2015-05-11T08:15:36-05:00 2014-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2013-07-01 830279242 Wyoming Medical Center Inc WYOM 3075777201 1233 E Second St Casper WY 82601 B Yvonne Wigington Senior VP & CFO 3075777201 2015-04-27 1 KIM C HUNWARDSEN P00484560 6122536500 2015-04-24 2013 2016-02-25 16:41:14Z Vickie Diamond 1233 E Second St Casper WY 82601 233067668 0 X www.wyomingmedicalcenter.org X 1986 WY WMC strives to advance the health and wellness of our community by providing excellent healthcare services, patient safety and experience at reasonable costs. Our highly skilled and engaged team of physicians, staff and volunteers ensures patients are well cared for while at WMC. 9 5 1501 96 1280677 582886 1168015 2009905 238138098 229866432 -153438 145982 474637 370518 239627312 232392837 0 0 0 0 96737408 95440348 0 0 0 127276548 125452980 224013956 220893328 15613356 11499509 282582727 295965882 73253376 57844895 209329351 238120987 X WMC strives to advance the health and wellness of our community by providing excellent healthcare services, patient safety and experience at reasonable costs. Our highly skilled and engaged team of physicians, staff and volunteers ensures patients are well cared for while at WMC. 1 0 201360885 229866432 Wyoming Medical Center's mission is to advance the health and wellness of our community by providing excellent healthcare services, patient safety and experience at reasonable costs. Wyoming Medical Center is the leader in health in the community and provides care to all people regardless of their ability to pay. The hospital was formed in 1986 as a non-profit corporation to provide health care to the residents of Natrona County. Since that time Wyoming Medical Center has grown into a Level II Trauma Center that provides critical services to Natrona County and to the entire state and beyond. Wyoming Medical Center held over 99 community-oriented events in FY2014. It also released its regular quarterly publication, For Your Health, to 10,000 homes in Natrona and Fremont counties. Wyoming Medical Center provided $11,019,000 in charity care services based on total direct and indirect costs. 201360885 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 308 1 1 1501 1 1 1 0 0 0 0 0 0 0 0 0 X 9 5 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X B Yvonne Wigington 3075772920 1233 East 2nd Street Casper WY 82601 X Christopher Muirhead Chair 5.00 0.00 X X 0 0 0 John Masterson Vice Chair 5.00 0.00 X X 0 0 0 David Wheeler MD Secretary 5.00 0.00 X X 0 0 0 Ruth Moran Board Member 5.00 0.00 X 0 0 0 Bill Huppert Board Member (Nov-Jun) 5.00 0.00 X 0 0 0 Mary MacGuire Board Member 5.00 0.00 X 0 0 0 VH McDonald Board Member 5.00 0.00 X 0 0 0 Linda Young Board Member (Jul-Oct) 5.00 7.00 X 0 0 0 Susan McMurry Board Member 5.00 2.00 X 0 0 0 John Pickrell MD Board Member 5.00 0.00 X 0 0 0 Vickie Diamond CEO 45.00 7.00 X 639528 0 27700 Don J Claunch CFO (Jul-Nov) 45.00 7.00 X 293644 0 97528 Yvonne Wigington Senior VP & CFO 45.00 7.00 X 146801 0 11415 Julia Cann-Taylor CNO 45.00 0.00 X 331296 0 210476 Robert M Kaiser VP of Employee Services 45.00 0.00 X 281854 0 74024 Patrice Weiner Intensivist-Pulmonary 45.00 0.00 X 369916 0 0 Robert Neff Nephrology 45.00 0.00 X 423221 0 10200 Casey Contant MD Nephrology 45.00 0.00 X 496891 0 10200 Mark McGinley MD Intensivist-Pulmonary 45.00 0.00 X 421449 0 10200 Rafael Perez MD Intensivist-Pulmonary 45.00 0.00 X 391313 0 10200 3795913 0 461943 88 0 1 0 Haselden Construction LLC 6000 E 2nd St Suite 1004 Casper WY 826094337 Construction 8840990 UHS of Wyoming 2521 W 15th St Casper WY 82609 Medical 3108157 ABM Healthcare Support Service PO Box 935695 Atlanta GA 311935695 Contract Services 2945846 Focusone Solutions LLC PO Box 3037 Omaha NE 68103 Temporary Staff 2627073 Sound Physicians of Wyoming PO Box 742936 Los Angeles CA 900742936 Medical Services 2004809 162 558038 535247 916620 2009905 Net Patient Revenue 621110 217724078 217287448 436630 Non-patient Non-operating 900099 6453558 6453558 JV Investment Income 621300 3818924 3402056 416868 Cafeteria Sales 722210 1078682 967656 111026 Lab Revenue 621500 316153 316153 475037 475037 229866432 118005 118005 961726 591208 370518 370518 370518 111600 83623 27977 27977 27977 232392837 228585755 1280677 516500 X 1870722 1870722 43504 43504 64711918 54441221 10270697 11466952 9646984 1819968 15569523 13098419 2471104 1777729 1457763 319966 214875 214875 77134 77134 29574352 28353345 1221007 794233 791174 3059 1745265 1578081 167184 5933067 5933067 2167045 2135668 31377 338099 122068 216031 85206 45917 