2016-11-03T13:33:52-05:00 2015-12-31 990 2015-01-01 810231792 HOLY ROSARY HEALTHCARE HOLY 4062332600 2600 WILSON STREET MILES CITY MT 59301 RON OLDFIELD VP FINANCIAL SVS & CFO 4062332600 2016-11-03 2015 2017-02-10 21:41:12Z PAUL LEWIS 2600 WILSON STREET MILES CITY MT 59301 48653840 0 0928 X WWW.HOLYROSARYHEALTHCARE.ORG X 1961 MT WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THEPEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR ANDVULNERABLE. 11 11 353 114 5875 -192 515304 1139551 37572962 46879473 136855 199123 427119 422586 38652240 48640733 135618 136797 0 0 19501474 18635270 0 0 0 21016934 24328759 40654026 43100826 -2001786 5539907 27334076 30998988 8552047 6677052 18782029 24321936 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OFTHE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POORAND VULNERABLE. 0 0 35020026 136797 47173400 FOUNDED IN 1910, HOLY ROSARY HEALTHCARE IS EASTERN MONTANA'S HEALTHCARE DESTINATION. HOLY ROSARY OPERATES A COMPREHENSIVE ACUTE-CARE HOSPITAL, PHYSICIAN CLINICS, A RESIDENTIAL LIVING COMMUNITY, AND HOSPICE AND PALLIATIVE CARE SERVICES - PROVIDING A COMPLETE CONTINUUM OF CARE TO A 10-COUNTY REGION OF EASTERN MONTANA. AS PART OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, A FAITH-BASED, NONPROFIT HEALTH SYSTEM, HOLY ROSARY HAS DIRECT ACCESS TO BEST PRACTICES, RESOURCES, TECHNOLOGY, TALENT AND STRATEGIC CAPITAL. SERVICES INCLUDE SURGICAL, ONCOLOGY, AND MATERNITY SERVICES, AS WELL AS 24-HOUR EMERGENCY ROOM AND DIAGNOSTIC AND THERAPEUTIC SERVICES. THE EXTENDED CARE UNIT PROVIDES SHORT-TERM TRANSITIONAL CARE AFTER ILLNESS, INJURY, OR SURGERY, AS WELL AS LONG-TERM CARE FOR THOSE UNABLE TO LIVE INDEPENDENTLY.IN AUGUST 1910, THE PRESENTATION SISTERS OF ABERDEEN, SOUTH DAKOTA, ASSUMED MANAGEMENT AND OPERATION OF THE COUNTY HOSPITAL IN MILES CITY AT THE REQUEST OF THE COMMUNITY, THE MILWAUKEE RAILROAD AND THE DOCTORS ASSOCIATED WITH THE RAILROAD. IN 1915, THE SISTERS PURCHASED THE HOSPITAL, COMMITTING TO A RELATIONSHIP WITH THE COMMUNITY THAT WOULD EXTEND FOR DECADES.IN 1995, HOLY ROSARY HEALTHCARE OPENED A NEW COST EFFECTIVE FACILITY ON A 58-ACRE CAMPUS IN MILES CITY THAT ALLOWED PHYSICIANS AND OTHER CARE FACILITIES TO LOCATE IN THE NEW HOSPITAL BUILDING. THE BUILDING OF THE NEW FACILITY AND MOVING INTO THE NEW FACILITY WAS A COMMUNITY-WIDE EFFORT, AND WAS ACCOMPLISHED THROUGH THE CONTRIBUTIONS OF THE STAFF, PHYSICIANS, BOARD MEMBERS, COMMUNITY MEMBERS AND VOLUNTEERS.IN KEEPING WITH THE NEW COVENANT PROCESS, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) ASSUMED SPONSORSHIP OF HOLY ROSARY HEALTHCARE IN 1997. TODAY, THE 25-BED ACUTE CARE HOSPITAL, RESIDENTIAL LIVING COMMUNITY AND 16-PHYSICIAN CLINIC ALL IN A SINGLE BUILDING, SERVES AS A CENTRALIZED SETTING FOR COMPREHENSIVE HEALTH CARE FOR THE PEOPLE ACROSS EASTERN MONTANA. PHYSICIAN SPECIALTIES INCLUDE FAMILY MEDICINE, INTERNAL/ADULT MEDICINE, GENERAL SURGERY, VASCULAR SURGERY, WOMEN'S HEALTH, ORTHOPEDICS, OPHTHALMOLOGY (EYE), PSYCHOLOGY, AUDIOLOGY, CARDIOLOGY, NEUROLOGY, NEUROSURGERY, ORAL SURGERY, NEPHROLOGY (KIDNEY), DERMATOLOGY, AND SLEEP MEDICINE/PULMONOLOGY.TODAY, HOLY ROSARY HEALTHCARE SERVES SEVERAL EASTERN MONTANA COUNTIES, WHICH COVER OVER 20,000 SQUARE MILES OR APPROXIMATELY 13% OF MONTANA. MORE THAN HALF OF THE PEOPLE RECEIVING HEALTHCARE IN MILES CITY, WHICH HAS A POPULATION OF 11,000, ARE FROM OUTSIDE CUSTER COUNTY. THEREFORE, HOLY ROSARY HEALTHCARE'S IMPACT ON THE HEALTHCARE DELIVERY SYSTEM REACHES FAR BEYOND CITY AND COUNTY LINES. WITH A POPULATION DENSITY OF 1.4 PERSONS PER SQUARE MILE ACROSS THE SEVEN-COUNTY REGION AROUND HOLY ROSARY, CLEARLY THIS DEGREE OF CONTEMPORARY HEALTH CARE IS EXTRAORDINARY.DURING 2015, HOLY ROSARY HEALTHCARE HAD THE FOLLOWING RESULTS:ADMISSIONS - 1,285OUTPATIENT VISITS - 59,952EMERGENCY ROOM VISITS - 4,902BIRTHS - 303SURGERIES - 1,481LAB TESTS - 96,053AS PART OF THE MONTANA REGION OF SCL HEALTH, HOLY ROSARY IS AFFILIATED WITH ST. JAMES HEALTHCARE IN BUTTE AND ST. VINCENT HEALTHCARE IN BILLINGS, GIVING IT ACCESS TO SOME OF THE STATE'S MOST ADVANCED MEDICAL TECHNOLOGY. HOLY ROSARY HAS A HISTORIC COMMITMENT TO SERVING THE POOR AND THOSE WITH LIMITED ACCESS TO HEALTHCARE. THE COMMITMENT IS TO THE WORTH AND DIGNITY OF THE WHOLE PERSON - SPIRITUAL, PSYCHOLOGICAL, AND MEDICAL.HOLY ROSARY IS CURRENTLY LICENSED BY THE STATE OF MONTANA AND IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTH CARE ORGANIZATIONS. HOLY ROSARY HAS 25 ACUTE CARE AND 86 EXTENDED