2018-05-15T08:23:13-05:00 2017-06-30 420714325 RSM US LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2016-07-01 410695596 ST CLOUD HOSPITAL STCL 3202512700 1406 SIXTH AVENUE NORTH ST CLOUD MN 563031901 GREGORY R KLUGHERZ CFO/TREASURER 3202512700 2018-05-01 1 TODD A JACKSON P00092672 6123324300 2016 2022-09-23 18:48:47Z CRAIG BROMAN 1406 SIXTH AVENUE NORTH ST CLOUD MN 563031901 897699201 0 X WWW.CENTRACARE.COM X 1962 MN AS A CATHOLIC REGIONAL HOSPITAL, WE IMPROVE THE HEALTH AND QUALITY OF LIFE FOR THE PEOPLE WE SERVE IN A MANNER THAT REFLECTS THE HEALING MISSION OF JESUS. 18 13 6749 1109 33685 0 3428698 3895471 798754446 845841945 22737608 21653266 -46604811 21705511 778315941 893096193 3601980 2411115 0 0 400453941 434479685 0 0 0 338944334 345664470 743000255 782555270 35315686 110540923 1130600833 1222939076 525467359 501672526 605133474 721266550 X AS A CATHOLIC REGIONAL HOSPITAL, WE IMPROVE THE HEALTH AND QUALITY OF LIFE FOR THE PEOPLE WE SERVE IN A MANNER THAT REFLECTS THE HEALING MISSION OF JESUS. 0 0 347523758 2411115 463667247 CENTRACARE HEALTH IS PRIMARILY ENGAGED IN SUPPORTING AND DIRECTING HEALTHCARE DELIVERY THROUGH ITS AFFILIATED ENTITIES. CENTRACARE OPERATES AS THE PARENT CORPORATION TO THE SAINT CLOUD HOSPITAL WHICH STRIVES TO IMPROVE THE QUALITY AND EXPAND THE CLINICAL SCOPE OF, ENHANCE ACCESS TO, AND ASSURE AFFORDABILITY OF, HEALTH SERVICES FOR RESIDENTS IN THE ST. CLOUD AREA AND CENTRAL MINNESOTA. THESE AIMS ARE SUPPORTED BY CENTRACARE'S COMMITMENT TO ADVANCE MEDICAL EDUCATION, TRAINING AND RESEARCH. AS A HIGH QUALITY REGIONAL MEDICAL CENTER, ST. CLOUD HOSPITAL PROVIDES A BROAD RANGE OF ACUTE INPATIENT SERVICES. WITH 487 LICENSED INPATIENT BEDS, ST. CLOUD HOSPITAL CARED FOR 27,627 INPATIENT ADMISSIONS WITH 118,367 ASSOCIATED PATIENT DAYS DURING FISCAL 2017. INPATIENT SERVICES INCLUDE MEDICAL AND SURGICAL CARE, BIRTHING SERVICES, CHILDREN'S SERVICES INCLUDING NEONATAL INTENSIVE CARE AND PEDIATRIC INTENSIVE CARE, BEHAVIORAL HEALTH CARE SERVICES FOR ADULTS AND ADOLESCENTS, ALONG WITH SPECIALIZED CARE IN CARDIOLOGY, NEUROSCIENCES, NEUROSURGERY, ORTHOPEDICS AND REHABILITATION SERVICES. 281840517 350645971 AS A HIGH QUALITY REGIONAL MEDICAL CENTER, ST. CLOUD HOSPITAL PROVIDES A BROAD RANGE OF OUTPATIENT SERVICES. OUTPATIENT ENCOUNTERS DURING FISCAL 2017 WERE 281,873 AND INCLUDED EMERGENCY ROOM SERVICES, BEHAVIORAL HEALTH CARE, CANCER TREATMENT, DIALYSIS, IMAGING PROCEDURES, DIAGNOSTIC HEART PROCEDURES, REHABILITATION THERAPY, SAME DAY SURGERY AND OTHER AMBULATORY CARE SERVICES. 28226898 31495042 AS PART OF THE ST. CLOUD HOSPITAL, ST. BENEDICTS SENIOR COMMUNITY PROVIDES RESIDENTIAL HEALTH CARE SERVICES INCLUDING INDEPENDENT LIVING, ASSISTED LIVING AND SHORT AND LONG TERM SKILLED NURSING SERVICES. IN FISCAL 2017 THERE WERE 222 SKILLED STAFFED BEDS AND RESIDENT DAYS OF 58,903. SHORT STAY SKILLED SERVICES INCLUDE AN EXTENSIVE REHABILITATIVE CARE PROGRAM WITH THE GOAL OF ENABLING RESIDENTS TO RETURN TO THEIR HOMES. IN FISCAL 2017 THERE WERE 380 HOUSING UNITS AND TENANT DAYS OF 118,137. ASSISTED LIVING AND INDEPENDENT LIVING COMMUNITIES ARE DESIGNATED AS HOUSING WITH SERVICES. HOMECARE SERVICES ARE PROVIDED TO THESE TENANTS ON A BASE RATE PLUS POINTS SYSTEM. COSTS ASSOCIATED WITH OTHER RELATED OR EXEMPT FUNCTION REVENUE, INCLUDING IMPLEMENTATION AND ONGOING SUPPORT OF EPIC ELECTRONIC MEDICAL RECORD SYSTEM FOR AFFILIATED ORGANIZATIONS, FEDERAL HEALTH INFORMATION TECHNOLOGY (HITECH) FUNDS, FOOD SALES AND OTHER HEALTH CARE RELATED ACTIVITIES. 