2022-05-16T08:47:37-05:00 2021-06-30 861065772 DELOITTE TAX LLP 50 SOUTH SIXTH STREET MINNEAPOLIS MN 55402 990 2020-07-01 410695596 ST CLOUD HOSPITAL STCL 3202512700 1406 SIXTH AVENUE NORTH ST CLOUD MN 563031901 MICHAEL A BLAIR CFO/TREASURER 3202512700 2022-05-10 1 MICHAEL BLAIR 999009999 CHRIS MESKIMEN P01314196 6123974000 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z JOY PLAMANN 1406 SIXTH AVENUE NORTH ST CLOUD MN 563031901 1136626024 0 X WWW.CENTRACARE.COM X 1962 MN WE'RE HERE FOR YOUR WHOLE LIFE - TO LISTEN THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. 19 13 0 716 40150 0 23914090 64563940 895296109 977780134 7425317 44005514 5312528 31632654 931948044 1117982242 637892 370744 0 0 480835563 509143016 0 0 0 395208376 457116720 876681831 966630480 55266213 151351762 1486537959 1702572092 782733658 701913310 703804301 1000658782 X WE'RE HERE FOR YOUR WHOLE LIFE - TO LISTEN THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. 0 0 729012372 370744 941284700 CENTRACARE HEALTH IS PRIMARILY ENGAGED IN SUPPORTING AND DIRECTING HEALTHCARE DELIVERY THROUGH ITS AFFILIATED ENTITIES. CENTRACARE OPERATES AS THE PARENT CORPORATION TO THE SAINT CLOUD HOSPITAL WHICH STRIVES TO IMPROVE THE QUALITY AND EXPAND THE CLINICAL SCOPE OF, ENHANCE ACCESS TO, AND ASSURE AFFORDABILITY OF, HEALTH SERVICES FOR RESIDENTS IN THE ST. CLOUD AREA AND CENTRAL MINNESOTA. THESE AIMS ARE SUPPORTED BY CENTRACARE'S COMMITMENT TO ADVANCE MEDICAL EDUCATION, TRAINING AND RESEARCH. AS A HIGH QUALITY REGIONAL MEDICAL CENTER, ST CLOUD HOSPITAL PROVIDES A BROAD RANGE OF ACUTE INPATIENT SERVICES. WITH 489 LICENSED INPATIENT BEDS, ST CLOUD HOSPITAL CARED FOR 24,773 INPATIENT ADMISSIONS WITH 113,159 ASSOCIATED PATIENT DAYS DURING FISCAL 2021. INPATIENT SERVICES INCLUDE MEDICAL AND SURGICAL CARE, BIRTHING SERVICES, CHILDREN'S SERVICES INCLUDING NEONATAL INTENSIVE CARE AND PEDIATRIC INTENSIVE CARE, BEHAVIORAL HEALTH CARE SERVICES FOR ADULTS AND ADOLESCENTS, ALONG WITH SPECIALIZED CARE IN CARDIOLOGY, NEUROSCIENCES, NEUROSURGERY, ORTHOPEDICS AND REHABILITATION SERVICES. 34703565 36495434 AS PART OF THE ST CLOUD HOSPITAL, ST BENEDICTS SENIOR COMMUNITY PROVIDES RESIDENTIAL HEALTH CARE SERVICES INCLUDING INDEPENDENT LIVING, ASSISTED LIVING AND SHORT AND LONG TERM SKILLED NURSING SERVICES. IN FISCAL 2021 THERE WERE 198 SKILLED STAFFED BEDS AND RESIDENT DAYS OF 51,369. SHORT STAY SKILLED SERVICES INCLUDE AN EXTENSIVE REHABILITATIVE CARE PROGRAM WITH THE GOAL OF ENABLING RESIDENTS TO RETURN TO THEIR HOMES. IN FISCAL 2021 THERE WERE 383 HOUSING UNITS AND TENANT DAYS OF 128,045. ASSISTED LIVING AND INDEPENDENT LIVING COMMUNITIES ARE DESIGNATED AS HOUSING WITH SERVICES. HOMECARE SERVICES ARE PROVIDED TO THESE TENANTS ON A BASE RATE PLUS POINTS SYSTEM. AS A HIGH QUALITY REGIONAL MEDICAL CENTER, ST CLOUD HOSPITAL PROVIDES A BROAD RANGE OF OUTPATIENT SERVICES. OUTPATIENT ENCOUNTERS DURING FISCAL YEAR 2021 WERE 339,804 AND INCLUDED EMERGENCY ROOM SERVICES, BEHAVIORAL HEALTH CARE, CANCER TREATMENT, DIALYSIS, IMAGING PROCEDURES, DIAGNOSTIC HEART PROCEDURES, REHABILITATION THERAPY, SAME DAY SURGERY AND OTHER AMBULATORY CARE SERVICES. 763715937 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X MICHAEL BLAIR 3202512700 1406 6TH AVENUE NORTH ST CLOUD MN 563031901 KENNETH D HOLMEN MD PRESIDENT/CEO 7.00 33.00 X X 0 1423120 42559 CRAIG BROMAN CHIEF OPERATING OFFICER/EVP 7.00 33.00 X X 0 1387560 51923 RICHARD E JOLKOVSKY MD DIRECTOR 35.00 5.00 X 0 586117 26612 TODD M SEVERNAK MD DIRECTOR 35.00 5.00 X 0 437482 21641 ALBERT J MERCURI MD DIRECTOR 35.00 5.00 X 0 417033 36613 NATHAN D LEE MD DIRECTOR 35.00 5.00 X 0 338670 41788 BOB THUERINGER CHAIR 0.20 1.80 X X 0 0 0 RENEE FRAUENDIENST VICE CHAIR 2.00 0.00 X X 0 0 0 ANNESA CHEEK DIRECTOR 2.00 0.00 X 0 0 0 BOB KOVELL DIRECTOR 2.00 0.00 X 0 0 0 CHIP MARTIN-CHAFFEE DIRECTOR 2.00 0.00 X 0 0 0 COLLEEN QUINLIVAN DIRECTOR 2.00 0.00 X 0 0 0 EILEEN DAUER DIRECTOR 2.00 0.00 X 0 0 0 JIM RUDOLPH DIRECTOR 2.00 0.00 X 0 0 0 MELINDA GAU DIRECTOR 2.00 0.00 X 0 0 0 PATRICIA SNIEZEK DIRECTOR 2.00 0.00 X 0 0 0 RYAN DANIEL DIRECTOR 2.00 0.00 X 0 0 0 SHONDA CRAFT DIRECTOR 2.00 0.00 X 0 0 0 WILLIE JETT DIRECTOR 2.00 0.00 X 0 0 0 MICHAEL BLAIR CHIEF FINANCIAL OFFICER/SR VP/TREASURER 18.00 22.00 X 0 544396 73619 SANTO CRUZ CHIEF LEGAL OFFICER/SR VP/SECRETARY 18.00 22.00 X 0 363379 45019 THOMAS G SCHRUP MD CHIEF PHYSICIAN OFFICER/EVP 20.00 20.00 X 0 654378 49047 MARK S MATTHIAS VICE PRESIDENT 18.00 22.00 X 0 584022 52952 KURT T OTTO VICE PRESIDENT 