CARE BEDS AND 24 PHYSICIAN OFFICES. MISSIONWE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.VISIONINSPIRED BY OUR FAITH,WE WILL BE DISTINGUISHED AS THE PREMIER PERSON-CENTERED HEALTH SYSTEM AND TRUSTED PARTNER.WE WILL ENGAGE PATIENTS IN THEIR CARE DECISIONS AND SHARE ACCOUNTABILITY WITH CLINICIANS AND OTHER STAKEHOLDERS TO COORDINATE CARE ACROSS ALL SETTINGS AND IMPROVE ACCESS, QUALITY, HEALTH OUTCOMES AND AFFORDABILITY.WE WILL GROW AS COMMUNITY-BASED HEALTH NETWORKS IN PARTNERSHIP WITH OTHERS WHO SHARE OUR VISION AND VALUES AND ALIGN WITH US TO BE AN ESSENTIAL PROVIDER TO THOSE WE SERVE.VALUES CARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON. EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS. GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS. INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE. SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES. STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US.HOLY ROSARY HEALTHCARE HAS A VARIETY OF PROGRAMS AND SERVICES TO SERVE THE COMMUNITY:CANCER CAREFROM INITIAL DIAGNOSIS TO TREATMENT AND RECOVERY, PATIENTS AND THEIR FAMILIES CAN ACCESS AN EXCEPTIONAL LEVEL OF CARE CLOSE TO HOME. CARDIAC SERVICESFOR OPTIMAL CONVENIENCE, HOLY ROSARY OFFERS A CONTINUUM OF CARE - STRESS TESTING, PACEMAKER IMPLANTATION, AND CARDIAC REHABILITATION. CHILDREN'S CAREWE UNDERSTAND THE SPECIAL NEEDS OF CHILDREN AND OFFER EXPERIENCED AND SKILLED NURSES, A FAMILY-FRIENDLY EMERGENCY DEPARTMENT AND BOARD-CERTIFIED PEDIATRICIANS.CLINICLOCATED ON THE HOSPITAL CAMPUS, THE HOLY ROSARY HEALTHCARE CLINIC WAS DEVELOPED TO PROVIDE OUTSTANDING PRIMARY AND SPECIALTY CARE. DIABETES CARETHE HOLY ROSARY DIABETES CARE TEAM, CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION, OFFERS BOTH INPATIENT AND OUTPATIENT SERVICES TO ASSIST PATIENTS. EMERGENCY AND TRAUMA SERVICESHOLY ROSARY'S TEAM OF EMERGENCY PROVIDERS AND NURSES ADEPTLY ASSESS CONDITIONS RANGING FROM A CHILD'S RISING FEVER TO LIFE-THREATENING HEART ATTACKS.HOSPICE AND PALLIATIVE CAREALL PALLIATIVE AND HOSPICE CARE TEAM MEMBERS ARE AVAILABLE TO MAKE HOME VISITS, NURSING HOME VISITS, ASSISTED LIVING VISITS AND TO VISIT PATIENTS AT HOLY ROSARY HEALTHCARE.HOSPITALIST PROGRAMA HOSPITALIST'S PRIMARY PROFESSIONAL FOCUS IS THE TOTAL CARE OF A PATIENT FROM THE TIME OF ADMISSION UNTIL THE PATIENT LEAVES THE HOSPITAL. LAB SERVICESTHE LABCHECK PROGRAM HELPS ENCOURAGE PEOPLE TO SEEK PREVENTIVE MEDICINE, ALLOWING PATIENTS TO RECEIVE BLOOD TESTS TO DETECT ILLNESSES AND DISORDERS AT A REDUCED COST.RADIOLOGY AND IMAGING SERVICESHOLY ROSARY HEALTHCARE OFFERS INPATIENT AND OUTPATIENT DIAGNOSTIC AND INTERVENTIONAL (MINIMALLY INVASIVE RADIOLOGY) SERVICES. RESIDENTIAL LIVINGRESIDENTIAL LIVING OFFERS NURSING FOR SHORT-TERM, POST-ACUTE HOSPITAL STAYS TO LONG-TERM LIVING. SPORTS MEDICINEPRACTITIONERS WORK CLOSELY WITH ATHLETES, PARENT, AND COACHES TO EDUCATE AND PROVIDE INDIVIDUAL, AS WELL AS TEAM CONSULTATIONS. SURGICAL SERVICESSURGICAL TEAMS BRING A PERSONAL TOUCH WITH THE SOPHISTICATION OF ADVANCED MEDICINE. THERAPY AND REHABILITATION SERVICESHOLY ROSARY HEALTHCARE OFFERS A HOLISTIC APPROACH TO TREATMENT, WITH SPECIAL CONSIDERATION FOR A PATIENT'S AGE, PHYSICAL ABILITIES, RELIGIOUS AND ETHNIC BELIEFS. WALK IN CLINICHOLY ROSARY HEALTHCARE WALK-IN CLINIC SERVES ALL AGES AND IS OPEN EVERY DAY OF THE WEEK. WOMEN'S HEALTH SERVICESCOMPREHENSIVE WOMEN'S HEALTH CARE TEAM PROVIDING SERVICES TO WOMEN IN EASTERN MONTANA. 35020026 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 68 0 1 353 1 1 1 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X KYLE ENGMAN 3038135543 500 ELDORADO BLVD SUITE 4200 BROOMFIELD CO 80021 RACHEL ARMSTRONG MEMBER 1.00 0.00 X 0 0 0 BILL BICKLE MEMBER 1.00 0.00 X 0 0 0 SR KATHERINE FRANCHETT MEMBER 1.00 0.00 X 0 0 0 RONALD HATHAWAY MEMBER 1.00 0.00 X 0 0 0 STACY KLIPPENSTEIN EDD MEMBER 1.00 0.00 X 0 0 0 TAMMIE MCFARLAND MEMBER 1.00 0.00 X 0 0 0 NIKI MUNROE MEMBER 1.00 0.00 X 0 0 0 BILL OFTEDAL CHAIR 2.00 0.00 X X 0 0 0 POLLY PETERSEN PHD SECRETARY 2.00 0.00 X X 0 0 0 JIM REGAN VICE CHAIR 2.00 0.00 X X 0 0 0 SISTER SHARON SMITH MEMBER 1.00 0.00 X 0 0 0 STEVE LOVELESS PRESIDENT CEO SVH-MT REG 50.00 0.00 X 0 563584 88745 PAUL LEWIS CHIEF EXECUTIVE OFFICER 50.00 0.00 X 0 316462 69153 RON OLDFIELD VP FINANCE - 7/7-12/31 50.00 0.00 X 0 302601 55464 TRAVIS SCHEVING VP FINANCE - 1/1/-7/6 50.00 0.00 X 0 177884 33814 DARREN WALKER VP HUMAN RESOURCES 50.00 0.00 X 0 244454 53245 MARK NICHOLS MD PSO PHYSICIAN