657591173 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 495 0 1 6749 1 1 1 0 0 0 0 0 0 0 0 0 X 18 13 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X GREGORY R KLUGHERZ 3202512700 1406 SIXTH AVENUE NORTH ST CLOUD MN 56303 CRAIG J BROMAN PRESIDENT 37.00 3.00 X X 1082537 0 52031 TIMOTHY WENSMAN DIRECTOR, CHAIR 2.00 X 0 0 0 FATHER THOMAS KNOBLACH DIRECTOR, VICE CHAIR 2.00 X 0 0 0 MERRYN JOLKOVSKY MD DIRECTOR, CHIEF OF STAFF 2.00 X 0 286697 20476 ALBERT MERCURI MD DIRECTOR 2.00 X 0 380316 51611 EDWARD B MARTIN-CHAFFEE MD DIRECTOR 2.00 38.00 X 0 569920 59030 MARIA MALLORY MD DIRECTOR 2.00 38.00 X 0 548042 56359 RICHARD JOLKOVSKY MD DIRECTOR 2.00 X 0 691810 57475 JENNIFER MROZEK DIRECTOR 2.00 X 0 0 0 ROBERT THUERINGER DIRECTOR 2.00 X 0 0 0 JAMES RUDOLPH DIRECTOR 2.00 X 0 0 0 LISA FOSS DIRECTOR 2.00 X 0 0 0 KARA HENNES OSB DIRECTOR 2.00 X 0 0 0 PATRICIA SNIEZERK OSB DIRECTOR 2.00 X 0 0 0 JAMES SCHLENNER DIRECTOR 2.00 X 0 0 0 EILEEN DAUER MD DIRECTOR 2.00 X 0 0 0 MELINDA SANDERS DIRECTOR 2.00 X 0 0 0 ROBERT KOVELL DIRECTOR 2.00 X 0 0 0 JOAN WILCOX RN DIRECTOR 2.00 X 0 0 0 GREGORY R KLUGHERZ TREASURER/CFO 11.00 29.00 X 798201 0 43401 PAUL R HARRIS ESQ SECRETARY 10.00 30.00 X 0 504874 83489 AMY PORWOLL VICE PRESIDENT 20.00 20.00 X 0 391565 74370 LINDA A CHMIELEWSKI VICE PRESIDENT 40.00 X 491104 0 9863 DUANE A RASMUSSON VICE PRESIDENT 20.00 20.00 X 0 453340 42243 LINDA L KAPPEL VICE PRESIDENT 40.00 X 317082 0 33451 KURT T OTTO VICE PRESIDENT 40.00 X 0 302800 57945 JESSICA P SWARTOUT MD PHYSICIAN 40.00 X 0 683495 62051 HANI S ALKHATIB MD PHYSICIAN 40.00 X 0 906243 64737 HILARY I UFEARO MD PHYSICIAN 40.00 X 0 804790 62051 DONALD J JURGENS MD PHYSICIAN 40.00 X 0 693724 60869 JON C BOWER PHYSICIAN 40.00 X 0 529508 57717 2688924 7747124 949169 4 0 1 0 CROTHALL HEALTHCARE 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 HOUSEKEEPING/LAUNDRY 3008752 ANESTHESIOLOGY ASSOCIATES PO BOX 725 ST CLOUD MN 563020725 ANESTHESIOLOGY SVCS 2841715 REHABCARE PO BOX 503534 ST LOUIS MO 631503534 THERAPY SERVICES 1604153 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 PHYSICIAN SERVICES 922998 CRUX QUALITY SOLUTIONS PO BOX 9127 ST LOUIS MO 63117 RAD ONC SERVICES 832475 300 3889072 6399 3895471 PATIENT/RESIDENT SERVICES 900099 828027595 828027595 FOOD SALES 900099 5005331 5005331 DEPT EXP REIMBURSEMENT 900099 3034089 3034089 OTHER MISC REVENUE 900099 932931 932931 HEALTH INFO TECH INCENTIVE 900099 192100 192100 8649899 8616214 33685 845841945 20786527 20786527 3625520 3625520 0 1625784 759045 866739 866739 866739 1072605 218443 854162 854162 GAIN ON INT RATE SWAPS 900099 20770027 20770027 PURCHASE DISCOUNTS 900099 81322 81322 20851349 893096193 845808260 33685 43358777 2227551 2227551 183564 183564 2550042 2550042 337055005 272690114 64364891 17706470 14261609 3444861 54060187 43456466 10603721 23107981 18560018 4547963 511549 410869 100680 32122 25800 6322 202113 202113 1526394 1526394 67827378 54478034 13349344 861958 692313 169645 1837856 1476141 361715 7198421 5781674 1416747 9537556 7660436 1877120 959511 770666 188845 8183493 6572871 1610622 48981633 39341385 9640248 1660017 1333303 326714 DRUGS/MEDICAL SUPPLIES 126550149 126550149 MEDICAID/MN CARE 14759851 14759851 BAD DEBT 10951576 10951576 44082893 35406783 8676110 782555270 657591173 124964097 0 30381263 46748403 50100000 50619765 124499628 119685828 8952296 8113167 4875410 5191749 996585458 484061490 520749982 512523968 299770963 388246689 76820675 69608217 14450616 22201290 1130600833 1222939076 81445797 83996732 364513733 353580171 79507829 64095623 525467359 501672526 X 605133474 721266550 605133474 721266550 1130600833 1222939076 X 110540923 35963693 -30371540 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 