2016-11-03T15:55:21-05:00 2015-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2015-01-01 820146328 Gritman Medical Center GRIT 2088824511 700 S Main Street Moscow ID 83843 Kara Besst CEO 2088824511 2016-10-31 1 TERRI REXRODE CPA MST P00096513 9206620016 2016-10-31 2015 2017-02-10 21:41:12Z Kara Besst 700 S Main Street Moscow ID 83843 56493951 0 X www.gritman.org X 1939 ID TO PROVIDE EXTRAORDINARY CARE TO IMPROVE THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES. 10 9 593 286 140740 55824 38624 186228 50129635 53166297 726971 1087676 -17558 152633 50877672 54592834 267489 284227 0 0 26093144 28964756 0 0 0 23268067 23670099 49628700 52919082 1248972 1673752 73990969 73609237 27903978 26763414 46086991 46845823 X To provide extraordinary care to improve the health of the people in our communities. 0 0 46150077 284227 51998088 Emergency Services: Providing emergency care to you and your family 24-hours-a-day, seven-days-a-week, is a priority at Gritman Medical Center. Our doors are always open to you. A doctor from Moscow Emergency Physicians and our highly-trained staff are ready to care for you. Our Emergency Services department is equipped for routine medical and obstetrical emergencies and has large trauma bays equipped with trauma resuscitation equipment and cardiac monitoring.Medical Surgical Unit:Our nursing staff works closely with the physicians to provide the best care possible. Inpatient care can also include physical, occupational, speech and massage therapy, as necessary for the best recovery. Patient-focused dieticians work directly with you to establish nutritious, appropriate diets. Specialized ostomy and wound care is available to inpatients and outpatients.Laboratory:Lab services are available to those without insurance or who are not covered for a particular test, through our Community Wellness Panel. These tests are patient-requested rather than physician-ordered and the results go directly to you. Payment is required at the time of service, but the tests or screenings are discounted.Family Birth Center: Upon arrival, patients are matched with one of our skilled and compassionate labor nurses. They will guide patients through their labor, monitor the progress of their baby and make sure their needs are met. They and the rest of the nursing team work together with the doctor to provide a welcoming environment for your newest family member.Surgery: Working together with surgeons, nursing, physical therapists, registered dietitians, lab, radiology, pharmacy, social services experts and others, we can help you regain your health. Gritman offers a full array of surgeries including General Surgery, Orthopedics, OB/GYN, Urology. Therapy Solutions: At Gritman Therapy Solutions, we have created a welcoming environment to provide you the best opportunity for a full recovery. We work with all ages of patients from infants through seniors.Whether you are recovering from a joint replacement, sports related injury or have a child struggling with speech, our skilled staff is here to help. We offer physical, speech, occupational and massage therapies in our outpatient therapy rooms, exercise gyms, outdoor therapy park and warm water therapy pool. We also provide service in many of our area schools. 46150077 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 120 0 1 593 1 1 1 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X PAT MCCONNELL 2088832220 700 S Main Street Moscow ID 83843 BJ swanson board chair 2.00 0.50 X X 0 0 0 Janie Nirk board vice-chairman 2.00 X X 0 0 0 robin woods secretary/treasurer 2.00 X X 0 0 0 greg mann trustee 2.00 X 0 0 0 charles jacobson md trustee 2.00 X 0 0 0 Barbara Wells trustee 2.00 X 0 0 0 greg kimberling BOARD REPRESENTATIVE 2.00 X X 0 0 0 dick Heimsch trustee 2.00 X 0 0 0 Kraig White MD trustee 2.00 X 0 0 0 Rula Awwad-Rafferty trustee 2.00 X 0 0 0 kara besst ceo 40.00 X 0 0 0 Preston Becker cfo 40.00 X 158703 0 19265 sheryl washburn cno 40.00 X 162815 0 6782 kane francetich CIO 40.00 X 128062 0 18861 connie osborn cqo 40.00 X 103142 0 15604 steven reitz crna 40.00 X 244208 0 17088 deborah mauro-bender crna 40.00 X 249822 0 