CLINIC 50.00 0.00 X 398362 0 25327 JEFFERY WILLIAMS MD PSO PHYSICIAN CLINIC 50.00 0.00 X 309555 0 33844 DOROTHY BRADBURY MD PSO PHYSICIAN ED 50.00 0.00 X 279834 0 21268 LISA CADWELL MD PSO PHYSICIAN CLINIC 50.00 0.00 X 255093 0 23726 STEVEN MAERTENS MD PSO PHYSICIAN ED 50.00 0.00 X 230885 0 18160 LISA SANFORD FORMER KEY EMPLOYEE 0.00 0.00 X 0 125166 24036 1473729 1730151 446782 18 1 1 0 MEDEFIS INC 10826 OLD MILL RD STE 101 OMAHA NE 68154 CONTRACT LABOR 760960 PRAIRIE TRAVELERS INC 130 3RD ST S STE 2 GLASGOW MT 59320 CLINICAL STAFFING 503062 SYNAPTIC HEALTHCARE LLC 2600 WILSON STREET STOP 1 MILES CITY MT 59301 CLINICAL STAFFING 228512 EXPRESS LAUNDRY CENTER 1115 S HAYNES AVE MILES CITY MT 59301 LAUNDRY SERVICES 159953 YELLOWSTONE ANESTHESIA ASSOCIATES PO BOX 1576 MILES CITY MT 59301 MEDICAL SERVICES 154398 6 1062258 77293 1139551 PATIENT SERVICES REVENUE 622110 46879473 46879473 46879473 207676 207676 122784 0 122784 122784 122784 8553 -8553 -8553 -8553 5009 4554 455 455 CAFETERIA 722310 291111 291111 ADMINISTRATIVE SERVICES 561000 5420 5420 DIETICIAN CONSULTING 541900 2816 2816 299347 48640733 47173400 5875 321907 X 136797 136797 1905406 1619595 285811 12753652 12260040 493612 824779 776863 47916 2110492 2092760 17732 1040941 980272 60669 300 300 890 890 4446298 4173251 273047 106733 100311 6422 112008 106168 5840 745409 742772 2637 169065 129148 39917 21665 21665 1301615 1301615 486274 486274 SYSTEM ALLOCATION 6747758 6747758 MEDICAL SUPPLIES 5178695 5178695 BAD DEBT EXPENSE 2665417 2665417 MAINTENANCE SERVICES 768169 768014 155 1578463 1480369 98094 43100826 35020026 8080800 0 116410 70431 7654132 7013319 13712 29941 48321 75974 912815 918157 678936 670435 45983617 31789319 12388851 14194298 5520899 8026433 27334076 30998988 8552047 6677052 8552047 6677052 X 18782029 24321936 18782029 24321936 27334076 30998988 5539907 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 890 890 0 PART II-B, LINE 1: HOLY ROSARY HEALTHCARE PAYS DUES TO THE MONTANA HOSPITAL ASSOCIATION AND LEADING AGE OF WHICH $890 IS ATTRIBUTED TO LOBBYING. 138189 138189 137825 364 138189 170833 233 33241 137825 157436 2655 13771 2500 529 170833 152032 8504 2500 600 157436 1.00000 0 1 1 135510 135510 14674511 8234520 6439991 12096412 9686456 2409956 18692922 13868343 4824579 384262 384262 14194298 THIRD PARTY SETTLEMENTS 451856 OTHER RECEIVABLE 16623 INTERCOMPANY RECEIVABLE 7557954 8026433 PART V, LINE 4: THE INTENDED USE FOR THE KENNETH HOM TRUST ENDOWMENT FUND IS TO PROVIDE NURSING SCHOLARSHIPS. ENDOWMENT FUNDS ARE HELD BY THE HOLY ROSARY HEALTHCARE FOUNDATION. 1 1 X 1 X 1 X 1 1 1 0 1 1 1477441 1477441 0.03650 4832332 5259993 0.00000 139761 185129 0.00000 6449534 5445122 1477441 0.03650 196846 109702 87144 0.00220 69638 2500 67138 0.00170 3985534 2726837 1258697 0.03110 50737 5050 45687 0.00110 4302755 2844089 1458666 0.03610 10752289 8289211 2936107 0.07260 5439 5439 0.00010 5747 5747 0.00010 953 953 0.00000 3293 3293 0.00010 4049 4049 0.00010 19481 19481 0.00040 1 2665417 0 13196901 14362422 -1165521 X 1 1 1 1 HOLY ROSARY HEALTHCARE 2600 WILSON STREET MILES CITY MT 59301 WWW.HOLYROSARYHEALTHCARE.ORG 13512 X X X HOLY ROSARY HEALTHCARE 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X WWW.HOLYROSARYHEALTHCARE.ORG/ABOUT-US X 1 15 1 WWW.HOLYROSARYHEALTHCARE.ORG/ABOUT-US 0 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X HOLYROSARYHEALTHCARE.ORG X HOLYROSARYHEALTHCARE.ORG X HOLYROSARYHEALTHCARE.ORG X X X X X 1 X 0 X X X X 1 X 0 0 HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 5: HOLY ROSARY HEALTHCARE (HRH) COMPLETED A CHNA IN 2015. THE CHNA PROCESS INCORPORATED DATA FROM BOTH QUALITATIVE AND QUANTITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDED SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); AS THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDED PRIMARY RESEARCH GATHERED THROUGH AN ONLINE KEY INFORMANT SURVEY. THE PURPOSE OF THE SURVEY WAS TO SOLICIT INPUT FROM THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY HRH WITH NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL.PARTICIPANTS IN THE SURVEY REPRESENTED ORGANIZATIONS WHO WORK WITH LOW INCOME, MINORITY POPULATIONS (INCLUDING AFRICAN-AMERICANS, THE AMISH, ASIANS, CARIBBEAN POPULATIONS, CHILDREN, HISPANICS, THE HOMELESS, LESBIAN/GAY/BISEXUAL/TRANSGENDER RESIDENTS, LOW-INCOME RESIDENTS, THE MENTALLY ILL, NATIVE AMERICANS, SENIORS, SINGLE PARENTS, SUBSTANCE ABUSERS, UNINSURED/UNDERINSURED RESIDENTS, AND