2021-05-17T15:34:58-05:00 2020-06-30 861065772 Deloitte Tax LLP 50 South Sixth Street Suite 2800 Minneapolis MN 55402 990 2019-07-01 420733472 St Anthony Regional Hospital and Nursing Home STAN 7127945246 311 South Clark Street PO Box 628 Carroll IA 51401 John Munson CFO/Vice President 7127945246 2021-05-17 1 SHAWNA M JANSONS P01222873 6123974000 2019 2022-09-23 18:48:47Z Edward H Smith Jr 311 South Clark Street PO Box 628 Carroll IA 51401 115786489 0 0928 X www.stanthonyhospital.org X 1905 IA Consistently providing high quality healthcare services to meet patient and community needs. 10 8 871 367 937 0 4133496 3037456 72907722 78805328 2052254 2453119 -1130779 -214277 77962693 84081626 8500 8500 0 0 43367439 42941731 0 0 0 36917900 35970679 80293839 78920910 -2331146 5160716 167687985 196663793 29465938 51215791 138222047 145448002 X St. Anthony Regional Hospital is inspired by faith and committed to excellence. We are dedicated to improving the health of the people we serve. We will lead in providing high quality, high value healthcare services responsive to the needs of our patients and the region. We are committed to the health ministry of our sponsors, St. Anthony Ministries. 0 0 51333527 8500 64163699 St. Anthony Regional Hospital is a 99 bed acute care facility and St. Anthony Nursing Home has 79 beds in Carroll, IA. In the year ended June 30, 2020, St. Anthony Regional Hospital and Nursing Home provided health care services to approximately 2,436 inpatients, 70,341 outpatients, and 41,034 clinic visits. St. Anthony Regional Hospital provided services for 1,407 acute care inpatients, and provided psychiatric, swing bed, and nursing home services for the remainder of inpatients. Outpatient services were provided to patients through ancillary departments, emergency room, and clinics.See Schedule O.St. Anthony Hospital provides services of cardiac rehabilitation, dialysis, hospice care, laboratory, observation, chemotherapy, pathology, radiology, respiratory therapy, physical therapy, occupational therapy, speech therapy, diabetes, medical oncology, radiation therapy, and surgical services. St. Anthony's largest patient service area is physical therapy. In the year ended June 30, 2020, St. Anthony serviced 7,020 patients in physical therapy, 5,847 in emergency room, and 5,643 in radiology. The activities pursued by St. Anthony Regional Hospital and Nursing Home in the provision of health care services are consistent with its exempt purpose. 23178634 14641629 As part of its mission, St. Anthony Regional Hospital provides medical care to individuals who are unable to pay for services, incurs costs in excess of reimbursement for services to Medicaid beneficiaries, and carries out other activities and programs free of charge to support the community in which it operates. Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care. 74512161 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 153 0 1 871 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IA X John R Munson 7127945115 311 South Clark St Carroll IA 514010628 Randal O Hess MD Physician 40.00 0.00 X 466372 0 38489 Patricia Teschke Physician 40.00 0.00 X 455620 0 9357 Edward H Smith Jr CEO/President 40.00 0.30 X 376354 0 52564 Richard C Sazama MD Physician 40.00 0.00 X 402422 0 11932 Nelson H Lo MD Physician 40.00 0.00 X 355914 0 36209 Nicholas Kuiper Physician 40.00 0.00 X 355247 0 18592 John Munson CFO/Vice President 40.00 0.30 X 203011 0 35011 Nick Badding Chairman 0.30 0.00 X X 0 0 0 Peggy White Vice-Chairman 0.30 0.30 X X 0 0 0 Sr Romona Klaubauf Secretary 0.30 0.00 X X 0 0 0 Howard J Drees Treasurer 0.30 0.00 X X 0 0 0 Fred Dolezal Board Member 0.30 0.00 X 0 0 0 Jeff Scharfenkamp Board Member (Beg 07/19) 0.30 0.00 X 0 0 0 Karl Eischeid DDS Board Member 0.30 0.30 X 0 0 0 Sr Donna Venteicher Board Member 0.30 0.00 X 0 0 0 Sr Maris Kerwin Board Member 0.30 0.00 X 0 0 0 Sr Theresa Keller Board Member 0.30 0.00 X 0 0 0 2614940 0 202154 48 0 1 0 Acute Care Inc PO Box 3288 Des Moines IA 50316 Emergency Physician Services 1489771 Medical Oncology 1221 Pleasant St Des Moines IA 50309 Oncology Services 681365 Medical Information Technology Meditech Circle Westwood MA 02090 EMR Services 388025 Shared Service Systems Inc 1725 S 20th St Omaha NE 681083889 Laundry Services 300663 Shared Medical