15680 kama white PHYSICIAN 40.00 X 211109 0 21686 Maria Bode CRNA 40.00 X 246992 0 17920 Modad Guillermo Physician 40.00 X 176754 0 12131 1681607 0 145017 23 0 1 1 moscow emergency physicians 700 S MAIN STreet moscow ID 83843 ER services 1576264 Cardinal Health 411 INC 3712 Collection Center Drive Chicago IL 60693 Pharmaceuticals 1203823 Cardinal Health PO Box 100552 Pasadena CA 91189 Nuclear Pharmacy Services 826703 Smith & Nephew Ortho PO Box 785921 Philadelphia PA 19178 Ortho Services 743646 Avista Utilities 1411 E Mission Avenue Spokane WA 99252 Utilities Services 553407 36 176532 9696 186228 net patient service revenue 621110 51998088 51998088 other revenue 621110 445584 445584 cafeteria revenue 900099 363744 363744 GIFT SHOP REVENUE 900099 151770 151770 EDUCATIONAL CLASS REVENUE 900099 129455 129455 77656 77656 53166297 942686 942686 1268740 1116107 152633 152633 63084 89549 760000 170000 760000 25010 0 144990 144990 144990 54592834 51998088 140740 2267778 284227 284227 613233 435265 177968 22018129 19930445 2087684 6333394 6032574 300820 56781 56781 96079 23991 72088 2674928 2310603 364325 763125 8296 754829 8640622 7750087 890535 697564 697564 469331 262213 207118 852770 852770 3553721 3553721 654468 654468 repairs and maintenance 2605444 1617199 988245 BAD DEBT EXPENSE 1563631 1563631 loss in joint venture 787681 787681 DUES AND SUBSCRIPTIONS 146666 65735 80931 107288 107288 52919082 46150077 6769005 0 1911179 449448 1317610 1344024 8740723 8252106 1773190 1528477 683700 840806 86552466 46321414 39324504 40231052 17661940 17339676 2578123 3623648 73990969 73609237 4493411 4765778 1310606 745848 14755000 14255000 5899201 6996788 1445760 0 27903978 26763414 X 46078655 46837487 8336 8336 46086991 46845823 73990969 73609237 1673752 -914920 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8925 8925 0 Part II-B, Line 1: expenses paid to strategic healthcare organizations whose focus is state and federal government relations and advocacy efforts on behalf of Hospital Associations. IHA dues - $740 AHA dues - $685 Stratgic Health Care Planning - $7,500 6646129 6646129 20280157 9676575 10603582 24852514 10565339 14287175 32360066 26079500 6280566 2413600 2413600 40231052 X 53098062 -914920 -1563631 -2478551 55576613 -983779 -983779 54592834 52339230 983779 983779 51355451 1563631 1563631 52919082 Part X, Line 2: In order to account for any uncertain tax positions, the Medical Center and Foundation determine whether it is more likely than not that a tax position will be sustained upon examination of the technical merits of the position, assuming the taxing authority has full knowledge of all information. If the tax position does not meet the more likely than not recognition threshold, the benefit of the tax position is not recognized in the financial statements. The Medical Center is also engaged, to a limited extent, in activities which the Internal Revenue Service (IRS) considers unrelated to the Medical Center's exempt purpose, and therefore, taxable. These activities, however, have resulted in net operating losses for income tax purposes. The Medical Center does not presently anticipate that a tax benefit from these net operating losses will be realized in the future. Accordingly, any potential deferred tax asset resulting from the availability of net operating loss carry-forward is offset by a valuation allowance of equal amount. No deferred tax assets and liabilities have been recognized since no other differences exist between the financial and tax basis of reporting the Medical Center's assets and liabilities. The Medical Center recorded no assets or liabilities for uncertain tax positions. Federal returns for the tax years 2012 and beyond remain subject to examination by the IRS. Part XI, Line 2d - Other Adjustments: BAD DEBT EXPENSE -1,563,631. Part XI, Line 4b - Other Adjustments: RENTAL EXPENSES -1,116,107. EMERGENCY DEPARTMENT REVENUE 23,273. CAFETERIA REVENUE 109,055. Part XII, Line 2d - Other Adjustments: RENTAL EXPENSES 1,116,107. EMERGENCY DEPARTMENT REVENUE -23,273. CAFETERIA REVENUE -109,055. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts 1,563,631. 