WOMEN), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (INCLUDING ADOLESCENTS/YOUNG ADULTS, THE AUTISTIC POPULATION, CHILDREN, THE DISABLED, THE ELDERLY, ETHNIC MINORITIES, THE HOMELESS, LGBT RESIDENTS, LOW-INCOME RESIDENTS, MEDICAID/MEDICARE RECIPIENTS, THE MENTALLY ILL, NATIVE AMERICANS, RURAL PATIENTS, SINGLE PARENTS, UNINSURED/UNDERINSURED RESIDENTS, AND VETERANS). HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 6B: THE HOLY ROSARY HEALTHCARE CHNA WAS COMPLETED WITH LOCAL GOVERNMENT AND SOCIAL SERVICE AGENCIES AND STAFF, INCLUDING MCCONE COUNTY HEALTH CENTER, GLENDIVE MEDICAL CENTER, GARFIELD PUBLIC HEALTH AND DAHL MEMORIAL HEALTHCARE ASSOCIATION, INC. HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 11: HOLY ROSARY HEALTHCARE TARGETED THE TOP THREE HEALTH AREAS IDENTIFIED BY OUR RECENT CHNA: ACCESS TO CARE, MENTAL HEALTH, AND TOBACCO CESSATION.IMPROVED ACCESS TO CARE: WE PROMOTE AWARENESS AND CONNECTIVITY TO ALLOW INDIVIDUALS TO ACCESS HEALTH CARE WITHIN THE COMMUNITY BY PROVIDING MULTIPLE COMMUNICATION OUTLETS THROUGH VIRTUAL TECHNOLOGY, PUBLIC MEDIA, FORUMS, SOCIAL MEDIA, COMMUNITY ACTIVITIES AND PLANNED EVENTS. THESE FOCUSED ACTIVITIES INCLUDE:- GROWING OUR RELATIONSHIP WITH FRONTIER CANCER CENTER TO PROMOTE AWARENESS AND AVAILABILITY OF CANCER-RELATED SERVICES. - EXPANDING OUR EXISTING TELE-MED SERVICES TO THE OUTLYING AREAS. - ADOPTING VIRTUAL HEALTH TECHNOLOGIES TO CONNECT COMMUNITY MEMBERS TO HEALTH SERVICES AND PROMOTE ACCESS TO MEDICAL RECORDS THROUGH MY CHART. - COLLABORATION WITH COMMUNITY PARTNERS TO IDENTIFY AND SUPPORT A CENTRALIZED ACCESS RESOURCE FOR SPECIALTY AND ROUTINE HEALTH CARE SERVICES. - OUR PARTNERSHIP WITH ST. VINCENT HEALTHCARE IN BILLINGS, MT TO BRING SPECIALISTS TO SERVE OUR COMMUNITY, ADDING TWO IN 2015 AND A THIRD COMING ON BOARD THE BEGINNING OF 2016. WE WELCOMED A NEW NURSE PRACTITIONER AS PART OF OUR PROVIDER CARE TEAM. - LATE IN 2015 WE EXPANDED OUR CLINIC ACCESS TO INCLUDE SATURDAY AND SUNDAY WALK-IN APPOINTMENTS, 8 HOURS EACH DAY. EARLY IN 2015 WE EXPANDED OUR WEEKDAY CLINIC HOURS BY ONE HOUR. THESE CHANGES HAVE GIVEN OUR COMMUNITY ACCESS TO HEALTHCARE WITHOUT DRIVING A 150 MILES DISTANCE, AND REDUCED THE COST TO GOVERNMENT AND PRIVATE HEALTH INSURANCE BY AVOIDING ED VISITS. BOTH OF THESE EXPANSIONS HAVE ALLOWED OUR EMERGENCY DEPARTMENT (ED) TO FOCUS ON APPROPRIATE LEVEL OF CARE. IN ADDITION, THE ED WAS EXPANDED TO INCLUDE AVERA WHICH PROVIDES CAMERA CONNECTION TO A SPECIALIZED TEAM THAT GIVES ASSISTANCE WITH TRAUMA AND UNIQUE ED CIRCUMSTANCES. MENTAL HEALTH: WE CONTINUE TO WORK WITH EASTERN MONTANA COMMUNITY MENTAL HEALTH CENTER (EMCMHC) TO DEVELOP PROCESSES TO MANAGE PATIENTS WHO COME TO THE ED WITH A MENTAL HEALTH CRISIS. BY OBTAINING EMCMHC'S INPUT, THE PROCESS IS WORKING WELL AND WE FEEL MENTAL HEALTH-NEED PATIENTS ARE BENEFITING FROM THIS NEW APPROACH. WE ARE DOING EXTENSIVE COLLABORATION WITH EMCMHC TO PROVIDE A SCREENING PROCESS IN OUR CLINIC FOR BEHAVIORAL HEALTH NEEDS AND TO PROVIDE OUTPATIENT SERVICES AT HRH OR IN THE COMMUNITY SO THAT PATIENTS WOULD RECEIVE CARE BEFORE A CRISIS ARRIVES. WE HAVE A TARGET DATE OF SUMMER OF 2016 TO OFFER THIS SERVICE. ISSUE 3: TOBACCO CESSATION: WE INITIATED THE PROCESS OF PROVIDING COUNSELING AND EDUCATION TO BOTH OUTPATIENT AND INPATIENT TOBACCO USERS AT HRH. THIS IS BEING TRACKED WITHIN OUR ELECTRONIC RECORDS (EPIC) AND THE INFORMATION WILL BE USED THIS YEAR TO DEVELOP AND MONITOR REPORTS. THE HRH TOBACCO CESSATION 9-MEMBER TEAM MEETS MONTHLY TO CONTINUE WITH EVALUATION AND DEVELOPMENT OF ACTION STEPS NEEDED TO BE SUCCESSFUL.THE REMAINDER OF NEEDS IDENTIFIED IN THE CHNA ARE IMPORTANT TO HRH BUT DUE TO SEVERELY LIMITED RESOURCES AT THE HOSPITAL LEVEL AND THE AVAILABILITY OF COMMUNITY ORGANIZATIONS WHO ARE ALREADY ADDRESSING NEEDS, HRH WILL FOCUS ON THE THREE HEALTH AREAS LISTED ABOVE. HRH CONTINUES TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ENSURE ALL NEEDS AND HEALTH INDICATORS ARE BEING ADDRESSED. 