20.00 20.00 X 0 430766 71127 DIANE R BUSCHENA-BRENNA VICE PRESIDENT 2.00 38.00 X 0 344361 71044 JOY M PLAMANN RN VICE PRESIDENT 20.00 20.00 X 0 387287 22350 CATHERINE M GREENLEE VICE PRESIDENT 20.00 20.00 X 0 261980 36669 JEFFREY S GERDES NEUROSURGEON 40.00 0.00 X 0 1866321 48630 UZMA SAMADANI NEUROSURGEON 40.00 0.00 X 0 1226162 39519 JERONE D KENNEDY NEUROSURGEON 40.00 0.00 X 0 1048754 67066 JESSICA P SWARTOUT PHYSICIAN 40.00 0.00 X 0 948590 71200 JENA J SWANSON PHYSICIAN 40.00 0.00 X 0 977848 27372 0 14228226 896750 0 0 1 0 MCGOUGH CONSTRUCTION CO LLC NW 5970 PO BOX 1450 MINNEAPOLIS MN 55485 CAPITAL CONSTRUCTION 18466782 DELOITTE CONSULTING LLP PO BOX 844717 DALLAS TX 75284 ERP IMPLEMENTATION CONSULTING SERVICES 4492877 MAHOWALD INSURANCE AGENCY 916 WEST SAINT GERMAIN ST STE 100 SAINT CLOUD MN 56301 INSURANCE 4104348 MARCO TECHNOLOGIES INC NW 7128 PO BOX 1450 MINNEAPOLIS MN 55485 COMPUTER EQUIPMENT MAINTENANCE CONTRACTS 2358084 AYA HEALTHCARE INC DEPT 3519 PO BOX 123519 DALLAS TX 75312 TEMPORARY STAFFING SERVICES 1701221 21 2528998 62010530 24412 64563940 PATIENT & SERVICE REVE 621110 969837832 969837832 OTHER PROGRAM REVENUE 621110 4398117 4357967 40150 FOOD SALES 621110 3544185 3544185 977780134 43933568 43933568 3697609 3976609 -279000 -279000 -279000 71946 0 71946 71946 71946 36627514 14667173 21960341 21960341 GAIN ON INTEREST RATE 900099 9951313 9951313 9951313 1117982242 977739984 40150 75638168 304151 304151 66593 66593 397517627 314038925 83478702 17880863 14125882 3754981 71102396 56170893 14931503 22642130 17887283 4754847 433002 342072 90930 88275747 69737840 18537907 96499 76234 20265 393163 310599 82564 38317282 30270653 8046629 4630649 3658213 972436 1889466 1492678 396788 748261 591126 157135 12537090 9904301 2632789 56408659 44562841 11845818 2819486 2227394 592092 DRUGS/MEDICAL SUPPLIES 200096748 158076431 42020317 MEDICAID/MNCARE 16788643 13263028 3525615 EQUIPMENT RENT & MAINT. 15957114 12606120 3350994 IMPLICIT PRICE CONCES. 15603368 12326660 3276708 2121543 1676020 445523 966630480 763715937 202914543 0 165179664 94802236 152461603 151010658 25907836 23224366 25106900 4518133 1106563423 619020954 514709547 487542469 428073358 737259451 116380694 32849934 58718357 171364845 1486537959 1702572092 102027642 111807783 1622868 405125588 389298431 275580428 199184228 782733658 701913310 X 703804301 1000658782 703804301 1000658782 1486537959 1702572092 X 151351762 122160215 23342504 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 45347 0 0 0 45347 0 PART II-B, LINE 1: ST. CLOUD HOSPITAL AND ST. BENEDICTS SENIOR COMMUNITY PAID $45,347 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS 17172374 17172374 700936824 330240872 370695952 388060616 288756542 99304074 393609 23540 370069 487542469 DUE FROM AFFILIATES 148987620 OPERATING LEASED ASSETS 21134179 OTHER ASSETS 1243046 171364845 THIRD PARTY PAYOR SETTLEMENTS 6987793 INTEREST RATE SWAP AGREEMENTS 22865880 ACCRUED PENSION LIABILITY 36189261 EXECUTIVE BENEFIT ACCRUAL 552394 ASSET RETIREMENT OBLIGATION 1215900 SETTLEMENTS RESERVE 1464505 OPERATING LEASE LIABILITY 21134271 ACCELERATED ADVANCED PAYMENTS 100403822 INTEREST PAYABLE 2440323 FICA PAYROLL TAX DEFERRAL 5930079 199184228 X PART X, LINE 2: CENTRACARE, THE CORPORATION, THE CLINIC, CCH - MELROSE, CCH - LONG PRAIRIE, CCH - SAUK CENTRE AND THE FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C )(3) OF THE INTERNAL REVENUE CODE. CCH - MONTICELLO, CCH - PAYNESVILLE AND CARRIS HEALTH, AS DISREGARDED LIMITED LIABILITY COMPANIES (LLCS) UNDER INTERNAL REVENUE SERVICE REGULATIONS, ACHIEVE TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF THEIR PARENT, CENTRACARE HEALTH SYSTEM. AT JUNE 30, 2021 AND 2020, THERE WERE NO UNCERTAIN TAX POSITIONS. 1 1 X 1 X 175.000000000000 1 X 1 1 1 0 1 1 2530271 2530271 0.00270 149040850 115847569 33193281 0.03490 151571121 115847569 35723552 0.03760 391461 391461 0.00040 4365000 2806220 1558780 0.00160 8715 8715 310012 310012 0.00030 153933 153933 0.00020 5229121 2814935 2414186 0.00250 156800242 118662504 38137738 0.04010 16588 16588 0.00000 26148 26148 0.00000 42736 42736 0.00000 1 15603368 253165267 237814718 15350549 X 1 1 1 1 ST CLOUD HOSPITAL 1406 6TH AVENUE NORTH ST CLOUD MN 563031901 WWW.CENTRACARE.COM/LOCATIONS/CENTRACAR 395453 X X X X REHAB, PSYCH, HOME HEALTH, HOSPICE, AND RENAL DIALYSIS ST CLOUD HOSPITAL 1 0 0 1 X X X X X X X X X X 18 1 1 1 1 X SEE PART V, PAGE 8 X 1 18 1 SEE PART V, PAGE 8 0 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X