1 1 1 X 1 X 1 1 1 0 0 1584882 1584882 0.03090 4570697 2920387 1650310 0.03210 6155579 2920387 3235192 0.06300 7 1132 88061 88061 0.00170 8 66 73732 73732 0.00140 4 1626285 827762 798523 0.01550 19 1198 1788078 827762 960316 0.01860 19 1198 7943657 3748149 4195508 0.08160 1 15625 15625 0.00030 1 15625 15625 0.00030 1 892364 10730383 11283837 -553454 X 1 1 1 Palouse Health properties llc property management 0.60850 0.39150 2 palouse surgery center llc outpatient surgery center 0.61700 0.38300 1 1 gritman medical center 700 s main street moscow ID 83843 www.gritman.org 39 X X X X gritman medical center 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X HTTP://WWW.GRITMAN.ORG/PDFS/CHNA13.PDF X 1 13 1 http://www.gritman.org/pdfs/CHNA13.pdf 1 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X 1 X www.gritman.org/billing-financial-policy.html#Charity X www.gritman.org/billing-financial-policy.html X www.gritman.org/billing-assistance.html X X X X X 1 0 X X X X 1 X 0 0 gritman medical center Part V, Section B, Line 5: LOCAL EXPERT ADVISORS WERE SELECTED ACCORDING TO CRITERIA REQUIRED BY FEDERAL GUIDELINES AND REGULATIONS. THE HOSPITAL'S DESIRE IS TO REPRESENT THE REGION'S GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. gritman medical center Part V, Section B, Line 11: In a number of ways, Gritman Medical Center is addressing the significant community needs that were identified from the initially conducted CHNA in 2013. In 2015 Gritman carried out the first year of its new strategic plan. A big part of the strategic plan and prioritization of initiatives were driven by the needs identified in the most recently conducted CHNA. Additionally, Gritman creates an annual management plan detailing specific initiatives to be addressed each year; again, utilizing data and information from the most recently filed CHNA for the management plans of 2015 and 2016 as a basis for prioritizing initiatives. Gritman's strategy has been to gainfully address the top 9 identified community needs based on public feedback during the initial CHNA. Following are ways in which Gritman is addressing those top 9 community health needs.In response to the first identified need (Mental Health/Suicide) Gritman Medical Center has done the following:1. Gritman is actively recruiting for mental health professionals who will provide services in our community. As of the end of 2015 there have not been any additional mental health professionals in the community; however, we continue the efforts.2. Gritman has entered into a relationship with St. Alphonsus Regional Medical Center in Boise, Idaho to provide outpatient Tele-Psych services to Gritman and the communities Gritman serves.3. Gritman provides resources to Latah Recovery Center, a community organization that provides resources, classes, and coaching to help people on their path to recovery.4. Gritman has a safe room available in its Emergency Department for patients presenting mental health issues.5. Gritman offers an Employee Assistance Program for employees and their family that includes four, free visits to mental health professionals per topic per year.6. Gritman hosts and is represented on a multi-agency Community Behavioral Health Team. This team helps expedite care, facilitate placement, and organize community-wide plans and solutions.7. Gritman provides resources to the Family Promise Organization, an organization that works with the local homeless population to provide services and resources to become sustainable.8. Gritman currently participates in a multi-hospital focus group to conduct research for additional facilities and services specifically regarding patients awaiting transfer to acute care.9. Gritman provides resources to LCYAC program that goes into schools to provide education on substance abuse and mental health.In regards to the second identified need (Affordability/Access) Gritman Medical Center has done the following:1. Continuing efforts to work with patients and the public in regards to financial assistance programs including Gritman's own Financial Assistance Program.2. Gritman is actively recruiting for