2022-02-02T16:05:38-06:00 2021-06-30 830332861 KOERWITZ MICHEL WRIGHT & ASSOC PC PO BOX 1362 THERMOPOLIS WY 82443 990 2020-07-01 836000182 HOT SPRINGS COUNTY HOSPITAL DIST HOTS 3078643121 150 E ARAPAHOE STREET THERMOPOLIS WY 82443 DAVID KOERWITZ DIRECTOR 3078643121 2022-01-17 DAVID KOERWITZ 999009999 MICHAEL J WRIGHT P00488529 3078643173 2022-02-02 2020 2022-09-23 18:48:47Z HOT SPRINGS HEALTH DAVID KOERWITZ 150 E ARAPAHOE STREET THERMOPOLIS WY 82443 32843388 false X WWW.HSCMH.ORG X HOSP. DIST. 1944 WY PARTNERING WITH OUR COMMUNITY FOR QUALITY HEALTH AND HEALING. 5 5 202 0 177018 3617256 24773492 27547965 -17647 101550 2636106 1572942 27568969 32839713 0 0 13068028 14542824 0 0 13088812 14640988 26156840 29183812 1412129 3655901 49255545 55349867 35298437 37736858 13957108 17613009 X PARTNERING WITH OUR COMMUNITY FOR QUALITY HEALTH AND HEALING. false false 25967313 HOT SPRINGS COUNTY HOSPITAL DISTRICT, A NOT FOR PROFIT AND GOVERNMENTAL HOSPITAL, PROVIDES COMPASSIONATE MEDICAL CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. HSCHD OFFERS 24/7 EMERGENCY CARE (2,023 VISITS), INPATIENT SERVICES(1,090 PATIENT DAYS), OUTPATIENT SERVICES (16,896 VISITS), BIG HORN CLINIC RURAL HEALTH CLINIC (3,251 VISITS), RED ROCK WORLAND (5689 VISITS), HSCHD SURGICAL CLINIC (792 VISITS), RED ROCK FAMILY PRACTICE RIVERTON (591 VISITS), RED ROCK SHOSHONI (245 VISITS), AND RED ROCK FAMILY PRACTICE CLINIC THERMOPOLIS(11,338 VISITS). THE HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM UNDER WHICH SERVICES ARE PROVIDED FOR FREE OR AT A REDUCED RATE. CHARITY CARE AWARDED UNDER THE FINANCIAL ASSISTANCE PROGRAM TOTALED 196,921. THE COST OF CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2021 BASED ON DIRECT AND INDIRECT COST OF PROVIDING CHARITY CARE SERVICES WAS 136,799. MANY EMPLOYEES ARE TEACHERS IN THE EDUCATION PROGRAMS OPEN TO THE PUBLIC SUCH AS CERTIFIED NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING, CENTRAL WYOMING COLLEGE AND NORTHWESTERN WYOMING COLLEGE ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCHD. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCHD WEBSITE. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. BIG HORN CLINIC, RED ROCK FAMILY PRACTICE THERMOPOLIS AND RED ROCK FAMILY PRACTICE WORLAND CLINIC PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCHD OFFERS SCHOLARSHIPS TO QUALIFYING CANDIDATES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCHD PARTICIPATES. 25967313 true true false false false false false false false false true false false false false false true false false false false false false false false false true true false false true true false false false false false true false false false false false false false false false false false false false true 80 80 true 202 true false false false false false false false false X 5 5 false true false false false false false true true false false false true true true true true true true false X MARGIE MOLITOR SEE STATEMENT 1 3078643121 150 E ARAPAHOE ST THERMOPOLIS WY 82443 JASON WEYER PHYSICIAN 40.00 X 531360 0 11400 WADE BOMENGEN PHYSICIAN 40.00 X 473537 0 11400 MATHEY MATTSON PHYSICIAN 40.00 X 401708 0 11400 HALLIE BISCHOFF PHYSICIAN 40.00 X 387970 0 11400 SUSAN BRIGHT PHYSICIAN 40.00 X 295223 0 11400 SHELLY LARSON CFO 40.00 X 140463 0 6154 CHARLES CALKIN FORMER CONTR 40.00 X 115093 0 0 DAN HERDT SEC/TREAS 2.00 