X 1 X 0 0 ST. CLOUD HOSPITAL PART V, SECTION B, LINE 3J: CENTRACARE UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE CHNA AND PREPARE THE IMPLEMENTATION STRATEGY WHICH WE CALLED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE MAPP PROCESS INCLUDES A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, STAKEHOLDER INTERVIEWS, COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH THREE COUNTY PUBLIC HEALTH DEPARTMENTS, AND SEVERAL COMMUNITY MEETINGS TO GATHER INFORMATION ON FORCES THAT CREATE HEALTH, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. THE CHNA INCLUDED A HEALTH EQUITY ASSESSMENT AND INFORMATION ON NATIONAL, STATE, AND OTHER LOCAL PLANNING PROCESSES RELATED TO HEALTH.AS A FOLLOW UP TO THE PRIOR CHNA PROCESS WHERE PUBLIC HEALTH DATA WAS A SIGNIFICANT GAP, THIS CHNA AND SUBSEQUENT CHIP WAS A COLLABORATIVE EFFORT EXECUTED WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH, AND STEARNS COUNTY PUBLIC HEALTH. THE RESULT WAS A JOINT CHNA AND CHIP. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 5: CENTRACARE POPULATION HEALTH CONDUCTED SPECIFIC AND COMPREHENSIVE EVALUATION OF ZIP CODE 56304 THAT HAS THE WORST HEALTH OUTCOMES IN THE THREE COUNTIES INCLUDED IN THE CHNA AND CHIP. THIS EVALUATION INCLUDED DATA EVALUATION, KEY INFORMANT INTERVIEWS, AND HEALTH INDICATORS FOR MINORITY GROUPS. THE CENTRAL MN ALLIANCE ALSO COMPLETED SEVERAL SURVEYS AND ASSESSMENTS TO GET INPUT FROM MULTIPLE SECTORS OF EACH COMMUNITY REPRESENTING DIFFERENT POPULATIONS IN ORDER TO COMPILE A LIST OF TOP PRIORITIES IN THE REGION:THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA) WAS DATA COLLECTED FROM THE COMMUNITY HEALTH ASSESSMENT COMPLETED IN 2018, CENTRACARE PATIENT DATA, MINNESOTA STUDENT SURVEY DATA, AND MINNESOTA PUBLIC HEALTH VITAL STATISTICS. THIS DATA WAS COMPARED TO DOCUMENTS AND DATASETS FROM THE MN STATEWIDE HEALTH ASSESSMENT (SHA), CENTRAL MN COMMUNITY HEALTH SURVEY DATA, PREVIOUS PLANNING PROCESS PRIORITY LISTS, HEALTH EQUITY DATA ANALYSES (HEDA) FROM EACH COUNTY, TYPES OF DATA REQUESTS OUR AGENCIES WERE GETTING FROM THE PUBLIC, AND THE MN DEPARTMENT OF HEALTH DATA INDICATOR LIST. A "COMMUNITY PIRORITY CATEGORY" WAS ASSIGNED TO EACH DATA POINT TO IDENTIFY A LIST OF COMMUNITY PRIORITIES.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA) WAS CONDUCTED IN THE FORM OF KEY STAKEHOLDER INTERVIEWS VIA PHONE WITH A WIDE VARIETY OF COMMUNITY PARTNERS THROUGHOUT THE THREE COUNTIES. A TOTAL OF 50 STAKEHOLDERS WERE INTERVIEWED FROM 20 DIFFERENT SECTORS INCLUDING YOUTH, PARENT, SMALL BUSINESS OWNER, CORPORATE BUSINESS OWNER, MEDIA, SCHOOL/EDUCATION, YOUTH-SERVING ORGANIZATION, LAW ENFORCEMENT, RELIGIOUS OR FAITH-BASED ORGANIZATION, PRIMARY HEALTHCARE, BEHAVIORAL HEALTH, HOSPITAL-BASED HEALTHCARE, STATE/LOCAL GOVERNMENT- ELECTED, STATE/LOCAL GOVERNMENT- NON-ELECTED, NON-PROFIT, CIVIC/VOLUNTEER GROUP, VETERANS INTEREST GROUP, AGING POPULATION INTEREST GROUP, ENVIRONMENTAL INTEREST GROUP, AND MINORITY INTEREST GROUP.FOR THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT (LPHSA) BENTON, SHERBURNE, AND STEARNS COUNTY LPH AGENCIES PARTICIPATED IN A CAPACITY ASSESSMENT TO HELP DETERMINE THE EXTENT TO WHICH REQUIRED LOCAL PUBLIC HEALTH ACTIVITIES ARE IN PLACE STATEWIDE. THE ASSESSMENT QUESTIONS WERE THEN UTILIZED TO FORMULATE A SURVEY FOR THREE SECTORS OF THE LOCAL PUBLIC HEALTH SYSTEM: EMERGENCY PREPAREDNESS, ENVIRONMENTAL HEALTH, AND HEALTHCARE ACCESS/INFECTIOUS DISEASE. COMMUNITY PARTNERS WERE INVITED TO PARTICIPATE IN THE SURVEY VIA EMAIL. AFTER ANALYZING THE RESULTS, THE LPHSA SUBGROUP DEVELOPED A LIST OF THEIR TOP 10 RECOMMENDATIONS FROM ALL 3 SECTORS TO SUPPORT THE DEVELOPMENT OF THE COMMUNITY COMMUNITY HEALTH IMPROVEMENT PLAN.THE FORCES OF CHANGE (FOC) ASSESSMENT WAS COMPLETED IN THE FORM OF A COMUNITY MEETING IN AUGUST OF 2018 TO IDENTIFY FORCES THAT MAY AFFECT A COMMUNITY AND OPPORTUNITIES AND THREATS ASSOCIATED WITH THOSE FORCES. THE AGENDA INCLUDED A BRAINSTORMING ACTIVITY AND TIME IN SMALL GROUP AND LARGE GROUP DISCUSSION. A FLIER ADVERTISING THE MEETING WAS DISTRIBUTED TO COMMUNITY MEMBERS VIA EMAIL. THERE WERE 68 PEOPLE THAT ATTENDED REPRESENTING 27 ORGANIZATIONS AND TWO THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. AS A FOLLOW UP TO THE FORCES OF CHANGE COMMUNITY MEETING, A WORLD CAFE WAS HELD IN JANUARY 2019 FOR MEMBERS OF THE COMMUNITY TO COME AND TALK ABOUT THEIR PERCEPTION OF NEEDS IN THE SURROUNDING COMMUNITIES. THERE WERE 94 PEOPLE THAT ATTENDED THE MEETING REPRESENTING 