psychiatrists, pediatricians, ENT, oncologist, family practice, orthopedic surgeons, pain management, and nurse practitioners.3. Gritman provides WWAMI, a rural medicine scholarship program through Gritman Medical Center Foundation, to encourage new medical graduates to practice in the area.4. Gritman is partners with Palouse Surgeons and Palouse Specialties, which are partnerships between Pullman Regional Hospital and Whitman Hospital and Medical Group and Gritman Medical Center, to employ specialty physicians to provide coverage in Latah and Whitman counties.5. Gritman has traveling specialties available including: pediatrics, cardiology, nephrology, asthma/allergy, neurosurgeon, and oncology/hematology.6. Gritman has entered into a relationship with St. Alphonsus Regional Medical Center in Boise, Idaho to provide outpatient Tele-Psych services to Gritman and the communities Gritman serves.7. Gritman Medical Foundation offers scholarships, through the Bosom Buddies program, to community members who need free assistance for mammograms.8. Gritman Participates in 19 health fairs including: free screenings, blood pressure, wound care assessments, massage, as well as health and wellness information.9. Gritman offers diabetes wellness classes hosted on site and free to public; free Fit & Fall Proof class; discounted osteoporosis fitness group; Motherhood Connections (new mother support group); and has cancer resource center.10. Gritman has established Rural Clinics in Kendrick, Troy, and Potlatch.11. Gritman Medical Center Foundation has scholarships to help individuals pay for services in Cardiac Rehab and Martin Wellness Center In regards to the third identified need (Alcohol/Drug Abuse) Gritman Medical Center has done the following:1. Gritman provides space for local NA and AA groups to meet at no cost.2. Gritman provides an Employee Assistance Program for employees and family members that includes four free visits to mental health professionals per topic per year.3. Gritman provides resources to Latah Recovery Center who in turn provides resources, classes and coaching to help community members recover from abuse.4. Gritman provides resources to the LCYAC program who provided education on substance abuse and mental health to local schools.5. Gritman has In-house resource available to provide materials and education and resources for substance abuse issues.In regards to the fourth identified need (Physicians) Gritman Medical Center has done the following:1. Gritman is actively recruiting for psychiatrists, pediatricians, ENT, oncologist, family practice, orthopedic surgeons, pain management, and nurse practitioners.2. Gritman provides WWAMI, a rural medicine scholarship program through the hospital foundation, to encourage recent medical graduates to practice in the area.3. Gritman is partners with Palouse Surgeons and Palouse Specialties, which are partnerships between Pullman Regional Hospital and Whitman Hospital and Medical Group and Gritman Medical Center, to employ specialty physicians who will provide coverage in Latah and Whitman counties.4. Gritman actively works with local practices to recruit physicians to the area.5. Gritman provides traveling specialties which include pediatrics, cardiology, nephrology, asthma/allergy, neurosurgeon, oncology/hematology6. Gritman has a CME Program that provides additional training and education to providers.7. Gritman provides space for clinical and simulation lab experience opportunities for first-year medical students. 8. Gritman has established a Physician Engagement Team to address physician needs.In regards to the fifth identified need (Obesity/Overweight) Gritman Medical Center has done the following:1. Gritman has added 'Healthy-Options' vending machines throughout the facility.2. Gritman has a Clinical nutrition and diabetes education program.3. The Martin Wellness Center provides land and water therapy classes.4. The Gritman Cardiac Rehab Department offers heart healthy, monitored exercise.5. The Diabetes Department has established the Diabetes Prevention Program in conjunction with the CDC.6. Gritman sponsors local 5K/run/walks.7. Gritman offers