X X 0 0 0 MELISSA JOHNSON DIRECTOR 2.00 X 0 0 0 DAVID KOERWITZ DIRECTOR 2.00 X 0 0 0 HEATH OVERFIELD VICE CHAIRMA 2.00 X X 0 0 0 BILL WILLIAMS CHAIRMAN 2.00 X X 0 0 0 MARGIE MOLITOR SEE STATEMENT 1 CEO 40.00 X 0 0 0 2345354 63154 7 true true false SLETTEN CONSTRUCTION 3225 BIGHORN AVE CODY WY 82414 CONSTRUCTION 9396885 HOLISTIC PAIN MANAGEMENT RYAN SHEDD PO BOX 1476 LOVELAND CO 80539 AGENCY STAFF 780240 HEALTHTECH MGT SER (SEE STATEMENT 3) 5110 MARYLAND WAY STE 2 BRENTWOOD TN 37027 MNGMT/CONTRACT 652813 XTEND HEALTHCARE 90 VOLUNTEER DR STE 150 HENDERSONVILLE TN 37075 BILLING SERVICE 379226 MORTIMORE AMBULANCE 620 ARAPAHOE ST THERMOPOLIS WY 82443 AMBULANCE SRVS 318565 5 3533048 84208 3617256 PATIENT SERVICE REVENUE 27144659 27144659 OTHER OPERATING REVENUE 403306 403306 27547965 11550 11550 19350 3675 15675 15675 15675 90000 90000 90000 90000 SPECIAL PURPOSE TAX 1031679 1031679 PROPERTY TAX 525588 525588 1557267 32839713 29222457 X 11924253 11031375 892878 305767 283140 22627 1350158 1250246 99912 962646 891410 71236 653236 653236 120020 120020 81750 81750 3833526 3228368 605158 4497217 4367144 130073 1019993 1011500 8493 131685 120156 11529 986958 986958 2590422 2201859 388563 197509 197509 DUES & SUBSCRIPTIONS 425689 322658 103031 RECRUITMENT 73354 45561 27793 LICENSE FEES 29629 29429 200 29183812 25967313 3216499 0 7629742 10931994 9860616 7745402 5391199 4664838 3958 13500 877058 910766 215552 188624 43427014 13169439 24576700 30257575 700720 637168 49255545 55349867 4270640 5329216 4319062 320607 26708735 32087035 35298437 37736858 X 4096492 9888679 9860616 7724330 13957108 17613009 49255545 55349867 3655901 X true true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 679687 679687 17211839 3870179 13341660 25535488 9299260 16236228 30257575 32839713 32839713 32839713 29183812 29183812 29183812 true true true X true X true true false true true 131191 131191 0.00450 1964929 945551 1019378 0.03490 2096120 945551 1150569 0.03940 228917 62369 166548 0.00570 3144947 2152011 992936 0.03400 3373864 2214380 1159484 0.03970 5469984 3159931 2310053 0.07920 false 2357085 707125 12882692 12591851 290841 true true HEALTHTECH MGMT SRV MANAGEMENT 1 1 HOT SPRINGS COUNTY HOSPITAL DISTRIC 150 E ARAPAHOE THERMOPOLIS WY 82443 WWW.HOTSPRINGSHEALTH.COM X HOT SPRINGS COUNTY HOSPITAL DISTRIC 1 false false true X X X X X X X 19 true false true true X WWW.HOTSPRINGSHEALTH.COM X true 20 true WWW.HOTSPRINGSHEALTH.COM false false true X 100.000000000000 300.000000000000 X X X X true true X X X true X WWW.HOTSPRINGSHEALTH.COM X WWW.HOTSPRINGSHEALTH.COM X WWW.HOTSPRINGSHEALTH.COM X X X X X X true X false X X X true X false false FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 3E THE CHNA REPORT DESCRIBES THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY. FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 5 PART V FACILITY INFORMATION FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRICT-PART V, LINE 5 THE COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE IS COMPRISED OF THE HOSPITAL REPRESENTATIVES, MARGIE MOLITOR, RN, CHIEF EXECUTIVE OFFICER, NINA LANDIS, RN, CHIEF NURSING OFFICER, MIRANDA NELSON, BSW SOCIAL WORKER; HOT SPRINGS COUNTY PUBLIC HEALTH, TRICIA MCPHIE, RN, PUBLIC HEALTH OFFICER AND HOT SPRINGS COUNTY COMMUNITY PREVENTION PROGRAM, JENNIFER CHENEY, COORDINATOR. IN ADDITION, THE FOLLOWING MEMBERS