7 1 - HOLY ROSARY FAMILY PRACTICEINT MED 2600 WILSON STREET MILES CITY MT 59301 FAMILY PRACTICE/INT MED CLINIC 2 - HOLY ROSARY HOSPITAL EMERGENCY 2600 WILSON STREET MILES CITY MT 59301 EMERGENCY CLINIC 3 - HOLY ROSARY HOSPITALIST 2600 WILSON STREET MILES CITY MT 59301 SURGICAL CLINIC 4 - HOLY ROSARY RURAL HEALTH CLINIC PEDIAT 2600 WILSON STREET MILES CITY MT 59301 PEDIATRIC CLINIC 5 - HOLY ROSARY RURAL HEALTH CLINIC WOMENS H 2600 WILSON STREET MILES CITY MT 59301 WOMEN'S CLINIC 6 - HOLY ROSARY RURAL HEALTH FAMILY PRACTICE 2600 WILSON STREET MILES CITY MT 59301 FAMILY PRACTICE CLINIC 7 - HOLY ROSARY SURGICAL SERVICES 2600 WILSON STREET MILES CITY MT 59301 SURGICAL CLINIC PART I, LINE 6A: THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,665,417. PART II, COMMUNITY BUILDING ACTIVITIES: HOLY ROSARY HEALTHCARE (HRH) CONTINUES TO WORK WITH COMMUNITY ORGANIZATIONS THAT ECONOMICALLY SUPPORT ACTIVITIES AND POLICY IN ITS COMMUNITY. IN 2015, HOSPITAL ADMINISTRATORS PARTICIPATED IN SEVERAL ECONOMIC-BUILDING BOARDS, SUCH AS THE MILES CITY ECONOMIC DEVELOPMENT COMMITTEE, EASTERN MONTANA INDUSTRIES MEETING, KIWANIS CLUB, AND THE MONTANA HEALTH NETWORK BOARD. HOLY ROSARY HEALTHCARE (HRH) ALSO ACTIVELY PARTICIPATES IN THE DEA'S DRUG TAKE BACK PROGRAM. TO PROVIDE FRESH FOOD AND FLOWERS TO THE COMMUNITY, HRH ESTABLISHED A COMMUNITY GARDEN ON ITS GROUNDS AS A MEANS FOR ANY CITIZEN TO PLANT WHAT THEY WOULD LIKE AND HRH PROVIDES FREE WATER. WE BELIEVE OUR PARTICIPATION IN THESE ACTIVITIES WILL ENSURE THE SOCIAL DETERMINANTS OF HEALTH ARE BEING ADDRESSED IN OUR COMMUNITY.PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE TO HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE ORGANIZATIONS FINANCIAL STATEMENTS THAT DESCRIBE THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL COLLECTION EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE MODIFICATIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS INCLUDES A RESERVE FOR BOTH UNINSURED PATIENTS AND BALANCES DUE FROM PATIENTS AFTER INSURANCE. PART III, LINE 8: THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. PART VI, LINE 2: AS PART OF OUR CORE VALUE OF RESPONSE TO NEED, HOLY ROSARY HEALTHCARE (HRH) TAKES ONGOING STEPS TO PROVIDE THE GREATEST GOOD FOR ITS COMMUNITY. HRH HOSTS A COMMUNITY BENEFIT COMMITTEE MADE UP OF VOLUNTEER CITIZENS WHO ARE CHARGED WITH REVIEW OF THE CHNA AND IMPLEMENTATION PLAN PROGRESS. THIS ENSURES THAT DATA FROM THE CHNA IS ALWAYS BEING CONSIDERED, EVEN IF NOT A TOP NEED. HRH PERFORMS AN ANNUAL BUSINESS DEVELOPMENT REVIEW OF ITS COMMUNITY - WHICH ENSURES THIS RURAL COMMUNITY AND CRITICAL ACCESS HOSPITAL KNOWS WHAT NEW HEALTH ISSUES MAY BE HAPPENING IN THEIR COMMUNITY. PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILBLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: THE HOLY ROSARY HEALTHCARE (HRH) SERVICE AREA INCLUDES TEN COUNTIES: CARTER, CUSTER, DAWSON, FALLON, GARFIELD, MCCONE, POWDER RIVER, PRAIRIE, ROSEBUD, AND TREASURE. THE HRH SERVICE AREA ENCOMPASSES 29,449.31 SQUARE MILES AND HOUSES A TOTAL POPULATION OF 40,754 RESIDENTS, ACCORDING TO LATEST CENSUS ESTIMATES. THIS IS A 2.4% DECREASE OR 981 PEOPLE FROM 2000 TO 2010 (US CENSUS BUREAU). THE HRH SERVICE AREA IS PREDOMINANTLY RURAL, WITH 60.3% OF THE POPULATION LIVING IN AREAS DESIGNATED AS RURAL. IN CONTRAST, OVER 50% OF THE STATE POPULATION AND OVER 80% OF THE NATIONAL POPULATION LIVES IN URBAN AREAS. IN THE HRH SERVICE AREA, 23.1% OF THE POPULATION ARE INFANTS, CHILDREN OR ADOLESCENTS (AGE 0-17); ANOTHER 59.6% ARE AGE 18 TO 64, WHILE 17.3% ARE AGE 65 AND OLDER.IN LOOKING AT RACE INDEPENDENT OF ETHNICITY (HISPANIC OR LATINO ORIGIN), 98.4% OF RESIDENTS OF THE HRH SERVICE AREA ARE WHITE AND 1.3% ARE NATIVE AMERICAN.THE LATEST CENSUS ESTIMATE SHOWS 14.9% OF THE HRH SERVICE AREA POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL. IN ALL, 35.4% OF SERVICE AREA RESIDENTS (AN ESTIMATED 14,000 INDIVIDUALS) LIVE BELOW 200% OF THE FEDERAL POVERTY LEVEL. HIGHER CONCENTRATIONS OF POVERTY EXIST IN CENSUS TRACTS IN PRAIRIE COUNTY AND PART OF SOUTHERN ROSEBUD COUNTY. A HIGHER CONCENTRATION OF PERSONS LIVING BELOW THE 200% POVERTY THRESHOLD IS FOUND IN CARTER COUNTY, PRAIRIE COUNTY, AND PART OF SOUTHERN ROSEBUD COUNTY, WITH PART OF SOUTHERN ROSEBUD COUNTY SHOWING THE HIGHEST CONCENTRATION.AMONG THE HRH SERVICE AREA POPULATION AGE 25 AND OLDER, AN ESTIMATED 9.8% (OVER 2,746 INDIVIDUALS) DO NOT HAVE A HIGH SCHOOL DIPLOMA.ACCORDING TO DATA DERIVED FROM THE US DEPARTMENT OF LABOR, THE UNEMPLOYMENT RATE IN THE HRH SERVICE AREA IN SEPTEMBER 2014 WAS 3.1%. PART VI, LINE 5: WE EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY BUILDING ACTIVITIES DEMONSTRATE THIS COMMITMENT. IN 2015, THE MOST SIGNIFICANT EXPENSE IN COMMUNITY BUILDING ACTIVITIES CONTINUED TO BE THE COST OF PHYSICIAN RECRUITMENT TO OUR MEDICALLY UNDERSERVED AREA. WE ARE ALSO INVOLVED IN MANY COMMUNITY ORGANIZATIONS THAT VARY IN SCOPE INCLUDING CRITICAL INCIDENT STRESS MANAGEMENT, COMMUNITY HEALTH ALLIANCE (WHICH