free blood pressure checks8. Gritman has registered dieticians on staff for inpatient and outpatient consultations and three certified diabetes educators.9. Gritman's cafeteria has introduced a Healthy Plate option available to everyone.In regards to the sixth identified need (Priority Population) Gritman Medical Center has done the following:1. Gritman has continued initiatives in place as identified in the most recently filed CHNA.In regards to the seventh identified need (Cancer) Gritman Medical Center has done the following:1. Gritman has continued initiatives in place as identified in the most recently filed CHNA.2. Gritman continues to work towards developing a full time cancer center in Moscow, Idaho which would include medical oncology. The plan is to place the cancer center in Gritman's new Medical Office Building, which is set to be completed early 2017. However, if the program begins before the building is complete, Gritman will have sufficient space available within the hospital to begin providing clinical oncology as soon as a partner is identified and practitioners are available.In regards to the eighth identified need (Diabetes) Gritman Medical Center has done the following:1. Gritman has continued initiatives in place as identified in the most recently filed CHNA.In regards to the ninth identified need (Dental) Gritman Medical Center has done the following:1. Gritman is working with the Community Health Association of Spokane (CHAS), which has an FQHC locally in Moscow. Gritman is planning a new Medical Office Building with expected completion in late 2016, in which CHAS has expressed interest in expanding services and growing into leasing larger space, potentially in Gritman's new building. This expansion includes adding needed dental services in our community. gritman medical center Part V, Section B, Line 16i: Gritman has 1.5 full-time financial counselor(s) to inform and educate patients. One financial counselor works with patients who visit us through our Emergency Department. After a patient is seen in the ED, the counselor will share information on all available payment options including county assistance and our charity care. If the patient cannot pay, the patient is given our charity care form and if needed can assist in filling out the form. Our case management staff refer patients to our financial counselors, as well, if patients express interest or need in receiving billing information. Our financial policy is available on our website and in brochure form. gritman medical center Part V, Section B, Line 22d: The hospital used The Prospective Method 1 1 - palouse surgery center llc 2300 West A street moscow ID 83843 General medical and surgery Part I, Line 7: Part I, Line 7: Lines 7a, b and c were calculated using a cost to charge ratio based on total operating expenses less bad debt divided by gross patient charges.Part I, Lines 7E,F,G and I were calculated from general ledger actual costs. Part I, Line 7g: THREE RURAL PHYSICIAN HEALTH CLINICS WERE INCLUDED IN LINE 7G. THE COST OF THE CLINICS WAS $798,523. 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 $ 1,563,631. Part II, Community Building Activities: GRITMAN MEDICAL CENTER IS COMMITTED TO SERVING THE HEALTHCARE NEEDS OF OUR COMMUNITY. WE ORGANIZE AND PARTNER WITH OTHERS IN OUR COMMUNITY, PARTICIPATE IN COMMUNITY EVENTS, AND PROVIDE USEFUL INFORMATION AND EDUCATE RESIDENTS YOUNG AND OLD ON WAYS TO IMPROVE THEIR HEALTH AND WELLNESS THROUGH PREVENTATIVE PROGRAMS. EXAMPLES INCLUDE FREE MONTHLY EDUCATIONAL CLASSES PRESENTED BY LOCAL EXPERTS ON TOPICS SUCH AS DIABETES, NUTRITION AND FITNESS. WE ORGANIZE AN ANNUAL FUN RUN EACH FEBRUARY TO ENCOURAGE HEART HEALTH AND PARTNER WITH THE UNIVERSITY OF IDAHO DURING THE SAME MONTH TO OFFER A FREE DANCE WORK SHOP.SPONSOR COMMUNITY EVENTS SUCH AS A FALL TRIATHLON FOR CHILDREN AND ADULTS. WE OFFER FREE "FIT AND FALL PROOF" CLASSES SEVERAL TIMES WEEKLY TO HELP IMPROVE THE BALANCE OF SENIORS AND THUS REDUCE THE RISK OF FALLS. WE OFFER FREE SUPPORT GROUPS, FREE BLOOD PRESSURE CLINICS AND FREE SMOKING CESSATION COUNSELING. THESE ARE JUST A FEW EXAMPLES OF THE