2016-05-12T08:27:37-05:00 2015-06-30 420714325 RSM US LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2014-07-01 410695596 ST CLOUD HOSPITAL STCL 3202512700 1406 SIXTH AVENUE NORTH ST CLOUD MN 563031901 GREGORY R KLUGHERZ CFO/TREASURER 3202512700 2016-04-29 1 TODD A JACKSON P00092672 6123324300 2014 2016-08-17 19:52:53Z CRAIG BROMAN 1406 SIXTH AVENUE NORTH ST CLOUD MN 563031901 800777297 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 12 6748 1086 82167 0 2874510 3424003 727370547 763172461 19693376 24037410 4530240 5452883 754468673 796086757 3110590 3906188 0 0 370398831 380587943 0 0 35190 308427373 313554451 681936794 698048582 72531879 98038175 1095555816 1153539895 497740201 504513951 597815615 649025944 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 320549302 3906188 391317732 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 489 LICENSED INPATIENT BEDS, ST CLOUD HOSPITAL CARED FOR 26,073 INPATIENT ADMISSIONS WITH 114,670 ASSOCIATED PATIENT DAYS DURING FISCAL 2015. 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. 253709622 333648447 AS A HIGH QUALITY REGIONAL MEDICAL CENTER, ST CLOUD HOSPITAL PROVIDES A BROAD RANGE OF OUTPATIENT SERVICES. OUTPATIENT ENCOUNTERS DURING FISCAL 2015 WERE 269,799 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. 23399474 26646062 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 2015 THERE WERE 197 SKILLED STAFFED BEDS AND RESIDENT DAYS OF 65,113. SHORT STAY SKILLED SERVICES INCLUDE AN EXTENSIVE REHABILITATIVE CARE PROGRAM WITH THE GOAL OF ENABLING RESIDENTS TO RETURN TO THEIR HOMES. IN FISCAL 2015 THERE WERE 308 HOUSING UNITS AND TENANT DAYS OF 105,467. 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. 1234583 16784104 COST 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. 1234583 16784104 598892981 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 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 1 494 0 1 6748 1 1 1 0 0 0 0 0 0 0 0 0 X 18 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X GREG KLUGHERZ 3202512700 1406 SIXTH AVENUE NORTH ST CLOUD MN 56303 CRAIG J BROMAN PRESIDENT 37.00 3.00 X X 739657 0 164742 CLAREEN HENNES OSB DIRECTOR, CHAIR 2.00 0.00 X X 0 0 0 TIMOTHY WENSMAN DIRECTOR, VICE CHAIR 2.00 0.00 X X 0 0 0 MARIA D MALLORY MD DIRECTOR, CHIEF OF STAFF 2.00 38.00 X X 0 559121 40659 SARAH R CARTER MD DIRECTOR 2.00 38.00 X 0 372119 41038 JOAN B VOLKMUTH ED D DIRECTOR 2.00 0.00 X 0 0 0 TERESA BOHNEN DIRECTOR 2.00 0.00 X 0 0 0 CHRISTOPHER COBORN DIRECTOR 2.00 2.00 X 0 0 0 RONALD HANSON MD DIRECTOR 2.00 0.00 X 0 0 0 MARY JACKLE OSB DIRECTOR 2.00 0.00 X 0 0 0 FATHER THOMAS KNOBLACH DIRECTOR 2.00 0.00 X 0 0 0 CINDA J MELLOY MD DIRECTOR 2.00 38.00 X 0 205316 37563 JAMES SCHLENNER DIRECTOR 2.00 0.00 X 0 0 0 CHRISTOPHER TACL MD DIRECTOR 2.00 0.00 X 0 0 0 MELINDA SANDERS DIRECTOR 2.00 0.00 X 0 0 0 EDWARD B MARTIN MD DIRECTOR 2.00 38.00 X 0 555927 41635 ROBERT KOVELL DIRECTOR 2.00 0.00 X 0 0 0 JOAN WILCOX RN DIRECTOR 2.00 0.00 X 0 0 0 JAMES RUDOLPH DIRECTOR 2.00 0.00 X 0 0 0 GREGORY R KLUGHERZ TREASURER/CFO 20.00 20.00 X 642402 0 136804 PAUL R HARRIS SECRETARY 10.00 30.00 X 0 431612 93140 MARK S MATTHIAS MD VICE PRESIDENT 40.00 0.00 X 496424 0 