32 ORGANIZATIONS AND THREE THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. ORGANIZATIONS THAT WERE REPRESENTED AT BOTH COMMUNITY MEETINGS INCLUDED LOCAL GOVERNMENT, HEALTHCARE, LOCAL NONPROFITS, EDUCATION, UNDERREPRESENTED COMMUNITIES, FAITH COMMUNITY, AND OTHERS.IN ORDER TO BETTER ENGAGE INDIVIDUALS OR ORGANIZATIONS WITH A PERSPECTIVE OF AT-RISK POPULATIONS, A HEALTH EQUITY ASSESSMENT WAS ALSO COMPLETED. FOCUS-GROUP MEETINGS WERE HELD ON THREE SEPARATE OCCASIONS AT THE GREAT RIVER REGIONAL LIBRARY IN ST. CLOUD, AND COMMUNITY INPUT WAS GATHERED AT THE BENTON, SHERBURNE, AND STEARNS COUNTY FAIRS TO REACH OUT TO A VARIETY OF COMMUNITIES. IN TOTAL, THERE WERE 30 SOMALI ADULTS WHO DISCUSSED POSITIVES, NEGATIVES, AND AREAS-TO-IMPROVE-ON WITHIN THE COMMUNITY. AT THE COUNTY FAIRS, INFORMATION WAS GATHERED FROM RESPONDENTS FROM THE 56304-ZIP CODE. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 6A: ST. CLOUD HOSPITAL CONDUCTED THE CHNA WITH CENTRACARE PAYNESVILLE, CENTRACARE MELROSE, AND CENTRACARE SAUK CENTRE. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 6B: ST. CLOUD HOSPITAL CONDUCTED THE CHNA WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH AND STEARNS COUNTY PUBLIC HEALTH. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 11: THE PRIORITIZATION PROCESS TOOK PLACE WHILE UTILIZING THE MAPP PROCESS. THE WORK OF EACH OF THE FOUR MAPP ASSESSMENT SUB-GROUPS RESULTED IN FOUR LISTS OF 10 COMMUNITY PRIORITIES. AS A REMINDER, THE FOUR ASSESSMENTS INCLUDE: COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH STATUS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT. THOSE FOUR LISTS OF 10 ARE INCLUDED IN THE NARRATIVE EARLIER IN THIS DOCUMENT.THE CORE SUPPORT TEAM WAS PROVIDED THOSE FOUR LISTS OF TEN PRIORITIES. THEY TOOK THOSE LISTS AND TALKED WITH THEIR AGENCY STAFF TO IDENTIFY ANY THEMES OR COMMONALITIES AMONGST THE FOUR LISTS. THE CORE SUPPORT TEAM THEN CAME TOGETHER IN A MEETING AND WENT THROUGH A FACILITATED PROCESS USING THE CENTRAL MN ALLIANCE VISION AS A GUIDE TO COME UP WITH A TOP 10 LIST TO SEND ON TO THE DELEGATED AUTHORITIES.THE DELEGATED AUTHORITIES MET AND CONTINUED THE DISCUSSION ABOUT THE PRIORITY LIST. THE PRIORITIES PASSED ON BY THE CORE SUPPORT TEAM WERE RUN THROUGH TWO PRIORITIZATION EXERCISES. THE FIRST WAS A RANKING DISCUSSION WITH POINTS ASSIGNED FOR CERTAIN CRITERIA. RANKS INCLUDED 3 FOR HIGH, 2 FOR MEDIUM, AND 1 FOR LOW. THE CRITERIA INCLUDED:URGENCY: IS THIS A PRIORITY ISSUE THAT NEEDS TO BE ADDRESSED IN THE NEXT 1-3 YEARS?POTENTIAL IMPACT: IS IT LIKELY THAT ADDRESSING THIS CRITICAL ISSUE WILL HAVE A SIGNIFICANT IMPACT ON ONE OR MORE SPECIFIC POPULATIONS? DO YOU HAVE REASON TO BELIEVE YOU CAN BE SUCCESSFUL ON THIS ISSUE?ACTIONABLE/FEASIBLE: ARE THERE OPPORTUNITIES FOR ACTION TO ADDRESS THE CRITICAL ISSUE? IS THERE ROOM TO MAKE MEANINGFUL IMPROVEMENT ON THE ISSUE?RESOURCES: ARE RESOURCES (FUNDS, STAFF, & EXPERTISE) EITHER READILY AVAILABLE OR LIKELY RESOURCES CAN BE OBTAINED TO ADDRESS THE CRITICAL ISSUE? ARE THERE RESOURCES THROUGH THE STATE AND COMMUNITY MEMBERS TO WORK ON THE ISSUE? IF NOT, CAN RESOURCES BE ACQUIRED?COMMUNITY READINESS: IS THIS A CRITICAL ISSUE IDENTIFIED AS IMPORTANT BY THE COMMUNITY? ARE PEOPLE IN THE COMMUNITY INTERESTED IN THE ISSUE? IS THERE COMMUNITY MOMENTUM TO MOVE THIS INITIATIVE FORWARD?INTEGRATION: IS THERE OPPORTUNITY FOR COLLABORATION? IS THERE OPPORTUNITY TO BUILD ON EXISTING INITIATIVES? WILL THIS DUPLICATE EFFORTS? FINALLY, THE PRIORITIES WERE PLACED ON A CONTROL/INFLUENCE GRID.THE PRIORITIES IDENTIFIED WERE AS FOLLOWS IN COMMUNITY INFORMED RANKING: 1) BUILDING FAMILIES, 2) MENTAL HEALTH, 3) ENCOURAGING SOCIAL CONNECTION, 4) ADVERSE CHILDHOOD EXPERIENCES (ACES), 5) TOBACCO/NICOTINE USE, 6) HEALTH CARE, 7) RISKY YOUTH BEHAVIOR, 8) FINANCIAL STRESS, 9) TRAUMA, AND 10) EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS. DUE TO THE NEWNESS OF THE COLLABORATION ON THIS WORK, A DECISION WAS MADE TO FOCUS ON THE TOP TWO PRIORITIES FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIES THREE THROUGH TEN WILL NOT SPECIFICALLY BE ADDRESSED THROUGH ACTION PLANNING OR MEASUREMENT, HOWEVER, THERE ARE WAYS MANY OF THESE PRIORITIES ARE BEING ADDRESSED EITHER WITHIN THE TOP TWO PRIORITIES OR THE COMMUNITY. IN THE FUTURE, THE GROUP WILL ASSESS THE CAPACITY TO EXPAND THE NUMBER OF PRIORITIES BEING ADDRESSED AND MEASURED. ALTHOUGH NOT DIRECTLY ADDRESSED IN THE PLAN, CENTRACARE DOES ACTIVELY SUPPORT OTHER ORGANIZATIONS WITHIN THE COMMUNITY WHO ARE