39289 13507209 13507209 1735215 1735215 Drugs and Medical Suppl 32452164 32388769 63395 Bad Debt Expense 28359447 28359447 Repairs and Maintenance 2349075 2349075 Equipment Lease/Rental 2260324 2244139 16185 3860270 3129820 730450 220893328 201360885 19532443 0 51859850 47154047 38044842 39130555 30884 30377 1323830 1360688 5631064 5460119 3608479 4295148 317907550 190836523 107241996 127071027 67746230 64010441 7095552 7453480 282582727 295965882 17788423 19524135 62410 32690 19475254 18960958 17500 35909789 19327112 73253376 57844895 X 209329351 237341446 779541 209329351 238120987 282582727 295965882 X 11499509 6249102 11043025 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 56367 0 0 56367 0 Part II-B, Line 1: WMC spent $56,367 in reimbursed expenses related to direct communications with legislators. 0 0 13914856 13914856 94892359 63349416 31542943 14790 9136 5654 154947774 122422148 32525626 54137771 5055823 49081948 127071027 Pension Liability 13119508 Estimated Third Party Payor Settlements 2282329 Post Retirement Benefits 693123 Construction Payables 3232152 19327112 X 220406325 6249102 -18235614 -11986512 232392837 0 232392837 191132641 0 191132641 29760687 29760687 220893328 Part X, Line 2: The Hospital is organized as a Wyoming nonprofit corporation and has been recognized by the Internal Revenue Service as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). WHMG is a single member LLC, wholly owned by the Hospital, and is therefore treated for tax purposes under the Hospital's tax exemption status. This entity is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. This entity has determined that they are subject to unrelated business income tax and have filed an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS. This entity believes that they have appropriate support for any tax positions taken affecting their annual filing requirements, and as such, do not have any uncertain tax positions that are material to the financial statements. This entity would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties incurred. Part XI, Line 2d - Other Adjustments: Expenses Recorded in Revenue on F/S -1,401,240. Change in Minimum Pension Liability Reported in Fund Balance on F/S 11,043,025. Eliminate WHMG Net Income Included in Revenue on Equity Basis -8,276,052. Eliminate Intercompany Transfers with WHMG 8,758,100. Bad Debt Expense Included in Revenue on Financial Statements -28,359,447. Part XII, Line 4b - Other Adjustments: Expenses Recorded in Revenue on Financial Statements 1,401,240. Bad Debt Expense Included in Revenue on Financial Statements 28,359,447. 1 1 X 1 X 1 X 275.000000000000 1 1 0 1 0 11019000 11019000 0.05720 14823231 10585862 4237369 0.02200 616707 273608 343099 0.00180 26458938 10859470 15599468 0.08100 961761 228597 733164 0.00380 757886 64429 693457 0.00360 4877645 1308887 3568758 0.01850 7900 7900 0.00000 6605192 1601913 5003279 0.02590 33064130 12461383 20602747 0.10690 11700 11700 0.00010 1507 1507 0.00000 795260 795260 0.00410 808467 808467 0.00420 1 28359447 0 49615879 58154470 -8538591 X 1 1 1 Outpatient Radiology LLC Imaging Services 0.50000 0.50000 2 Central Wyoming Outpatient Surgery Center LLC Surgical Center 0.50000 0.25000 0.25000 3 Wyoming Imaging Center LLC Imaging Services 0.20570 0.79430 4 North Platte Pathology LLC Pathological Services 0.50000 0.50000 1 1 Wyoming Medical Center 1233 East 2nd Street Casper WY 82601 www.wyomingmedicalcenter.org 0713181 X X X Wyoming Medical Center 1 1 X X X X X X 12 1 0 1 X See Line 5 Narrative X X X X X X 0 0 1 1 200.000000000000 1 275.000000000000 1 X X X 1 1 X X X 1 0 X X X X 1 X 0 1 Wyoming Medical Center Part V, Section B, Line 3: The Hospital worked with the National Rural Health Resources Center which partnered with Wyoming Business Coalition on Health, Community Health Center, Wyoming Kids First-Natrona County, and the City of Casper. The team conducted focus groups which consisted of senior citizens, caregivers, business leaders, young professionals, and healthcare professionals. Wyoming Medical Center Part V, Section B, Line 5d: The CHNA is available at wyomingmedicalcenter.org/index.php/about/category/community-benefit. Wyoming Medical Center Part V, Section B, Line 6i: The implementation strategy is made available upon request. The implementation strategy is available at wyomingmedicalcenter.org/index.php/about/category/community-benefit. Wyoming Medical Center Part V, Section B, Line 7: Regarding the first implementation plan goal to foster better communication between healthcare providers and agencies