vessel Occlusion was developed with the Transfer Center and Emergency Departments. A dysphagia performance improvement project continued throughout FY24, with mandatory iLearn dysphagia training implemented. Monument Health received the American Heart Association Get with Guidelines Gold Plus Award for Stroke.Diabetes, Nutrition, Physical Activity, and Weight ManagementMonument Health pursued three objectives to improve diabetes care:Increased community awareness of diabetes prevention and management programs by providing screenings and education at 20 different community health fairs, offering certified trainers for the Monument Health Diabetes Prevention Program and Better Choices Better Health programs, and continuing the annual Diabetes Symposium, which attracted over 150 participants.Improved transition from inpatient to outpatient care by streamlining the outpatient referral process with the inpatient Case Management Team, implementing system-wide RN Diabetes rounding, expanding the inpatient Endocrinology team with greater outreach, and partnering with nursing triage services for post-discharge support.Improved patient access for Primary Care and Diagnostic Procedures through ongoing outreach clinics and streamlined Dietetic Services.Mental Health and Substance Abuse ResourcesMonument Health implemented six strategies to increase access and awareness of mental health and substance abuse resources:Established clear direction for substance abuse disorder care by developing consistent care guidelines and aligning programming with national standards to offer a broader spectrum of outpatient services for adults.Developed strategies to mitigate labor challenges by implementing new services to retain staff, clarifying roles for APPs to maximize their use, and developing telemedicine capabilities to expand patient access.Improved therapeutic programming for inpatients through standardized therapeutic objectives and clarified operational reporting structures for therapeutic teams.Defined effective patient flow strategies with standardized guidelines for both inpatient and outpatient services, improved care delivery for geriatric psychiatric patients, and optimized operational setup of outpatient clinics.Defined a strategy for health equity through partnerships with Indian Health Services and Oyate and development of population health research strategies.Met community needs through optimized provider scheduling tools, improved Medicaid funding initiatives, and evaluation of care delivery and billing practices.Access to Medical Services: Right Care, Right PlaceMonument Health increased access to care through several key project activities: Increased visit volume through optimized templates and greater provider availability. Improved scheduling accuracy to route patients to correct providers and reduced rescheduling needs. Enhanced patient retention through referral capture, resulting in additional visits and downstream revenue. Expanded patient acquisition through digital options and conveniences like online scheduling. Increased staff efficiency through standardized workflows and cross-coverage within the Patient Contact Center. Improved provider satisfaction with streamlined workflows and simplified referral processes. Maintained focus on Primary Care recruitment.The Care Access Workplan included four main components:Integrated Team efforts to efficiently use patient and clinician time, assign patients to appropriate care levels quickly, improve communication, and support roles based on licensure.Nurse Triage to prioritize care based on clinical assessment and Schmidt and Thompson protocols, enhance patient experience, and support provider efficiencies.Scheduling Templates with accurate templates and locations, appropriate security, and alignment to provider in-clinic time.Referrals with proactive management of ordered services and close-the-loop follow-up procedures to promote continuity of care.Through these comprehensive efforts across all five priority areas, Monument Health demonstrated its commitment to addressing the most pressing health needs of its communities. 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 118 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/community-health-needs-assessment/ Group A-Facility 4 -- Monument Health Lead-Deadwood Hospital Part V, Section B, line 11: During fiscal year 2024, Monument Health focused on five priority areas identified through the most recent Community Health Needs Assessment (CHNA): Cancer; Heart Disease and Stroke; Diabetes, Nutrition, Physical Activity and Weight; Mental Health and Substance Abuse; and Access to Medical Services: Right Care, Right Place. Teams from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and community representatives collaborated on implementing the Community Health Improvement Plan (CHIP).Cancer Care InitiativesMonument Health made significant strides in cancer prevention, treatment, and survivorship with three key objectives:Improved patient access and expanded services through the Cancer Care Institute Expansion, increased infusion capacity, reestablished Breast Surgery Program, reinstituted survivorship visits, support groups, and education