96125 AMY M PORWOLL VICE PRESIDENT 40.00 0.00 X 325655 0 79200 LINDA A CHMIELEWSKI VICE PRESIDENT 40.00 0.00 X 400289 0 83517 DUANE A RASMUSSON VICE PRESIDENT 40.00 0.00 X 411068 0 79680 LINDA L DOERR VICE PRESIDENT 40.00 0.00 X 271994 0 50308 KURT T OTTO VICE PRESIDENT 40.00 0.00 X 267016 0 64987 JON C BOWAR MD PHYSICIAN 40.00 0.00 X 443237 0 40920 MARY E LUNDE MD PHYSICIAN 40.00 0.00 X 336327 0 35285 JOEL P SPALDING MD PHYSICIAN 40.00 0.00 X 309794 0 39831 JOHN SCHMITZ MD PHYSICIAN 40.00 0.00 X 336739 0 42551 JERRFERY DERR MD PHYSICIAN 40.00 0.00 X 304503 0 33780 JOHN R FROBENIUS FORMER PRESIDENT 0.00 0.00 X 173970 0 0 5459075 2124095 1201765 316 1 1 0 CENTRACARE CLINIC 1200 SIXTH AVENUE NORTH ST CLOUD MN 56303 PHYSICIAN SERVICES 18101817 CROTHALL HEALTHCARE 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 HOUSEKEEPING/LAUNDRY 3235276 ANESTHESIOLOGY ASSOCIATES PO BOX 725 ST CLOUD MN 56302 ANESTHESIOLOGY SVCS 2886379 REHABCARE 680 SOUTH FOURTH STREET LOUISVILLE KY 40202 THERAPY SERVICES 1388139 D J KRANZ CO INC 725 HIGHWAY 169 NORTH PLYMOUTH MN 55441 CONSTRUCTION 1193237 79 24 3366666 57313 3424003 PATIENT/RESIDENT SERVICES 900099 748123474 748123474 FOOD SALES 900099 4632412 4632412 OTHER MISC REVENUE 900099 3870124 3870124 OTHER SERVICES PERFORMED 900099 3055860 3055860 HEALTH INFO TECH INCENTIVE 900099 1317050 1317050 2173541 2173541 763172461 23899288 23899288 3029805 3029805 0 968151 830029 138122 138122 138122 977538 830706 146832 146832 INFORMATION SERVICES 541512 5016561 4978677 37884 289490 245207 44283 5306051 796086757 768396345 82167 24184242 3731691 3731691 174497 174497 4856350 4856350 291684804 259402058 32282746 15991273 14602921 1388352 47609803 41725539 5884264 20445713 17935530 2510183 4053660 3492397 561263 1613131 1613131 173440 173440 167344 8907 158437 1197724 1197724 59215888 49621243 9594645 777727 450331 327396 8097239 5828955 2268284 10282380 10282380 6934648 5020979 1907596 6073 827768 758058 69710 1825471 841013 984458 11782833 9257536 2514328 10969 42130537 28740776 13371613 18148 2669675 400207 2269468 DRUGS/MEDICAL SUPPLIES 116541333 116423122 118211 OTHER MISC EXPENSES 23544281 18757849 4786432 MEDICAID/MN CARE 13439077 13439077 BAD DEBT 8280295 8280295 698048582 598892981 99120411 35190 45542228 37740660 104631133 114282623 7091474 8054885 6792091 10590204 905474364 405012527 484231961 500461837 362355117 394992461 75096584 78572908 9815228 8844317 1095555816 1153539895 75756489 70821603 363975605 368887321 58008107 64805027 497740201 504513951 X 597812486 649025944 3129 0 597815615 649025944 1095555816 1153539895 X 98038175 -24100165 -22727681 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 1 95113 1 72230 0 0 167343 0 PART II-B, LINE 1: ST. CLOUD HOSPITAL PAID $42,882 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS. 15906119 15906119 571574043 191533558 380040485 302689745 213462097 89227648 15304457 16872 15287585 500461837 FUNDS HELD BY TRUSTEE, WORKER'S COMP & FUTURE BUILDING 78572908 C 78572908 OTHER LONG TERM LIABILITIES 64805027 64805027 1 1 1 X 175.000000000000 1 X 1 1 1 0 1 1 2934184 0 2934184 0.00430 121750049 96747620 25002429 0.03630 124684233 96747620 27936613 0.04060 796991 6446 