1 104954 1 97159 0 0 202113 0 PART II-B, LINE 1: ST. CLOUD HOSPITAL PAID $202,113 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS. 18489774 18489774 632955851 233744793 399211058 339492033 250301717 89190316 5647800 14980 5632820 512523968 FUNDS HELD BY TRUSTEE, WORKER'S COMP & FUTURE BUILDING 69608217 C 69608217 OTHER LONG TERM LIABILITIES 64095623 64095623 X PART X, LINE 2: CENTRACARE, THE CORPORATION, THE CLINIC, CCH - MELROSE, CCH - LONG PRAIRIE, CCH - SAUK CENTRE, AND THE FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CCH - MONTICELLO AND CCH - PAYNESVILLE, AS DISREGARDED LLCS UNDER INTERNAL REVENUE SERVICE REGULATIONS, ACHIEVE TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF THEIR PARENT, CENTRACARE HEALTH SYSTEM. AT JUNE 30, 2017 AND 2016, THERE WERE NO UNCERTAIN TAX POSITIONS. 1 1 1 X 175.000000000000 1 X 1 1 1 0 1 1 2542491 0 2542491 0.00330 152938763 111426550 41512213 0.05380 155481254 111426550 44054704 0.05710 1586261 15100 1571161 0.00200 4169886 2166082 2003804 0.00260 15128 14293 835 0.00000 185563 0 185563 0.00020 2520166 0 2520166 0.00330 8477004 2195475 6281529 0.00810 163958258 113622025 50336233 0.06520 60 13352 13352 0.00000 104 5036 5036 0.00000 164 18388 18388 0.00000 1 10951575 294305056 288767836 5537220 X 1 1 1 1 SAINT CLOUD HOSPITAL 1406 6TH AVE N ST CLOUD MN 563031901 X X X X REHAB, PSYCH, HOME HEALTH, HOSPICE AND RENAL DIALYSIS ST CLOUD HOSPITAL 1 0 0 1 X X X X X X 15 1 1 0 1 X WWW.CENTRACARE.COM X X 1 15 1 WWW.CENTRACARE.COM 0 1 X 175.000000000000 250.000000000000 X X 1 1 X X X X 1 X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X X 1 X X X X X X 1 X 0 0 ST. CLOUD HOSPITAL PART V, SECTION B, LINE 3J: CCH'S CHNA PRIMARY NEEDS WERE IDENTIFIED USING THE CENTER FOR DISEASE CONTROL'S COMMUNITY HEALTH STATUS INDICATORS (CHSI). THE PROCESS ALSO CONSIDERED SECONDARY DATA FROM THE DARTMOUTH ATLAS, ROBERT WOOD JOHNSON, MINNESOTA DEPARTMENT OF HEALTH, US CENSUS BUREAU, MINNESOTA HOSPITAL ASSOCIATION, AND PUBLIC HEALTH DEPARTMENTS FROM APPROPRIATE COUNTIES AND ADDITIONAL FEDERAL AND STATE ENTITIES. WE DID NOT RECEIVE ANY INPUT OR COMMENTS FROM THE PUBLIC ON THE 2015 CHNA SURVEY. THE CHNA WAS INFORMED BY A COLLABORATIVE AND ONGOING COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH A NUMBER OF AREA COUNTIES WHO WERE JOINTLY CONDUCTING COMMUNITY SURVEYS TO INFORM THEIR COMMUNITY HEALTH ASSESSMENTS IN SUPPORT OF DEVELOPMENT OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS.LACK OF CURRENT PUBLIC HEALTH DATA WAS A SIGNIFICANT INFORMATION GAP IN THE CHNA AS THE SURVEY COULD NOT BE COMPLETED IN TIME TO INCLUDE ITS DATA IN THE CCH CHNA. CCH HAS COMMITTED TO A CONTINUING EFFORT WITH PUBLIC HEALTH OFFICIALS TO JOINTLY DEVELOP PRIORITIES WITH THE COUNTIES AS A PART OF ITS ACTION PLANS. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 5: DATA WAS OBTAINED FROM LOCAL COUNTY PUBLIC HEALTH DEPARTMENTS, INCLUDING THEIR MOST RECENT HEALTH ASSESSMENTS AND COMMUNITY REPORTS. IN ADDITION, HEALTH-RELATED INFORMATION WAS COLLECTED FROM AREA NONPROFIT ORGANIZATIONS THAT REGULARLY CONDUCT ASSESSMENTS AND EVALUATIONS OF THE SERVICES THEY PROVIDE AND THEIR TARGETED DEMOGRAPHICS. USEFUL MATERIAL WAS GATHERED FROM THE LOCAL UNITED WAY, CATHOLIC CHARITIES, THE CENTRAL MINNESOTA COUNCIL ON AGING, AND THE TRI-COUNTY ACTION PROGRAM (TRI-CAP). THESE ORGANIZATIONS SUPPORT A BROAD RANGE OF CONSTITUENTS WITH DIVERSE HEALTH-RELATED NEEDS; THEY REPRESENT DEMOGRAPHICS THAT ARE STATISTICALLY MORE LIKELY TO ENCOUNTER HEALTH-RELATED BARRIERS. CCH ALSO CONDUCTED A SERIES OF FOCUS GROUPS THAT INFORMED ITS CHNA. SPECIFICALLY, THE FOCUS GROUPS REPRESENTED POPULATIONS OF COLOR, RECENT IMMIGRANT POPULATIONS, CULTURAL MINORITIES, THOSE WHO WERE AUDIBLY CHALLENGED AND OTHERS WHO WERE DEEMED TO BE UNDER-REPRESENTED OR UNDER-SERVED. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 6A: CCH CONDUCTED ITS CHNA JOINTLY WITH ALL OF ITS 501(C)(3) HOSPITALS AS OF THE BEGINNING OF ITS FISCAL 2016. THOSE FACILITIES INCLUDED ST. CLOUD HOSPITAL, CENTRACARE HEALTH - MELROSE, CENTRACARE HEALTH - LONG PRAIRIE, CENTRACARE HEALTH - SAUK CENTRE, CENTRACARE HEALTH - MONTICELLO AND CENTRACARE HEALTH - PAYNESVILLE.EACH HOSPITAL PREPARED INDIVIDUAL ACTION PLANS TO THE CHNA BASED ON SPECIFIC INPUT FROM THOSE COMMUNITIES. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 7D: IN ADDITION TO MAKING ITS CHNA AVAILABLE TO THE PUBLIC ON ITS WEB SITE AND AT ITS BUSINESS OFFICE, CCH HAS SHARED COPIES OF THE CHNA WITH COUNTY PUBLIC HEALTH OFFICIALS AND, INTERNALLY, WITH INDIVIDUALS WORKING ON QUALITY IMPROVEMENT AND COMMUNITY HEALTH INITIATIVES. CCH HAS ALSO PUBLISHED CONTACT INFORMATION FOR ITS DIRECTOR OF COMMUNITY & GOVERNMENT RELATIONS TO RESPOND TO QUESTIONS OR CONCERNS ABOUT THE CHNA. THE DIRECTOR HAS ALSO PRESENTED RESULTS OF THE CHNA TO COMMUNITY GROUPS AND TO REPRESENTATIVES OF LOCAL FUNDING GROUPS. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 11: THE NEEDS IDENTIFIED BY THE CHNA ARE CURRENTLY IN ORGANIZATIONAL WORK PLANS AND ARE UNDER IMPLEMENTATION. TO PRIORITIZE IDENTIFIED NEEDS, CHNA ADVISORY TASK FORCE MEMBERS DEVISED A SET OF CRITERIA. THE CRITERIA USED WERE: COMMUNITY IMPACT, POTENTIAL FOR CHANGE, ECONOMIC FEASIBILITY, COMMUNITY ASSETS, AND VALUE AND MISSION. THE PRIORITIZATION PROCESS IDENTIFIED THE FOLLOWING SIX, BROAD COMMUNITY HEALTH ISSUES: 1 - ADULT OBESITY2 - ADULT DIABETES3 - OLDER ADULT PREVENTABLE HOSPITALIZATIONS4 - STROKE DEATHS5 - CORONARY HEART DISEASE DEATHS6 - CANCER DEATHSST. CLOUD HOSPITAL WILL MAINTAIN ITS ENGAGEMENTS WITH THE CHNA ADVISORY TASK FORCE TO ENSURE EFFECTIVE COLLABORATION AND COMMUNICATION WITH THE OTHER CENTRACARE HOSPITALS. THE CHNA ADVISORY TASK FORCE WILL CONTINUE TO MEET DURING THE THREE-YEAR PERIOD IN WHICH THE IMPLEMENTATION STRATEGY WILL UNFOLD. DURING THIS TIME THE GROUP WILL:- IDENTIFY WHAT OTHER COMMUNITY ORGANIZATION ARE DOING IN REGARD TO HEALTH PRIORITY AREAS;- DEVELOP SPECIFIC GOALS AND METRICS TO MONITOR AND MEASURE PROGRESS AND OUTCOMES;- COMMUNICATE SHORT-TERM AND LONG-TERM RESULTS OF ACTION PLANS WITHIN THE COMMUNITY.BASED ON THE FINDINGS AND PRIORITIES ESTABLISHED BY THE CHNA, AND AFTER HAVING REVIEWED THE COMMUNITY BENEFITS ACTIVITIES THAT CURRENTLY EXIST, ST. CLOUD HOSPITAL WILL CONTINUE TO SUPPORT THE SYSTEM-WIDE INITIATIVES OUTLINED BELOW AND WILL PARTICIPATE IN LOCALIZED ADAPTIONS (AS DESCRIBED IN THE ACTION STEPS) OF THESE PROGRAMS WITH REGARD TO THE SPECIFIC NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. TO SEE THE SPECIFIC ACTION PLAN FOR EACH OF THE SIX PRIORITY HEALTH AREAS SEE THE FULL IMPLEMENTATION STRATEGY FOR FISCAL YEAR 2016 - 2018 LOCATED ON THE WEBSITE AT HTTP://WWW.CENTRACARE.COM/APP/FILES/PUBLIC/5221/COMMUNITY-HEALTH-NEEDS-ASSESSMENT---CENTRACARE-HEALTH-SYSTEM.PDF.PER GUIDANCE FROM THE IRS, REGULATION 1.501(R)-3(C), THE CHNA FOR CCH ELECTED NOT TO DIRECTLY ADDRESS SEVERAL DETERMINANTS OF HEALTH THAT IT IDENTIFIED IN ITS PROCESS WHICH WERE NOT WITHIN THE ORGANIZATION'S CAPABILITIES OR CORE COMPETENCIES. EXAMPLES OF ISSUES NOT SPECIFICALLY ADDRESSED IN THE CHNA ACTION PLANS INCLUDE HIGH SCHOOL GRADUATION RATES, AFFORDABLE HOUSING OR SUPPORTED HOUSING. (CCH DID SUPPORT AN EFFORT OF THE CITY OF ST. CLOUD TO CONDUCT A HOUSING ASSESSMENT AS A RESULT OF THE CHNA PROCESS AND IS ALREADY THE LARGEST AREA PROVIDER OF SUPPORTED HOUSING DUE TO ITS EXTENSIVE CHEMICAL DEPENDENCY PROGRAMS AND SENIOR HOUSING PROGRAMS.) ST. CLOUD HOSPITAL PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 18E: THE ORGANIZATION EMPLOYS THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE GARNISHMENTS & LAWSUITS AS WELL. ALL LEGAL ACTIONS ARE REVIEWED & APPROVED BY CCH MANAMGEMENT PRIOR TO INITIATING. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 19E: THE ORGANIZATION EMPLOYS THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE GARNISHMENTS & LAWSUITS AS WELL. ALL LEGAL ACTIONS ARE REVIEWED & APPROVED BY CCH MANAMGEMENT PRIOR TO INITIATING. 1 1 - SAINT BENEDICT'S SENIOR COMMUNITY 1810 MINNESOTA BLVD ST CLOUD MN 56304 SKILLED NURSING FACILITY PART I, LINE 6A: CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. PART II, COMMUNITY BUILDING ACTIVITIES: THE ACTIVITIES INCLUDED IN COMMUNITY BUILDING ACTIVITIES INCLUDE COMMUNITY SUPPORT WHICH CONSISTS OF SEVERAL ST. CLOUD HOSPITAL DIRECTORS PARTICIPATING IN A VARIETY OF COMMITTEES SUCH AS THE BOARD OF BIG BROTHERS/BIG SISTERS, REHAB BOARD ETC. UNDER COMMUNITY HEALTH IMPROVEMENTS ADVOCACY, EMPLOYEES PARTICIPATED WITH CREATE COMMUNITY, WHICH IS A COLLABORATION TO BUILD INCLUSION AMONGST DIVERSE POPULATION AND SEVERAL COUNTY TASK FORCES TO ADVOCATE FOR MENTAL AND CHEMICAL HEALTH. FINALLY UNDER WORKFORCE DEVELOPMENT, AN EMPLOYEE IS A BOARD MEMBER OF THE STEARNS BENTON WORKFORCE COUNCIL AND STUDENTS WERE GIVEN TOURS OF THE HOSPITAL AND ATTENDED PRESENTATIONS ON CAREERS IN HEALTHCARE. PART III, LINE 2: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PART III, LINE 4: THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 OF THE ORGANIZATION'S AUDITED FINANCIALS."PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FORUNCOLLECTIBLE ACCOUNTS. THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS, CONSIDERING HISTORICAL NET COLLECTION, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CENTRACARE FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY CENTRACARE." PART III, LINE 8: THE AMOUNT ON LINE 7 OF PART III WAS DETERMINED BY UTILIZING THE MEDICARE COST REPORT. UTILIZING KEY SECTIONS OF THAT REPORT, PRIMARILY THE D SERIES AND E SERIES, ALONG WITH KEY SECTIONS FROM THE HOME HEALTH, HOSPICE AND DIALYSIS SECTIONS. PART III, LINE 9B: THE COLLECTION POLICIES AT ST. CLOUD HOSPITAL REQUIRE COLLECTION STAFF TO OFFER CHARITY CARE TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY CARE, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY CARE, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY CARE OR NOT, ARE REPORTED TO CREDIT REPORTING AGENCIES. PART VI, LINE 2: ST. CLOUD HOSPITAL FOUNDATION HAS IN PLACE A COMMUNITY COLLABORATION COMMITTEE WHICH HAS A MEMBERSHIP OF OVER 30 MEMBERS. THIS COMMITTEE IS MADE UP OF COMMUNITY LEADERS FROM BOTH THE HEALTHCARE AND BUSINESS WORLD. THESE MEMBERS MEET MONTHLY TO ADDRESS COMMUNITY HEALTH ISSUES (SEE PROMOTION OF COMMUNITY HEALTH FOR MORE DETAIL). THESE IDENTIFIED HEALTH NEEDS ARE THEN COMMUNICATED TO ST. CLOUD HOSPITAL. PART VI, LINE 3: INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. PART VI, LINE 4: ST. CLOUD HOSPITAL'S IMMEDIATE SERVICE AREA CONSISTS OF STEARNS, BENTON AND SHERBURNE COUNTIES. COLLECTIVELY THEIR ESTIMATED POPULATION IN 2017 IS 298,094 AND IS PROJECTED TO GROW BY 3.3% IN 2022. THE PROJECTED POPULATION GROWTH BY AGE BRACKET FOR 2017 TO 2022 IS 0-24, -.2%; 25-44, 3.7%; 45-64, .1% AND 65+ 18%. THE OTHER NINE COUNTIES LOCATED IN THE SERVICE AREA ARE