classes post-COVID, and added Integrative & Complementary Medicine Services.Positioned the Cancer Care Institute for the future by reviewing investments in Oncology pharmacy support through alignment with other ambulatory pharmacy service lines and adding Specialty & Clinical Pharmacists. The organization invested in oncology devices & technological advances including CT and Radiation Oncology Machine upgrades.Increased awareness of cancer resources by implementing South Dakota's Comprehensive Cancer Control Program and building relationships with the Monument Health Foundation, Black Hills Road Trip of Hope, Walking Forward, and American Cancer Society.Heart Disease and Stroke AdvancementsMonument Health maintained stable coronary angiography and PCI volumes while achieving the lowest number of post-PCI deaths in recorded facility history. Their post-PCI In-Hospital Risk Standardized Mortality rates ranked better than the 90th percentile compared to over 1,700 participating sites. For the 12th consecutive year, Monument Health received the American Heart Association Chest Pain MI Platinum Achievement Award.All AMI performance composites continued to exceed national averages. Despite a 25% increase in AMI patients, primarily due to more NSTEMI patients, mortality rates remained stable. The AMI In-Hospital Risk Standardized Mortality reached the 90th percentile compared to over 700 participating hospitals. The cardiovascular surgery program continued to grow with excellent results.Stroke care advanced with the development of a Comprehensive Stroke Center staffed by two Interventional Neurologists and an expanded IR team. Education enriched the knowledge of medical staff and patients about early stroke recognition. Emergency Room stroke protocols were updated across the health system to meet Joint Commission guidelines. A new stroke alert process for Large Vessel Occlusion was developed with the Transfer Center and Emergency Departments. A dysphagia performance improvement project continued throughout FY24, with mandatory iLearn dysphagia training implemented. Monument Health received the American Heart Association Get with Guidelines Gold Plus Award for Stroke.Diabetes, Nutrition, Physical Activity, and Weight ManagementMonument Health pursued three objectives to improve diabetes care:Increased community awareness of diabetes prevention and management programs by providing screenings and education at 20 different community health fairs, offering certified trainers for the Monument Health Diabetes Prevention Program and Better Choices Better Health programs, and continuing the annual Diabetes Symposium, which attracted over 150 participants.Improved transition from inpatient to outpatient care by streamlining the outpatient referral process with the inpatient Case Management Team, implementing system-wide RN Diabetes rounding, expanding the inpatient Endocrinology team with greater outreach, and partnering with nursing triage services for post-discharge support.Improved patient access for Primary Care and Diagnostic Procedures through ongoing outreach clinics and streamlined Dietetic Services.Mental Health and Substance Abuse ResourcesMonument Health implemented six strategies to increase access and awareness of mental health and substance abuse resources:Established clear direction for substance abuse disorder care by developing consistent care guidelines and aligning programming with national standards to offer a broader spectrum of outpatient services for adults.Developed strategies to mitigate labor challenges by implementing new services to retain staff, clarifying roles for APPs to maximize their use, and developing telemedicine capabilities to expand patient access.Improved therapeutic programming for inpatients through standardized therapeutic objectives and clarified operational reporting structures for therapeutic teams.Defined effective patient flow strategies with standardized guidelines for both inpatient and outpatient services, improved care delivery for geriatric psychiatric patients, and optimized operational setup of outpatient clinics.Defined a strategy for health equity through partnerships with Indian Health Services and Oyate and development of population health research strategies.Met community needs through optimized provider scheduling tools, improved Medicaid funding initiatives, and evaluation of care delivery and billing practices.Access to Medical Services: Right Care, Right PlaceMonument Health increased access to care through several key project activities: Increased visit volume through optimized templates and greater provider availability. Improved scheduling accuracy to route patients to correct providers and reduced rescheduling needs. Enhanced patient retention through referral capture, resulting in additional visits and downstream revenue. Expanded patient acquisition through digital options and conveniences like online scheduling. Increased staff efficiency through standardized workflows and cross-coverage within the Patient Contact Center. Improved provider satisfaction with streamlined workflows and simplified referral processes. Maintained focus on Primary Care recruitment.The Care Access Workplan included