MANY ACTIVITIES WE ARE INVOLVED IN THAT HELP PROMOTE BETTER HEALTH IN OUR COMMUNITY. Part III, Line 2: This amount is calculated using the cost-to-charge ratio applied against charges less bad debt recoveries. Part III, Line 4: The medical center and surgery center report patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. the medical center and surgery center provide an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. as a service to the patient, the medical center and surgery center bill third party payers directly and bill the patient when the patient's liability is determined. patient accounts receivable are due in full when billed. the receivables are non-interest bearing. accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Part III, Line 8: information was from gritman medical center's 2015 cost report. Part III, Line 9b: gritman medical center does not collect from patients initially known to qualify for charity care. If a patient in collections is later determined to qualify for charity care, gritman medical center ceases collection efforts for that patient. Part VI, Line 2: Gritman evaluates data from Idaho public health district #2 which includes information on Latah County (among others) from the Behavioral Risk Factor Surveillance System, developed by the Centers for Disease Control and Prevention and designed to estimate the prevalence of risk factors for major causes of morbidity and mortality in the United States. Part VI, Line 3: Gritman has 1.5 full-time financial counselor(s) to inform and educate patients. One financial counselor works with patients who visit us through our Emergency Department. After a patient is seen in the ED, the counselor will share information on all available payment options including county assistance and our charity care. If the patient cannot pay, the patient is given our charity care form and if needed can assist in filling out the form. Our case management staff refer patients to our financial counselors, as well, if patients express interest or need in receiving billing information. Our financial policy is available on our website and in brochure form. Part VI, Line 4: GRITMAN MEDICAL CENTER IS A NOT-FOR-PROFIT, COMMUNITY-OWNED HOSPITAL IN A RURAL/AGRICULTURAL AREA OF NORTH IDAHO CALLED THE PALOUSE. GRITMAN MEDICAL CENTER HAS BEEN A PART OF THE COMMUNITY FOR MORE THAN 100 YEARS.THE PRIMARY SERVICE AREA FOR GRITMAN MEDICAL CENTER IS LATAH COUNTY. LATAH COUNTY IS 2000 SQUARE MILES WITH APPROXIMATELY 38,778 PEOPLE. LATAH COUNTY IS COMPOSED OF MOSCOW, THE COUNTY SEAT AND 10 SMALL TOWNS. THERE IS WIDE VARIATION IN MEDIAN AGE IN OUR SERVICE AREA: 5.7% ARE PERSONS UNDER 5 YEARS; 18.5% ARE PERSONS UNDER 18 YEARS; AND 12.2% ARE PERSONS 65 YEARS AND OVER. MEDIAN HOUSEHOLD INCOME BETWEEN 2010-2014 WAS $41,944. BETWEEN 2010-2014, 19.9% OF OUR POPULATION LIVES BELOW THE POVERTY LEVEL.GRITMAN IS IN A HIGHLY COMPETITIVE MARKET WITH FOUR OTHER HOSPITALS LOCATED WITHIN 35 MILES. ALL BUT ONE IS A CRITICAL ACCESS HOSPITAL. Part VI, Line 5: Gritman Medical Center was originally established not for economic opportunity but to address a need for health services in our community. At the heart of Gritman Medical Center is our commitment to serving your healthcare needs. As a not-for-profit organization, we take seriously our social responsibility to provide access to services regardless of one's ability to pay. Gritman's commitment to our community includes giving back in other ways, too. We offer free mammograms to local women who are unable to cover the screening on their own through the Bosom Buddies program. We provide services to help cancer patients improve their quality of life through the Light A Candle program. We offer free and low cost therapy, fitness classes, wellness screenings, free blood pressure clinics and smoking cessation classes as well as support groups for caregivers. Gritman also helps provide support to local organizations and programs within the community through volunteer, in-kind and financial contributions. 