ST MARYS HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS HOSPITAL INC (EIN 82-0226453)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-15
- IRS object ID
- 201931359349308203
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-15T13:35:25-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 820226453 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 2089623251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 137 | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83522 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JYL RULAND | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 2089623251 | PhoneNum |
| Signature | 2019-05-15 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.72.48.249 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-15 | IPDt |
| IP Tm | 13:35:21 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 451E9B1FD6949C5516D1E526EBCF18571DBE2BB9 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LENNE BONNER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 137 | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,635,403 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SMH-CVHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | ID | LegalDomicileStateCd |
| Activity Or Mission | THROUGHOUT ESSENTIA HEALTH, WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. AS A MEMBER OF THE ESSENTIA HEALTH FAMILY, ST. MARY'S HOSPITAL, INC.'S MISSION AS A CATHOLIC, BENEDICTINE SPONSORED FACILITY IS TO PROMOTE CHRIST'S MINISTRY OF HOLISTIC HEALING FOR ALL HUMAN LIFE WITH SPECIAL CONCERN FOR THE POOR AND POWERLESS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 250 | TotalEmployeeCnt |
| Total Volunteers | 37 | TotalVolunteersCnt |
| Total Gross UBI | $2,683 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$642 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $506,717 | PYContributionsGrantsAmt |
| CY Contributions Grants | $559,061 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,470,955 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,037,659 | CYProgramServiceRevenueAmt |
| PY Investment Income | $362,668 | PYInvestmentIncomeAmt |
| CY Investment Income | $377,965 | CYInvestmentIncomeAmt |
| PY Other Revenue | $51,270 | PYOtherRevenueAmt |
| CY Other Revenue | $43,583 | CYOtherRevenueAmt |
| PY Total Revenue | $22,391,610 | PYTotalRevenueAmt |
| CY Total Revenue | $22,018,268 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $159,357 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $149,290 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,716,464 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,926,077 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $12,354 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,048,472 | PYOtherExpensesAmt |
| CY Other Expenses | $8,092,788 | CYOtherExpensesAmt |
| PY Total Expenses | $21,924,293 | PYTotalExpensesAmt |
| CY Total Expenses | $22,168,155 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $467,317 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$149,887 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,324,959 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,532,601 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,725,759 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,590,022 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,599,200 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,942,579 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THROUGHOUT ESSENTIA HEALTH, WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. AS A MEMBER OF THE ESSENTIA HEALTH FAMILY, ST. MARY'S HOSPITAL, INC.'S MISSION AS A CATHOLIC, BENEDICTINE SPONSORED FACILITY IS TO PROMOTE CHRIST'S MINISTRY OF HOLISTIC HEALING FOR ALL HUMAN LIFE WITH SPECIAL CONCERN FOR THE POOR AND POWERLESS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,731,121 | ExpenseAmt |
| Grant | $149,290 | GrantAmt |
| Revenue | $21,037,659 | RevenueAmt |
| Desc | ST. MARY'S HOSPITAL, INC. IS CREATED AND ORGANIZED EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, EDUCATIONAL, AND SCIENTIFIC PURPOSES. MORE SPECIFICALLY, ST. MARY'S HOSPITAL, INC. IS CREATED AND ORGANIZED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH. IN KEEPING WITH THIS SPECIFIC PURPOSE, ALL WORKS SHALL BE CARRIED OUT IN ACCORDANCE WITH THE CHARISM OF THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION, A MINNESOTA NONPROFIT CORPORATION.ST. MARY'S HOSPITAL, INC. HAS A 25-BED HOSPITAL AND PRIMARY CARE CLINICS THAT SERVE COTTONWOOD AND THE SURROUNDING AREAS OF KAMIAH, GRANGEVILLE, NEZPERCE AND CRAIGMONT. ST. MARY'S HOSPITAL, INC. PROVIDES GENERAL MEDICAL AND SURGICAL CARE FOR INPATIENT, OUTPATIENT, AND EMERGENCY ROOM PATIENTS.ST. MARY'S HOSPITAL, INC. EMPLOYS APPROXIMATELY 160 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED APPROXIMATELY 2,500 HOSPITAL PATIENT DAYS AND 23,000 OUTPATIENT VISITS DURING FISCAL YEAR ENDED JUNE 30, 2018. THE CLINICS HAD 21,000 ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2018, ST. MARY'S HOSPITAL, INC. PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $485,000 IN CHARITY CARE, $278,000 COSTS IN EXCESS OF MEDICAID PAYMENTS, $6,000 IN COMMUNITY SERVICES, $108,000 IN HEALTH PROFESSION EDUCATION, AND $13,000 IN CASH AND IN-KIND CONTRIBUTIONS. | Desc |
| Total Program Service Expenses | $17,731,121 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 53 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 250 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JYL RULAND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2089623251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 CEDAR | AddressLine1Txt |
| City | OROFINO | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83544 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| LENNY HILL | ||||||||
| BOARD CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SISTER MARJORIE SCHMIDT | ||||||||
| BOARD SECRETARY/TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JACK BRUNER II MD | ||||||||
| BOARD DIRECTOR | 39.00 | 1.00 | Yes (X) | $309,093 | $0 | $27,171 | ||
| RENE FORSMAN | ||||||||
| BOARD DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KIM INGRAM | ||||||||
| BOARD DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SISTER LISA MAURER | ||||||||
| BOARD DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KELLY MCGRATH MD | ||||||||
| BOARD DIRECTOR | 1.00 | 59.00 | Yes (X) | $0 | $273,270 | $32,009 | ||
| PAUL NUSSER | ||||||||
| BOARD DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY O'BRIEN | ||||||||
| BOARD DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TIMOTHY SAYLER | ||||||||
| BOARD DIRECTOR | 1.00 | 59.00 | Yes (X) | $0 | $487,627 | $94,267 | ||
| MATT SARTINI | ||||||||
| BOARD DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINA ULMER | ||||||||
| BOARD DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SISTER DANILE LYNCH | ||||||||
| BOARD DIRECTOR THRU 4/18 | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| LENNE BONNER | ||||||||
| PRESIDENT | 30.00 | 30.00 | Yes (X) | $0 | $229,139 | $49,196 | ||
| JYL RULAND | ||||||||
| CHIEF FINANCIAL OFFICER | 30.00 | 30.00 | Yes (X) | $0 | $129,323 | $17,693 | ||
| ANDREW JONES DO | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $484,614 | $0 | $23,598 | Yes (X) | ||
| CLARENCE BRUNSON MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $305,036 | $0 | $19,463 | Yes (X) | ||
| JARED PIKUS DO | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $270,165 | $0 | $27,419 | Yes (X) | ||
| ALVIN SECREST III MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $264,483 | $0 | $36,389 | Yes (X) | ||
| RONALD SIGLER MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $222,067 | $0 | $25,441 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,855,458 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,119,359 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $352,646 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PALOUSE IMAGING CONSULTANTS PLLC | |||||
| PO BOX 9583 | MOSCOW | ID | 83843 | RADIOLOGY SERVICES | $263,294 |
| COMPUNET INC | |||||
| PO BOX 410802 | SALT LATE CITY | UT | 84141 | IT SERVICES | $241,080 |
| PATHOLOGISTS REGIONAL LAB | |||||
| PO BOX 956 | LEWISTON | ID | 83501 | LAB SERVICES | $124,940 |
| MEDREC PARTNERS LLC | |||||
| 591 E PLAZA CIRCLE 2193 | LITCHFIELD PARK | AZ | 85340 | TRANSCRIPTION | $122,574 |
| FUSION MEDICAL STAFFING LLC | |||||
| PO BOX 82674 | LINCOLN | NE | 68501 | OCCUPATIONAL THERAPIST | $106,667 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $188,292 | RelatedOrganizationsAmt |
| Government Grants | $339,414 | GovernmentGrantsAmt |
| All Other Contributions | $31,355 | AllOtherContributionsAmt |
| Total Contributions | $559,061 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INPATIENT AND OUTPATIENT REVENUES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $21,037,659 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,034,976 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,683 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,037,659 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $189,936 | TotalRevenueColumnAmt |