to improve overall health, Wyoming Medical Center (WMC) has made significant progress. It hired and trained its transition coaches who are now working to assist patients in their transition from the hospital to home, skilled nursing care, home health or hospice. Wyoming Medical Center's CEO also holds quarterly focus groups with a randomly selected group of patients each quarter, and the most recent group met in May 2014. WMC's electronic health record is fully implemented and the public portal has opened, where patients can see some of their records with secure access online. This access will be expanded over the next several years. Ongoing work will continue to ensure accurate dissemination of data to all providers. The state of Wyoming's health insurance exchange has lost its funding, and WMC is therefore no longer participating in the effort to transmit data to the exchange. Efforts continue to encourage providers across the state to access health records electronically through Cerner.In response to the Affordable Care Act, Wyoming Medical Center has committed itself to educating the community on options for accessing health insurance. In addition to financial counselors being available, WMC has become a Certified Application Counselor Organization for the Health Insurance Marketplace and has held several community talks, most recently in February 2014, to help people navigate the complicated process. Wyoming Medical Center will continue to offer these services, especially during open enrollment. Wyoming Medical Center's efforts to promote health education continue. Several physicians (employed and from other practices in partnership with WMC) and WMC staff have committed to speaking engagements across Natrona County on subjects ranging from a heart healthy diet to the importance of safety. Continued advertisement of various support groups and monthly screenings is seen in various media, including newspaper, social media, radio and more. Wyoming Medical Center's news site, The Pulse, launched in August 2013 and features information on various health topics and events. The Pulse had more than 50,000 unique visitors between August 2013 and June 2014. There are various needs addressed in the community health needs assessment that are being addressed in partnership with other community partnerships. Regarding smoking, Wyoming Medical Center has worked closely with Casper Medical Imaging to launch a low-dose lung cancer screening program for longtime smokers in 2012 and that program continues. Safe Communities, a federal grant-funded program run at WMC, works with various agencies including local police to address motor-vehicle related issues, specifically drunken driving, seat belt use (including car seats) and texting and driving. The Wyoming Medical Center-run Safe Kids program also raises funds to offer car seats to those who cannot afford them as well car seat checks by registered technicians. Wyoming Medical Center's Foundation is working on plans and funding for a Wellness Center to be housed in the new McMurry West Tower, which will offer another option for indoor exercise. It is expected to open in 2016. A health resource directory for the Senior Action Netork is completed and was updated in 2013. Extended hours in WMC's outpatient clinics is in the planning stage and is expected in 2015. Wyoming Medical Center Part V, Section B, Line 12i: In addition to income level and Medicaid/Medicare, WMC will bypass the application process if the patient already qualifies for other county or state programs, such as the Food Stamp Program. Wyoming Medical Center Part V, Section B, Line 14g: In addition to the full policy being provided on the website and available upon request, WMC provides a brochure at the time of admissions with financial options in the patient's information packet and a summary is provided in the billing invoices. A financial service counselor is also available to explain the financial assistance program. Wyoming Medical Center Part V, Section B, Line 22: All individuals eligible under the Medical Center financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. 