four main components:Integrated Team efforts to efficiently use patient and clinician time, assign patients to appropriate care levels quickly, improve communication, and support roles based on licensure.Nurse Triage to prioritize care based on clinical assessment and Schmidt and Thompson protocols, enhance patient experience, and support provider efficiencies.Scheduling Templates with accurate templates and locations, appropriate security, and alignment to provider in-clinic time.Referrals with proactive management of ordered services and close-the-loop follow-up procedures to promote continuity of care.Through these comprehensive efforts across all five priority areas, Monument Health demonstrated its commitment to addressing the most pressing health needs of its communities. 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/financial-assistance/ 4 1 - Monument Health Sturgis Care Center 2140 Junction Ave Sturgis SD 57785 Skilled Long Term Nursing Home 2 - Monument Health Hot Springs Clinic 1100 Highway 71 South Suite 101 Hot Springs SD 57747 Clinic 3 - Monument Health Assisted Living 423 N 10th Street Custer SD 57730 Assisted Living 4 - Monument Health Buffalo Clinic 209 Ramsland Street Buffalo SD 57720 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. This report is available at the facilities and can be found 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, 7f, and 7i. Part II, Community Building Activities: Monument Health provides numerous community benefit health events and screenings throughout the Black Hills Region. Additionally, Monument Health provides in-kind support and employee volunteers to help support community health events and acvities. 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., and Monument Health Network, Inc. These corporations work together to meet the health care needs of the region. 0 Spearfish High School 1725 N Main Spearfish SD 57783 460278406 Govt 5100 0 Sponsorship 1 0 0 1 0 0 0 0 0 1 0 Paulette Davidson President and CEO 0 1158268 0 369600 0 199445 0 224622 0 28860 0 1980795 0 176555 Ray Jensen MD Physician - Orthopedic Surgery 1754532 0 5980 0 68403 0 109231 0 35517 0 1973663 0 68403 0 Andrew VanOsdol MD Physician - Surgery 1006591 0 8020 0 26793 0 75700 0 35100 0 1152204 0 26793 0 Christopher Milnes MD Physician - Radiologist 973291 0 20000 0 0 0 62949 0 27295 0 1083535 0 0 0 Wesley Badger Physician -Surgery 939710 0 25020 0 12609 0 67713 0 13368 0 1058420 0 12609 0 Garrett Cox Physician - Radiologist 874733 0 0 0 38980 0 73788 0 35246 0 1022747 0 38980 0 Brad Archer MD Chief Medical Officer 0 643589 0 148000 0 85077 0 98862 0 25891 0 1001419 0 71687 Mark A Thompson CFO/CBDO From 01/2024 0 593215 0 116600 0 158766 0 25504 0 24478 0 918563 0 150096 Thomas Worsley Pres Spearfish Hosp/Hills Markets 427446 0 100100 0 40732 0 58062 0 33096 0 659436 0 17889 0 Patrick Woodard Chief Healthcare Infor. Officer 0 426049 0 65528 0 74398 0 57376 0 8549 0 631900 0 0 Heather Brewer MD Board member/Employed Physician 480888 0 10000 0 42413 0 53913 0 32682 0 619896 0 42413 0 Mark Schulte VP Rapid city market 0 283862 0 54200 0 26105 0 27611 0 33842 0 425620 0 10981 Jason Knudson Board Member/Employed Physician 327849 0 8500 0 16083 0 39095 0 32422 0 423949 0 16083 0 Mark Schmidt Pres Sturgis, Lead-Deadwood Market 274831 0 51200 0 26810 0 26851 0 24468 0 404160 0 12519 0 Austin Willuweit VP Finance/CFO from 01/2024 0 264550 0 50700 0 24790 0 27071 0 33168 0 400279 0 10653 Barbara Hespen Pres Custer Market/System CNO 222768 0 37700 0 15675 0 23781 0 28881 0 328805 0 0 0 Charles Lewis DO Board Member/Employed Physician 255264 0 0 0 0 0 8596 0 11355 0 275215 0 0 0 Nicole Kerkenbush Former-CNPO/Performance Officer 0 169529 0 0 0 34321 0 15612 0 2030 0 221492 0 27979 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, Line 4b 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 Schedule J, column C: Paulette Davidson $209,620 Brad Archer MD $84,592 Austin Willuweit $13,920 Nicole Kerkenbush $6,342 Mark Schulte $14,888 Thomas Worsley $43,532 Mark Schmidt $14,068 Heather Brewer $35,924 Jason Knudson $20,975 Ray Jensen $94,596 Andrew Vanosdol $61,065 Christopher Milnes $49,749 Wesley Badger $53,804 Garrett Cox $59,153 Barbara Hespen $15,471 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. Paulette Davidson $176,555 Ray Jensen MD $68,403 Brad Archer MD $71,687 Mark Thompson $150,096 Austin Willuweit $10,653 Heather Brewer MD $42,413 Andrew VanOsdol MD $26,793 Nicole Kerkenbush $27,979 Jason Knudson MD $16,083 Thomas Worsley $17,889 Mark Schmidt $12,519 Wesley Badger MD $12,609 Garrett Cox MD $38,980 Mark Schulte $10,981 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 1a 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: Brad Archer, MD; Mark Thompson; Patrick Woodard, Austin Willuweit, Mark Schulte, 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 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. Form 990, Part XI, line 9: Equity Transfer 155,628. Released From Restriction -398,400. 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 Same Day Surgery Center 2805 S 5th St Rapid City SD 57701 460339629 Medical services SD N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0