Services Inc 209 Limestone Pass Cottage Grove WI 53527 Imaging Services 283049 18 3018297 19159 19159 3037456 Patient Svc Revenue 621400 44732348 44732348 Medicare/Medicaid Pmts 621400 33700658 33700658 Cafeteria Sales 621400 372322 372322 78805328 1547023 937 1546086 3038125 3252402 -214277 -214277 -214277 29292192 66365 28451555 906 840637 65459 906096 906096 84081626 78433006 937 2610227 X 7500 7500 1000 1000 574285 574285 34296096 33162595 1133501 696454 623277 73177 5071003 4821154 249849 2303893 2202133 101760 82458 82458 243747 243747 7619 7619 317515 317515 6675875 5687094 988781 304195 7775 296420 1894530 1755974 138556 654461 654461 2241919 2232559 9360 277656 242081 35575 623417 623417 5918250 5918250 374359 374359 Medical Supplies 14200493 14200493 Repair and Maintenance 2154185 1998039 156146 78920910 74512161 4408749 0 311617 21622267 12168584 8832710 245 186 2081015 2302761 558737 662515 161270817 90748192 66104752 70522625 66570964 70617553 3143301 5046493 16748770 17056683 167687985 196663793 6426554 22366189 20364355 26459921 1119176 702010 1555853 1687671 29465938 51215791 X 127029130 134059831 11192917 11388171 138222047 145448002 167687985 196663793 X 5160716 2121574 -56335 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7619 7619 0 Part II-B, Line 1: St. Anthony Regional Hospital and Nursing Home is a member of the Iowa Hospital Association and the Catholic Health Organization. A percentage of dues are paid for lobbying activities. 18596647 98672 1108234 14850 742029 19046674 14742656 2531749 1454273 15000 117031 18596647 13393000 202723 2011722 9750 855039 14742656 12173907 143951 1764112 9750 679220 13393000 11720664 357317 138893 9500 33467 12173907 0.00000 0.40000 0.60000 0 1 1 693934 693934 106472564 56276558 50196006 42777307 34471634 8305673 11327012 11327012 70522625 Deferred Compensation Investments 1687671 Beneficial Interest in Net Assets of the Foundation 15369012 17056683 Deferred Compensation 1687671 1687671 X 89248723 2121574 176095 2297669 86951054 317515 -3186943 -2869428 84081626 82022768 3419373 3419373 78603395 317515 317515 78920910 Part V, Line 4: All restricted endowed funds held at the St. Anthony Foundation are used for the benefit of St. Anthony Regional Hospital and Nursing Home and for scholarships. Part X, Line 2: The Internal Revenue Service has determined that the Hospital is an organization exempt from income tax under the Internal Revenue Code; and accordingly, no provision for income taxes is recorded in the consolidated statement of activities. Accounting for income taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. The Hospital recorded no liabilities for unrecognized tax benefits as of June 30, 2020 and 2019. The Hospital is engaged in certain activities that result in unrelated business income recorded within other revenue in the consolidated statements of activities. Part XI, Line 2d - Other Adjustments: Change in beneficial interest of net assets of St. Anthony Foundation 176,095. Part XI, Line 4b - Other Adjustments: Rental Expenses -3,252,402. Realized Gain on Sale of Assets 65,459. Part XII, Line 2d - Other Adjustments: Rental Expenses 3,252,402. Realized Gain on Sale of Assets -65,459. Transfer to Foundation - Reimbursed Expenses 232,430. 1 1 1 X 1 X 399.000000000000 1 1 0 1 1 453369 0 453369 0.00570 8750320 6497380 2252940 0.02850 9203689 6497380 2706309 0.03420 173422 7490 165932 0.00210 219465 5000 214465 0.00270 13407304 8082936 5324368 0.06750 174754 48823 125931 0.00160 13974945 8144249 5830696 0.07390 23178634 14641629 8537005 0.10810 14627 0 14627 0.00020 14627 14627 0.00020 1 1455076 0 20606954 25761684 -5154730 X 1 1 1 1 St Anthony Regional Hospital 311 South Clark St PO Box 628 Carroll IA 514010628 www.stanthonyhospital.org 14009OH X X X St Anthony Regional Hospital 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X See Part V, Section C X 1 18 1 See Part V, Section C 0 1 X 200.000000000000 399.