4 Central WY Outpatient Surgery Center 1201 E 3rd St Casper WY 82601 Surgical Center Outpatient Radiology 419 S Washington St Ste 100 Casper WY 82601 Imaging Services WY Health Medical Group MultiSpecialty 1233 E 2nd St Casper WY 82601 Physician Practice North Platte Pathology LLC 111 S Jefferson Street Casper WY 82601 Pathological Services Part I, Line 7: Line 7a financial assistance was converted to cost based on the average ratios of cost to gross charges.Line 7b Medicaid gross patient charges are tracked and the cost to charge ratio that is calculated from Schedule H Worksheet 2 is applied. This amount is offset by net patient service revenue which is a calculation of actual payment minus total expected payment (account balance x reimbursement percentage). Lines 7e-i are actual expenses from the general ledger. Part I, Line 7g: Line 7g includes $1,740,764 of costs attributable to a clinic. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator of the calculations was $28,359,447. Part II, Community Building Activities: The community building activities promote health of the community by providing needed specialists and physicians as well as determining what is needed by the residents in the local community and surrounding area. Wyoming Medical Center spent $795,260 in recruiting physicians for pediatrics, OB/GYN, primary care, radiology services, and emergency care. WMC also spent $1,507 for proper disposal service for unwanted and unusable pharmaceuticals in order to keep the community and environment safe. A WMC employee also donated $11,700 of his time to serve on the Casper Area Economic Development Association. Part III, Line 2: Bad debt is reported at charges as recorded by the organization. Part III, Line 3: The Medical Center follows Healthcare Financial Management Association Statement No. 15, and therefore bad debt does not include amounts that would be attributable to charity care. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in Footnote 1 on page 9 of the attached financial statements. Part III, Line 8: The Hospital used the Medicare operating cost-to-charge ratio to calculate the costs relating to Medicare revenue applied against actual receipts. Providing Medicare services promotes access to healthcare services for these patients in our community and, therefore, is a direct benefit to our population in our community. Part III, Line 9b: Collection practices are only pursued if the patient is determined to not qualify for charity care or does not qualify for another program. This includes notification to the patient via a letter 10 days prior to assignment of an account to collections. Once a patient is determined to be eligible for financial assistance, all collection practices are ceased. Part VI, Line 2: In April 2011 WMC, Community Health Center of Central Wyoming, Wyoming Business Coalition, Kids First Natrona County and the City of Casper conducted a needs assessment survey. These surveys were sent through the mail. In June 2011 focus group meetings were conducted through Casper. Results were compiled and presented to the board in October 2011. An implementation strategy was presented to the board and put into place prior to November 15, 2013. The IRS April 3, 2013 proposed regulations provided transitional relief allowing WMC to adopt an implementation strategy on or before November 15, 2013. Part VI, Line 3: Through Wyoming Medical Center's charity care program, individuals and families who are unable to pay may be offered full or partially subsidized services. Patients are given a brochure at the time of admission that provides information on financial options. If the patient is concerned about the cost of care, there is always an assessment to try and match them with a program that will help, whether it is a federal or state program, reduced cost or full charity care. Our patient financial service counselors meet one on one with patients and explain the financial assistance programs that are available to them. Counselors are also versed in the federal health insurance exchange and can provide information on availability and eligibility. Part VI, Line 4: Wyoming Medical Center has 191 beds in over 900,000 square feet. With over 50 specialties offered, Wyoming Medical Center offers hundreds of statewide clinics each year. A full spectrum of integrated healthcare services includes emergency care and trauma, intensive care, surgical, cardiac services, obstetric and pediatric and orthopedic care. Wyoming Medical Center also operates several outpatient clinics in Casper.In addition to Wyoming Medical Center, Casper currently has a specialty hospital, a rehabilitation hospital and a behavioral health center.According to 2010 census data, Natrona County is home to just over 75,000 residents with 568,000 statewide. Natrona County and the state of Wyoming have low population density, with 14.1 persons per square mile and 5.8 persons per square mile respectively. Natrona County is 92.8% white, .9% black, 