| Exclusion | $189,936 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,349 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,349 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,349 | TotalRevenueColumnAmt |
| Exclusion | $3,349 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,805,164 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,608,681 | SecuritiesAmt |
| Other | $8,454 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $196,483 | SecuritiesAmt |
| Other | -$8,454 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $188,029 | TotalRevenueColumnAmt |
| Exclusion | $188,029 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 722514 | $37,075 | $37,075 |
| MISCELLANEOUS | 900099 | $1,603 | $1,603 |
| MEDICAL RECORD COPIES | 900099 | $1,556 | $1,556 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $40,234 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,018,268 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,034,976 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,683 | UnrelatedBusinessRevenueAmt |
| Exclusion | $421,548 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,290 | TotalAmt |
| Program Services | $149,290 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,507 | TotalAmt |
| Management And General | $207,507 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,687 | TotalAmt |
| Program Services | $30,687 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,508,633 | TotalAmt |
| Program Services | $9,721,666 | ProgramServicesAmt |
| Management And General | $1,779,823 | ManagementAndGeneralAmt |
| Fundraising | $7,144 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,935 | TotalAmt |
| Program Services | $283,921 | ProgramServicesAmt |
| Management And General | $39,605 | ManagementAndGeneralAmt |
| Fundraising | $409 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,114,288 | TotalAmt |
| Program Services | $934,363 | ProgramServicesAmt |
| Management And General | $179,699 | ManagementAndGeneralAmt |
| Fundraising | $226 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $741,027 | TotalAmt |
| Program Services | $616,088 | ProgramServicesAmt |
| Management And General | $124,054 | ManagementAndGeneralAmt |
| Fundraising | $885 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,864 | TotalAmt |
| Management And General | $25,864 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548 | TotalAmt |
| Management And General | $548 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,718 | TotalAmt |
| Management And General | $51,718 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,208,849 | TotalAmt |
| Program Services | $1,800,771 | ProgramServicesAmt |
| Management And General | $407,205 | ManagementAndGeneralAmt |
| Fundraising | $873 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,578 | TotalAmt |
| Program Services | $452 | ProgramServicesAmt |
| Management And General | $49,126 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,656,458 | TotalAmt |
| Program Services | $1,499,075 | ProgramServicesAmt |
| Management And General | $156,070 | ManagementAndGeneralAmt |
| Fundraising | $1,313 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,354 | TotalAmt |
| Program Services | $22,560 | ProgramServicesAmt |
| Management And General | $10,751 | ManagementAndGeneralAmt |
| Fundraising | $43 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,736 | TotalAmt |
| Program Services | $261,337 | ProgramServicesAmt |
| Management And General | $109,998 | ManagementAndGeneralAmt |
| Fundraising | $401 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,184 | TotalAmt |
| Program Services | $174,974 | ProgramServicesAmt |
| Management And General | $64,210 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,210 | TotalAmt |
| Program Services | $13,979 | ProgramServicesAmt |
| Management And General | $7,231 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,515 | TotalAmt |
| Program Services | $4,515 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $824,717 | TotalAmt |
| Program Services | $557,818 | ProgramServicesAmt |
| Management And General | $265,839 | ManagementAndGeneralAmt |
| Fundraising | $1,060 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,439 | TotalAmt |
| Program Services | $237,681 | ProgramServicesAmt |
| Management And General | $12,758 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES & SUBSCRIPTIONS | $598,536 | $69,362 | $529,174 |
| MEDICAL SUPPLIES | $597,680 | $597,680 | |
| BAD DEBT EXPENSE | $590,761 | $590,761 | |
| AFFILIATE SUPPORT FEE | $479,430 | $103,509 | $375,921 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,211 | TotalAmt |
| Program Services | $60,632 | ProgramServicesAmt |
| Management And General | $27,579 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,168,155 | TotalAmt |
| Program Services | $17,731,121 | ProgramServicesAmt |
| Management And General | $4,424,680 | ManagementAndGeneralAmt |
| Fundraising | $12,354 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,050 | BOYAmt |
| EOY | $1,050 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,639,081 | BOYAmt |
| EOY | $1,252,303 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,399 | BOYAmt |
| EOY | $126,999 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,058,805 | BOYAmt |
| EOY | $3,675,139 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,909 | BOYAmt |
| EOY | $12,947 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $326,334 | BOYAmt |
| EOY | $331,438 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,708 | BOYAmt |
| EOY | $208,449 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,209,099 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,420,748 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,680,465 | BOYAmt |
| EOY | $4,788,351 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,301,204 | BOYAmt |
| EOY | $10,135,925 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,004 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,324,959 | BOYAmt |
| EOY | $20,532,601 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,510,015 | BOYAmt |
| EOY | $1,463,475 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,407 | BOYAmt |
| EOY | $59,097 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,337 | BOYAmt |
| EOY | $67,450 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,725,759 | BOYAmt |
| EOY | $1,590,022 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,599,200 | BOYAmt |
| EOY | $18,942,579 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,599,200 | BOYAmt |
| EOY | $18,942,579 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,324,959 | BOYAmt |
| EOY | $20,532,601 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$149,887 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $489,599 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $3,667 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $548 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $548 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING ACTIVITY EXPLANATION: ST. MARY'S HOSPITAL, INC. PAYS DUES TO A CERTAIN ORGANIZATION RELATED TO THE INDUSTRY WHICH HAS LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $645,702 | OtherCostOrOtherBasisAmt |
| Book Value | $645,702 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,677,206 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,412,136 | DepreciationAmt |
| Book Value | $2,265,070 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,572,659 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,001,261 | DepreciationAmt |
| Book Value | $1,571,398 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $313,532 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,351 | DepreciationAmt |
| Book Value | $306,181 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,788,351 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | POOLED INVESTMENT FUND | Desc |
| Book Value | $10,135,925 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $10,135,925 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| FIN 47 ASSET RETIREMENT OBLIGATION | $20,337 |
| PAYABLES TO RELATED TAX-EXEMPT ORGANIZATION | $47,113 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $67,450 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 160.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 310.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $484,887 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $484,887 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02250 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 153 | PersonsServedCnt |
| Total Community Benefit Expns | $1,957,443 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,679,010 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $278,433 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01290 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 153 | PersonsServedCnt |