CROW WING, DOUGLAS, KANDIYOHI, MEEKER, MILLE LACS, MORRISON, POPE, TODD AND WRIGHT. COLLECTIVELY THEIR POPULATION IN 2017 WAS 397,004 AND IS PROJECTED TO GROW BY 2.3% BY 2022. THAT NINE COUNTY PROJECTED POPULATION GROWTH TO 2022 BY AGE BRACKET ARE AS FOLLOWS: 0-24, 3.0%; 25-44, -.9%; 45-64, -3.4% AND 65+ 14%. THE PROJECTED 2022 ETHNICITY BREAKDOWN FOR THE ENTIRE 12-COUNTY AREA IS AS FOLLOWS: WHITE - 92.4%; AFRICAN AMERICAN - 2.4%; ASIAN - 1.3%; TWO OR MORE RACES - 1.9%, OTHER - 1.3%, AMERICAN INDIAN OR ALASKA NATIVE 0.7%. THE DEMOGRAPHIC INFORMATION IS UPDATED EVERY 2 YEARS BY THE ORGANIZATION, WITH THIS REPORTING YEAR BEING THE FIRST YEAR. PART VI, LINE 5: THE COMMUNITY COLLABORATION COMMITTEE (CCC), A STANDING COMMITTEE OF CENTRACARE HEALTH FOUNDATION, HAS A MEMBERSHIP OF OVER 15 PERSONS REPRESENTING HEALTHCARE AND COMMUNITY NEEDS ACROSS CENTRAL MINNESOTA. THE CCC MEETS QUARTERLY TO DISCUSS WAYS TO ADDRESS TYPICAL HEALTH ISSUES THROUGH AWARENESS BUILDING, EDUCATION AND ADVOCACY. THERE ARE SEVERAL COMMUNITY HEALTHY OUTREACH INITIATIVES THAT THE FOUNDATION IS INVOLVED WITH, THESE INITIATES INCLUDE: GREATER ST. CLOUD DEVELOPMENT CORPORATION; WELLBEING 5 SURVEY - A WORKPLACE ASSESSMENT TO ENGAGE 20,000 CENTRAL MINNESOTA EMPLOYEES IN THEIR OWN HEALTH AND WELLBEING; FEELING GOOD MN - ADVANCING HEALTH IN OUR COMMUNITIES BY BUILDING ON THE SUCCESS OF EXISTING HEALTH IMPROVEMENT PROGRAMS AND BRINGING EVERYONE TOGETHER TO COLLABORATE IN A WAY THAT WILL STRENGTHEN COMMUNITIES THROUGH POLICY, SYSTEMS, ENVIRONMENT (PSE) WORK; BLEND CHILDHOOD OBESITY COALITION OF CENTRAL MINNESOTA - GOAL IS TO REDUCE THE INCIDENCE OF CHILDHOOD OBESITY; CRAVE THE CHANGE - WORKING TO BUILD HEALTHY, TOBACCO-FREE COMMUNITIES FOR THE NEXT GENERATION; PROJECT BRAINSAFE - A COMMUNITY COLLABORATIVE AROUND THE PREVENTION AND TREATMENT OF CONCUSSIONS AND TRAUMATIC BRAIN INJURIES; IHI INTEGRATED BEHAVIORAL HEALTH PROJECT - IMPROVING ACCESS AND CARE DELIVERY FOR OUR PATIENTS WITH BEHAVIORAL HEALTH NEEDS. PART VI, LINE 6: THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 SISTERS OF THE ORDER OF ST BENEDICT 104 CHAPEL LANE ST ST JOSEPH MN 56374 410693973 501(C)(3) 100000 TO PAY FOR HEALTHCARE COSTS CENTRACARE HEALTH FOUNDATION 1406 6TH AVE N ST CLOUD MN 56303 411855173 501(C)(3) 1788195 TO SUPPORT THE CENTRACARE FOUNDATION 2 HOME DELIVERED MEALS 215 183564 BOOK COST TO PROVIDE MEALS TO THE NEEDY PART I, LINE 2: CENTRACARE HEALTH SYSTEM, INCLUDING ST. CLOUD HOSPITAL, HAS THE FOLLOWING POLICY REGARDING CHARITABLE CONTRIBIONS: CONTRIBUTIONS MUST BE IN KEEPING WITH THE MISSION OF CENTRACARE HEALTH, WHICH IS TO WORK TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. CONTRIBUTIONS WILL BE MADE TO ORGANIZATIONS RATHER THAN TO INDIVIDUALS WITHIN THE CENTRAL MINNESOTA REGION. CENTRACARE'S CHARITABLE FUNDS MAY NOT BE USED TO SUPPORT ANY ORGANIZATION OR EVENT THAT WOULD RESULT IN BENEFITS OF ANY KIND TO AN EMPLOYEE OF THE HEALTH SYSTEM OR A MEMBER OF THE VARIOUS BOARDS OF DIRECTORS, EITHER DIRECTLY OR INDIRECTLY. ONE EXCEPTION EXISTS TO THE GUIDELINE REGARDING BENEFIT TO EMPLOYEES: WE WILL SUPPORT, VIA SCHOLARSHIPS AND THE PURCHASE OF SUPPLIES, THE MEDICAL MISSION WORK OF OUR STAFF AND PHYSICIANS. THE CENTRACARE HEALTH CONTRIBUTIONS COMMITTEE IS MADE UP OF: ONE REPRESENTATIVE FROM CENTRACARE HEALTH FOUNDATION; ONE REPRESENTATIVE FROM ST. CLOUD HOSPITAL HUMAN RESOURCES/DIVERSITY COMMITTEE; THE DIRECTOR OF CENTRACARE HEALTH'S COMMUNICATIONS DEPARTMENT AND THE COMMUNICATIONS/MARKETING SPECIALIST RESPONSIBLE FOR CENTRACARE CLINIC; THE DIRECTOR OF COMMUNICATIONS/MARKETING FOR ST. BENEDICT'S SENIOR