WORKING ON DETERMINANTS OF HEALTH IDENTIFIED DURING THE CHNA PROCESS LIKE ACES, TOBACCO, TRAUMA, EDUCATING POLICYMAKERS, ETC.THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS THE ACTION PLAN THAT USES GUIDING PRINCIPLES AND STRATEGIES TO ADDRESS THE COMMUNITY PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THE TOP PRIORITIES ARE BUILDING FAMILIES AND MENTAL HEALTH. WE WILL USE THE GUIDING PRINCIPLES OF COMMUNITY COLLABORATION, AWARENESS, RESILIENCE, EQUITY, EDUCATION, AND HEALTH ORGANIZATIONS TO DRIVE OUR STRATEGIES. IN THE CURRENT FISCAL YEAR THE ORGANIZATION LOOKED AT GRANTS FOR SCHOOLS TO TEACH IN THEIR CURRICULUM AND LOOKED AT PARTNERING WITH OTHER ORGANIZATIONS TO OFFER CLASSES/RESOURCES FOR THOSE IN NEED OF PARENTING SKILLS AND CAREGIVER RESOURCES. THEY ALSO LOOKED INTO CREATING SUPPORT GROUPS, MEDICATION ASSISTED TREATMENT AND ADDITIONAL AWARENESS WITHIN THE COMMUNITY REGARDING MENTAL HEALTH NEEDS.THE ST. CLOUD HOSPITAL, CENTRACARE- MELROSE HOSPITAL, CENTRACARE- SAUK CENTRE, AND CENTRACARE- PAYNESVILLE WILL MAINTAIN THEIR ENGAGEMENTS WITH THE CENTRAL MN ALLIANCE AND FOLLOW THE MAPP LEADERSHIP STRUCTURE TO CARRY OUT THE STRATEGIES OUTLINED IN THE CHIP. THERE WILL BE MEETINGS AS OUTLINED IN THE CHIP UNDER LEADERSHIP SYSTEM & PROCESS FOR MONITORING AND REVISION. TO SEE THE FULL CHIP GO TO THE CENTRACARE WEBSITE AT HTTPS://WWW.CENTRACARE.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT ST. CLOUD HOSPITAL PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 20E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY CARE INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST A PATIENT. PART V, SECTION B, LINE 22B: THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REV. PROC. 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 22B. DURING THE TAX PERIOD ENDED JUNE 30, 2021, THE FINANCIAL ASSISTANCE POLICY DID NOT INCLUDE THE PERCENTAGE CALCULATED FOR THE "AMOUNTS GENERALLY BILLED" USING THE LOOK BACK METHOD. CENTRACARE IDENTIFIED THIS ERROR IN MARCH 2022 DURING THE PREPARATION OF THE FORM 990 FOR THE TAX PERIOD ENDED JUNE 30, 2021 AND CORRECTED THIS ERROR IN APRIL 2022. THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN AFTER THE DISCOVERY OF THE ERROR. PART V, SECTION B, LINE 7A: HTTPS://WWW.CENTRACARE.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART V, SECTION B, LINE 10A: HTTPS://WWW.CENTRACARE.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 28 1 - SAINT BENEDICT'S SENIOR COMMUNITY 990 19TH ST SOUTH SARTELL MN 56377 SKILLED NURSING FACILITY 2 - COBORN CANCER CENTER 1900 CENTRACARE CIRCLE ST CLOUD MN 56303 OUTPATIENT CANCER 3 - CENTRACARE FAMILY HEALTH CENTER 1555 NORTHWAY DR STE 200 ST CLOUD MN 56303 CLINIC SERVICES 4 - ST CLOUD HOSPITAL BEHAVIOR HEALTH 166 19TH ST S STE 201 ST CLOUD MN 56303 OUTPATIENT CLINIC 5 - RECOVERY PLUS 713 ANDERSON AVE ST CLOUD MN 56303 OUTPATIENT SERVICES 6 - DIAGNOSTIC CENTER 1900 CENTRACARE CIRCLE ST CLOUD MN 56303 OUTPATIENT RADIOLOGY 7 - ST CLOUD SLEEP CENTER 1586 COUNTY RD 134 ST CLOUD MN 56303 OUTPATIENT SERVICES 8 - ST CLOUD PHYSICAL THERAPY 12800 ROLLING ROCK RIDGE RD BECKER MN 55308 PHYSICAL THERAPY 9 - SARTELL PSYCHOLOGY 166 19TH ST S SARTELL MN 56377 BEHAVIORAL HEALTH 10 - PASSAGE HOME 121 PARK AVE SO ST CLOUD MN 56301 SUBSTANCE ABUSE 11 - JOURNEY HOME 1485 10TH AVE NE SAUK RAPIDS MN 56379 SUBSTANCE ABUSE 12 - CLARA'S HOUSE 1564 COUNTY ROAD 134 ST CLOUD MN 56303 ADOLESCENT MENTAL HEALTH 13 - ST CLOUD HOSPITAL WOUND CARE CENTER 2035 15TH ST NORTH SUITE 130 ST CLOUD MN 56303 WOUND CARE 14 - ST CLOUD HOSPITAL PHYSICAL THERAPY 320 3RD AVE ALBANY MN 56307 PHYSICAL THERAPY 15 - RECOVERY PLUS RESIDENTIAL - ADOLESCENT 1572 CO RD 134 ST CLOUD MN 563030346 BEHAVIORAL HEALTH 16 - RECOVERY PLUS WOMEN'S OUTPATIENT SERV 1428 2ND ST N SAUK RAPIDS MN 563792533 BEHAVIORAL HEALTH 17 - DIALYSIS - LITCHFIELD 520 HWY 12 E SUITE 6 LITCHFIELD MN 55355 DIALYSIS 18 - DIALYSIS - STAPLES 403 PRAIRIE AVE NE STAPLES MN 56479 DIALYSIS 19 - DIALYSIS - BRAINERD 2024 6TH STREET BRAINERD MN 56401 DIALYSIS 20 - DIALYSIS - ALEXANDRIA 111 17TH AVE E ALEXANDRIA MN 56308 DIALYSIS 21 - DIALYSIS - PRINCETON 112 S RUM RIVER DR SUITE 10 PRINCETON MN 55371 DIALYSIS 22 - DIALYSIS - BIG LAKE 16830 198TH AVE NW BIG LAKE MN 55309 DIALYSIS 23 - DIALYSIS - LITTLE FALLS 808 3RD ST SSE LITTLE FALLS MN 56345 DIALYSIS 24 - DIALYSIS - CAMBRIDGE 520 11TH AVE SW SOUTH BLD CAMBRIDGE MN 55008 DIALYSIS 25 - DIALYSIS - OLIVIA 600 EAST PARK AVE SUITE 1 OLIVIA MN 56277 DIALYSIS 26 - CENTRACARE