1% American Indian and Alaska Native, .7% Asian, .1% Native Hawaiian and other Pacific Islander, 2.4% of people report two or more races and 6.9% are of Hispanic or Latino origin. According to Census data, 8.4% of people in Natrona County are below the poverty level and 9.8% are below the poverty level in Wyoming. Median household income is $50,936 in Natrona County and $53,802 in Wyoming. Part VI, Line 5: Wyoming Medical Center is a not-for profit hospital. The Hospital is governed by a volunteer board of directors. Our medical staff is open to all qualified physicians and allied health professionals. The facility applies surplus funds to improvements in patient care, medical education, and research. Our emergency department is open to all individuals regardless of their ability to pay. Wyoming Medical Center subsidized $8,276,048 in healthcare services through its operation of Wyoming Health Medical Group, LLC. Services offered include Neurosurgical Care, Internal Medicine and Family Practice, Pulmonology and Nephrology. All specialties treat all patients regardless of their ability to pay. Wyoming Medical Center provides air transportation for physicians to deliver service to clinics in several communities across Wyoming.Wyoming Medical Center's diabetes education is a self-management education program that includes a staff of knowledgeable health professionals who provide participants with comprehensive information about diabetes management. The team includes a medical director, director and a host of specially trained registered nurses and certified diabetes educators. The Community Development Office markets clinical services throughout the area, including the secondary outreach markets. Services include, but are not limited to, free educational seminars by physicians and other health professionals. Wyoming Medical Center works with the Wyoming Medical Center Foundation's Masterson Place to provide sleeping rooms to patients and their families at reduced rates or free when being treated at the hospital. WMC also provides taxi services to those individuals who cannot afford transportation to receive healthcare.WMC's CEO works in the community to provide community benefit relationships. There is also on-going work provided by WMC personnel on the Community Health Needs Assessment.Wyoming Medical Center is a training site for many specialties. We provide training for students in Nursing, Phlebotomy, Respiratory Therapy, Paramedic Services, Occupational Therapy assistants, Physical Therapist, and Family Practice residents. Wyoming Medical Center has been instrumental in implementing a Telehealth Stroke program for Wyoming. This allows Casper physicians to view and treat patients from a remote location giving the patient time needed care. Wyoming Medical Center provides Women Services to women who are pregnant or want to become pregnant. This includes prenatal and post delivery education and support to mothers. We also provide diabetes education and weight management programs. During FY 2014 Wyoming Medical Center had nearly 51,000 patient days and over 37,000 emergency department visits.Wyoming Medical Center houses the Safe Kids and Safe Communities programs with the help of donations and grants from various sources. Both programs focus on injury prevention and in addition to the other community education and outreach, offer monthly car seat checks and provide car seats to those who cannot afford them.The Hospital provides services for sexually assaulted victims through the SANE program in the emergency department. The Hospital provides a variety of health improvement options for the community and its patients. For example, the hospital provides education and products for weight loss, diabetes, stroke and smoking cessation. The community building activities promote health of the community by providing needed specialists and physicians as well as determining what is needed by the residents in the local community and surrounding area. WMC also provides a proper disposal service of unwanted and unusable pharmaceuticals in order to keep the community and environment safe. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 Vickie Diamond CEO 520175 0 106819 0 12534 0 27700 0 1366 0 668594 0 0 0 Don J Claunch CFO (Jul-Nov) 230422 0 62793 0 429 0 97528 0 1025 0 392197 0 0 0 Yvonne Wigington Senior VP & CFO 136947 0 9674 0 180 0 11415 0 1056 0 159272 0 0 0 Julia Cann-Taylor CNO 265405 0 64155 0 1736 0 210476 0 1366 0 543138 0 0 0 Robert M Kaiser VP of Employee Services 250095 0 31403 0 356 0 74024 0 1252 0 357130 0 0 0 Patrice Weiner Intensivist-Pulmonary 356516 0 12500 0 900 0 0 0 1366 0 371282 0 0 0 Robert Neff Nephrology 390341 0 32482 0 398 0 10200 0 1366 0 434787 0 0 0 Casey Contant MD Nephrology 369751 0 126798 0 342 0 10200 0 1366 0 508457 0 0 0 Mark McGinley MD Intensivist-Pulmonary 408020 0 12500 0 929 0 10200 0 1366 0 433015 0 0 0 Rafael Perez MD Intensivist-Pulmonary 377067 0 12550 0 1696 0 10200 0 1366 0 402879 0 0 0 Part I, Line 1a Vickie Diamond - Petroleum Club Dues - $620 Vickie Diamond - Casper Country Club - $3,120 Vickie Diamond - Rotary Club - $788 These amounts were not treated as taxable wages during the reporting year. The Rotary Club dues are for a civic organization that is not subject to tax. Form 990, Schedule J, Part II, Column C: Compensation of Officers, Directors, Key Employees, Highest Compensated Employees: Included in other deferred compensation is the estimated current year increase in the actuarial value of the defined benefit plan. These amounts do not represent any current year contributions to the plan. They are estimates of the increase in the actuarial value of the plans received from the NRECA. The current year expense and the increase in actuarial value for each employee are reflected in the statement for Form 990, Part VII, Column f. A Natrona County Wyoming 836000113 638813CB9 2011-02-28 20039909 Construction of New West Tower 0 0 0 A 1135000 20044228 1667185 3714645 257480 18119563 2014 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 Form 990, Schedule K, Part II, Line 3: The difference between Part I, Column (e) and Part II, Line 3 represents investment earnings on the bond proceeds during the construction phase. Wyoming Neurologic Associates Owned 100% by Board Member Dr. Wheeler Community Service Agreement X 51323 5377 0 1 1 Wyoming Neurologic Associates Owned 100% by Board Member Dr. Wheeler Community Service Agreement X 25000 25000 0 1 1 30377 Wyoming Cardiopulmonary Service PC Board Member Dr. John Pickrell owns 20% 202864 Echo Tech Services 0 Wyoming Neurologic Associates Board Member Dr. David Wheeler owns 100% 350199 Physician and on call services 0 3rd Street Medical LLC Board Member Susan McMurry owns 50% 939853 Rent 0 Medical Holding Properties Board Member Susan McMurry owns 33% 121337 Construction and Utility Costs 0 Samuel Cann Son of Julia Cann-Taylor 43504 Compensation and benefits 0 Form 990, Part III, line 2 Wyoming Medical Center launched two outpatient practices in FY 2014. Wyoming Endocrine and Diabetes Clinic (August 2013) and Wyoming Outpatient Therapies (January 2014). It also launched the Pediatric Hospitalist program in conjunction with Casper pediatricians in October 2013. These activities are in furtherance of Wyoming Medical Center's exempt purpose. Form 990, Part VI, Section A, line 1 The Executive Committee has broad authority to act on behalf of the Board of Directors. The Executive Committee consists of the Chair, Vice Chair and Secretary. The Executive Committee is responsible for carrying out the directives of the Board of Directors in the interim between regular board meetings, and is empowered to make such decisions or take such actions. All substantive decisions made or actions taken by the Executive Committee are reported to the Board of Directors in the Chair's standing report at the following regular board meeting, and acceptance of the report constitutes ratification by the Board of Directors of such decisions or actions. Form 990, Part VI, Section A, line 2 Vickie Diamond, Don Claunch and Linda Young have a business relationship due to serving on a related taxable organization board together. Vickie Diamond and Susan McMurry have a business relationship due to serving on a related organization board together. Form 990, Part VI, Section B, line 11 The Form 990 was presented in its entirety to the Board of Directors. The full Form 990 was given to each board member and the CFO went through a detailed review with the members. Form 990, Part VI, Section B, line 12c Wyoming Medical Center's conflict of interest policy applies to directors, the principal officer and any member of a committee with board-delegated powers. WMC officers, directors, and key employees will also follow the Corporate Compliance Conflict of Interest Policy. Each individual governed by the policy annually signs a conflict of interest statement. Periodic reviews are conducted to ensure that WMC operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax in connection with any actual or possible conflicts of interest. Members of the