790545 0.00110 4005439 1097540 2907899 0.00420 786574 16938 769636 0.00110 373937 93933 280004 0.00040 3127772 0 3127772 0.00450 9090713 1214857 7875856 0.01130 133774946 97962477 35812469 0.05190 300 22000 22000 0.00000 8522 8522 0.00000 2000 6289 6289 0.00000 120 3884 3884 0.00000 2420 40695 40695 1 8280295 240528559 241988032 -1459473 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 X X X X 13 1 1 0 1 X WWW.CENTRACARE.COM X X 1 13 1 WWW.CENTRACARE.COM 0 0 1 X 175.000000000000 250.000000000000 X X X 1 1 X X X X 1 X WWW.CENTRACARE.COM X X X X X 1 X X 1 X X X X X X 1 X X 0 0 ST. CLOUD HOSPITAL PART V, SECTION B, LINE 3J: CCH'S CHNA PROCESS ALSO CONSIDERED SECONDARY DATA FROM THE DARTMOUTH ATLAS, ROBERT WOOD JOHNSON, MINNESOTA DEPARTMENT OF HEALTH, US CENSUS BUREAU, MINNESOTA HOSPITAL ASSOCIATION, ST. CLOUD AREA UNITED WAY, CATHOLIC CHARITIES OF THE DIOCESE OF ST. CLOUD, MINNESOTA SENIOR FEDERATION, PUBLIC HEALTH DEPARTMENTS FROM APPROPRIATE COUNTIES AND ADDITIONAL FEDERAL AND STATE ENTITIES. 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 SURVEYS 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 END OF ITS FISCAL 2013. THOSE FACILITIES INCLUDED ST. CLOUD HOSPITAL, CENTRACARE HEALTH - MELROSE, CENTRACARE HEALTH - LONG PRAIRIE, CENTRACARE HEALTH - SAUK CENTRE AND CENTRACARE HEALTH - MONTICELLO. 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 - ACCESS TO PRIMARY CARE2 - CULTURALLY COMPETENT CARE3 - HEART DISEASE MORBIDITY AND MORTALITY (PRIMARILY IN BENTON COUNTY)4 - LINGUISTICALLY COMPETENT CARE5 - MENTAL HEALTH SERVICES6 - STROKE MORBIDITY AND MORTALITY (PRIMARILY BENSON COUNTY) ST. CLOUD HOPSITAL WILL MAITAIN 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 ORGANIZATIONS 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 2013 - 2015 LOCATED ON THE WEBSITE AT WWW.CENTRACARE.COM/APP/FILES/PUBLIC/1547/IMPLEMENTATION-STRATEGY.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 16I: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE CHARITY CARE INFORMATION EITHER VIA A TELEPHONE CALL OR A LETTER. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 18D: THE ORGANIZATION EMPLOYS THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE LAWSUITS (WAGE GARNISHMENTS) AS WELL. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 19D: THE ORGANIZATION EMPLOYS THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE LAWSUITS (WAGE GARNISHMENTS) AS WELL. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 20E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY CARE INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST A PATIENT. ST. CLOUD HOSPITAL PART V, SECTION B, LINE 22D: PER AGREEMENT WITH THE MINNESTOA ATTORNEY GENERAL, THE ORGANIZATION PROVIDES A DISCOUNT TO THE UNINSURED EQUAL TO THE AVERAGE DISCOUNT OF OUR LARGEST (BY VOLUME) NON-GOVERNMENTAL PAYOR. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY ST. CLOUD HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: WWW.CENTRACARE.COM 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 FOR UNCOLLECTIBLE 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 SHORTFALL OF $1.46 MILLION OF TREATING MEDICARE PATIENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT IN ITS ENTIRETY. THE HOSPITAL PROVIDES AN EXCELLENT LEVEL OF CARE TO THE PEOPLE IN THE COMMUNITY. DESPITE THE SHORTFALL IN REIMBURSEMENT FORM MEDICARE, THE HOSPITAL CONTINUES TO PROVIDE ESSENTIAL HEALTHCARE SERVICES TO THE POPULATION. 