| Total Community Benefit Expns | $2,442,330 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,679,010 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $763,320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03540 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 9360 | PersonsServedCnt |
| Total Community Benefit Expns | $6,384 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,384 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 15 | PersonsServedCnt |
| Total Community Benefit Expns | $107,912 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $107,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 1221 | PersonsServedCnt |
| Total Community Benefit Expns | $12,750 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 10596 | PersonsServedCnt |
| Total Community Benefit Expns | $127,046 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $127,046 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00590 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 10749 | PersonsServedCnt |
| Total Community Benefit Expns | $2,569,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,679,010 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $890,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04130 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $590,761 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $9,822 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,761,705 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,802,712 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$41,007 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 LEWISTON STREET | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SMH-CVHC.ORG | WebsiteAddressTxt |
| State License | 33 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.SMH-CVHC.ORG/GETPAGE.PHP?NAME=COMMUNITY_HEALTH | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTPS://WWW.ESSENTIAHEALTH.ORG/ABOUT/COMMUNITY-INVOLVEMENT/CHNA/ | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.SMH-CVHC.ORG/GETPAGE.PHP?NAME=COMMUNITY_HEALTH | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 160.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 310.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTAN | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTAN | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTAN | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ST. MARY'S HOSPITAL, INC. | PART V, SECTION B, LINE 5: IN 2011, THE HOSPITAL CONVENED A CONSORTIUM WITH REPRESENTATIVES FROM ALL HOSPITALS, CLINICS, PUBLIC HEALTH, TRIBAL HEALTH, AND SOCIAL SERVICE AGENCIES IN THE TRI-COUNTY SERVICE AREA. THIS CONSORTIUM REPRESENTS ALL EXISTING HEALTHCARE FACILITIES AND RESOURCES WITHIN THE COMMUNITY THAT ARE AVAILABLE TO RESPOND TO THE HEALTH NEEDS OF THE COMMUNITY. ADDITIONAL ORGANIZATIONS ARE ADDED AS NECESSARY AND ABLE WHEN ADDITIONAL NEEDS ARISE. ORGANIZATIONS REPRESENTED IN THIS CONSORTIUM INCLUDE: CLEARWATER COUNTY HUMAN NEEDS COUNCIL , CLEARWATER VALLEY HOSPITAL AND CLINICS, INC., THE HUMAN NEEDS COUNCIL (REGIONAL), NIMIIPUU HEALTH, PUBLIC HEALTH - IDAHO NORTH CENTRAL DISTRICT, SAINT ALPHONSUS REGIONAL MEDICAL CENTER, ST. MARY'S HOSPITAL, INC., AND SYRINGA HOSPITAL DISTRICT.ALL THE ABOVE ORGANIZATIONS PROVIDE INPUT FOR MINORITY POPULATIONS. NIMIIPUU HEALTH HAS SPECIAL INSIGHT INTO THE NEEDS OF NATIVE AMERICANS. FEW OTHER RACIAL, ETHNIC, OR LINGUISTIC MINORITIES LIVE IN THE AREA. OTHER ORGANIZATIONS SHARE THE MINORITY PERSPECTIVE OF THOSE WHO ARE GEOGRAPHICALLY ISOLATED.ORGANIZATIONS WITH SPECIAL INPUT INTO THE NEEDS OF THE MEDICALLY UNDERSERVED INCLUDE CLEARWATER VALLEY HOSPITAL AND CLINICS, INC., ST. MARY'S HOSPITAL, INC., NIMIIPUU HEALTH, PUBLIC HEALTH - IDAHO NORTH CENTRAL DISTRICT, AND SYRINGA HOSPITAL DISTRICT. THE HUMAN NEEDS COUNCILS HAVE SPECIAL INSIGHT INTO LOW-INCOME POPULATIONS.THE CONSORTIUM WAS INVOLVED IN THE CURRENT CHNA, INCLUDING ASSESSING AND PRIORITIZING HEALTH NEEDS AND DESIGNING THE IMPLEMENTATION STRATEGY. CONSORTIUM MEMBERS MEET REGULARLY. THE HUMAN NEEDS COUNCILS MEET MONTHLY, AND THE ENTIRE CONSORTIUM MEETS EVERY TWO TO THREE MONTHS. STANDING AGENDA ITEMS FOR THE CONSORTIUM INCLUDE LEARNING IN THE PRESENT, MAKING A DIFFERENCE TOGETHER, AND CREATING THE FUTURE.THE MAJORITY OF CLEARWATER, IDAHO, AND LEWIS COUNTIES ARE RURAL ACCORDING TO THE 2012 UWPHI COUNTY HEALTH RANKINGS DATA: 57.3% (CLEARWATER), 79.1% (IDAHO), AND 100% (LEWIS). GIVEN THE KNOWN HEALTH DISPARITIES OF RURAL POPULATIONS, ALL ATTENDEES OF THE CONSORTIUM MEETINGS ARE REPRESENTATIVES AND/OR MEMBERS OF MEDICALLY-UNDERSERVED AND LOW INCOME POPULATIONS, AS WELL AS POPULATIONS WITH CHRONIC DISEASE NEEDS. OUTSIDE THE BORDERS OF THE NEZ PERCE RESERVATION, THE SERVICE AREA POPULATION IS 93.5% CAUCASIAN.THE MEDICALLY-UNDERSERVED AND LOW-INCOME POPULATIONS ARE REPRESENTED BY OFFICERS OF COUNTY HUMAN NEEDS COUNCILS. THESE COUNCILS SERVE AS UMBRELLA NETWORKING ENTITIES FOR SOCIAL SERVICE, SCHOOLS, AND FAITH-BASED AGENCIES THROUGHOUT THE REGION. IN ADDITION, SURVEYS WERE OBTAINED FROM A SAMPLE OF PRE-DIABETIC ADULTS IN 2015.THE CHNA CONSORTIUM INCLUDES NIMIIPUU TRIBAL HEALTH TO ADDRESS THE NEEDS OF THE AREA'S NATIVE AMERICANS, ON AND OFF THE RESERVATION. MEMBERS OF NIMIIPUU TRIBAL HEALTH, REPRESENTING THE NEZ PERCE TRIBE, PARTICIPATED VIA EMAILS ON DEVELOPMENT OF THE ACTION PLAN AND ATTENDANCE AT EARLIER CONSORTIUM MEETINGS. MEETING PARTICIPANTS WERE SPECIFICALLY INSTRUCTED TO CONSIDER THEMSELVES REPRESENTATIVES OF THE COMMUNITY-AT-LARGE. THE CONSORTIUM HAS BEEN MEETING REGULARLY SINCE 2012.THE HOSPITAL DID NOT RECEIVE ANY COMMENTS ON THEIR PREVIOUS CHNA. ANY COMMENTS WOULD HAVE BEEN TAKEN INTO CONSIDERATION IN THE DEVELOPMENT OF THE CHNA. |
| ST. MARY'S HOSPITAL, INC. | PART V, SECTION B, LINE 6A: TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY, THE CHNA WAS CONDUCTED IN COLLABORATION WITH CLEARWATER VALLEY HOSPITAL AND CLINICS, INC., A RELATED ORGANIZATION. |
| ST. MARY'S HOSPITAL, INC. | PART V, SECTION B, LINE 6B: ST. MARY'S HOSPITAL, INC. PARTNERED WITH CLEARWATER COUNTY HUMAN NEEDS COUNCIL, THE REGIONAL HUMAN NEEDS COUNCIL, NIMIIPUU HEALTH, AND PUBLIC HEALTH - IDAHO NORTH CENTRAL DISTRICT. |
| ST. MARY'S HOSPITAL, INC. | PART V, SECTION B, LINE 11: THE OVER-ARCHING NEEDS OF THE COMMUNITY WERE IDENTIFIED AS:1. ACCESS TO CARE2. OBESITY AND OTHER CONTRIBUTORS TO CHRONIC DISEASE3. MENTAL HEALTH STATUS4. CANCERWHILE CANCER CARE IS AN IDENTIFIED NEED, THE HOSPITAL LACKS RESOURCES AND EXPERTISE TO COMPLETELY ADDRESS THIS NEED. WE WILL SEEK TO PROVIDE SCREENINGS AND WORK WITH PARTNERS AS APPROPRIATE TO FIND AFFORDABLE SOLUTIONS TO CANCER CARE.DUE TO THE PROXIMITY OF THE HOSPITALS AND THE OVERLAP IN THE PATIENTS AND COMMUNITIES SERVED, ST. MARY'S HOSPITAL, INC. AND CLEARWATER VALLEY HOSPITAL AND CLINICS, INC., AS RELATED ORGANIZATIONS, JOINTLY ADDRESSED THE ABOVE-MENTIONED COMMUNITY NEEDS. THE STATISTICS IN THIS DISCLOSURE ARE INCLUSIVE OF BOTH HOSPITALS.TO ADDRESS PRIORITY #1 (ACCESS TO CARE), THE HOSPITALS INCREASED THE NUMBER OF RESIDENTS WHO HAVE AT LEAST ONE ANNUAL HEALTH CONTACT THAT COULD RESULT IN A MEASURABLE IMPACT ON THEIR HEALTH. TO DO THIS, THE HOSPITALS CREATED A CORPS OF 11 COMMUNITY HEALTH WORKERS (CHWS) TO SERVE 3 IDAHO COUNTIES. THIS TEAM OF CHW'S HELD SCREENING EVENTS, AND, AS PART OF THE EVENTS, THEY PERFORMED HGBA1C TESTING; ADMINISTERED FIT TESTS SCREENING FOR COLON CANCER; AND CONDUCTED DEPRESSION, BODY MASS INDEX (BMI), AND BLOOD PRESSURE SCREENINGS. THEY WERE TRAINED TO LEAD CDSMP CLASSES (STANFORD CHRONIC DISEASE SELF-MANAGEMENT PROGRAM) AND REFERRED PATIENTS TO DSME (DIABETES SELF-MANAGEMENT EDUCATION) AND DPP (DIABETES PREVENTION PROGRAM) CLASSES WHICH WERE CONDUCTED BY OUR PARTNERS. THEY CREATED WALKING EVENTS AND ASSISTED IN DEVELOPING TRAILS, COMMUNITY GARDENS AND EDUCATION CENTERS. A CORPS OF COMMUNITY HEALTH WORKERS VARYING FROM 3.0 TO 4.25 FTE (FULL-TIME EQUIVALENT) STAFF CONDUCTED OUTREACH EVENTS OVER A TRI-COUNTY REGION FROM MAY 2017 TO APRIL 2018. EVENTS WERE COORDINATED WITH PUBLIC HEALTH, TRIBAL HEALTH, AND MULTIPLE SOCIAL SERVICE AGENCIES. THEY WERE CONDUCTED IN SETTINGS WHICH INCLUDED FOOD BANKS, WORKPLACES, SENIOR CENTERS, AND EVEN LIVESTOCK AUCTIONS. RESIDENTS WERE SCREENED FOR AT LEAST ONE OF THE FOLLOWING: BLOOD PRESSURE, BODY MASS INDEX, A1C (BLOOD SUGAR), COLON CANCER, DEPRESSION, ACCESS TO PRIMARY CARE PROVIDER, AND HEALTH INSURANCE STATUS. 1,620 INDIVIDUALS, ABOUT 6% OF THE TOTAL POPULATION, ATTENDED THESE OUTREACH EVENTS. COMMUNITY HEALTH WORKERS PROVIDED 844 BLOOD PRESSURE CHECKS, AND 882 BLOOD SUGAR TESTS FOR DIABETES. THE FIT TEST TARGET WAS MET WITH 136 TESTS BEING DONE FOR COMMUNITY MEMBERS. 196 PARTICIPANTS REQUESTED ASSISTANCE IN ESTABLISHING CARE IN A PATIENT-CENTERED MEDICAL HOME; 181 OF THOSE REQUESTS WERE FILLED WITHIN 2 MONTHS. THE CHW'S SCREENED NEARLY 1600 PEOPLE AT OVER 91 EVENTS FROM MAY 2017 THROUGH APRIL 2018, REACHING APPROXIMATELY 6% OF THE POPULATION IN THE TRI-COUNTY AREA. AFTER JUNE 2017, WHEN A NEW SCREENING QUESTION WAS ADDED, IT WAS DISCOVERED THAT MORE THAN 100 OF THOSE SCREENED HAD NOT SEEN A DOCTOR IN THE PREVIOUS 3 YEARS. TO ALSO ADDRESS PRIORITY #1, THE HOSPITALS PLAN TO IMPROVE THE RATE OF RESIDENTS WHO OBTAIN, RETAIN, AND USE HEALTH INSURANCE. THE HOSPITALS WILL PARTNER WITH LOCAL INSURANCE BROKERS, THE STATE AFFORDABLE CARE ACT MARKETPLACE, AND CHNA CONSORTIUM MEMBERS TO PROVIDE NAVIGATION SERVICES TO EXISTING RESOURCES. THE PARTNERSHIP WILL DO THIS BY IMPLEMENTING A BENEFITS COUNSELOR PROGRAM.AS OF DECEMBER 2016, A FULL-TIME BENEFITS COUNSELOR HAD BEEN HIRED TO SERVE IDAHO, LEWIS, AND CLEARWATER COUNTIES. THE COUNSELOR IS FAR EXCEEDING HER TARGETS. FROM MAY 2017 TO APRIL 2018 SHE HAS ASSISTED 2,103 PEOPLE WITH ENROLLING, RETAINING, OR USING THEIR INSURANCE COVERAGE. 