PLAZA REHAB 1900 CENTRACARE CIRCLE ST CLOUD MN 56303 PHYSICIAL, OCCUPATIONAL, SPEECH THERAPY 27 - CENTRACARE SOUTHWAY REHAB 1301 33RD ST S ST CLOUD MN 56301 PHYSICIAL, OCCUPATIONAL, SPEECH THERAPY 28 - DIALYSIS - AITKIN 200 BUNKER HILLS DR AITKIN MN 56431 DIALYSIS PART I, LINE 6A: CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $15,603,368 PART II, COMMUNITY BUILDING ACTIVITIES: THE ACTIVITIES INCLUDED IN COMMUNITY BUILDING ACTIVITIES INCLUDE COMMUNITY SUPPORT WHICH CONSISTS OF SEVERAL ST. CLOUD HOSPITAL DIRECTORS PARTICIPATING IN A VARIETY OF COMMITTEES SUCH AS THE BOARD OF BIG BROTHERS/BIG SISTERS, REHAB BOARD ETC. UNDER COMMUNITY HEALTH IMPROVEMENTS ADVOCACY, EMPLOYEES PARTICIPATED WITH CREATE COMMUNITY, WHICH IS A COLLABORATION TO BUILD INCLUSION AMONGST DIVERSE POPULATION AND SEVERAL COUNTY TASK FORCES TO ADVOCATE FOR MENTAL AND CHEMICAL HEALTH. FINALLY UNDER WORKFORCE DEVELOPMENT, AN EMPLOYEE IS A BOARD MEMBER OF THE STEARNS BENTON WORKFORCE COUNCIL AND STUDENTS WERE GIVEN TOURS OF THE HOSPITAL AND ATTENDED PRESENTATIONS ON CAREERS IN HEALTHCARE.THE HEALTH SYSTEM PROVIDED DRIVE THROUGH TEST SITES, FREE VACCINATION CLINICS, MANDATED EMPLOYEE VACCINATION, TRAINING, SCREENING, PRODUCTS TO ENSURE SAFE ENVIRONMENTS, AND OTHER VARIOUS SERVICES/PRODUCTS. PART III, LINE 2: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PART III, LINE 4: THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 ON PAGE 11 OF THE ORGANIZATION'S AUDITED FINANCIALS."CENTRACARE REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH CENTRACARE EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED." PART III, LINE 8: THE AMOUNT ON LINE 6 OF PART III WAS DETERMINED BY UTILIZING THE MEDICARE COST REPORT UTILIZING KEY SECTIONS OF THAT REPORT, PRIMARILY THE D SERIES AND E SERIES. PART III, LINE 9B: THE COLLECTION POLICIES AT ST. CLOUD HOSPITAL REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT REPORTING AGENCIES. PART VI, LINE 2: ST. CLOUD HOSPITAL FOUNDATION HAS IN PLACE A COMMUNITY COLLABORATION COMMITTEE WHICH HAS A MEMBERSHIP OF OVER 30 MEMBERS. THIS COMMITTEE IS MADE UP OF COMMUNITY LEADERS FROM BOTH THE HEALTHCARE AND BUSINESS WORLD. THESE MEMBERS MEET MONTHLY TO ADDRESS COMMUNITY HEALTH ISSUES (SEE PROMOTION OF COMMUNITY HEALTH FOR MORE DETAIL). THESE IDENTIFIED HEALTH NEEDS ARE THEN COMMUNICATED TO ST. CLOUD HOSPITAL. PART VI, LINE 3: INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. PART VI, LINE 4: ST. CLOUD HOSPITAL'S IMMEDIATE SERVICE AREA CONSISTS OF STEARNS, BENTON AND SHERBURNE COUNTIES. COLLECTIVELY THEIR ESTIMATED POPULATION IN 2022 IS 316,326 AND IS PROJECTED TO GROW BY 4.2% IN 2027.THE PROJECTED POPULATION GROWTH BY AGE BRACKET FOR 2022 TO 2027 IS 0-24, 1.5%; 25-44, 3.7%; 45-64, 0.2% AND 65+ 18.1%.THE OTHER NINE COUNTIES LOCATED IN THE SERVICE AREA ARE CROW WING, DOUGLAS, KANDIYOHI, MEEKER, MILLE LACS, MORRISON, POPE, TODD AND WRIGHT.COLLECTIVELY THEIR POPULATION IN 2022 WAS 419,079 AND IS PROJECTED TO GROW BY 3.4% BY 2027.THAT 9-COUNTY PROJECTED POPULATION GROWTH TO 2025 BY AGE BRACKET ARE AS FOLLOWS: 0-24, 4.3%; 25-44, -1.0%; 45-64, -2.4% AND 65+ 14.7%.THE PROJECTED 2027 ETHNICITY BREAKDOWN FOR THE ENTIRE 12-COUNTY AREA IS AS FOLLOWS: WHITE 86.8%, BLACK 4.8%, ASIAN & PACIFIC ISLANDER 1.5%, HISPANIC 4.4% AND OTHER 2.6%. THE DEMOGRAPHIC INFORMATION IS UPDATED EVERY 2 YEARS BY THE ORGANIZATION. PART VI, LINE 5: THE CENTRACARE FOUNDATION BOARD OF DIRECTORS HAS A MEMBERSHIP OF OVER 20 PERSONS REPRESENTING HEALTHCARE AND COMMUNITY NEEDS ACROSS CENTRAL MINNESOTA. THE BOARD MEETS QUARTERLY TO DISCUSS WAYS TO ADDRESS TYPICAL HEALTH ISSUES THROUGH AWARENESS BUILDING, EDUCATION AND ADVOCACY WITHIN CENTRACARE AS WELL AS THE COMMUNITY. THERE ARE SEVERAL COMMUNITY HEALTHY OUTREACH INITIATIVES THAT THE FOUNDATION HAS DEPLOYED FUNDING TOWARDS INCLUDING: ACES TRAUMA-INFORMED CARE - INCREASE AWARENESS AND INTERVENTIONS SURROUNDING ADVERSE CHILDHOOD EXPERIENCES, STATE-OF-THE-ART $2.9 MILLION SIMULATION CENTER RENOVATION AVAILABLE FOR COMMUNITY USE, ADULT AND PEDIATRIC BARIATRIC WEIGHT MANAGEMENT COLLABORATIVES, CHILD ADVOCACY CENTER HELPS CHILDREN WHO HAVE BEEN PHYSICALLY, SEXUALLY OR EMOTIONALLY ABUSED. BY WORKING CLOSELY WITH LAW ENFORCEMENT, CHILD PROTECTION, COUNTY ATTORNEYS, ADVOCATES, MENTAL HEALTH AND MEDICAL PROFESSIONALS IN ONE LOCATION, WE CAN ENSURE CHILDREN RECEIVE THE PROPER CARE AND SUPPORT DURING AND AFTER A CHILD ABUSE INVESTIGATION. 