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 St. Anthony Regional Hospital Part V, Section B, Line 5: In the year ended 6/30/19, St. Anthony Regional Hospital conducted a CHNA assessment. A total of 8 individuals were interviewed. Primary data collection included key stakeholder interviews and a web based community survey. The interviews were conducted by Dory Escobar, PhD for Community Catalyst in May of 2019. Interviews were conducted with representatives from local hospitals and other health care providers with residents over a 6 county area. All interviews were reviewed and comments analyzed to identify the most frequently mentioned community health issues. The primary data collection included a web based online community survey in English and Spanish during February 2019. Community stakeholders participated in identifying key issued focused on health and well being through the life span. 260 people participated in the online survey. St. Anthony Regional Hospital Part V, Section B, Line 6b: St. Anthony Regional Hospital and Nursing Home contracted with Community Catalyst for assistance with the Community Health Needs Assessment. St. Anthony Regional Hospital Part V, Section B, Line 7d: https://www.stanthonyhospital.org/webres/File/legal/Community%20Health%20Needs%20Assessment%202019%20Final.pdfPart V, Section B, line 10a, Implementation Strategy Website:https://www.stanthonyhospital.org/webres/File/legal/St%20Anthony%20Implementation%20Strategy%202019.pdf St. Anthony Regional Hospital Part V, Section B, Line 11: The following significant health needs were identified in the St. Anthony Regional Hospital and Nursing Home service area.- Access to care and Health Education- Cancer - Treatment and Prevention- Chronic Disease Management- Mental Health Services- Nutrition and Exercise- Substance Abuse - Tobacco and Alcohol- Transportation- VaccinationsSt. Anthony Regional Hospital and Nursing Home has worked to meet these identified heath needs this year in the following ways:Access to Care and Health Education:- Developed updated list of service providers and other resources. - Organized community health fairs and events for vulnerable populations.- Promoted community service opportunities to address needs of target population. - Provided support groups for individuals with health issues.Cancer - Treatment and Prevention:- The development of a new cancer center and resources for the community.- Community runs for cancer to raise awareness and funds with partners Carroll Chamber and Carroll Cancer Crusaders. - Participation in Iowa Cancer Consortium on HPV.Chronic Disease Management:- Ongoing leadership and participation in activities and events in the community to promote health living and chronic disease prevention and management.Mental Health:- Community education on Adverse Childhood Experiences (ACES).- Provided parent education on child development and mental health.- Caregiver education on self care.- Mentoring programs.- Community and school based mental health promotion programs and events for middle school and high school students.- Bereavement support programs.Nutrition and Exercise:- Community gardens and gardening classes.- Community events promoting physical activity and education about healthy eating and drinking water.- Healthy eating education and health weight management programs.- Diabetes prevention and management programs.- Accredited diabetes education.- Participation in the Live Health Iowa initiative and Carroll County Wellness Coalition.- WIC clinics.- Fall prevention education and activities for older adults and providers.Substance Abuse - Tobacco and Alcohol:- Provider education.- Community and school based programs to prevent substance use amount adults, children and adolescents.- Responsible beverage service training.- Drivers education presentations regarding alcohol use.- Tobacco cessation "Quit Line".- Tobacco/nicotine free work policy with area work places and with area child care providers.- Collaboration with healthcare providers to implement 2A and R - Ask, Advise, Refer system.Vaccinations:- Community education about HPV and promotion of vaccination.- Radio and newspaper ads, social media posts to increase HPV and meningitis immunizations.- Community based immunizations clinics.Transportation:- Collaborate to increase transportation to healthcare services for vulnerable population, including older adults, people with disabilities and covered by Medicaid.