319 PREVIOUSLY UNINSURED INDIVIDUALS ATTAINED HEALTH INSURANCE COVERAGE. AN ADDITIONAL 769 PEOPLE VERIFIED RENEWAL OF INSURANCE COVERAGE. IN ADDITION TO THE TARGET NUMBERS, THE HUMAN IMPACT OF THE PROGRAM IS HIGH.TO ADDRESS PRIORITY #2 (OBESITY AND OTHER CONTRIBUTORS TO CHRONIC DISEASE), THE HOSPITALS PLAN TO BUILD COMMUNITY WELLNESS RESOURCES. TO DO THIS, THE HOSPITALS ARE PARTNERING WITH CHNA CONSORTIUM MEMBERS TO INCREASE HEALTH LITERACY AND THE USE OF HEALTH RESOURCES AMONG RESIDENTS. ACTIONS TAKEN BY THIS PARTNERSHIP WILL INCLUDE: 1) IMPROVING RESIDENTS' KNOWLEDGE OF HEALTHY EATING, ACTIVE LIVING, AND OTHER PREVENTION MEASURES AND 2) INTRODUCING AND MARKETING WELLNESS CLASSES AND OTHER INITIATIVES, INCLUDING THE DIABETES PREVENTION PROGRAM AND COMMUNITY GARDENS TO MULTIPLE COMMUNITIES.ALL PARTICIPANTS WHO WERE SCREENED AT OUTREACH EVENTS RECEIVED PREVENTION AND SELF-CARE GUIDANCE WHICH CORRESPONDED WITH THEIR PERSONAL LEVEL OF RISK. THE GUIDANCE INCLUDED LINKS TO COMMUNITY-BASED WELLNESS RESOURCES. 739 ATTENDEES AGREED TO BE SCREENED FOR OBESITY.CHWS WILL SERVE AS "EARLY DETECTION AGENTS, AND REPRESENT A WARM FRONT DOOR INTO PRIMARY CARE. SCREENING WILL IDENTIFY RESIDENTS AT MODERATE TO HIGH RISK FOR CHRONIC DISEASE. THESE INDIVIDUALS WILL RECEIVE REFERRALS TO AN APPROPRIATE LEVEL OF PROVIDER, WITH A TIMELINE TO BE SEEN (E.G. WITHIN 24 HOURS, WITHIN TWO MONTHS). CHWS WILL SUPPORT PARTICIPANTS TO CLEAR SOCIO-ECONOMIC BARRIERS TO BEING SEEN INSURANCE, TRANSPORTATION, SCHEDULING. IMPROVED ACCESS TO PRIMARY CARE, INCLUDING HRSA-FUNDED MEDICAL HOME PLUS CLINICS, WILL LEAD TO MORE TIMELY INTERVENTIONS AND BETTER-CONTROLLED CONDITIONS. TIMELY ACCESS TO CARE WILL LEAD TO IMPROVED POPULATION HEALTH OUTCOMES AND POPULATION HEALTH STATUS OVER TIME HEALTHIER INDIVIDUALS AND HEALTHIER COMMUNITIES.THERE WERE FOUR COHORTS OF THE CDC-APPROVED NATIONAL DIABETES PREVENTION PROGRAM OFFERED IN TWO DIFFERENT LOCATIONS FROM MAY 2017 THROUGH APRIL 30, 2018. A TOTAL OF 24 PARTICIPANTS WERE INVOLVED IN THOSE COHORTS WITH AVERAGE ATTENDANCE OF 17 OUT OF 24 SESSIONS. THAT GIVES AN AVERAGE TOTAL OF MEETINGS ATTENDED AT 884. FINALLY, THREE EVENTS WERE HELD IN CONJUNCTION WITH ELEMENTARY SCHOOLS INVOLVING 54 FAMILIES OF ELEMENTARY SCHOOL CHILDREN. EDUCATION WAS ON HEALTHY MEAL PLANNING AND SHOPPING ON A BUDGET AS WELL AS FAMILY FUN ACTIVITIES FOR INCREASED ENGAGEMENT OF THE WHOLE FAMILY IN PHYSICAL ACTIVITY.TO ADDRESS PRIORITY #3 (MENTAL HEALTH STATUS), THE HOSPITALS PLAN TO IMPROVE AWARENESS, SCREENING, AND ACCESS TO CARE BY PARTNERING WITH ST. ALPHONSUS, THE UNIVERSITY OF UTAH, AND CHNA CONSORTIUM MEMBERS. THIS PARTNERSHIP WILL CONDUCT SCREENINGS AND ENHANCE ACCESS TO CARE THROUGH THE FOLLOWING ACTIONS: 1) CONDUCT SCREENINGS IN CLINICS AND AT HEALTH FAIRS AND OUTREACH EVENTS AND 2) PROVIDING ACCESS TO PSYCHIATRISTS VIA TELEHEALTH.FROM MAY 2017 TO APRIL 2018, 692 OUTREACH INDIVIDUALS WERE SCREENED FOR MENTAL HEALTH STATUS. THESE PARTICIPANTS ALL RECEIVED SELF-CARE GUIDANCE BASED ON THEIR RISK LEVELS, AS WELL AS LINKS TO COMMUNITY RESOURCES.BETWEEN MAY 2017 AND APRIL 2017, 216 TELEPSYCH VISITS WERE CONDUCTED AT CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. AND ST. MARY'S HOSPITAL, INC. THIS PROVIDED HELP THAT PEOPLE WOULD HAVE OTHERWISE HAD TO DRIVE FOR 6 HOURS TO RECEIVE. |
| ADDITIONAL DISCLOSURES NOT REQUIRED FOR PART V, SECTION C: | SCHEDULE H, PART V, SECTION B, LINE 3E:ST. MARY'S HOSPITAL, INC. CHOSE TO ADDRESS THREE PRIORITY HEALTH NEEDS BASED ON STAKEHOLDER GROUP FEEDBACK. THE NEEDS ARE NOT RANKED IN ORDER, ALL THREE HEALTH NEEDS ARE CONSIDERED PRIORITIES. THE HOSPITAL WILL WORK ON ADDRESSING EACH NEED SIMULTANEOUSLY.SCHEDULE H, PART V, SECTION B, LINE 7A:THE CHNA IS POSTED AT: HTTP://WWW.SMH-CVHC.ORG/GETPAGE.PHP?NAME=COMMUNITY_HEALTH.SCHEDULE H, PART V, SECTION B, LINE 7B:THE CHNA IS ALSO POSTED AT: HTTPS://WWW.ESSENTIAHEALTH.ORG/ABOUT/COMMUNITY-INVOLVEMENT/CHNA/.SCHEDULE H, PART V, SECTION B, LINE 10A:THE HOSPITAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS INCLUDED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT POSTED AT: HTTP://WWW.SMH-CVHC.ORG/GETPAGE.PHP?NAME=COMMUNITY_HEALTH.SCHEDULE H, PART V, SECTION B, LINE 16I:DUE TO THE SMALL SIZES OF THE LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS OF THE COMMUNITIES SERVED BY THE ORGANIZATION, THE ORGANIZATION WAS NOT REQUIRED TO TRANSLATE THE FINANCIAL ASSISTANCE POLICY (FAP), THE FAP APPLICATION FORM, OR THE PLAIN LANGUAGE SUMMARY OF THE FAP TO OTHER LANGUAGES. EVEN THOUGH IT WAS NOT REQUIRED, THE ORGANIZATION TRANSLATED THE FAP APPLICATION FORM INTO SPANISH. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ST MARY'S COTTONWOOD MEDICAL CLINIC | ||||
| 701 LEWISTON ST | COTTONWOOD | ID | 83522 | MULTI-SPECIALTY CLINIC |
| 2 - ST MARY'S KAMIAH MEDICAL CLINIC | ||||
| 518 OAK | KAMIAH | ID | 83536 | MULTI-SPECIALTY CLINIC |
| 3 - ST MARY'S GRANGEVILLE MEDICAL CLINIC | ||||
| 617 W N 2ND STE 2 | GRANGEVILLE | ID | 83530 | MULTI-SPECIALTY CLINIC |
| 4 - ST MARY'S KAMIAH PHYSICAL THERAPY | ||||
| 619 4TH ST | KAMIAH | ID | 83536 | PHYSICAL THERAPY CLINIC |
| 5 - ST MARY'S GRANGEVILLE PHYSICAL THERAPY | ||||
| 617 W N 2ND STE 1 | GRANGEVILLE | ID | 83530 | PHYSICAL THERAPY CLINIC |
| 6 - ST MARY'S CRAIGMONT MEDICAL CLINIC | ||||
| 320 N DIVISION | CRAIGMONT | ID | 83523 | PRIMARY CARE CLINIC |
| 7 - ST MARY'S NEZPERCE MEDICAL CLINIC | ||||
| 501 OAK | NEZPERCE | ID | 83543 | MULTI-SPECIALTY CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. TO BE ELIGIBLE, REPORTABLE ASSETS MAY NOT EXCEED $25,000 FOR A HOUSEHOLD OF ONE (1), OR $50,000 FOR A HOUSEHOLD OF TWO (2) OR MORE. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRA'S, 401(K)'S, HSA/HRA, AND ADDITIONAL PROPERTY, ETC. |
| PART I, LINE 6A: | THE ORGANIZATION'S COMMUNITY BENEFIT INFORMATION IS INCLUDED ON ESSENTIA HEALTH'S (EMPLOYER IDENTIFICATION NUMBER 20-0360007) WEBSITE AT WWW.ESSENTIAHEALTH.ORG. ESSENTIA HEALTH, HEADQUARTERED IN DULUTH, MINNESOTA, IS THE PARENT OF A FULLY INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, WISCONSIN, NORTH DAKOTA AND IDAHO. |
| PART I, LINE 7: | THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE THE COSTS FOR THE FOLLOWING COMMUNITY BENEFITS: CHARITY CARE AND UNREIMBURSED MEDICAID. ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $590,761. |
| PART III, LINE 2: | DISCOUNTS, CHARITY CARE, AND BAD DEBT EXPENSE ARE ACCOUNTED FOR AS REDUCTIONS TO REVENUE. BAD DEBT EXPENSE ON PATIENT ACCOUNTS WOULD BE IDENTIFIED AS ANY BALANCE ON THE ACCOUNT, LESS ANY PREVIOUS PAYMENTS AND DISCOUNTS, THAT HAS AGED AND IS ABSENT OF ANY PAYMENTS. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. |
| PART III, LINE 3: | ST. MARY'S HOSPITAL, INC. APPLIED A HIGH-LEVEL, CONSERVATIVE ANALYTIC REVIEW BY MULTIPLYING THE RATIO OF CHARITABLE ALLOWANCES TO GROSS PATIENT REVENUE AGAINST BAD DEBT EXPENSE TO ARRIVE AT AN APPROXIMATION OF CHARITY CARE THAT RESIDES IN BAD DEBT.ST. MARY'S HOSPITAL, INC. IS A PART OF A LARGER ORGANIZATION, ESSENTIA HEALTH. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, ESSENTIA HEALTH MAKES QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS. |
| PART III, LINE 4: | PAGE 11 OF THE AUDIT CONTAINS THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE METHODOLOGY USED IN DETERMINING THE REPORTED MEDICARE ALLOWABLE COST BEGINS WITH THE HOSPITAL'S GENERAL LEDGER SYSTEM. THE COSTS ARE OBTAINED FROM THE GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES, AND MEDICAL EDUCATION, ARE REMOVED AND REPORTED SEPARATELY.EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR:EACH ESSENTIA HEALTH HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE.THE EXTENT TO WHICH ANY SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AND THE RATIONALE FOR THE ORGANIZATION'S OPINION:ST. MARY'S HOSPITAL, INC. IS A PART OF A LARGER ORGANIZATION, ESSENTIA HEALTH. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE THE FULL VALUE OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. THE RATIONALE FOR THE ORGANIZATION'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE AND IT IS LIKELY TO GET WORSE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. |