committees with board delegated powers consider the proposed transaction or arrangement after disclosure of the financial interest, all material facts and after discussion with the interested person. The individual with the conflict leaves the board or committee meeting while the final determination of a conflict of interest is discussed and voted upon. The remaining board or committee members decide if a conflict of interest exists. A voting member of the board or any committee, who receives compensation, directly or indirectly, from WMC, is precluded from voting on matters pertaining to that member's compensation. Physician board members are precluded from voting on any compensation matters involving other physicians. Form 990, Part VI, Section B, line 15 Wyoming Medical Center's executive compensation policy has the primary objective of providing a total compensation program that recognizes individual performance and experience and current market value of the position based on the skills, knowledge and behaviors required of a fully competent incumbent. The compensation of the President & CEO is under the authority of the compensation review committee of the Board of Directors. The compensation of the other officers is under the authority of the President & CEO, who is accountable to the Board of Directors. Annually, the employee services department completes a thorough market analysis for all executive positions. This market review considers equivalent positions in the industry and comparable organizations at the local, regional and national levels. This analysis is provided to the compensation review committee. This process included review and approval by independent persons, comparability data and contemporaneous substantiation. Form 990, Part VI, Section C, line 19 Wyoming Medical Center does not make its governing documents or conflict of interest policy available to the public. The financial statements are attached to the public disclosure copy of the Form 990. Form 990, Part VII, Section A, Column (F): Compensation of Officers- Included in column "f", estimated amount of other compensation, is the estimated annual increase in the actuarial value of the defined benefit plan. The estimated increase for Julia Cann-Taylor is $210,476, $97,528 for Donnie Claunch, $74,024 for Robert Kaiser, and $5,181 for Yvonne Wigington. These amounts are estimates in the increase of the value of the plan and are not current year expenses of the cooperative. The current year expense for this defined benefit plan was $101,626, $13,081, $12,859, and $0 respectively. Form 990, Part IX, line 11g Professional Fees: Program service expenses 12,646,085. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,646,085. Contract Services: Program service expenses 7,694,742. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,694,742. Other Fees: Program service expenses 5,297,138. Management and general expenses 1,221,007. Fundraising expenses 0. Total expenses 6,518,145. Locums: Program service expenses 2,038,735. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,038,735. Collection Fees: Program service expenses 676,645. Management and general expenses 0. Fundraising expenses 0. Total expenses 676,645. Form 990, Part XI, line 9: Change in Minimum Pension Liability 11,043,025. Wyoming Health Medical Group LLC 1233 E 2nd St Casper WY 82601 800307419 Medical Services WY 6171010 1407579 Wyoming Medical Center Wyoming Medical Center Foundation 1233 E 2nd St Casper WY 82601 830230808 Charity Activities WY 501(c)(3) Line 11a, I Wyoming Medical Center Inc 1 WyMedco Care Inc 1233 E 2nd St Casper WY 82601 830279267 Support in the Nonprofit Mission of WMC WY 501(c)(3) Line 11a, I Wyoming Medical Center Inc 1 Central Wyoming Outpatient Surgery Center LLC 1201 E 3rd St Casper WY 82601 830331130 Medical Services WY Wyoming Medical Center Inc Related 1268604 1089425 0 1 0.50000 North Platte Pathology 111 S Jefferson St Casper WY 82601 453676843 Medical Services WY Wyoming Medical Center Inc Related 137641 90928 0 1 0.50000 WyMedco Ventures Inc 1233 E 2nd St Casper WY 82601 830281137 Medical Services WY Wyoming Medical Center Inc C 970723 4629349 1.00000 1 Hospital Foundation Ventures Inc 1233 E 2nd St Casper WY 82601 830282249 Business Investment WY N/A C 0 0 0 1 1 0 0 0 0 0 1 0 1 1 1 1 0 1 0 1 Central Wyoming Outpatient Surgery Center LLC J 350000 Actual Receipts Central Wyoming Outpatient Surgery Center LLC S 1431342 Actual Receipts Wyoming Medical Center Foundation C 558038 Actual Receipts North Platte Pathology S 185000 Actual Receipts