- Community fundraiser to fund travel vouchers for low income individuals. St. Anthony Regional Hospital Part V, Section B, Line 13h: Additional eligibility criteria for financial assistance include Medicaid/Medicare coverage, and State regulations. Part V, line 16a, FAP website: https://www.stanthonyhospital.org/patients-visitors/patients/financial-assistance/ Part V, line 16b, FAP Application website: https://www.stanthonyhospital.org/patients-visitors/patients/financial-assistance/ Part V, line 16c, FAP Plain Language Summary website: https://www.stanthonyhospital.org/patients-visitors/patients/financial-assistance/ 6 1 - St Anthony Regional Hospice 311 South Clark St Carroll IA 51401 Hospice Services 2 - St Anthony Regional Hospital 311 South Clark St Carroll IA 51401 Dialysis Services 3 - St Anthony Regional Home Hlth Agency 311 South Clark St Carroll IA 51401 Home Health Services 4 - St Anthony Regional Hospital 311 South Clark St Carroll IA 51401 Psychiatric Services 5 - Wall Lake Medical Clinic 311 West First St Wall Lake IA 51466 Rural Health Clinic 6 - St Anthony Nursing Home 311 South Clark St Carroll IA 51401 Nursing Home Part I, Line 3c: In addition to FPG, the Hospital will consider the extent to which the patient's household has assets that could be used to meet his or her financial obligation. Assets may include, but are not limited to, cash, savings and checking account, certificates of deposit, stocks and bonds, individual retirement accounts (IRAs), trust funds, real estate (excluding the patient's home) and motor vehicles. The hospital will take into account any liabilities that are the responsibility of the patient's household. To relieve stress related to financial burdens, families with a medical catastrophe with self-pay balances greater than 20 percent of their annual household income in one calendar year may be eligible for substantial discounts. Part I, Line 7: The cost to charge ratio was used when calculating the amounts reported in Part 1, line 7, with the exception of line 7g, subsidized health services. Subsidized health services are reported using departmental cost from the 2020 cost report. Part I, Line 7g: St. Anthony Regional Hospital has eight physician clinics that are included in subsidized health services where cost exceeds the reimbursements. Part II, Community Building Activities: The Hospital CEO participates in the Carroll Area Development board that is active in workforce development. The hospital emergency room director attended regional meetings on disaster readiness. The CEO is a board member of the Iowa Hospital Association Board of Directors. There are managers of the Hospital that serve on local health advisory boards. Part III, Line 2: St. Anthony Regional Hospital reports bad debt in accordance with generally accepted accounting principles (GAAP). Bad debt at cost is calculated with the same cost to charge ratio used for the charity care at cost multiplied by the estimated debt charges. Part III, Line 3: St. Anthony Regional Hospital works with those qualifying for charity care along every step of the process including accepting applications for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the Hospital regarding payment plans, financial assistance or with those trying to help get on government programs. For individuals not providing necessary information it is impossible to know the reason for not cooperating and therefore know whether the will qualify for charity care. St. Anthony Regional Hospital is unable to reasonably determine whether any amount of bad debt could have been classified as charity care if individuals do not provide the necessary information to evaluate their situation to determine qualification with the charity care policy. Part III, Line 4: St. Anthony Regional Hospital's audited financial statements include a footnote for the provision for bad debts on Page 8 in the section entitled 'Net Patient Service Revenue'. Part III, Line 8: The amount of Medicare short fall on line 6 should be included in the community benefit because Medicare pays less than the cost for rendering services. The Medicare allowable costs are taken from the Medicare cost report and determined based on the cost to charge ratio from the Medicare report. Part III, Line 9b: The policy states that St. Anthony Regional Hospital offers charity care to all patients who meet criteria for financial aid and want assistance. Patients who do not have insurance may qualify for St. Anthony Cares based on annual income and family