PARTNERS WITH ALL LOCAL HEALTH ORGANIZATION TO CREATE COMMUNITY HEALTH IMPROVEMENT), AND OTHER CIVIC MINDED ORGANIZATIONS. WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. OUR BOARD OF DIRECTORS INCLUDES MEDICAL AND BUSINESS PROFESSIONALS WHO LIVE AND WORK IN OUR COMMUNITY. THEY ARE NOT EMPLOYEES OF HOLY ROSARY AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN HOLY ROSARY HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES BY ENCOURAGING THEM TO VOLUNTEER WITH COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS FOOD DRIVES, RELAY FOR LIFE (AMERICAN CANCER SOCIETY), SCHOOL SUPPLY DRIVES FOR LOCAL IN-NEED CHILDREN BEFORE EVERY SCHOOL YEAR, AND MANY OTHERS. HRH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL OR SOME OF THE HOSPITAL'S DEPARTMENTS.WE ARE GOOD CITIZENS BY PARTNERING WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY. HOLY ROSARY IS REPRESENTED ON A NUMBER OF COMMUNITY-BASED ORGANIZATIONS AND BOARDS INCLUDING: COMMUNITY HEALTH ALLIANCE, MONTANA HEALTH NETWORK, MILES CITY AREA ECONOMIC DEVELOPMENT, KIWANIS, ROTARY, EASTERN MONTANA INDUSTRIES, MILES COMMUNITY COLLEGE, EASTERN MONTANA AREA HEALTH EDUCATION, AMERICAN CANCER SOCIETY RELAY FOR LIFE, KEEP AMERICA BEAUTIFUL-MILES CITY CHAPTER, MILES CITY COMMUNITY GARDEN, AND A NUMBER OF ADDITIONAL NOT-FOR-PROFIT, COMMUNITY-FOCUSED, CHARITABLE ORGANIZATIONS. IN 2015, HOLY ROSARY EMPLOYEES PROVIDED OVER 1,500 HOURS OF VOLUNTEER EFFORT TO THE COMMUNITY. PART VI, LINE 6: HOLY ROSARY HEALTHCARE IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE." WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITIES, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES NINE HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,000 FULL-TIME ASSOCIATES AND MORE THAN 500 EMPLOYED PROVIDERS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEMWIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.HOLY ROSARY HEALTHCARE PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION AND REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES,TAX SERVICES AND MISSION INTEGRATION. 1 HOLY ROSARY FOUNDATION 2600 WILSON STREET MILES CITY MT 59301 202270238 501(C)(3) 111512 SUPPORT MISSION RURAL HEALTH DEVELOPMENT INC 11 S 7TH STREET NO 241 MILES CITY MT 59301 363769758 501(C)(3) 10600 PROMOTE HEALTH IN COMMUNITY 2 0 PART I, LINE 2: THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASON FOR SUCH SUPPORT. ELIGIBILITY FOR FUNDING IS DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO THE ORGANIZATION'S MISSION. 0 1 0 0 0 0 0 1 0 STEVE LOVELESS PRESIDENT CEO SVH-MT REG 0 441345 0 109303 0 12936 0 70757 0 17988 0 652329 0 0 PAUL LEWIS CHIEF EXECUTIVE OFFICER 0 207390 0 22630 0 86442 0 48901 0 20252 0 385615 0 73864 RON OLDFIELD VP FINANCE - 7/7-12/31 0 215029 0 44708 0 42864 0 38912 0 16552 0 358065 0 36575 TRAVIS SCHEVING VP FINANCE - 1/1/-7/6 0 135589 0 9655 0 32640 0 16631 0 17183 0 211698 0 0 DARREN WALKER VP HUMAN RESOURCES 0 203347 0 39823 0 1284 0 35556 0 17689 0 297699 0 0 MARK NICHOLS MD PSO PHYSICIAN CLINIC 370800 0 5000 0 22562 0 10817 0 14510 0 423689 0 0 0 JEFFERY WILLIAMS MD PSO PHYSICIAN CLINIC 300177 0 5000 0 4378 0 18802 0 15042 0 343399 0 0 0 DOROTHY BRADBURY MD PSO PHYSICIAN ED 255712 0 14271 0 9851 0 12992 0 8276 0 301102 0 0 0 LISA CADWELL MD PSO PHYSICIAN CLINIC 191370 0 57500 0 6223 0 15450 0 8276 0 278819 0 0 0 STEVEN MAERTENS MD PSO PHYSICIAN ED 199028 0 31500 0 357 0 0 0 18160 0 249045 0 0 0 LISA SANFORD FORMER KEY EMPLOYEE 0 46666 0 11850 0 66650 0 19598 0 4438 0 149202 0 0 PART I, LINE 3 THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. PART I, LINE 4B A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COST AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS PRIOR TO 2014 PRIOR TO 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. THE RELATED ORGANIZATION HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THE AMOUNTS ARE VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE VESTED IN THE CURRENT YEAR, ARE CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. FOR SOME OF THE PARTICIPANTS, AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE FEDERAL AND STATE GOVERNMENTS AS WITHHOLDING ON THE TAXABLE BENEFIT. NO CASH PAYMENT IS MADE DIRECTLY TO THE PARTICIPANT AND THE REMAINING BENFIT AMOUNT STAYS IN THE RETIREMENT PLAN. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2015 WERE: PAUL LEWIS - $29,158, RON OLDFIELD - $16,000. FOR AMOUNTS CONTRIBUTED TO THE NQDC SERP PLAN PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. STARTING IN 2014, FOR CONTRIBUTIONS TO THE NQDC SERP PLAN, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2015. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2015 WERE: LISA SANFORD - $65,992. PART I, LINE 7 THE AT RISK COMPENSATION PLAN WAS ESTABLISHED TO ENABLE THE HEALTH CARE SYSTEM AND ITS CARE SITES TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION, VISION, STRATEGIC PRIORITIES AND KEY INITIATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND IS FUNDED EACH YEAR BY MEETING THRESHOLD LEVELS OF OPERATING INCOME. TARGET AWARD AMOUNTS ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR SPECIFIC ROLE AT THE HEALTH CARE SYSTEM. ACTUAL AWARDS ARE PAID OUT BASED ON ATTAINMENT OF BOARD APPROVED GOALS, INCLUDING OPERATING INCOME, STEWARDSHIP, PATIENT EXPERIENCE, EMPLOYEE SAFETY AND COMMUNITY BENEFIT/MISSION TARGETS. AWARDS ARE BASED ON THE BOARD'S DETERMINATION ON HOW WELL THE HEALTH CARE SYSTEM PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLANS ARE BASED ON A COMBINATION OF PERFORMANCE MEASURES. PERFORMANCE MEASURES INCLUDE OPERATING INCOME, STEWARDSHIP, PATIENT EXPERIENCE, EMPLOYEE SAFETY AND COMMUNITY BENEFIT/MISSION TARGETS. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. ADDITIONAL OFFICER AND BOARD DISCLOSURES THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF NINE HOSPITALS, NINE FOUNDATIONS, TWO SAFETY-NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES. SCLHS AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARD OF DIRECTORS (BOARD) IS COMPENSATED FOR THAT SERVICE. SCLHS' BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. LISA CADWELL HIGHEST PAID EMPLOYEE RETENTION LOAN X 44458 16210 0 1 1 STEVEN MAERTANS HIGHEST PAID EMPLOYEE RETENTION LOAN X 26500 13731 0 1 1 29941 YELLOWSTONE ANESTHESIA SEE PART V 154398 SEE PART V 0 FORM 990, SCHEDULE L, PART IV BOARD MEMBER, RACHEL ARMSTRONG'S SPOUSE OWNS 33% OF YELLOWSTONEANESTHESIA ASSOCIATES, INC. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF HOLY ROSARY HEALTHCARE. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF HOLY ROSARY HEALTHCARE, APPOINTS MEMBERS OF HOLY ROSARY HEALTHCARE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND THE BYLAWS INCLUDING THE APPOINTMENT OR REMOVAL OF BOARD MEMBERS AND THE PRESIDENT/CEO. SCLHS ALSO HAS CERTAIN RESERVE POWERS OVER ANY CHANGE IN OWNERSHIP OF THE CORPORATION, CHANGE IN MISSION, ACQUISITION OF ASSETS, DISPOSAL OF ASSETS, LEASING OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, APPOINTMENT OF AUDITORS AND OVERSIGHT AND APPROVAL OF COMPENSATION AND BENEFITS FOR DIRECTORS, OFFICERS, KEY EMPLOYEES AND PHYSICIANS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY HOLY ROSARY HEALTHCARE AND THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (COLLECTIVELY REFERRED TO AS SCL HEALTH), REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS. PERSONS CONSIDERED TO BE IN AN INFLUENTIAL POSITION, SUCH AS BOARD MEMBERS, OFFICERS, PHYSICIANS, EXECUTIVES AND MANAGERS ARE ALL REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT AND APPROPRIATE LEADERSHIP. A REPORT IS PROVIDED TO SCLHS' PRESIDENT/CEO AND THE BOARD OF DIRECTORS. THE BUSINESS AND AFFAIRS OF SCL HEALTH WILL AT ALL TIMES BE CONDUCTED IN A MANNER THAT IS SOLELY IN THE BEST INTERESTS OF SCL HEALTH AND NOT BE INFLUENCED BY CONFLICTING INTERESTS OF PERSONS RESPONSIBLE FOR ADMINISTERING THOSE AFFAIRS. THE EXISTENCE OF ANY CONFLICTS OF INTEREST WILL BE DISCLOSED AND THE PROCEDURES SET FORTH HEREIN WILL BE FOLLOWED. CERTAIN TRANSACTIONS SUGGESTIVE OF A CONFLICT OF INTEREST ARE PROHIBITED. ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SCL HEALTH IS CONSIDERED AN INTERESTED PERSON. THIS TERM INCLUDES, BUT IS NOT LIMITED TO THE FOLLOWING: - BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND DIRECTORS; - SENIOR LEADERS AND EXECUTIVES (CEO, PRESIDENT, SVP, VP, EXECUTIVE DIRECTORS); - EMPLOYED PHYSICIANS AND PHYSICIANS IN MEDICAL STAFF LEADERSHIP ROLES (E.G., DEPARTMENT CHAIRS, MEMBERS OF MEDICAL STAFF COMMITTEES); - MEDICAL DIRECTORS OF CLINICAL PROGRAMS THAT ASSESS, REVIEW, RECOMMEND OR REQUEST PURCHASE OF ANY SPECIFIC PHARMACEUTICAL PRODUCTS, MEDICAL DEVICES, SUPPLIES AND/OR EQUIPMENT; - DEPARTMENT DIRECTORS AND MANAGERS; AND - OTHER SELECT INDIVIDUALS IDENTIFIED BY LEADERSHIP WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, SUPPLY CHAIN AND FINANCE. UPON BECOMING AN INTERESTED PERSON AND ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CURRENT CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT ("STATEMENT") AS APPROVED BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER. THE CHIEF INTEGRITY AND COMPLIANCE OFFICER WILL OVERSEE THE REVIEW OF THE STATEMENTS AND THE RESOLUTION OF ANY IDENTIFIED CONFLICTS OF INTEREST AND ALERT THE SCL HEALTH CEO AND/OR THE CHAIR OF THE SCL HEALTH BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. WHEN AN INTERESTED PERSON BECOMES AWARE OF A CONFLICT OF INTEREST WHICH HAS NOT BEEN DISCLOSED ON A STATEMENT, HE OR SHE SHALL CONTACT THE LOCAL COMPLIANCE AND PRIVACY OFFICER OR THE CHIEF INTEGRITY AND COMPLIANCE OFFICER, OBTAIN A STATEMENT FORM, COMPLETE AND RETURN IT TO THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT. WHENEVER AN INTERESTED PERSON BECOMES AWARE THAT AN ARRANGEMENT WITH RESPECT TO WHICH HE OR SHE HAS A CONFLICT OF INTEREST IS BEING CONSIDERED, THE INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS CONCERNING THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR (IF AN EMPLOYEE OTHER THAN THE ORGANIZATIONS SCL HEALTH CEO) OR TO THE APPLICABLE BOARD OR COMMITTEE CHAIR (IF THE SCL HEALTH CEO OR A BOARD OR COMMITTEE MEMBER), EVEN IF THE CONFLICT OF INTEREST HAS BEEN PREVIOUSLY DISCLOSED. WITH REGARD TO EMPLOYEES OTHER THAN THE SCL HEALTH CEO, THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. WITH REGARD TO THE SCL HEALTH CEO AND BOARD OR COMMITTEE MEMBERS, THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. PERSON(S) RESPONSIBLE FOR THE DETERMINATION SHOULD OBTAIN FURTHER GUIDANCE FROM THE SCL HEALTH INTEGRITY AND COMPLIANCE OR LEGAL DEPARTMENTS. UPON MAKING HIS OR HER DISCLOSURE, THE INTERESTED PERSON WILL LEAVE THE MEETING OR OTHERWISE REMOVE HIM OR HERSELF FROM THE DELIBERATIONS OR OTHER DECISION-MAKING PROCESS UNTIL SUCH TIME AS A DETERMINATION IS REACHED. IF A DETERMINATION HAS BEEN MADE THAT NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY BE PRESENT AND PARTICIPATE IN THE DELIBERATION REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, IF AN INTERESTED PERSON HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, HE OR SHE MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT; BE PRESENT DURING THE DELIBERATION OR DECISION-MAKING; OR BE ALLOWED TO MAKE A PRESENTATION PRIOR TO THE DELIBERATION AND DECISION-MAKING ACTIVITIES. WHEN AN INTERESTED PERSON HAS A CONFLICT OF INTEREST, THE DECISION-MAKER/DECISION-MAKING BODY CONSIDERING THE TRANSACTION OR ARRANGEMENT WILL TAKE REASONABLE MEASURES, PRIOR TO APPROVING OR ENTERING INTO THE TRANSACTION OR ARRANGEMENT, TO ENSURE THAT THE PROPOSAL IS IN SCL HEALTH'S BEST INTERESTS. THE PROPOSED TRANSACTION OR ARRANGEMENT MAY PROCEED IF THE DECISION-MAKER/DECISION-MAKING BODY, AFTER HAVING BEEN FULLY INFORMED OF THE MATERIAL FACTS ESTABLISHING THE CONFLICT OF INTEREST, DETERMINES THAT THE TRANSACTION OR ARRANGEMENT IS IN SCL HEALTH'S BEST INTERESTS AND IS FAIR AND REASONABLE. A MAJORITY VOTE OF THE DISINTERESTED DECISION-MAKERS IS REQUIRED WHEN A DETERMINATION IS MADE BY A BOARD, COMMITTEE OR OTHER DECISION-MAKING BODY. MANAGEMENT OF POTENTIAL CONFLICTS IS DONE BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER AND/OR CARE SITE COMPLIANCE AND PRIVACY OFFICERS AND REPORTED ANNUALLY TO THE CARE SITE LEADERSHIP COMMITTEES AND/OR EXECUTIVE INTEGRITY AND COMPLIANCE COMMITTEE, THE AUDIT COMMITTEE, ORGANIZATIONAL INTEGRITY AND COMPLIANCE COMMITTEE OF THE SCL HEALTH BOARD OF DIRECTORS. ANY REPORTED CONFLICTS OR POTENTIAL CONFLICTS WILL ALSO BE REPORTED TO AND REVIEWED BY THE SCL HEALTH TAX DIRECTOR FOR COMPLIANCE WITH THE FORM 990 TAX RETURN. FORM 990, PART VI, SECTION B, LINE 15B THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 2,069,990. MANAGEMENT AND GENERAL EXPENSES 197,875. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,267,865. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,699,552. MANAGEMENT AND GENERAL EXPENSES 11,255. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,710,807. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 253,544. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 253,544. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 125,648. MANAGEMENT AND GENERAL EXPENSES 63,917. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,565. MISC PROFESSIONAL CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 24,517. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,517. 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