1 Gritman Medical Center Foundation Inc 700 S Main Street MOSCOW ID 83843 200586022 501(C)(3) 220935 OPERATING EXPENSES Part I, Line 2: WHEN GRANT FUNDS ARE RECEIVED THEY ARE PLACED IN THEIR OWN FUND ACCOUNT AND TRACKED TO MAKE SURE THEY ARE SPENT IN ACCORDANCE WITH THE GRANT. X X X 0 0 0 0 0 0 0 0 0 Preston Becker cfo 158703 0 0 0 0 0 6584 0 12681 0 177968 0 0 0 sheryl washburn cno 162815 0 0 0 0 0 6596 0 186 0 169597 0 0 0 steven reitz crna 244208 0 0 0 0 0 4996 0 12092 0 261296 0 0 0 deborah mauro-bender crna 249822 0 0 0 0 0 10032 0 5648 0 265502 0 0 0 kama white PHYSICIAN 211109 0 0 0 0 0 8659 0 13027 0 232795 0 0 0 Maria Bode CRNA 246992 0 0 0 0 0 9972 0 7948 0 264912 0 0 0 Modad Guillermo Physician 176754 0 0 0 0 0 0 0 12131 0 188885 0 0 0 SCHEDULE J, PART II KARA BESST, CEO, RECEIVED COMPENSATION OF $339,061 FROM AN UNRELATED ORGANZATION, QUORUM HEALTH RESOURCES. A Idaho health facilities authority 826051863 45129UAV6 2003-06-01 18545000 new hospital wing 0 0 0 A 4290000 18904302 281940 17384432 2003 0 0 0 0 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 Form 990, Part VI, Section B, line 11 Gritman Medical Center's CFO presents a copy of the Form 990 to the Board for review prior to signature of the return by the organization's CEO. Form 990, Part VI, Section B, line 12c Potential conflicts are required to be disclosed to the board throughout the year. Legal counsel reviews all potential conflicts of interest and then determines if a conflict of interest is present. It is the policy of Gritman Medical Center that any board member with an undisclosed conflict of interest may be subject to immediate termination from service on the board. Form 990, Part VI, Section B, line 15 THE ORGANIZATIONS CEO IS AN EMPLOYEE OF QUORUM HEALTH RESOURCES (QHR) AS SUCH, THEIR PAY RATE IS DETERMINED BY QHR. QHR PERFORMS A COMPENSATION SURVEY TO DETERMINE THE CEO'S COMPENSATION, THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS ALL CONTRACTS WITH QHR TO DETERMINE REASONABLE SALARIES. GRITMAN HAS FOUR OTHER SENIOR ADMINISTRATIVE STAFF, THE CHIEF FINANCIAL OFFICER (CFO), THE CHIEF NURSING OFFICER (CNO), THE CHIEF QUALITY OFFICER (CQO), AND THE CHIEF INFORMATION OFFICER (CIO) EACH YEAR PRIOR TO THE ANNUAL PAY INCREASE THEIR POSITIONS ARE REVIEWED BY THE HUMAN RESOURCES DIRECTOR THEIR SALARY GRADE MINIMUM AND MAXIMUM RATES AND THEIR ACTUAL PAID RATES ARE COMPARED TO STATE AND REGIONAL SALARY SURVEY DATA TO DETERMINE THEIR RELATIONSHIP TO OUR EXTERNAL Market IN ADDITION TO THE EXTERNAL COMPARISON, WE ENSURE WE HAVE INTERNAL EQUITY BASED ON THEIR SALARY GRADE LEVEL, YEARS OF EXPERIENCE AND HOW THEIR RESPONSIBILITIES COMPARE TO THOSE IN OTHER POSITIONS. ALL PAY INCREASES ARE REVIEWED AND APPROVED BY THE CEO THE PAY INCREASES ARE THEN INCORPORATED INTO THE ANNUAL BUDGET WHICH IS APPROVED BY THE BOARD OF DIRECTORS. SALARY DECISIONS ARE MADE BY THOSE WITHOUT CONFLICT AND THE DECISIONS ARE DOCUMENTED THE PAY INCREASE ARE NOT APPROVED UNTIL THE ANNUAL BUDGET IS APPROVED BY THE BOARD. Form 990, Part VI, Section C, line 19 financial information is made available at gritman's annual board meeting in may of each year, which is open to the public. FORM 990, PART XII, LINE 2C: REQUESTS FOR PROPOSALS ARE SENT OUT TO MULTIPLE AUDITING FIRMS EVERY 3 YEARS. THE CEO, CFO, AND BOARD MEMBERS LOOK OVER THE PROPOSALS AND THE BOARD VOTES ON THE ACCOUNTING FIRM TO CONDUCT THE AUDIT. THIS PROCESS HAS NOT CHANGED. GRITMAN MEDICAL PARK LLC 700 S WASHINGTON MOSCOW ID 83843 REAL ESTATE RENTALS ID 63084 10062542 GRITMAN MEDICAL CENTER Gritman Medical Center Foundation 700 s main street moscow ID 83843 200586022 hospital support ID 501(c)(3) 7 Gritman Medical Center 1 Palouse surgery center llc 2300 west a street moscow ID 83843 810593962 outpatient surgery center ID gritman medical center related 26848 398272 0 0 0.61700 Palouse health propertiesllc 2300 west a street moscow ID 83843 810593963 property management ID gritman medical center related 64226 521644 0 0 0.60850 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 PALOUSE SURGERY CENTER LLC S 26848 ACTUAL PALOUSE HEALTH PROPERTIES LLC S 64226 ACTUAL Gritman Medical Center Foundation Inc C 176532 ACTUAL Gritman Medical Center Foundation Inc B 220935 ACTUAL