size. Patients with insurance may also qualify for St. Anthony Cares for bills not covered by insurance. Charity information is available upon admission an disclosed in monthly billing statements. An application is completed by the patient and based on income and family size the amount of charity is determined based on the federal poverty guidelines. Patients receive statements and make payment arrangements with Preferred Medical Deposits (PMD). Accounts at PMD with no activity after 60 days are turned over to a collection agency, Avadyne Health.Reasonable efforts will be extended to patients to make them aware of the Care. It includes the following action:- Providing written notice on their billing statement from the payment processor that financial assistant is available.- Making a determination regarding Financial Assistance eligibility if the patient submits a complete CARES application during the application period.- Notify the patient who submits an incomplete CARES application about how to complete it properly, and giving the patient a reasonable opportunity to do so.The Hospital must provide this notification in writing and must provide contact information for resources in assisting the patient with completing the CARES application. Providing a Plain Language Summary identifying the ECAs that the Hospital may take if needed, and stating a deadline after which ECAs may be initiated that is no earlier than 30 days after the date when the written notice is provided. Part VI, Line 2: The Hospital and county performs a community needs assessment every three years to identify specific health concerns of the county. Meetings are held with community partners to identify needs from the daily work and with clients, students, educators, health care, volunteer services, case management, behavior medicine, and others in the county. A survey was developed to gather county resident's identified needs. The primary data collection included a web based community survey. The survey was posted on the hospital website. There were 260 people who participated in the survey. The needs assessment was completed and adopted by the St. Anthony Hospital Board of Directors. The implementation strategy was developed and implemented based on the assessment of the survey. The hospital intends to coordinate efforts with the Carroll County Public Health Department to ensure that community benefit resources address needs to improve the health of residents of the service area. The Carroll County Public Health Department provides emergency preparedness, blood pressure clinics, care for your self program, disease management, health opportunities for parents, immunizations, senior health, assistant to obstetrics patients, and TB testing to the community. Part VI, Line 3: The financial counselor from the organization informs and educates patients about eligibility of federal, state and local government programs and charity policies. The charity care policy is made available to patients in the admissions office and provided in the admission packets. If patients have questions they can stop in the business office and discuss them with the financial counselor. Part VI, Line 4: The Hospital is located in the city of Carroll in West Central Iowa, Carroll County with a population of 20,320. St. Anthony Hospital also serves portions of 6 surrounding counties with a radius of 50 miles. St. Anthony Hospital operates 6 satellite physician clinics in the service area, in addition to 2 physician clinics in the hospital. The six countries of Audubon, Carroll, Calhoun, Crawford, Green, and Sac comprise the hospital's primary service area. The estimated population of St. Anthony's six county area was 71,498 in 2017. The estimated 2017 median house hold income for all counties in the service area is less than the median Iowa household income of $56,570. The majority of the population in the St. Anthony, six county service area is White/Caucasian. Crawford County has a significant Hispanic population, with more than 30% of the population being Hispanic. The majority of the service area is comprised of English speaking residents. The exception is Crawford County where 8 % of the population in not proficient in English, the majority of whom are Spanish speaking. Part VI, Line 5: St. Anthony Regional