| PART III, LINE 9B: | THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR ESSENTIA HEALTH'S FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM ESSENTIA HEALTH, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS. THE ORGANIZATION OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR REPORT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS.THE ORGANIZATION WILL NOT CHARGE A PATIENT GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS.AT ANY TIME THE ORGANIZATION RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE ORGANIZATION CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS.AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE.THE ORGANIZATION TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO ESSENTIA HEALTH.IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE ORGANIZATION AND ITS OUTSIDE DEBT COLLECTION AGENCIES SUSPEND ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND ESSENTIA HEALTH HAS NOTIFIED THE PATIENT OF ITS DECISION. |
| PART VI, LINE 2: | NEEDS ASSESSMENT:WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH MANY WAYS INCLUDING THE FOLLOWING:MARKETING RESEARCH - CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. AND ST. MARY'S HOSPITAL, INC. REVIEW INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USE(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (E.G., PRIMARY CARE), PAYOR INFORMATION, AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN STRATEGIC PLANS FOR GROWING SERVICES, AS WELL AS, CHANGES TO INTERNAL PROCESSES FOR HEALTH CARE ACCESS. POPULATION CARE MANAGEMENT - WE REGULARLY COMPARE OUR HEALTH RANKINGS AND RATINGS TO STATE AND NATIONAL DATA TO IDENTIFY GREATEST AREAS OF HEALTH CARE NEEDS. WE PREPARE INTERVENTIONS TARGETED TO AREAS OF GREATEST NEED, SUCH AS UNCONTROLLED DIABETES OR PRE-DIABETES. WE THEN MEASURE THE EFFECT OF INTERVENTIONS COMPARED TO OVERALL COUNTY RANKINGS. WE USE THIS DATA TO ASSESS THE IMPLICATIONS OF EXPANDING PILOT PROGRAMS. PLANNED INTERACTION WITH VARIOUS COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS - AN UMBRELLA COALITION OF COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS MEETS REGULARLY TO SHARE PERSPECTIVES ON COMMUNITY NEEDS AND THE ROLE ESSENTIA HEALTH CAN PLAY IN ADDRESSING THOSE NEEDS AS A COLLABORATIVE PARTNER. INTERACTIONS HAVE RESULTED IN SUCCESSFUL PROGRAMS FOR NURSE CASE MANAGEMENT, COMMUNITY REFERRAL COORDINATOR, COMMUNITY HEALTH WORKER, AND BENEFITS COUNSELOR POSITIONS.INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEAD TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS INCLUDES PATIENT ACTIVITY AND OUTCOMES, ALLOWING FOR ESSENTIA HEALTH TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS, WHICH CAN BE UTILIZED TO ASSESS THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. HEALTH DATA PROVIDED BY PAYOR ORGANIZATIONS, NAMELY GOVERNMENT AND COMMERCIAL HEALTH INSURERS - THIS HEALTH DATA TYPICALLY INVOLVES MEDICAL TREATMENT AND OUTCOMES THAT REFLECT TRENDS OF UNHEALTHY LIFESTYLES AND BEHAVIORS. OUR OBJECTIVE IS TO UNDERSTAND THESE RELATIONSHIPS AND TO DEVELOP ACTION STEPS TO INTERVENE ON THE FRONT END TO PREVENT SUCH MEDICAL SITUATIONS FROM OCCURRING. EXAMPLES INCLUDE MANAGEMENT OF CARDIOVASCULAR HEALTH AND OPIOID USE. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ORGANIZATION MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO THE PATIENT. INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS IS AVAILABLE ON THE ESSENTIA HEALTH WEBSITE (WWW.ESSENTIAHEALTH.ORG, SELECT PATIENTS & VISITORS) WHERE THE INFORMATION AND APPLICATION IS EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED AND PRINTED AT NO CHARGE TO THE PATIENT. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN ALL COLLECTION LETTERS AND PATIENT STATEMENTS. FAP INFORMATION AND/OR APPLICATIONS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. THE ORGANIZATION EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING AND COLLECTIONS, ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION. CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES (FINANCIAL COUNSELORS & PATIENT ACCOUNTS REPRESENTATIVES) HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING THAT THE PATIENT MAY BE ELIGIBLE FOR THIS PROGRAM. PATIENT ADVOCACY SERVICES ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF ASSISTANCE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. THE ORGANIZATION RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY. |
| PART VI, LINE 4: | COMMUNITY INFORMATION:ST. MARY'S HOSPITAL, INC. IS LOCATED IN COTTONWOOD, ID. ST. MARY'S HOSPITAL, INC. IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. ST. MARY'S HOSPITAL, INC. OPERATES 1 HOSPITAL AND 7 CLINICS THAT SERVE THE COMMUNITIES OF IDAHO, LEWIS AND CLEARWATER COUNTIES COVERING 2,400 SQUARE MILES. THE OVERALL COMMUNITY IS CLASSIFIED AS RURAL.ST. MARY'S HOSPITAL, INC. COVERS A SERVICE AREA OF APPROXIMATELY 27,000 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 19% UNDER THE AGE OF 18; 56% BETWEEN THE AGES OF 18 AND 65; AND 25% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 91% CAUCASIAN; 3% HISPANIC; AND 6% OTHER. THE GENDER SPLIT RATIO IS 48% WOMEN AND 52% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $40,000.ST. MARY'S HOSPITAL, INC., AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 3.5% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 9.1% FROM MEDICAID RECIPIENTS. IDAHO AND LEWIS COUNTIES ARE CURRENTLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS.AS MENTIONED ABOVE, ST. MARY'S HOSPITAL, INC. IS PART OF ESSENTIA HEALTH. ESSENTIA HEALTH STAFFS HOSPITALS AND CLINICS IN FEDERALLY-RECOGNIZED UNDERSERVED AREAS AND SUPPORTS THE HEALTH OF ITS COMMUNITIES THROUGH AN ACTIVE OUTREACH PROGRAM THAT BRINGS SPECIALISTS LIKE ONCOLOGISTS, CARDIOLOGISTS, NEUROLOGISTS AND OTHERS INTO ITS SMALLER COMMUNITIES. THIS ELIMINATES BARRIERS TO CARE FOR MANY PATIENTS, PARTICULARLY THOSE WHO ARE ELDERLY, LIVING ON LOW INCOMES, OR ARE FACED WITH OTHER CHALLENGES THAT MAKE IT DIFFICULT TO TRAVEL LONG DISTANCES FOR CARE.THERE ARE 4 OTHER HOSPITALS OUTSIDE OF THE ESSENTIA HEALTH UMBRELLA THAT SERVICE THE COMMUNITY. |
| PART VI, LINE 5: | PROMOTION OF COMMUNITY HEALTH:ST. MARY'S HOSPITAL, INC.'S BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE COMMUNITIES IT SERVES. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO ARE PROPERLY SCREENED. ALL APPLICANTS THAT APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE FACILITY'S GOVERNING BOARD IN ORDER TO PROVIDE SERVICES AT THE HOSPITAL. IN ADDITION, THE HOSPITAL SERVES AS A CLINICAL PRACTICE SITE FOR MANY STUDENTS IN X-RAY TECHNOLOGY, NURSING, PHYSICIAN ASSISTANT, NURSE PRACTITIONER, AND MEDICAL RESIDENCY PROGRAMS. THIS IS ESPECIALLY IMPORTANT BECAUSE IDAHO HAS ONE OF THE LOWEST PHYSICIAN PER CAPITA RATES IN THE NATION.ST. MARY'S HOSPITAL, INC.'S REGULARLY REVIEWS FACILITIES AND EQUIPMENT AND DEVELOPS AN ATTRITION PROCESS TO REPLACE AGING PLANT OPERATIONS AND EQUIPMENT. WE ALSO LOOK FOR OPPORTUNITIES TO BRING NEW SERVICES TO THE COMMUNITIES VIA INVESTING IN NEW SKILLS AND TECHNOLOGY WHERE APPROPRIATE.ST. MARY'S HOSPITAL, INC.'S ENGAGED COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF LOCAL EVENTS AND COMMUNITY PROGRAMS. THESE INCLUDE THE FORMATION OF COMMUNITY AND SCHOOL GARDENS, HEALTH TALKS, SPONSORSHIP OF RACES, AND PARTICIPATION IN COUNTY FAIR ACTIVITIES. WE PROMOTE BETTER MENTAL HEALTH BY BRINGING CHILD AND ADULT PSYCHIATRISTS TO OUR FRONTIER COMMUNITIES USING TELEMEDICINE. THIS MODEL HAS WON STATE AND NATIONAL AWARDS FOR INNOVATION IN REACHING THE MEDICALLY UNDERSERVED. WE ARE ALSO ACTIVE PARTICIPANTS IN NATIONAL DEMONSTRATION PROJECTS AND OTHER COLLABORATIONS TO PROVIDE AN EVIDENCE BASE FOR EFFECTIVE PROCESSES TO PROMOTE RURAL HEALTH.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, SOME OTHER PROJECTS UNDERTAKEN BY THE ORGANIZATION'S NAME INCLUDE THE FOLLOWING:MOST MONTHS WE HAVE AN OVERALL THEME TARGETING A CHRONIC DISEASE STATE WITH SPECIAL PROGRAMS AND OUTREACH TO OUR COMMUNITIES (E.G., FEBRUARY IS HEART MONTH, OCTOBER IS BREAST CANCER AWARENESS, NOVEMBER IS DIABETES, ETC.). DOC TALKS ARE GEARED TO THE MONTHLY THEME WITH SCREENINGS AND INFORMATION PROVIDED AT THE EVENTS. OUR CARE MANAGERS, REFERRAL COORDINATORS, AND QUALITY DIRECTOR ARE ESPECIALLY ACTIVE IN COORDINATING THESE ACTIVITIES AND REACHING OUT TO PATIENTS WHO MAY NOT BE AWARE OF THE SERVICES OFFERED. COLON CANCER AWARENESS AND SCREENING HAS BEEN A MAJOR OUTREACH EFFORT AT HEALTH FAIRS, LOCAL BAZAARS, SOME OF THE FARMER'S MARKET DAYS, AND WITHIN ALL OF THE CLINICS OVER THE PAST YEAR. ASTHMA EDUCATION AND SMOKING CESSATION ARE ONGOING TOPICS OF CONVERSATION AND SPECIAL EVENTS ARE SCHEDULED AROUND THESE EFFORTS IN COLLABORATION WITH THE LOCAL PUBLIC HEALTH DEPARTMENT. THE HOSPITAL IS AN ACTIVE PARTICIPANT IN ATTENDING AND SITTING ON THE BOARDS OF THE LOCAL HUMAN NEED COUNCILS WITHIN THE SERVICE AREAS. WE HAVE A PRESENCE ON MULTIPLE COALITIONS THROUGHOUT NORTHERN AND NORTH CENTRAL IDAHO. THIS IS OFTEN ACCOMPLISHED BY PHONE CONFERENCING IN ORDER TO PARTICIPATE IN THE DISCUSSIONS AND GROWTH WITHOUT INCURRING TRAVEL EXPENSE. WE ARE ALSO ACTIVELY ENGAGED IN STATE COALITIONS ON CHRONIC DISEASE (OFTEN SEEN AS MENTORS WITHIN THESE GROUPS FOR THE ACCOMPLISHMENTS ACHIEVED OVER THE PAST FEW YEARS). FUNDRAISERS AND VOLUNTEER EFFORTS ARE ESTABLISHED AND ONGOING WITH LOCAL FOOD BANKS, CLOTHING DISTRIBUTION DRIVES, AND OTHER VOLUNTEERS THAT ARE GEARED AROUND NATURAL DISASTERS AND OTHER NEEDS WITHIN OUR AREA. EFFORTS ARE BEING MADE TO BRING SAFE WALKING AND BIKE