COMMUNITY; THE DIRECTOR OF CENTRACARE HEALTH'S MARKETING DEPARTMENT; THE DIRECTOR OF ST. CLOUD HOSPITAL VOLUNTEER SERVICES; AND ST. CLOUD HOSPITAL'S DIRECTOR OF MISSION & SPIRITUAL CARE. THE COMMITTEE MEETS MONTHLY TO ENSURE A STREAMLINED, COORDINATED PROCESS OF REVIEWING REQUESTS AND DETERMINING FUNDING. THE COMMITTEE MAINTAINS A DATABASE TO TRACK ALL CONTRIBUTIONS. OTHER CENTRACARE ENTITIES, INCLUDING CENTRACARE HEALTH - LONG PRAIRIE, MELROSE, MONTICELLO, PAYNESVILLE AND SAUK CENTRE, MAY DEVELOP A BUDGET FOR APPROVAL AND IMPLEMENT THEIR OWN CONTRIBUTIONS DECISIONS WITHIN THE GUIDELINES OF THIS DOCUMENT. CONTRIBUTIONS MAY NOT EXCEED THE STATED BUDGET AND NO MULTI-YEAR COMMITMENTS TO ORGANIZATIONS MAY BE MADE WITHOUT APPROVAL FROM THE CENTRACARE HEALTH EXECUTIVE COUNCIL. INDIVIDUALS AND DEPARTMENTS FROM THROUGHOUT ST. CLOUD HOSPITAL AND CENTRACARE CLINIC SHOULD FORWARD ALL OUTSIDE FUNDING REQUESTS TO A MEMBER OF THE COMMITTEE FOR THE FULL GROUP'S CONSIDERATION. THOSE REQUESTING FUNDS SHOULD BE ASKED TO SUBMIT REQUESTS IN WRITING. X X X X X X 0 1 0 0 0 0 1 0 0 CRAIG J BROMAN PRESIDENT 774848 0 141148 0 166541 0 35775 0 22555 0 1140867 0 128772 0 MERRYN JOLKOVSKY MD DIRECTOR, CHIEF OF STAFF 0 269702 0 16062 0 933 0 20476 0 2869 0 310042 0 0 ALBERT MERCURI MD DIRECTOR 0 349865 0 29463 0 988 0 26335 0 28718 0 435369 0 0 EDWARD B MARTIN-CHAFFEE MD DIRECTOR 0 532938 0 18040 0 18942 0 33754 0 27966 0 631640 0 0 MARIA MALLORY MD DIRECTOR 0 528229 0 19137 0 676 0 31224 0 27593 0 606859 0 0 RICHARD JOLKOVSKY MD DIRECTOR 0 574885 0 113689 0 3236 0 35775 0 32369 0 759954 0 0 GREGORY R KLUGHERZ TREASURER/CFO 575712 0 88532 0 133957 0 26845 0 22462 0 847508 0 104969 0 PAUL R HARRIS ESQ SECRETARY 0 371496 0 65685 0 67693 0 56781 0 31458 0 593113 0 52707 AMY PORWOLL VICE PRESIDENT 0 311938 0 54269 0 25358 0 50212 0 27570 0 469347 0 0 LINDA A CHMIELEWSKI VICE PRESIDENT 57437 0 39101 0 394566 0 2122 0 7776 0 501002 0 47418 0 DUANE A RASMUSSON VICE PRESIDENT 0 338139 0 53467 0 61734 0 24936 0 21358 0 499634 0 43465 LINDA L KAPPEL VICE PRESIDENT 252902 0 43555 0 20625 0 19259 0 15563 0 351904 0 19212 0 KURT T OTTO VICE PRESIDENT 0 225910 0 30671 0 46219 0 32787 0 27168 0 362755 0 27670 JESSICA P SWARTOUT MD PHYSICIAN 0 618131 0 31475 0 33889 0 35775 0 33645 0 752915 0 0 HANI S ALKHATIB MD PHYSICIAN 0 883359 0 21062 0 1822 0 35775 0 31740 0 973758 0 0 HILARY I UFEARO MD PHYSICIAN 0 761370 0 25052 0 18368 0 35775 0 30712 0 871277 0 0 DONALD J JURGENS MD PHYSICIAN 0 659474 0 16062 0 18188 0 35593 0 27463 0 756780 0 0 JON C BOWER PHYSICIAN 0 496316 0 14484 0 18708 0 31941 0 26313 0 587762 0 0 PART I, LINE 4B THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: CRAIG J BROMAN - PAID $128,772, ACCRUED $0 GREGORY R KLUGHERZ - PAID $104,969, ACCRUED $0 PAUL R HARRIS - PAID $52,707, ACCRUED $32,842 LINDA A CHIMIELEWSKI - PAID $47,418, ACCRUED $0 DUANE A RASMUSSEN - PAID $43,465 ACCRUED $0 AMY M PORWOLL - PAID $0, ACCRUED $23,258 LINDA L KAPPEL - PAID $19,212, ACCRUED $0 KURT T OTTO - PAID $27,670, ACCRUED $17,695 PART I, LINE 6 THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR SAINT CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM; QUALITY, THROUGH ACHIEVING SAINT CLOUD HOSPITAL AND SYSTEM QUALITY METRICS; PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; AND PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID. FORM 990, PART VI, SECTION A, LINE 2 MARRYN JOLKOVSKY AND RICHARD JOLKOVSKY - FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 4 ST. CLOUD HOSPITAL AMENDED ITS GOVERNING DOCUMENTS TO INCREASE THE CENTRACARE HEALTH (CCH) BOARD AUTHORITY AND