OF THE HOT SPRINGS COUNTY PREVENTION COALITION MEMBERS PROVIDED INPUT FOR THE DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSEMENT. THE MEMBERS INCLUDED, TRICIA MCPHIE, RN, PUBLIC HEALTH OFFICER, JENNIFER CHENEY, COORDINATOR, HOT SPRINGS COUNTY COMMUNITY PREVENTION PROGRAM; KATIE HILMER, WELLSPRING COUNSELING; CURTIS CHENEY, ASSISTANT COUNTY ATTORNEY; MARY ANN RUSH, EXECUTIVE DIRECTOR THERMOPOLIS CHAMBER OF COMMERCE; RANAE BALDES, HOT SPRINGS COUNTY VICTIM WITNESS PROGRAM; SHARON SKIVER WYOMING PIONEER HOME ADMINISTRATOR; MARY GORDON, PUBLIC HEALTH RESPONSE COORDINATOR; SHERIFF JERIMIE KRAUSHAAR, HOT SPRINGS COUNTY SHERIFF DEPARTMENT; CATHERINE CRUMPLER, WISDOM TREE COUNSELING; ALLAN BRAATEN, EXECUTIVE DIRECTOR WELLSPRING COUNSELING SERVICES, DAISY TORRES, EXECUTIVE DIRECTOR, HOPE AGENCY; BETH LEWIS, EXECUTIVE DIRECTOR, CHILDRENS RESOURCE CENTER EXECUTIVE DIRECTOR, PENNY HERDT, ADMINISTRATIVE ASSISTANT HOT SPRINGS COUNTY COMMISSIONERS, BARB RICE, HOT SPRINGS COUNTY YOUTH ALTERNATIVES; PENNIE ANDERSON, SUPERVISOR, DEPARTMENT OF FAMILY SERVICES; ELISA DANIELS, HOT SPRINGS COUNTY SCHOOL DISTRICT COUNSELOR, AND JILL VAN HULE, HEAD START. FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRICT-PART V, LINE 6B. REFER TO FACILITY 1-PART V, LINE 5, SEE ABOVE. FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 6B OTHER ORGANIZATIONS FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 11 THE COMMUNITY HEALTH NEEDS WERE PRIORITIZED BASED ON THE FOLLOWING FIVE CRITERIA: 1.MAGNITUDE/SCALE OF THE PROBLEM 2.SEVERITY OF THE PROBLEM 3.HEALTH DISPARITIES 4.IMPORTANCE TO THE COMMUNITY 5.ABILITY TO LEVERAGE THE THREE PRIORITY COMMUNITY HEALTH NEEDS CHOSEN WERE BEHAVIORAL HEALTH, POVERTY AND OPIODS. THE GOAL FOR BEHAVIORAL HEALTH IS TO HAVE MORE ACCESS TO BEHAVIORAL HEALTH SERVICES. POVERTY GOALS INCLUDED DECREASING PROVERTY AND INCREASING SERVICES. THE OPIOD GOALS INCLUDE REDUCTION IN USE AND EDUCATION. THE COMMUNITY PARTNERS FOR THESE THREE INITIATIVES INCLUDE HOT SPRINGS COUNTY PREVENTION COALITION, HOT SPRINGS COUNTY SCHOOL DISTRICT 1, WELLSPRING COUNSELING CENTER, LAW ENFORCEMENT, COUNTY ATTORNEY'S OFFICE, HOPE AGENCY WISDOM TREE COUNSELING, YOUTH ALTERNATIVES PROGRAM, HELP CENTER, YELLOWSTONE COMMUNITY ASSISTANCE NETWORK, DEPARTMENT OF FAMILY SERVICES, HOT SPRINGS COUNTY PUBLIC HEALTH, MINISTERIAL ALLIANCE, RIVER OF LIFE FELLOWSHIP, HOT SPRINGS COUNTY SENIOR CENTER, MESSIAH'S MALL. FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 13B INCOME LEVEL SCHEDULE H, PART I, LINE 3C THE FACILITIES CRITERIA FOR ELIGIBLITY FOR FREE OR DISCOUNTED CARE IS BASED ON THE FEDERAL PROVERTY GUIDELINES, FAMILY SIZE, AND THE PATIENT'S EQUITY RESOURCES (ASSETS LESS MEDICAL DEBT). IN ADDITION, THE PATIENT AND FAMILY MEMBERS MUST RECEIVE A DENIAL FROM MEDICAID OR OTHER PUBLIC ASSISTANCE PROGRAMS. EXTENUATING CIRCUMSTANCES (DEATH, ACTS OF NATURE, ETC.) ARE CONSIDERED IN DETERMINING ELIGIBILTY FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART I, LINE 7G THE SUBSIDIZED HEALTH SERVICES WERE CALCULATED FOR SERVICES PROVIDED TO PATIENTS WHO ARE TREATED IN THE FACILITIES EMERGENCY ROOM. THIS DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. SCHEDULE H, PART III, LINE 2 ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LAWS AND REGULATIONS OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE ALLOWANCE FOR BAD DEBTS. THE FACILITIES ESTIMATE OF BAD DEBT WHICH WOULD QUALIFY FOR FINANCIAL ASSISTANCE IS BASED ON THE STANDARD INDUSTRY BENCHMARK AND THE REVIEW OF BAD DEBT ACCOUNTS AT THE TIME OF WRITE-OFF. NO COMMUNITY BENEFIT IS CLAIMED FOR ANY PORTION OF THE BAD DEBT. PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY SEE ABOVE, SAME METHODOLOGY FOR PART III, LINE 2 SCHEDULE H, PART III, LINE 4 TEXT OF FINANCIAL STATEMENT FOOTNOTE (SEE PAGE 25, NOTE 3 OF THE AUDITED FINANCIALS). ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LEGISLATION OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE PROVISION FOR BAD DEBT. SCHEDULE H, PART III, LINE 8 THE HOSPITAL IS LICENSED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS A CRITICAL ACCESS HOSPITAL. AS A CRITICAL ACCESS HOSPITAL IT IS REIMBURSED ON 101% OF COSTS LESS THE 2% SEQUESTRATION ADJUSTMENT. THE HOSPTITAL UTILIZED THE ANNUAL COST REPORT FOR FISCAL YEAR JUNE 30, 2020 WHICH IT IS REQUIRED TO SUBMIT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS THE SOURCE TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE IN CONNECTION WITH THE REVENUE RECEIVED FROM MEDICARE. SCHEDULE H, PART III, LINE 9B THE HOSPITAL MAKES EVERY EFFORT TO COMPLETE A FINANCIAL EVALUATION AT THE EARLIST POSSIBLE POINT IN THE REVENUE CYCLE FOR ALL PATIENTS INDICATING AN INABILITY TO MEET THEIR FINANCIAL OBLIGATIONS. A FINANCIAL ASSISTANCE PROGRAM APPLICATION IS COMPLETED ONCE ALL OTHER OPTIONS FOR REIMBURSEMENTS HAVE BEEN EXHAUSTED. false false false false false false false false false JASON WEYER PHYSICIAN 531360 11400 542760 WADE BOMENGEN PHYSICIAN 473537 11400 484937 MATHEY MATTSON PHYSICIAN 401708 11400 413108 HALLIE BISCHOFF PHYSICIAN 387970 11400 399370 SUSAN BRIGHT PHYSICIAN 295223 11400 306623 CHARLES CALKIN FORMER CONTROLLER 115093 115093 A HOT SPRINGS COUNTY HOSPITAL DISTRIC HOT SPRINGS COUNTY HOSPITAL DISTRIC 836000182 2018-12-20 21346000 BUILDING CONSTRUCTION AND EQUIPMENT false false false B HOT SPRINGS COUNTY HOSPITAL DISTRIC HOT SPRINGS COUNTY HOSPITAL DISTRIC 836000182 2018-12-20 5335971 BUILDING CONSTRUCTION AND EQUIPMENT false false false A 21346000 1198362 479945 19667693 2021 false false true true B 5335971 299634 119975 4916362 2021 false false true true A false false false false false false false B false false false false false false false A false false false false false false false false false B false false false false false false false false false A false B false PURPOSE OF ISSUE DESCRIPTION HOT SPRINGS COUNTY HOSPITAL DISTRICT BUILDING CONSTRUCTION AND EQUIPMENT PURPOSE OF ISSUE DESCRIPTION HOT SPRINGS COUNTY HOSPITAL DISTRICT BUILDING CONSTRUCTION AND EQUIPMENT DR ASSAY EMPLOYEE RECRUITMENT X 10000 10000 false true true DR BRIGHT EMPLOYEE RECRUITMENT X 10000 3500 false true true 13500 FORM 990, PAGE 2, PART III, LINE 4A HOT SPRINGS COUNTY HOSPITAL DISTRICT, A NOT FOR PROFIT AND GOVERNMENTAL HOSPITAL, PROVIDES COMPASSIONATE MEDICAL CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. HSCHD OFFERS 24/7 EMERGENCY CARE (2,023 VISITS), INPATIENT SERVICES(1,090 PATIENT DAYS), OUTPATIENT SERVICES (16,896 VISITS), BIG HORN CLINIC RURAL HEALTH CLINIC (3,251 VISITS), RED ROCK WORLAND (5689 VISITS), HSCHD SURGICAL CLINIC (792 VISITS), RED ROCK FAMILY PRACTICE RIVERTON (591 VISITS), RED ROCK SHOSHONI (245 VISITS), AND RED ROCK FAMILY PRACTICE CLINIC THERMOPOLIS(11,338 