Hospital has demonstrated a commitment to promoting health care to further its exempt purpose of providing quality health care in the community and surrounding counties for one hundred and fourteen years. The majority of the Hospital's board members are from local businesses and reside in the community. The Hospital's medical staff consists of 31 active staff, 3 associate staff in the community, and 91 courtesy staff from outside the community. St. Anthony Regional Hospital is a regional provider and is committed to providing quality care to the community. Part VI, Line 7, Reports Filed With States IA 1 American Cancer Society 1717 Ingersol Ave Suite 111 Des Moines IA 50309 141788491 501(c)(3) 7500 0 Support for Cancer Prevention 1 0 Part I, Line 2: The organization will be funding and conducting research, sharing expert information, supporting patients and their caregiviers, advocating for policy, and spreading the word about prevention. While there is no specific procedure for monitoring the use of the grants, the St. Anthony Regional Hospital and Nursing Home provided the grant to the American Cancer Society and the funds are indicated for a specific purpose - the support of cancer prevention. X X X X 0 1 0 0 0 0 0 1 0 Randal O Hess MD Physician 447773 0 1455 0 17144 0 13700 0 24789 0 504861 0 0 0 Patricia Teschke Physician 397914 0 50000 0 7706 0 0 0 9357 0 464977 0 0 0 Edward H Smith Jr CEO/President 310386 0 35161 0 30807 0 26175 0 26389 0 428918 0 0 0 Richard C Sazama MD Physician 393202 0 0 0 9220 0 10783 0 1149 0 414354 0 0 0 Nelson H Lo MD Physician 355714 0 200 0 0 0 10918 0 25291 0 392123 0 0 0 Nicholas Kuiper Physician 339487 0 7820 0 7940 0 0 0 18592 0 373839 0 0 0 John Munson CFO/Vice President 192198 0 9150 0 1663 0 5606 0 29405 0 238022 0 0 0 Part I, Line 4b St. Anthony Regional Hospital and Nursing Home has a non qualified deferred compensation plan that complies with section 457(f) of the Internal Revenue Code and the short-term deferral provisions of section 409A of the code. The plan is to be an unfunded plan maintained primarily for the purpose of providing deferred compensation benefits for a select group of management or highly compensated employees. No individuals received payments from the non qualified deferred compensation plan during calendar year 2019. Part I, Line 7 In their roles as executives employed by St. Anthony Regional Hospital and Nursing Home, the executives are eligible for incentive payouts. The incentive award will be a percentage of the base pay compensation for the CEO, CFO, and other executives. The ultimate payout includes a reduction/increase multiplier depending on whether the organization reached specified performance metrics identified by the Board of Directors. A City of Carroll IA 426004322 000000000 2012-11-26 4820000 Refund Bonds Issued 12/20/2001 0 0 0 A 3374000 4820000 50000 4770000 2009 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 Drees Co Entity more than 35% controlled by Howard J. Drees, Treasurer, and family. 4953643 Construction and Plumbing/Heating Services 0 Badding Construction Entity more than 35% controlled by Nick Badding, board Chairman, and family 1370557 Construction Services 0 Form 990, Part VI, Section A, line 2 Sister Romona Klaubauf, Sister Theresa Keller, Sister Maris Kerwin, and Sister Donna Venteicher have a business relationship through their membership in the Franciscan Sisters of Perpetual Adoration. Form 990, Part VI, Section A, line 6 The former members of the St. Anthony Regional Hospital and Nursing Home are the sisters of the religious community known as the Congregation of the Sisters of the Third Order of the St. Francis of Perpetual Adoration (FSPA). The FSPA has formed St. Anthony Ministries to assume canonical sponsorship and membership of St. Anthony Regional Hospital and Nursing Home, performed previously by the FSPA. St. Anthony Ministries has the power to elect the board of directors, amend the articles of incorporation and bylaws of the organizations and dissolve the organization. Form 990, Part VI, Section A, line 7a St. Anthony Ministries, as the sole member of St. Anthony Regional Hospital and Nursing Home, elects and approves the Board of Directors for St. Anthony Regional Hospital and Nursing Home. Form 990, Part VI, Section A, line 7b All