CONTROL TO OPERATE THE INTEGRATED HEALTH SYSTEM. THE ST. CLOUD HOSPITAL (SCH) BOARD APPOINTMENT PROCESS WAS AMENDED SO THAT THE CCH BOARD APPOINTS THE SCH BOARD BASED ON RECOMMENDATION OF THE SCH JOINT NOMINATION COMMITTE. FORM 990, PART VI, SECTION A, LINE 6 ST. CLOUD HOSPITAL'S MEMBERS CONSIST OF EX-OFFICIO REPRESENTATIVES OF THE DIOCESE OF ST. CLOUD AND THE SISTER OF THE ORDER OF SAINT BENEDICT AND TWO TO FOUR MEMBERS APPOINTED BY THESE EX-OFFICIO MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A ST. CLOUD HOSPITAL'S MEMBERS CONSIST OF EX-OFFICIO REPRESENTATIVES OF THE DIOCESE OF ST. CLOUD AND THE SISTER OF THE ORDER OF SAINT BENEDICT AND TWO TO FOUR MEMBERS APPOINTED BY THESE EX-OFFICIO MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO APPOINTING THE ST. CLOUD HOSPITAL BOARD, THE MEMBERS APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION, APPROVE DISSOLUTION OF THE HOSPITAL, AND SUPPORT AND ASSESS THE HOSPITAL'S ROMAN CATHOLIC IDENTITY AND MISSIONS. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEWS THE 990 TAX RETURN REGULARLY DURING THE PREPARATION PROCESS, THEY FIELD QUESTIONS FROM STAFF AND MANAGE DEADLINES WHICH MUST BE MET. THEY ARE ALSO ACTIVELY INVOLVED WITH THE THIRD PARTY FIRM WHO ASSISTS IN THE FINAL COMPILATION OF THE REPORT. ONCE A COMPLETED 990 REPORT HAS BEEN PRODUCED, ANNUALLY AT THE BOARD'S APRIL MEETING, PRIOR TO FILING, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW THE IRS FORM 990 WITH THE STAFF, TO ASK QUESTIONS AND SEEK CLARIFICATIONS, AND TO APPROVE THE FINAL DOCUMENT. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15 15A: THE COMPENSATION AND BENEFITS OF THE PRESIDENT ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE MAY 2017. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. 15B: THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS COMPLETED IN MAY 2017. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM PROVIDES AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. FORM 990, PART XI, LINE 9: ADJUSTMENTS TO FUNDED STATUS OF PENSION PLAN 14,364,000. EQUITY TRANSFER TO CENTRACARE HEALTH SYSTEM -44,768,921. ELIMINATION ENTRIES 33,381. CENTRACARE HEALTH SYSTEM 1406 6TH AVE N ST CLOUD MN 56303 411813221 HEALTHCARE HOLDING COMPANY MN 501(C)(3) LINE 1 N/A 0 CENTRACARE HEALTH SYSTEM - MELROSE 11 NORTH 5TH AVE WEST MELROSE MN 56352 411865315 ACUTE/LT CARE MN 501(C)(3) LINE 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH SYSTEM - LONG PRAIRIE 20 SE 9TH STREET LONG PRAIRIE MN 56347 411924645 ACUTE/LT CARE MN 501(C)(3) LINE 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH SYSTEM - SAUK CENTRE 425 ELM STREET NORTH SAUK CENTRE MN 56378 452438973 ACUTE/LT CARE MN 501(C)(3) LINE 3 CENTRACARE HEALTH SYSTEM 0 CENTRAL MINNESOTA EMERGENCY PHYSICIANS 1406 6TH AVE N ST CLOUD MN 56303 411708142 EMERGENCY PHYSICIANS MN 501(C)(3) LINE 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE CLINIC 1200 6TH AVE NORTH ST CLOUD MN 56303 411806657 MULTI-SPECIALTY MN 501(C)(3) LINE 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH FOUNDATION 1406 6TH AVE N ST CLOUD MN 56303 411855173 FUNDRAISING MN 501(C)(3) LINE 7 CENTRACARE HEALTH SYSTEM 0 MONTICELLO SURGERY CENTER LLC 1013 HART BOULEVARD MONTICELLO MN 55362 813593057 AMBULATORY SURGERY CENTER MN N/A CENTRACARE PHARMACY SERVICES 1406 6TH AVE N ST CLOUD MN 56303 411620618 RETAIL PHARMACIES MN N/A C 0 CENTRACARE HOLDINGS INC 1406 6TH AVE N ST CLOUD MN 56303 472688595 INVESTMENTS MN N/A C 0 ST CLOUD MEDICAL GROUP PA 1406 6TH AVE N ST CLOUD MN 56303 410986131 PHYSICIAN SERVICES MN N/A C 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1