TRAILS TO COMMUNITIES WITHIN OUR SERVICE AREAS. A RESULT OF ALMOST EVERY SURVEY AND CONVERSATION IS THAT THE COMMUNITIES WANT MORE WAYS TO ENGAGE SAFELY IN PHYSICAL ACTIVITY AT LITTLE OR NO EXPENSE.ST. MARY'S HOSPITAL, INC. IS A PART OF ESSENTIA HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH FACILITIES IN MINNESOTA, WISCONSIN, NORTH DAKOTA, AND IDAHO. AS A NON-PROFIT ORGANIZATION, ESSENTIA HEALTH REINVESTS SURPLUS REVENUES INTO MEDICAL TRAINING, PROGRAMS, AND TECHNOLOGY DESIGNED TO REDUCE THE RISK OF PREVENTABLE HARM TO OUR PATIENTS AND INCREASE THE HEALTH AND VITALITY OF COMMUNITIES WE SERVE. ESSENTIA HEALTH PROVIDES SERVICES PREDOMINANTLY IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. MANY OF ESSENTIA HEALTH'S CLINICS AND COMMUNITY HOSPITALS ARE LOCATED IN COMMUNITIES THAT ARE FEDERALLY RECOGNIZED AS BEING MEDICALLY UNDERSERVED. WE INVEST IN FACILITY UPGRADES, TECHNOLOGY, AND STAFFING THAT ENHANCE CARE IN THESE COMMUNITIES TO ENSURE PATIENTS CAN RECEIVE AS MUCH CARE AS POSSIBLE CLOSE TO HOME - A VITAL COMPONENT OF COMMUNITY HEALTH IN AREAS WHERE RESIDENTS ARE OFTEN ELDERLY, LIVING ON LIMITED INCOMES, AND RESTRICTED IN THEIR TRANSPORTATION OPTIONS.RESIDENTS OF GEOGRAPHICALLY ISOLATED COMMUNITIES SERVED BY ESSENTIA HEALTH ALSO BENEFIT FROM TELEHEALTH SERVICES THAT PROVIDE LOCAL ACCESS TO SPECIALISTS AND SPECIALTY SERVICES USUALLY AVAILABLE ONLY IN LARGER URBAN AREAS. SERVICES ARE AVAILABLE IN MORE THAN 20 SPECIALTIES, RANGING FROM CARDIOLOGY AND BEHAVIORAL HEALTH TO SPEECH THERAPY AND MEDICAL WEIGHT LOSS. PATIENTS TREATED IN A NUMBER OF ESSENTIA HEALTH EMERGENCY DEPARTMENTS BENEFIT FROM TELEHEALTH CONNECTIONS THAT ALLOW COMMUNITY HOSPITAL PHYSICIANS AND NURSES TO COMMUNICATE WITH TRAUMA AND OTHER SPECIALISTS LOCATED IN ESSENTIA HEALTH'S LARGER HOSPITALS.ESSENTIA HEALTH WAS ONE OF THE FIRST ACCOUNTABLE CARE ORGANIZATIONS (ACO) IN THE COUNTRY TO RECEIVE THE HIGHEST LEVEL OF ACCREDITATION FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). AS AN ACO, ESSENTIA HEALTH IS COMMITTED TO MEETING THE TRIPLE AIM OF IMPROVING CARE AND POPULATION HEALTH, WHILE REDUCING THE OVERALL COSTS FOR PATIENTS AND SOCIETY AS A WHOLE. ONE OF THE NEWEST PROGRAMS UNDER THE ACO IS A POPULATION CARE MANAGEMENT TEAM OF REGISTERED NURSES WHO CAREFULLY REVIEW MEDICAL HISTORIES OF HIGH-RISK PATIENTS ON GOVERNMENT ASSISTANCE PROGRAMS TO ENSURE THEY ARE GETTING THE CARE NEEDED TO KEEP THEM HEALTHY AND OUT OF THE HOSPITAL. PATIENTS WITH MULTIPLE HIGH-RISK CONDITIONS (E.G. DIABETES, CONGESTIVE HEART FAILURE, MENTAL HEALTH ISSUES) AND THOSE WHO HAVE NOT RECENTLY RECEIVED CARE ARE CONNECTED WITH PRIMARY CARE CLINICIANS, NURSES, SPECIALISTS, THERAPISTS, AND OTHERS WHO CAN PROVIDE ADDITIONAL CARE, THERAPY, OR EDUCATION. THE GOAL IS IMPROVING PATIENTS' HEALTH AND REDUCING THE LIKELIHOOD OF HOSPITALIZATIONS OR OTHER HIGH-COST CARE. SINCE A MAJORITY OF HEALTHCARE COSTS ARE DIRECTLY RELATED TO CARING FOR PATIENTS WHO HAVE CHRONIC CONDITIONS, ESSENTIA HEALTH IS COMMITTED TO IMPROVING HEALTH OUTCOMES FOR PATIENTS, ESPECIALLY THOSE WITH CHRONIC DISEASES. FOR EXAMPLE, ESSENTIA HEALTH NOW OFFERS ONE-ON-ONE TOBACCO CESSATION COUNSELING AT 37 SITES ACROSS MINNESOTA, WISCONSIN, AND NORTH DAKOTA. THESE SITES COVER A WIDE GEOGRAPHY, FROM SMALL RURAL COMMUNITIES TO LARGER URBAN AREAS, AND OFTEN SERVE PEOPLE LIVING ON LOW AND MODERATE INCOMES. IN CASES WHERE THESE SERVICES ARE NOT COVERED BY PRIVATE OR GOVERNMENT INSURANCE OR PROGRAMS, ESSENTIA HEALTH COVERS THE REMAINING COSTS.DOZENS OF ESSENTIA HEALTH NURSES AND DIABETES EDUCATORS ARE ALSO INVOLVED IN DIABETES EDUCATION, PREVENTION, AND OUTREACH PROGRAMS IN THE COMMUNITIES ESSENTIA HEALTH SERVES. THEIR WORK HAS BEEN RECOGNIZED BY A NUMBER OF COMMENDATIONS AND AWARDS FROM GOVERNMENT AGENCIES AND DIABETES ORGANIZATIONS. THESE COMMUNITY-BASED EFFORTS ARE FREE TO THE PUBLIC AND ALL INDIVIDUALS ARE WELCOME.ESSENTIA HEALTH SUPPORTS THE HEALTH OF OUR COMMUNITIES THROUGH ACTIVE RESEARCH AND CLINICAL TRIALS THROUGH THE ESSENTIA INSTITUTE OF RURAL HEALTH (INSTITUTE). THE INSTITUTE CONDUCTS CLINICAL, TRANSLATIONAL, AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. VARIOUS ESSENTIA HEALTH ORGANIZATIONS CONTRIBUTED APPROXIMATELY $3.9 MILLION IN SUPPORT TO THE INSTITUTE DURING THE PAST YEAR. ESSENTIA HEALTH IS ALSO A PRIMARY SUPPORTER OF MEDICAL EDUCATION, PARTICULARLY IN THE AREA OF RURAL PRIMARY CARE. ESSENTIA HEALTH PHYSICIANS SERVE AS FACULTY AND PRECEPTORS FOR THE UNIVERSITY OF MINNESOTA SCHOOL OF MEDICINE IN DULUTH, MN. ESSENTIA HEALTH ALSO PROVIDES FUNDING, ADMINISTRATIVE SUPPORT, AND RESIDENCY OPPORTUNITIES FOR THE DULUTH FAMILY PRACTICE RESIDENCY PROGRAM. THIS PROGRAM IS VITAL IN ADDRESSING THE GROWING SHORTAGE OF PRIMARY CARE PHYSICIANS IN RURAL COMMUNITIES. |
| PART VI, LINE 6: | AFFILIATED HEALTH CARE SYSTEM:ST. MARY'S HOSPITAL, INC. IS PART OF ESSENTIA HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH 15 HOSPITALS, MORE THAN 70 CLINICS, SIX LONG-TERM CARE FACILITIES, THREE ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SIX AMBULANCE SERVICES, AND ONE RESEARCH INSTITUTE IN FOUR STATES: MINNESOTA, WISCONSIN, NORTH DAKOTA AND IDAHO. ESSENTIA HEALTH SERVES A PREDOMINANTLY RURAL POPULATION WHOSE MEDIAN INCOMES GENERALLY FALL BELOW AVERAGES OF THE STATES WHERE THEY LIVE. THE PRESENCE OF OUR CLINICS AND HOSPITALS ENSURES THAT PEOPLE WITH FEW ECONOMIC RESOURCES DO NOT HAVE TO DRIVE AN HOUR OR MORE TO RECEIVE BASIC (AND IN SOME CASES LIFESAVING) MEDICAL CARE.IN ADDITION TO STAFFING HOSPITALS AND CLINICS IN FEDERALLY RECOGNIZED UNDERSERVED AREAS, ESSENTIA HEALTH SUPPORTS THE HEALTH OF COMMUNITIES THROUGH ACTIVE OUTREACH PROGRAMS THAT BRING ONCOLOGISTS, CARDIOLOGISTS, NEUROLOGISTS, AND OTHERS INTO SMALL HOSPITALS AND CLINICS. ESSENTIA HEALTH'S SIZE AND INTEGRATED STRUCTURE ALSO ALLOW THE ORGANIZATION TO EXTEND SERVICES LIKE CHEMOTHERAPY, CONGESTIVE HEART FAILURE MANAGEMENT, WOUND CARE, AND HOSPICE CARE TO SMALLER COMMUNITIES.PATIENTS ARE ABLE TO TRAVEL SEAMLESSLY BETWEEN ESSENTIA HEALTH'S SMALLER COMMUNITY CLINICS AND ITS LARGER SPECIALTY CARE CENTERS THANKS TO SIGNIFICANT INVESTMENTS IN ELECTRONIC HEALTH RECORDS (EHRS). EVERY ESSENTIA HEALTH HOSPITAL AND CLINIC IS LINKED TO THIS SYSTEM, ALLOWING CLINICIANS TO SHARE EVERYTHING FROM LAB RESULTS AND RADIOLOGY IMAGES TO NOTES ON CLINIC VISITS, HOSPITAL STAYS, AND SERVICES LIKE PHYSICAL REHABILITATION. THE EHR IS ALSO AN INCREASINGLY VALUABLE TOOL FOR PATIENTS AND THEIR FAMILIES, THANKS TO MYHEALTH, WHICH OFFERS PATIENTS SECURE, 24/7 ONLINE ACCESS TO THEIR MEDICAL RECORD. MYHEALTH ALSO ALLOWS PATIENTS TO CONTACT THEIR PHYSICIAN OR CLINIC, SCHEDULE APPOINTMENTS, AND ORDER MEDICATION REFILLS. THESE SERVICES ARE ALL OFFERED AT NO COST TO PATIENTS AND THEIR AUTHORIZED FAMILY, FRIENDS, AND CAREGIVERS.ESSENTIA HEALTH ALSO PROMOTES THE HEALTH OF ALL OF ITS COMMUNITIES THROUGH ADHERENCE TO EVIDENCE-BASED BEST PRACTICE STANDARDS AND CLINICAL QUALITY GOALS DESIGNED TO ENSURE THAT PATIENTS RECEIVE THE SAME HIGH STANDARD OF CARE AT ANY ESSENTIA HEALTH HOSPITAL OR CLINIC.THE ESSENTIA INSTITUTE OF RURAL HEALTH (INSTITUTE) ACTIVELY SUPPORTS COMMUNITY HEALTH THROUGH ITS TRANSLATIONAL AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. THE INSTITUTE ALSO SPONSORS A NUMBER OF CONFERENCES AND OTHER EDUCATIONAL EVENTS, OPEN TO ALL MEDICAL PROFESSIONALS IN THE REGION, TO ENSURE THAT RURAL CLINICIANS HAVE ACCESS TO CURRENT MEDICAL EDUCATION AND TRAINING CLOSE TO HOME.ESSENTIA HEALTH'S HOSPITALS AND CLINICS PLAY ADDITIONAL ROLES IN PROMOTING HEALTH WITHIN THEIR COMMUNITIES. EACH OF ESSENTIA HEALTH'S 15 HOSPITALS CONDUCTS A COMMUNITY HEALTH ASSESSMENT TO DETERMINE THE UNIQUE HEALTH NEEDS OF COMMUNITY RESIDENTS. THESE ASSESSMENTS, WHICH ARE BASED ON INPUT FROM A BROAD RANGE OF COMMUNITY RESIDENTS AND STAKEHOLDERS, ARE THE BASIS FOR ACTION PLANS AIMED AT ADDRESSING THE COMMUNITY'S MOST PRESSING HEALTH NEEDS. MOST RECENTLY, TOPICS OF CONCERN HAVE INCLUDED ELIMINATING SOCIAL AND ECONOMIC BARRIERS TO HEALTH AND WELLNESS, IMPROVING MENTAL HEALTH SERVICES AND AWARENESS, AND ADDRESSING OBESITY AND CREATING OPPORTUNITIES FOR FITNESS. THESE ISSUES ARE THEN ADDRESSED THROUGH COLLABORATION WITH PRIVATE BUSINESSES, GOVERNMENT AGENCIES, AND OTHER NON-PROFITS.TWO OF THE MOST PROMINENT COLLABORATIONS CURRENTLY ARE CROW WING ENERGIZED AND CASS COUNTY ENERGIZED, JOINT PUBLIC-PRIVATE PARTNERSHIPS AIMED AT IMPROVING THE OVERALL HEALTH STATUS OF THESE COUNTIES THROUGH COORDINATED PROGRAMMING AIMED AT LIFESTYLE ISSUES RANGING FROM EXERCISE TO HEALTHY EATING. IN ADDITION TO VARIOUS TYPES OF IN-KIND ASSISTANCE, THE COORDINATORS OF THESE PROGRAMS RECEIVE 50 PERCENT OF THEIR COMPENSATION FROM ESSENTIA HEALTH.IN AN EFFORT TO HELP SOME OF OUR COMMUNITIES' OLDEST AND FRAILEST RESIDENTS REMAIN AT HOME AND OUT OF THE HOSPITAL OR NURSING HOME, ESSENTIA HEALTH HAS LAUNCHED COMMUNITY PARAMEDIC PROGRAMS IN FARGO, NORTH DAKOTA, AS WELL AS BRAINERD, ADA, AND DETROIT LAKES, MINNESOTA. PARAMEDICS MAKE HOUSE CALLS TO PATIENTS WHO HAVE BEEN IDENTIFIED AS AT RISK FOR EMERGENCY DEPARTMENT VISITS. DURING THE CALLS, THEY TAKE VITAL SIGNS, ASSESS FOR POSSIBLE HEALTH AND SAFETY RISKS, AND DETERMINE IF PATIENTS MAY BENEFIT FROM ADDITIONAL COMMUNITY RESOURCES. ESSENTIA HEALTH EMPLOYEES CONTRIBUTE DIRECTLY TO THE HEALTH AND WELLNESS OF THEIR COMMUNITIES BY VOLUNTEERING IN PROGRAMS RANGING FROM HABITAT FOR HUMANITY TO UNITED WAY FOOD AND CLOTHING DRIVES. THEY ARE ACTIVE FUNDRAISERS FOR HEALTH-RELATED ORGANIZATIONS IN THEIR COMMUNITIES, LIKE LOCAL CHAPTERS OF THE AMERICAN HEART ASSOCIATION AND MARCH OF DIMES. ESSENTIA HEALTH ENCOURAGES AND SUPPORTS THESE VOLUNTEER EFFORTS IN A VARIETY OF WAYS, INCLUDING SPONSORSHIPS, FINANCIAL CONTRIBUTIONS, AND VOLUNTEER RECOGNITION.WE ALSO SUPPORT COMMUNITY HEALTH THROUGH THE ESSENTIA HEALTH FOUNDATION AND THROUGH CONTRIBUTIONS THAT FOCUS ON PROGRAMS AND SERVICES, LIKE AFTER-SCHOOL MEAL AND TUTORING PROGRAMS OR RESPITE SERVICES FOR CAREGIVERS OF LOVED ONES WITH DEMENTIA, THAT BENEFIT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | |||||||