408 VICTIMS OF CHILD ABUSE FROM BENTON AND STEANS COUNTIES HAVE RECEIVED CARE IN THE FIRST TWO YEARS AT THE CAC WITH NO COST TO THEIR FAMILIES, CAREER ONE SUMMER INTERNSHIP PROGRAM FOR YOUTH. PART VI, LINE 6: THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 HOME DELIVERED MEALS 128 66593 FMV PROVIDED 18,192 MEALS TO THE NEEDY. PART I, LINE 2: CONTRIBUTIONS MUST BE IN KEEPING WITH THE MISSION OF CENTRACARE HEALTH, WHICH IS TO WORK TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. CONTRIBUTIONS WILL BE MADE TO ORGANIZATIONS RATHER THAN TO INDIVIDUALS WITHIN THE CENTRAL MINNESOTA REGION. CENTRACARE'S CHARITABLE FUNDS MAY NOT BE USED TO SUPPORT ANY ORGANIZATION OR EVENT THAT WOULD RESULT IN BENEFITS OF ANY KIND TO AN EMPLOYEE OF THE HEALTH SYSTEM OR A MEMBER OF THE VARIOUS BOARDS OF DIRECTORS, EITHER DIRECTLY OR INDIRECTLY. ONE EXCEPTION EXISTS TO THE GUIDELINE REGARDING BENEFIT TO EMPLOYEES: WE WILL SUPPORT, VIA SCHOLARSHIPS AND THE PURCHASE OF SUPPLIES, THE MEDICAL MISSION WORK OF OUR STAFF AND PHYSICIANS. THE CENTRACARE HEALTH CONTRIBUTIONS COMMITTEE IS MADE UP OF: ONE REPRESENTATIVE FROM CENTRACARE HEALTH FOUNDATION; ONE REPRESENTATIVE FROM ST. CLOUD HOSPITAL HUMAN RESOURCES/DIVERSITY COMMITTEE; THE DIRECTOR OF CENTRACARE HEALTH'S COMMUNICATION DEPARTMENT AND THE COMMUNICATION/MARKETING FOR ST. BENEDICT'S SENIOR COMMUNITY; THE DIRECTOR OF CENTRACARE HEALTH'S MARKETING DEPARTMENT; THE DIRECTOR OF ST. CLOUD HOSPITAL VOLUNTEER SERVICES; AND ST. CLOUD HOSPITAL'S DIRECTOR OF MISSION & SPIRITUAL CARE. THE COMMITTEE MEETS MONTHLY TO ENSURE A STREAMLINED, COORDINATED PROCESS OF REVIEWING REQUESTS AND DETERMINING FUNDING. OTHER CENTRACARE ENTITIES INCLUDING CENTRACARE HEALTH - LONG PRAIRIE, MELROSE, MONTICELLO, PAYNESVILLE, AND SAUK CENTRE, MAY DEVELOP A BUDGET FOR APPROVAL AND IMPLEMENT THEIR OWN CONTRIBUTION DECISIONS WITHIN THE GUIDELINES OF THIS DOCUMENT. CONTRIBUTIONS MAY NOT EXCEED THE STATED BUDGET AND NO MULTI-YEAR COMMITMENTS TO ORGANIZATIONS MAY BE MADE WITHOUT APPROVAL FROM THE CENTRACARE HEALTH EXECUTIVE COUNCIL. INDIVIDUALS AND DEPARTMENTS FORM THROUGHOUT ST. CLOUD HOSPITAL AND CENTRACARE CLINIC SHOULD FORWARD ALL OUTSIDE FUNDING REQUESTS TO A MEMBER OF THE COMMITTEE FOR THE FULL GROUP'S CONSIDERATION. THOSE REQUESTING FUNDS SHOULD BE ASKED TO SUBMIT REQUESTS IN WRITING. 0 1 0 0 0 0 0 1 0 JEFFREY S GERDES NEUROSURGEON 0 1851088 0 9692 0 5541 0 26000 0 22630 0 1914951 0 0 KENNETH D HOLMEN MD PRESIDENT/CEO 0 1025380 0 0 0 397740 0 14981 0 27578 0 1465679 0 0 CRAIG BROMAN CHIEF OPERATING OFFICER/EVP 0 956517 0 250000 0 181043 0 27625 0 24298 0 1439483 0 199215 UZMA SAMADANI NEUROSURGEON 0 865308 0 360293 0 561 0 38156 0 1363 0 1265681 0 0 JERONE D KENNEDY NEUROSURGEON 0 988506 0 54650 0 5598 0 44155 0 22911 0 1115820 0 0 JESSICA P SWARTOUT PHYSICIAN 0 939329 0 4650 0 4611 0 39000 0 32200 0 1019790 0 0 JENA J SWANSON PHYSICIAN 0 968605 0 4650 0 4593 0 0 0 27372 0 1005220 0 0 THOMAS G SCHRUP MD CHIEF PHYSICIAN OFFICER/EVP 0 550409 0 0 0 103969 0 26000 0 23047 0 703425 0 39658 MARK S MATTHIAS VICE PRESIDENT 0 456401 0 0 0 127621 0 26000 0 26952 0 636974 0 0 MICHAEL BLAIR CHIEF FINANCIAL OFFICER/SR VP/TREASU 0 524778 0 0 0 19618 0 45500 0 28119 0 618015 0 0 RICHARD E JOLKOVSKY MD DIRECTOR 0 506162 0 75160 0 4795 0 25572 0 1040 0 612729 0 0 KURT T OTTO VICE PRESIDENT 0 373663 0 0 0 57103 0 45500 0 25627 0 501893 0 51669 TODD M SEVERNAK MD DIRECTOR 0 425415 0 4650 0 7417 0 0 0 21641 0 459123 0 0 ALBERT J MERCURI MD DIRECTOR 0 405626 0 4650 0 6757 0 8717 0 27896 0 453646 0 0 DIANE R BUSCHENA-BRENNA VICE PRESIDENT 0 280047 0 0 0 64314 0 45500 0 25544 0 415405 0 0 JOY M PLAMANN RN VICE PRESIDENT 0 336411 0 0 0 50876 0 0 0 22350 0 409637 0 41727 SANTO CRUZ CHIEF LEGAL OFFICER/SR VP/SECRETARY 0 336391 0 0 0 26988 0 19500 0 25519 0 408398 0 0 NATHAN D LEE MD DIRECTOR 0 324398 0 4650 0 9622 0 14972 0 26816 0 380458 0 0 CATHERINE M GREENLEE VICE PRESIDENT 0 215405 0 0 0 46575 0 21021 0 15648 0 298649 0 0 PART I, LINE 3 THE COMPENSATION PAID TO THE PRESIDENT AND VICE PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: THOMAS SCHRUP - PAID $39,658 KURT OTTO - PAID $51,669 JOY PLAMANN - PAID $41,727 CRAIG BROMAN - PAID $199,215 PART I, LINE 7 THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR SAINT CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM; QUALITY, THROUGH ACHIEVING SAINT CLOUD HOSPITAL AND SYSTEM QUALITY METRICS; PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; AND PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID. FORM 990, PART V, LINE 15 ST. CLOUD HOSPITAL