decisions, including dissolution of the organization, made by the Board of Directors of St. Anthony Regional Hospital and Nursing Home are subject to the approval of St. Anthony Ministries. Form 990, Part VI, Section B, line 11b St. Anthony Regional Hospital and Nursing Home gathers the necessary information for the completion of the Form 990 within the finance department and with assistance form the human resources and operation departments. The form was prepared by an independent accounting firm. Drafts of the form were reviewed by the CFO and the Audit committee. After the internal reviews were complete, the final version of the form 990 was given to each member of the Board of Directors prior to filing the return. Form 990, Part VI, Section B, line 12c The Officers and Board Members annually disclose in writing, "any interest which would be inconsistent with the expeditious, proper, and impartial performance of duties." Defining disclosable conflict or duality of interest as any matter in which the corporations are "interested which affects the financial interest or employment of such member, a member of his/her family by blood or marriage, or any business enterprise in which he/she or such family member is employed or has a financial interest." Officers and Board members are required to disclose the facts surrounding any possible conflict of interest throughout the year. If a conflict of interest is disclosed by an Officer or Board Member, during a board meeting the Officer or Board Member will not participate in any discussions or deliberations regarding the matter and would abstain from any voting decisions on this matter during the meeting. All conflict of interests that are disclosed will be reported in the minutes of the board meetings. Form 990, Part VI, Section B, line 15 At the direction of the Board of Directors the CEO gathers compensation information (salary and benefits) from various sources including Iowa Hospital Association and benefit consultants for like-sized organizations. The Executive Committee then determines the annual compensation for the CEO, other officers, and any key employees for the total board approval. The compensation process for the CEO is completed in August annually. The other officers compensation is completed in March annually. Form 990, Part VI, Section C, line 19 The St. Anthony Regional Hospital and Nursing Home mails its audited financial statements to financial institutions, governmental institutions, board members, and the Iowa Hospital Association. The Form 990 is available at guidestar.org. St. Anthony Regional Hospital and Nursing Home discloses financial statements to bondholders, the IHA, and the Iowa Attorney General's office. St. Anthony Regional Hospital and Nursing Home's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Physician Fees: Program service expenses 2,377,177. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,377,177. Patient Service Fees: Program service expenses 590,577. Management and general expenses 0. Fundraising expenses 0. Total expenses 590,577. Contract Labor: Program service expenses 1,669,033. Management and general expenses 9,980. Fundraising expenses 0. Total expenses 1,679,013. Laundry Fees: Program service expenses 282,546. Management and general expenses 0. Fundraising expenses 0. Total expenses 282,546. Consulting Fees: Program service expenses 20,594. Management and general expenses 54,676. Fundraising expenses 0. Total expenses 75,270. Professional Fees: Program service expenses 613,693. Management and general expenses 868,262. Fundraising expenses 0. Total expenses 1,481,955. Recruiting Fees: Program service expenses 133,474. Management and general expenses 55,863. Fundraising expenses 0. Total expenses 189,337. Form 990, Part XI, line 9: Transfer to Foundation - Reimbursed Expenses -232,430. Change in beneficial interest of net assets of St. Anthony Foundation 176,095. St Anthony Foundation 311 South Clark St PO Box 628 Carroll IA 51401 421419695 Fundraising IA 501(c)(3) 12a St Anthony Regional Hospital and Nursing Home 1 St Anthony Ministries 311 South Clark St PO Box 628 Carroll IA 51401 000000000 Religious Order IA 501(c)(3) 1 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 St Anthony Foundation C 3018297 FMV St Anthony Foundation P 232430 FMV