| 301 CEDAR | OROFINO | ID | 83544 | 820497771 | 501(C)(3) | $129,430 | PROGRAM SUPPORT |
| ESSENTIA HEALTH FOUNDATION | |||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 271984704 | 501(C)(3) | $7,732 | PROGRAM SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PROCEDURES FOR MONITORING USE OF GRANT FUNDS: ST. MARY'S HOSPITAL, INC.'S MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | Yes (1) | InitialContractExceptionInd |
| Rebuttable Presumption Proc | Yes (1) | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JACK BRUNER II MD | ||||||||||||||
| BOARD DIRECTOR | $268,925 | $0 | $40,168 | $0 | $0 | $0 | $10,800 | $0 | $16,371 | $0 | $336,264 | $0 | $0 | $0 |
| KELLY MCGRATH MD | ||||||||||||||
| BOARD DIRECTOR | $0 | $273,270 | $0 | $0 | $0 | $0 | $0 | $10,468 | $0 | $21,541 | $0 | $305,279 | $0 | $0 |
| TIMOTHY SAYLER | ||||||||||||||
| BOARD DIRECTOR | $0 | $394,985 | $0 | $83,400 | $0 | $9,242 | $0 | $65,281 | $0 | $28,986 | $0 | $581,894 | $0 | $0 |
| LENNE BONNER | ||||||||||||||
| PRESIDENT | $0 | $200,789 | $0 | $28,350 | $0 | $0 | $0 | $29,672 | $0 | $19,524 | $0 | $278,335 | $0 | $0 |
| ANDREW JONES DO | ||||||||||||||
| PHYSICIAN | $425,960 | $0 | $58,654 | $0 | $0 | $0 | $10,799 | $0 | $12,799 | $0 | $508,212 | $0 | $0 | $0 |
| CLARENCE BRUNSON MD | ||||||||||||||
| PHYSICIAN | $238,625 | $0 | $66,411 | $0 | $0 | $0 | $2,551 | $0 | $16,912 | $0 | $324,499 | $0 | $0 | $0 |
| JARED PIKUS DO | ||||||||||||||
| PHYSICIAN | $220,903 | $0 | $49,262 | $0 | $0 | $0 | $10,461 | $0 | $16,958 | $0 | $297,584 | $0 | $0 | $0 |
| ALVIN SECREST III MD | ||||||||||||||
| PHYSICIAN | $240,219 | $0 | $24,264 | $0 | $0 | $0 | $10,800 | $0 | $25,589 | $0 | $300,872 | $0 | $0 | $0 |
| RONALD SIGLER MD | ||||||||||||||
| PHYSICIAN | $178,743 | $0 | $43,324 | $0 | $0 | $0 | $8,506 | $0 | $16,935 | $0 | $247,508 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ST. MARY'S HOSPITAL, INC.'S PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: LENNE BONNER $21,194 TIMOTHY SAYLER $43,681 |
| PART I, LINE 8 | INITIAL CONTRACT EXCEPTION: ST. MARY'S HOSPITAL INC.'S PHYSICIAN, CLARENCE BRUNSON, MD, RECEIVED COMPENSATION DURING THE YEAR UNDER AN INITIAL EMPLOYMENT AGREEMENT SUBJECT TO THE INITIAL CONTRACT EXCEPTION. THROUGH AN AUTHORIZED BODY OF THE ORGANIZATION, THIS COMPENSATION ARRANGEMENT WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS USING COMPARABILITY DATA AND THE BASIS FOR DETERMINATION WAS DOCUMENTED. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUNE BEHLER | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | RELATED TO SISTER MARJORIE SCHMIDT | RelationshipDescriptionTxt |
| Transaction | $30,687 | TransactionAmt |
| Transaction | COMPENSATION OF FAMILY MEMBER OF BOARD MEMBER | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1C | NO GAMING (GAMBLING) WINNINGS. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: DURING THE FISCAL YEAR ENDED JUNE 30, 2018, THE BYLAWS OF ST. MARY'S HOSPITAL, INC. WERE AMENDED TO MAKE THE CRITICAL ACCESS GROUP PRESIDENT AN EX OFFICIO DIRECTOR WITHOUT VOTE. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OF ORGANIZATION: CRITICAL ACCESS GROUP IS THE SOLE MEMBER OF ST. MARY'S HOSPITAL, INC. AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. ESSENTIA HEALTH AND BENEDICTINE SISTERS BENEVOLENT ASSOCIATION HAVE RESERVED POWERS WITH RESPECT TO ST. MARY'S HOSPITAL, INC. AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBER WITH RIGHT TO ELECT GOVERNING BODY: CRITICAL ACCESS GROUP APPOINTS AND REMOVES ST. MARY'S HOSPITAL, INC.'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISION: ST. MARY'S HOSPITAL, INC. IS A SUBSIDIARY OF ESSENTIA HEALTH, WHOSE BOARD OF DIRECTORS HAS RESERVED POWERS WITH RESPECT TO THIS CORPORATION AND ITS SUBSIDIARIES, AND ALLOF THE OTHER DIRECT AND INDIRECT SUBSIDIARIES OF ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). ESSENTIA HEALTH'S RESERVED POWERS ARE AS FOLLOWS: STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. DEBT. APPROVAL OF THE INCURRENCE OF DEBT BY, AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF ALL ENTITIES IN THE SYSTEM. MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (A) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (B) FROM THE CATHOLIC ENTITIES TO THE SECULAR ENTITIES OR FROM THE SECULAR ENTITIES TO THE CATHOLIC ENTITIES IN A MANNER OR TO AN EXTENT THAT WOULD CAUSE THE CATHOLIC ENTITIES TO BE IN VIOLATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS) IN THE JUDGMENT OF THE LOCAL ORDINARY; OR (C) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. RESERVED POWERS. AUTHORITY TO CREATE ADDITIONAL ESSENTIA HEALTH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 80% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS (EXCLUDING THE ESSENTIA HEALTH CEO); PROVIDED, HOWEVER, THAT ANY ADDITIONAL ESSENTIA HEALTH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE RESERVED POWERS OF BENEDICTINE SISTERS BENEVOLENT ASSOCIATION. THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION ("BSBA") ALSO HAS CERTAIN RESERVED POWERS OVER ESSENTIA HEALTH'S CATHOLIC FACILITIES. BSBA'S RESERVED POWERS ARE AS FOLLOWS: MISSION. AUTHORITY TO APPROVE THE MISSION AND PURPOSE STATEMENTS FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM. *ADHERENCE TO ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS). AUTHORITY TO APPROVE THE METHODS, POLICIES AND PROCEDURES PERTAINING TO THE ADHERENCE OF CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM TO THE ERDS. *OFFICIAL CATHOLIC DIRECTORY. AUTHORITY TO OVERSEE THE LISTING OF QUALIFIED ENTITIES AND FACILITIES WITHIN THE SYSTEM IN THE OFFICIAL CATHOLIC DIRECTORY, SUBJECT TO THE APPROVAL OF APPLICABLE CATHOLIC AUTHORITIES. *CATHOLIC HEALTH ASSOCIATION. AUTHORITY TO REQUIRE CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM TO JOIN THE MEMBERSHIP OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES. ALIENATION OF STABLE PATRIMONY OR ECCLESIASTICAL GOODS. AUTHORITY TO APPROVE ALIENATION OF EITHER STABLE PATRIMONY OR OTHER ECCLESIASTICAL GOODS WITHIN THE SYSTEM IF SUCH GOODS INVOLVED IN A SPECIFIC TRANSACTION APPROVED BY ESSENTIA HEALTH PURSUANT TO THE AFFILIATION AGREEMENT, HAVE A DOLLAR VALUE EQUAL TO OR GREATER THAN 70% OF THE AMOUNT ESTABLISHED FROM TIME TO TIME THAT REQUIRES APPROVAL FROM THE HOLY SEE; PROVIDED, HOWEVER, THAT IT IS THE INTENT OF THE PARTIES THAT THIS PROVISION NOT BE APPLIED TO RESTRICT OR TO IMPEDE ESSENTIA HEALTH FROM ACTING AND MAKING DECISIONS ON BEHALF OF THE SYSTEM IN THE ORDINARY COURSE OF BUSINESS BUT BE APPLIED TO PREVENT THE TRANSFER OF SUBSTANTIAL ASSETS OF CATHOLIC ENTITIES WITHIN THE SYSTEM TO SUPPORT THE SECULAR ENTITIES WITHIN THE SYSTEM WITHOUT THE PRIOR APPROVAL OF BSBA. *MISSION EFFECTIVENESS. AUTHORITY TO APPROVE ANNUAL PLANS AND EVALUATIONS RELATING TO MISSION EFFECTIVENESS AND CHAPLAINCY FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM, INCLUDING THE USE OF RELIGIOUS SYMBOLS AND PRAYERS. AMENDMENTS. AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF ESSENTIA HEALTH, ESSENTIA HEALTH EAST (SMDC), ESSENTIA HEALTH CENTRAL (BLIHS), ESSENTIA HEALTH WEST (INNOVIS) OR CRITICAL ACCESS GROUP (CAG) THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS; AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC CAG SUBSIDIARIES, THE CATHOLIC SMDC SUBSIDIARIES, THE CATHOLIC BLIHS SUBSIDIARIES OR THE CATHOLIC SUBSIDIARIES OF INNOVIS, WHICH COULD MATERIALLY AFFECT SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION, INCLUDING WITHOUT LIMITATION ANY AMENDMENT THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS; AND AUTHORITY TO CAUSE ESSENTIA HEALTH TO MAKE AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC SUBSIDIARIES OF ESSENTIA HEALTH'S DIRECT SUBSIDIARIES, WHICH AMENDMENTS BSBA DETERMINES IN GOOD FAITH ARE NECESSARY TO PRESERVE SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION. MERGERS AND DISSOLUTION. SUBJECT TO THE APPROVAL OF THE DULUTH BENEDICTINES, AUTHORITY TO APPROVE A PROPOSED MERGER, CONSOLIDATION, LIQUIDATION, OR DISSOLUTION OF ST. MARY'S MEDICAL CENTER (SMMC) AND ST. JOSEPH'S MEDICAL CENTER (SJMC), OR THE DISPOSITION OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF SMMC AND SJMC. BSBA SPONSORSHIP. AUTHORITY TO ESTABLISH, ACCEPT, TRANSFER OR TERMINATE BSBA SPONSORSHIP OR CO-SPONSORSHIP OF A HEALTHCARE FACILITY. *RESERVED POWER CURRENTLY DELEGATED TO THE SPONSORSHIP COUNCIL. NOTE: SOME OF THE RESERVED POWERS OF THE BSBA BOARD LISTED ABOVE MAY ALSO BE RESERVED TO THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY OF DULUTH (THE "CHAPTER OR "DULUTH BENEDICTINES"). PRIOR TO THESE MATTERS GOING TO THE CHAPTER, ORDINARILY THEY WILL BE CONSIDERED AND ACTED UPON BY THE BSBA BOARD. THE FOLLOWING ACTIONS OF THE BSBA BOARD ARE SUBJECT TO APPROVAL BY THE CHAPTER: 1. APPROVE MERGERS, CONSOLIDATIONS, LIQUIDATIONS, OR DISSOLUTIONS INVOLVING SMMC OR SJMC. 2. APPROVE THE ACQUISITION OR DISPOSITION OF REAL ESTATE OWNED BY BSBA. 3. APPROVE DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, ASSETS OF SMMC OR SJMC. 4. APPROVE INDEBTEDNESS THAT WILL BE GUARANTEED BY BSBA. |