HAS PERFORMED THE CALCULATION TO DETERMINE THAT IT IS SUBJECT TO AN EXCISE TAX UNDER IRC SECTION 4960 FOR REMUNERATION PAID IN EXCESS OF $1,000,000. THE FORM 4720 WILL BE FILED WITH THE IRS BY CENTRACARE HEALTH ON BEHALF OF ST. CLOUD HEALTH TO REPORT THE EXCISE TAX. FORM 990, PART VI, SECTION A, LINE 2 MERRYN JOLKOVSKY & RICHARD JOLKOVSKY - FAMILY RELATIONSHIP (MARRIED) FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATE MEMBERS OF ST. CLOUD HOSPITAL ARE TWO REPRESENTATIVES OF THE SISTERS OF THE ORDER OF SAINT BENEDICT, TWO REPRESENTATIVES OF THE DIOCESE OF ST. CLOUD, AND FOUR OTHER CORPORATE MEMBERS APPOINTED BY THE FOUR REPRESENTATIVES. THE CORPORATE MEMBERS SERVE AS REPRESENTATIVES OF THE LOCAL CATHOLIC CHURCH OF SAINT CLOUD. FORM 990, PART VI, SECTION A, LINE 7A THE CENTRACARE HEALTH SYSTEM (CCHS) BOARD APPOINTS THE ST. CLOUD HOSPITAL (SCH) BOARD BASED ON RECOMMENDATION OF THE SCH JOINT NOMINATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO APPOINTING THE ST. CLOUD HOSPITAL BOARD, THE MEMBERS APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION, APPROVE DISSOLUTION OF THE HOSPITAL, AND SUPPORT AND ASSESS THE HOSPITAL'S ROMAN CATHOLIC IDENTITY AND MISSIONS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS HAS DELEGATED THE APPROVAL AUTHORITY OF THE FORM 990 TO THE AUDIT COMMITTEE. ANNUALLY, AT THE AUDIT COMMITTEE MEETING, PRIOR TO FILING WITH THE IRS, THE AUDIT COMMITTEE REVIEWS AND APPROVES FORM 990. A COPY OF FORM 990 IS THEN PROVIDED FOR THE FULL BOARD TO REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND BENEFITS OF THE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE IN JUNE 2021. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM SERVICES. THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE ALSO PAID BY A RELATED ORGANIZATION AND SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE IN JUNE 2021. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES RELEASE AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. FORM 990, PART XI, LINE 9: ADJUSTMENTS TO FUNDED STATUS OF PENSION PLAN 30,285,536. NET EQUITY TRANSFERS TO AFFILIATED ORGANIZATIONS -7,261,054. OTHER CHANGES IN NET ASSETS 318,022. FORM 990, PART XII, LINE 3B: DUE TO COVID-19 THE OFFICE OF MANAGEMENT AND BUDGET EXTENDED THE SINGLE AUDIT DUE DATE. DUE TO THIS THE SINGLE AUDIT REQUIRED TO BE COMPLETED IS IN PROCESS, HOWEVER THE JUNE 30, 2020 SINGLE AUDIT HAS BEEN COMPLETED. ST BENEDICTS SENIOR COMMUNITY 1810 MINNESOTA BOULEVARD SE ST CLOUD MN 56304 411321978 ACUTE/LT CARE MN 38702600 13520030 ST CLOUD HOSPITAL CENTRACARE HEALTH SYSTEM 1406 6TH AVENUE NORTH SAINT CLOUD MN 56303 411813221 INTEGRATED HEALTHCARE SYSTEM MN 501(C)(3) 3 N/A 0 CENTRACARE HEALTH - MELROSE 11 NORTH 5TH AVENUE WEST MELROSE MN 56352 411865315 ACUTE/LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH - LONG PRAIRIE 50 CENTRACARE DRIVE LONG PRAIRIE MN 56347 411924645 ACUTE/LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH - SAUK CENTRE 425 ELM STREET NORTH SAUK CENTRE MN 56378 452438973 ACUTE/LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE CLINIC 1200 6TH AVENUE NORTH SAINT CLOUD MN 56303 411806657 MULTI-SPECIALTY MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH FOUNDATION 1406 6TH AVENUE NORTH SAINT CLOUD MN 56303 411855173 FUNDRAISING MN 501(C)(3) 7 CENTRACARE HEALTH SYSTEM 0 CUSHMAN ALBERT RICE TRUST 1100 WEST ST GERMAIN STREET SAINT CLOUD MN 56303 416019335 SUPPORT FOR CARRIS HEALTH MN 501(C)(3) 12A, I CARRIS HEALTH 0 CARRIS HEALTH FOUNDATION 301 BECKER AVENUE SOUTHWEST WILLMAR MN 56201 411611555 SUPPORT FOR CARRIS HEALTH MN 501(C)(3) 7 CENTRACARE HEALTH FOUNDATION 0 MONTICELLO CANCER CENTER 1001 HART BOULEVARD SUITE 50 MONTICELLO MN 55362 261909519 RADIATION & ONCOLOGY SERVICES MN N/A 0 0 BENSON MEDICAL LLC 1228 ATLANTIC AVENUE BENSON MN 56215 203149203 HEALTHCARE MN N/A 0 0 CENTRACARE HOLDINGS INC 1406 6TH AVENUE NORTH SAINT CLOUD MN 56303 472688595 INVESTMENT/PHARMACY MN N/A C 0 AFFILIATED COMMUNITY MEDICAL CENTERS PA 301 BECKER AVENUE SOUTHWEST WILLMAR MN 56201 410850702 HEALTHCARE SYSTEM MN N/A C 0 AFFILIATED COMMUNITY HEALTH NETWORK INC 101 WILLMAR AVENUE SOUTHWEST WILLMAR MN 56201 411765606 HEALTH NETWORK MN N/A C 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 CENTRACARE HEALTH SYSTEM P 733216730 FMV CENTRACARE HEALTH SYSTEM O 86114929 FMV CENTRACARE HEALTH SYSTEM K 205468 FMV CENTRACARE HEALTH SYSTEM N 55118622 FMV CENTRACARE HEALTH FOUNDATION C 1440825 FMV CENTRACARE HEALTH SYSTEM C 1088173 FMV