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 TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, 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 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 ST. CLOUD'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 POPULATION IN 2014 IS 290,232 AND IS PROJECTED TO GROW BY 2.3% IN 2019. THE PROJECTED POPULATION GROWTH BY AGE BRACKET FOR 2014 TO 2019 IS 0-24, -1.2%; 25-44, 1.8%; 45-64, 1.1% AND 65+ 17.1%. 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 2014 WAS 393,552 AND IS PROJECTED TO GROW BY 1.9% BY 2019. THAT NINE COUNTY PROJECTED POPULATION GROWTH TO 2019 BY AGE BRACKET ARE AS FOLLOWS: 0-24, 3.4%; 25-44, -2.7%; 45-64, -2.7% AND 65+ 13.4%. THE 2019 ETHNICITY BREAKDOWN FOR THE ENTIRE 12-COUNTY AREA IS AS FOLLOWS: WHITE - 92.4%; AFRICAN AMERICAN - 2.0%; ASIAN - 1.5%; TWO OR MORE RACES - 2.1%, OTHER - 1.4%, AMERICAN INDIAN OR ALASKA NATIVE 0.6%. THE DEMOGRAPHIC INFORMATION IS UPDATED EVERY 2 YEARS BY THE ORGANIZATION, WITH THIS REPORTING YEAR BEING THE SECOND YEAR. PART VI, LINE 5: THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IN SEVERAL IMPORTANT WAYS. ONE OF THESE WAYS IS THROUGH THE COMMUNITY COLLABORATION COMMITTEE (CCC), A STANDING COMMITTEE OF THE CENTRACARE HEALTH FOUNDATION. THE CCC HAS A MEMBERSHIP OF OVER 30 PERSONS REPRESENTING HEALTHCARE AND COMMUNITY NEEDS ACROSS CENTRAL MINNESOTA. THE CCC MEETS MONTHLY TO DISCUSS WAYS TO ADDRESS TYPICAL HEALTH ISSUES THROUGH AWARENESS BUILDING, EDUCATION AND/OR AN INTERVENTION PROJECT. THERE ARE SEVERAL COMMUNITY HEALTH OUTREACH INITIATIVES THAT THE FOUNDATION IS INVOLVED WITH. THESE INITIATIVES INCLUDE: 1) BLEND CHILDHOOD OBESITY COALITION OF CENTRAL MINNESOTA (GOAL IS TO REDUCE THE INCIDENCE OF CHILDHOOD OBESITY BY 2016), 2) SMOKE FREE COMMUNITIES (CONTINUED EFFORTS TO CREATE CLEAN INDOOR AND OUTDOOR AIR FOR ALL), 3) TOBACCO CESSATION SERVICES CLINICS (COLLABORATION WITH CENTRACARE CLINIC, 4) CENTRACARE CLINIC TEAM BASED CARE PILOT, 5) ST. CLOUD HOSPITAL - TRANSITION OF CARE PILOT (CREATE MORE SEAMLESS INTEGRATION FROM CARE SETTING TO CARE SETTING, AND 6) CENTRACARE CLINIC - DIVERSITY AND CULTURAL COMPETENCY TRAINING. 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) 3251386 TO SUPPORT THE CENTRACARE FOUNDATION THE MESSAGE PROGRAM 2311 10TH AVE SOUTH ST ST CLOUD MN 56301 200293323 501(C)(3) 86122 FMV MEDICAL EQUIPMENT AND SUPPLIES PROGRAM SUPPORT AMERICAN KIDNEY FUND 11921 ROCKVILLE PIKE ST 300 ROCKVILLE MD 20852 237124261 501(C)(3) 114600 TO SUPPORT KIDNEY PATIENTS WITH INSURANCE COVERAGE 4 HOME DELIVERED MEALS 200 174497 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 592132 0 140893 0 6632 0 148251 0 30405 0 918313 0 0 0 MARIA D MALLORY MD DIRECTOR, CHIEF OF STAFF 0 501477 0 54639 0 3005 0 19500 0 21913 0 600534 0 0 SARAH R CARTER MD DIRECTOR 0 318974 0 51900 0 1245 0 19880 0 21913 0 413912 0 0 CINDA J MELLOY MD DIRECTOR 0 138173 0 65727 0 1416 0 15405 0 