| FORM 990, PART VI, SECTION A, LINE 8B | COMMITTEES: THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE 2017 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY ST. MARY'S HOSPITAL, INC.'S MANAGEMENT AND GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A COPY OF THE 2017 FORM 990. ST. MARY'S HOSPITAL, INC.'S FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE HIS/HER MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND IF APPROPRIATE, WITHDRAW, FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, HE OR SHE WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ST. MARY'S HOSPITAL, INC.'S PRESIDENT WAS 2018. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ST. MARY'S HOSPITAL, INC.'S CHIEF FINANCIAL OFFICER WAS 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). |
| FORM 990, PART XII LINE 3 | CONSOLIDATED A-133: ST. MARY'S HOSPITAL, INC., AS PART OF ESSENTIA HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, WAS REQUIRED AND UNDERWENT A CONSOLIDATED AUDIT SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE CONSOLIDATED AUDIT IS REVIEWED BY THE ESSENTIA HEALTH AUDIT COMMITTEE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BRAINERD LAKES INTEGRATED HEALTH SYSTEM | |||||||||||
| 2024 S 6TH ST | BRAINERD | MN | 56401 | 371532145 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12B, II | ESSENTIA HEALTH | Yes (1) | |
| BRAINERD MEDICAL CENTER INC | |||||||||||
| 2024 S 6TH ST | BRAINERD | MN | 56401 | 371532148 | CLINIC | MN | 501(C)(3) | LINE 3 | BRAINERD LAKES INTEGRATED HEALTH SYSTEM | Yes (1) | |
| BRIDGES MEDICAL CENTER | |||||||||||
| 201 9TH ST W | ADA | MN | 55805 | 200479568 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | |||||||||||
| 301 CEDAR | OROFINO | ID | 83544 | 820497771 | HOSPITAL/CLINIC | ID | 501(C)(3) | LINE 3 | CRITICAL ACCESS GROUP | Yes (1) | |
| CRITICAL ACCESS GROUP | |||||||||||
| 503 E 3RD ST STE 400 | DULUTH | MN | 55805 | 261219624 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12B, II | ESSENTIA HEALTH | Yes (1) | |
| DEER RIVER HEALTHCARE CENTER INC | |||||||||||
| 115 10TH AVE NE | DEER RIVER | MN | 56636 | 410844574 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| ESSENTIA HEALTH | |||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 200360007 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |
| ESSENTIA HEALTH FOUNDATION | |||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 271984704 | FOUNDATION | MN | 501(C)(3) | LINE 7 | ESSENTIA HEALTH | Yes (1) | |
| ESSENTIA INSTITUTE OF RURAL HEALTH | |||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 271291124 | RESEARCH | MN | 501(C)(3) | LINE 4 | THE DULUTH CLINIC LTD | Yes (1) | |
| FIRST CARE MEDICAL SERVICES | |||||||||||
| 900 HILLIGOSS BLVD SE | FOSSTON | MN | 56542 | 410706143 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| GRACEVILLE HEALTH CENTER | |||||||||||
| 115 WEST 2ND ST | GRACEVILLE | MN | 56240 | 410726173 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| INNOVIS HEALTH LLC | |||||||||||
| 3000 32ND AVE S | FARGO | ND | 58103 | 261175213 | HOSPITAL/CLINIC | DE | 501(C)(3) | LINE 3 | ESSENTIA HEALTH | Yes (1) | |
| MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC | |||||||||||
| 4418 HAINES RD | DULUTH | MN | 55811 | 411674021 | MEDICAL EQUIPMENT | MN | 501(C)(3) | LINE 10 | ST MARY'S MEDICAL CENTER | Yes (1) | |
| NORTHERN PINES MEDICAL CENTER | |||||||||||
| 5211 HWY 110 | AURORA | MN | 55705 | 410841441 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| PINE MEDICAL CENTER | |||||||||||
| 705 LUNDORFF DR S | SANDSTONE | MN | 55072 | 411884597 | HOSPITAL | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| POLINSKY MEDICAL REHABILITATION CENTER | |||||||||||
| 530 E 2ND ST | DULUTH | MN | 55805 | 410691275 | REHABILITATION SERVICES | MN | 501(C)(3) | LINE 3 | ST MARY'S MEDICAL CENTER | Yes (1) | |
| SMDC MEDICAL CENTER | |||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 411878730 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| ST JOSEPH'S MEDICAL CENTER | |||||||||||
| 523 N 3RD ST | BRAINERD | MN | 56401 | 410695602 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | BRAINERD LAKES INTEGRATED HEALTH SYSTEM | Yes (1) | |
| ST MARY'S DULUTH CLINIC HEALTH SYSTEM | |||||||||||
| 407 E 3RD ST | DULUTH | MN | 55805 | 411836633 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12B, II | ESSENTIA HEALTH | Yes (1) | |
| ST MARY'S EMS | |||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 411805811 | EMERGENCY SERVICES | MN | 501(C)(3) | LINE 10 | INNOVIS HEALTH LLC | Yes (1) | |
| ST MARY'S HOSPITAL OF SUPERIOR | |||||||||||
| 3500 TOWER AVE | SUPERIOR | WI | 54880 | 411811073 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | ST MARY'S MEDICAL CENTER | Yes (1) | |
| ST MARY'S INNOVIS HEALTH | |||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 262861321 | PHARMACY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| ST MARY'S MEDICAL CENTER | |||||||||||
| 407 E 3RD ST | DULUTH | MN | 55805 | 410695604 | HOSPITAL | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| ST MARY'S REGIONAL HEALTH CENTER | |||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 411620386 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| THE DULUTH CLINIC LTD | |||||||||||
| 400 E 3RD ST | DULUTH | MN | 55805 | 410883623 | CLINIC | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PMC-GATEWAY IMAGING LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 LUNDORFF DR S | AddressLine1Txt |
| City | SANDSTONE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55072 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261634764 | EIN |
| Primary Activities | IMAGING SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ESSENTIA HEALTH INSURANCE SERVICES SPC LTD | BusinessNameLine1Txt |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1159 | AddressLine1Txt |
| City | GRAND CAYMAN | CityNm |
| Country | CJ | CountryCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 000000000 | EIN |
| Primary Activities | SELF INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | ||
| A | $224 | ACTUAL COST |
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | ||
| B | $129,430 | ACTUAL COST |
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | ||
| C | $88,292 | ACTUAL COST |
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | ||
| O | $372,257 | ACTUAL COST |
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | ||
| P | $1,316,259 | ACTUAL COST |
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | ||
| Q | $1,636,398 | ACTUAL COST |
| CRITICAL ACCESS GROUP | ||
| M | $479,100 | ACTUAL COST |
| ESSENTIA HEALTH | ||
| P | $426,617 | ACTUAL COST |
| ESSENTIA HEALTH FOUNDATION | ||
| C | $100,000 | ACTUAL COST |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, COLUMN (A) | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING ESSENTIA HEALTH ENTITIES HAVE A DOING BUSINESS AS NAME: LEGAL NAME; DOING BUSINESS AS NAME BRAINERD LAKES INTEGRATED HEALTH SYSTEM; ESSENTIA HEALTH CENTRAL BRAINERD MEDICAL CENTER, INC.; ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC BRIDGES MEDICAL CENTER; ESSENTIA HEALTH ADA DEER RIVER HEALTHCARE CENTER, INC.; ESSENTIA HEALTH DEER RIVER FIRST CARE MEDICAL SERVICES; ESSENTIA HEALTH FOSSTON GRACEVILLE HEALTH CENTER; ESSENTIA HEALTH HOLY TRINITY HOSPITAL INNOVIS HEALTH, LLC; ESSENTIA HEALTH WEST MIDWEST MEDICAL EQUIPMENT AND SUPPLIES, INC.; ESSENTIA HEALTH MEDICAL EQUIPMENT & SUPPLIES NORTHERN PINES MEDICAL CENTER; ESSENTIA HEALTH NORTHERN PINES PINE MEDICAL CENTER; ESSENTIA HEALTH SANDSTONE POLINSKY MEDICAL REHABILITATION CENTER; ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER SMDC MEDICAL CENTER; ESSENTIA HEALTH DULUTH ST. JOSEPH'S MEDICAL CENTER; ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ST. MARY'S DULUTH CLINIC HEALTH SYSTEM; ESSENTIA HEALTH EAST ST. MARY'S EMS; ESSENTIA HEALTH ST. MARY'S EMERGENCY MEDICAL SERVICES-DETROIT LAKES ST. MARY'S HOSPITAL OF SUPERIOR; ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR ST. MARY'S MEDICAL CENTER; ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER ST. MARY'S REGIONAL HEALTH CENTER; ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES | ExplanationTxt |