VISITS). THE HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM UNDER WHICH SERVICES ARE PROVIDED FOR FREE OR AT A REDUCED RATE. CHARITY CARE AWARDED UNDER THE FINANCIAL ASSISTANCE PROGRAM TOTALED 196,921. THE COST OF CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2021 BASED ON DIRECT AND INDIRECT COST OF PROVIDING CHARITY CARE SERVICES WAS 136,799. MANY EMPLOYEES ARE TEACHERS IN THE EDUCATION PROGRAMS OPEN TO THE PUBLIC SUCH AS CERTIFIED NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING, CENTRAL WYOMING COLLEGE AND NORTHWESTERN WYOMING COLLEGE ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCHD. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCHD WEBSITE. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. BIG HORN CLINIC, RED ROCK FAMILY PRACTICE THERMOPOLIS AND RED ROCK FAMILY PRACTICE WORLAND CLINIC PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCHD OFFERS SCHOLARSHIPS TO QUALIFYING CANDIDATES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCHD PARTICIPATES. FORM 990, PAGE 6, PART VI, LINE 3 HSCHD CONTRACTS WITH HEALTHTECH MANAGEMENT SERVICES, INC. FOR MANAGEMENT SERVICES INCLUDING THE CEO POSITION. THE CEO IS EMPLOYED BY HEALTHTECH MANAGEMENT SERVICES, INC. FORM 990, PAGE 6, PART VI, LINE 11B THE CURRENT FISCAL YEAR 6/30/21 FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR DISCUSSION AND REVIEW. THE ENTIRE BOARD OF DIRECTORS APPROVED THE CURRENT FISCAL YEAR 6/30/21 FORM 990 AT A REGULARLY SCHEDULED BOARD MEETING. FORM 990, PAGE 6, PART VI, LINE 12C THE HOSPITAL HAS A FORMAL CONFLICT OF INTEREST POLICY WHICH REQUIRES EMPLOYEES TO MAKE A PROMPT WRITTEN FULL DISCLOSURE OF ANY POTENTIAL SITUATION WHICH MAY INVOLVE A CONFLICT OF INTEREST. THE POLICY PROVIDES A LIST OF POTENTIAL CONFLICTS. EMPLOYEES WHO VIOLATE THE POLICY ARE SUBJECT TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. THE POLICY IS REVIEWED AT LEAST 2 TIMES A YEAR WITH EMPLOYEES; THE ANNUAL SKILLS FAIR AND THE ANNUAL EMPLOYEE EVALUATION. THE EMPLOYEE COMPLETES AND SIGNS A NEW DISCLOSURE AT THE TIME OF THEIR EVALUATION. THE HOSPITAL DOES REQUIRE GOVERNING BOARD MEMBERS, OFFICERS, MANAGERS, AND MEDICAL REPRESENTATIVES WITH ADMINISTRATIVE RESPONSIBILITY TO DISCLOSE IN WRITING ALL POTENTAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS AS WELL. FORM 990, PAGE 6, PART VI, LINE 15A THE ORGANIZATION'S CEO IS A LEASED-EMPLOYEE, WHO CONDUCTS THE EVALUATION AND COMPARABILITY OF SALARY DATA. FORM 990, PAGE 6, PART VI, LINE 15B THE ORGANIZATION COMPLETES AN ANNUAL REVIEW OF OTHER KEY EMPLOYEES AND COMPLETES A COMPARISON OF SALARIES WITH WYOMING HOSPITAL ASSOCIATION SALARY SURVEY DATA. THE ANNUAL REVIEW IS COMPLETED BY THE CEO. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION IS A GOVERNMENTAL ENTITY, ALL BOARD OF TRUSTEE MEETINGS ARE PUBLIC MEETINGS. ALL REPORTS (NOT CONSIDERED CONFIDENTIAL) ARE SUBJECT TO THE OPEN MEETING LAWS UNDER STATE OF WYOMING LAWS. IN ADDITION THESE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION IN ACCORDANCE WITH FEDERAL AND STATE LAW. FORM 990, PART IX, LINE 11G AMBULANCE SERVICES 333,571 0 0 COLLECTION FEES 0 234,837 0 CONSULTING FEES 85,726 24,282 0 CONTRACT AND PURCH SERVICES 546,825 297,503 0 COST REPORT 0 10,750 0 PHYSICIAN FEES 1,465,621 0 0 PUBLIC RELATIONS/ADVERTISING 25,574 37,786 0 STAFFING AGENCY FEES 771,051 0 0 TOTAL 3,228,368 605,158 0