22536 0 243257 0 0 EDWARD B MARTIN MD DIRECTOR 0 481670 0 55302 0 18955 0 19500 0 27889 0 603316 0 0 GREGORY R KLUGHERZ TREASURER/CFO 442053 0 87461 0 112888 0 120553 0 20175 0 783130 0 87558 0 PAUL R HARRIS SECRETARY 0 331254 0 62700 0 37658 0 66572 0 35552 0 533736 0 34588 MARK S MATTHIAS MD VICE PRESIDENT 368925 0 70550 0 56949 0 70958 0 39006 0 606388 0 52607 0 AMY M PORWOLL VICE PRESIDENT 278176 0 44713 0 2766 0 55133 0 33803 0 414591 0 0 0 LINDA A CHMIELEWSKI VICE PRESIDENT 297158 0 57126 0 46005 0 66326 0 23579 0 490194 0 40733 0 DUANE A RASMUSSON VICE PRESIDENT 278587 0 51838 0 80643 0 62489 0 23316 0 496873 0 70668 0 LINDA L DOERR VICE PRESIDENT 210016 0 38025 0 23953 0 41413 0 19957 0 333364 0 20097 0 KURT T OTTO VICE PRESIDENT 214797 0 41448 0 10771 0 39920 0 27128 0 334064 0 8606 0 JON C BOWAR MD PHYSICIAN 407980 0 34357 0 900 0 18125 0 23281 0 484643 0 0 0 MARY E LUNDE MD PHYSICIAN 275061 0 42365 0 18901 0 13871 0 21901 0 372099 0 0 0 JOEL P SPALDING MD PHYSICIAN 256378 0 35314 0 18102 0 18795 0 21523 0 350112 0 0 0 JOHN SCHMITZ MD PHYSICIAN 319356 0 15875 0 1508 0 20286 0 22751 0 379776 0 0 0 JERRFERY DERR MD PHYSICIAN 273218 0 30385 0 900 0 12366 0 21901 0 338770 0 0 0 JOHN R FROBENIUS FORMER PRESIDENT 0 0 0 0 173970 0 0 0 0 0 173970 0 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 $0, ACCRUED $128,751 GREGORY R KLUGHERZ - PAID $87,558, ACCRUED $104,953 MARK S MATTHIAS - PAID $52,607, ACCRUED - $60,363 LINDA A CHIMIELEWSKI - PAID $40,733, ACCRUED $47,411 DUANE A RASMUSSEN - PAID $70,668 ACCRUED $43,458 AMY M PORWOLL - PAID $0, ACCRUED $36,478 LINDA L DOERR - PAID $20,097, ACCRUED $23,178 KURT T OTTO - PAID $8,606, ACCRUED $27,513 PAUL R HARRIS - PAID $34,588, ACCRUED $52,699 PART I, LINE 6 THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR CENTRACARE CLINIC OR CENTRACARE HEALTH SYSTEM; ACHIEVEMENT OF IMPROVEMENT IN PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; ACHIEVEMENT OF IMPROVEMENT IN OVERALL EMPLOYMENT ENGAGEMENT SCORES; AND ACHIEVEMENT OF UP TO THREE INDIVIDUAL GOALS WHICH ARE TIED TO THE CENTRACARE SYSTEM'S STRATEGIC PLAN. 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 INCENTIVE COMPENSATION IS PAID. 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 11 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 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 2015. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. FORM 990, PART VI, QUESTION 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 2015. 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 -2,999,928. OTHER CHANGES IN UNRESTRICTED NET ASSETS 4,164,780. NET EQUITY TRANSFERS TO AFFILIATED ORGANIZATIONS -23,542,600. ELIMINATION ENTRIES -349,933. 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 NORTH STAR SURGICAL SERVICES LLC 6339 E SPEEDWAY BLVD SUITE 201 TUCSON AZ 85710 201585814 LITHOTRIPSY SERVICES AZ CENTRACARE HOLDINGS INC N/A 0 0 CENTRACARE PHARMACY SERVICES 1406 6TH AVE N ST CLOUD MN 56303 411620618 RETAIL PHARMACIES MN CENTRACARE HEALTH SYSTEM C 0 CENTRACARE HOLDINGS INC 1406 6TH AVE N ST CLOUD MN 56303 472688595 INVESTMENTS MN CENTRACARE HEALTH SYSTEM C 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1