2022-08-10T10:52:15-05:00 2021-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-10-01 450226426 St Andrew's Hospital STAN 7012289300 316 Ohmer Street Bottineau ND 58318 Christopher Albertson President & CEO 7012289300 2022-08-09 1 Christopher Albertson 999009999 Kim Hunwardsen CPA P00484560 6122536500 2022-08-09 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SMP Health - St Andrew's Christopher Albertson 316 Ohmer Street Bottineau ND 58318 15341415 0 0928 X https://smphealth.org/standrews/ X 1913 ND Acute care critical access hospital 8 7 139 10 0 0 82185 1438254 11098051 13826476 56910 54050 21978 22635 11259124 15341415 0 0 0 0 5242265 6116537 0 0 0 5786275 7316921 11028540 13433458 230584 1907957 12375452 12327244 5221720 2686854 7153732 9640390 X St. Andrew's Health Center, in union with the Sisters of Mary of the Presentation, works for the glory of God by bringing the Word and Healing of Jesus Christ to all, with a special concern for the poor and elderly. Through the shared ministry with the laity, St. Andrew's Health Center participates in the health care mission in the work of healing which is the work of God. Our individual inspiration is Jesus and His Gospel message. Permeated with the Charism of the Sisters of Mary of the Presentation, we minister to one another and to all who come to us for care. 0 1 11588426 13826476 SMP Health St. Andrew's (Health Center), formerly doing business as St. Andrew's Health Center, is a 25bedacute care hospital and a senior apartment facility located in Bottineau, North Dakota. SMP Health - St. Andrew's has been a part of the community since 1913. Our mission is to provide services to all who come to us for care; this is something that we are very proud of. Our ability to better the lives of those most in need is the core of our beliefs and knowing that we can make a difference in the lives of those we serve. In addition, we believe that through our leadership and presence in the community that we have been and will continue to be an essential part of the healthcare delivery team. Statement continued on Schedule O.St. Andrew's Hospital is designated as a Critical Access Hospital and has had the designation since July 2001. There were 311 acute patient days and 5,876 swing-bed days. The percent of occupancy was 67.8%.We continue to utilize "The Guide for Planning and Reporting Community Benefit" book that was prepared by the Catholic Health Care Association to help determine what qualifies as a community benefit. We attend a variety of educational opportunities throughout the year to provide direction in reporting on our benefits to the community.The Health Center provides healthcare services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Health Center does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was $11,000 for the year ended September 30, 2021, calculated by multiplying the ratio of cost to gross charges for the Health Center by the gross uncompensated charges associated with providing charity care to its patients.The Health Center also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable.SMP Health entered into an Affiliation Agreement on January 1, 2021 with St. Margaret's Health-Peru, St. Margaret's Health-Spring Valley, IV HealthCorp, and Illinois Valley Community Hospital Foundation. The affliation was completed to better ensure the entities and related entities could accomplish the charitable healthcare purposes for which they were organized. 11588426 1 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 15 0 1 139 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 1 1 X Christopher Albertson 7012289300 316 Ohmer Street Bottineau ND 58318 Jeremi Tweed - Director until July 2021 then Chair 0.50 0.00 X X 0 0 0 Steven Gorder Chair until July 2021 0.50 0.00 X X 0 0 0 Melissa Block Vice Chair 0.50 0.00 X X 0 0 0 Sr Debra Berry Director 0.50 1.50 X 0 0 0 Dan Bullinger Director 0.50 0.00 X 0 0 0 Dwane Getzlaff Director as of July 2021 0.50 0.00 X 0 0 0 Rick Gustafson Director as of July 2021 0.50 0.00 X 0 0 0 Sr Anne Germaine Picard Director as of July 2021 0.50 1.00 X 0 0 0 Darin Bohl Director until July 2021 0.50 0.00 X 0 0 0 Sr Dorothy Bunce Director until July 2021 0.50 1.50 X 0 0 0 Christopher Albertson President & CEO 40.00 0.00 X X 0 232114 52351 Courtney Vandal CFO 40.00 0.00 X 0 40385 10912 Robert Hamilton MD Family Medicine Physician 40.00 0.00 X 279733 0 27832 Jessica Skjolden MD Family Medicine Physician 40.00 0.00 X 242090 0 26174 Steve Arnold NP Nurse Practitioner 40.00 0.00 X 155682 0 22818 Cory Miller MD Family Medicine Physician 20.00 0.00 X 152227 0 19590 Janel Agnes Pharmacist 40.00 0.00 X 119875 0 21724 Alfred Sams Former President & CEO 0.00 40.00 X 0 247177 45152 Steve Lindemann Former CFO 0.00 40.00 X 0 167617 37165 949607 687293 263718 7 1 1 0 Sisters of Mary of the Presentation Heal PO Box 10007 Fargo ND 58106 Mgmt fees, pastoral care and legal 532125 CPSI PO Box 850309 Mobile AL 36685 Software maintenance 236630 Guardian Healthcare PO Box 306098 Nashville TN 37230 Travel Nursing Staff 236391 DMS PO Box 670747 Dallas TX 75267 Nuclear medicine, ultrasound purchased s 112653 Avera Health 3900 W Avera Dr Sioux Falls SD 57108 ePharmacy, eEmergency 107625 5 20000 1310142 108112 1438254 Patient Service Revenue 621110 13473696 13473696 Congregate Housing 623990 147333 147333 Management Fee 900099 2100 2100 203347 203347 13826476 54050 54050 22635 0 22635 22635 22635 15341415 13826476 0 76685 X 4827112 4252206 574906 117906 79395 38511 848165 747149 101016 323354 309311 14043 16170 16170 42810 42810 2705421 2153214 552207 25026 5179 19847 503598 398881 104717 284438 264278 20160 18378 11500 6878 5741 5741 385 385 7852 6864 988 438247 383102 55145 93207 93207 Medical Supplies 2412843 2381134 31709 Repairs and maintenance 431774 343611 88163 Food 104622 104622 Bad Debt 88246 88246 138163 49032 89131 13433458 11588426 1845032 0 4374717 2754789 1446668 2228209 333026 237540 163045 151894 10609967 8368921 2606113 2241046 2148601 3667730 1303282 1046036 12375452 12327244 1044562 1057187 3561190 102900 4250 3500 611718 275086 1073181 0 175000 5221720 2686854 X 6304466 8622970 849266 1017420 7153732 9640390 12375452 12327244 X 1907957 421127 157574 X X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 118981 118981 6973765 5448178 1525587 3396286 2817915 578371 120935 102828 18107 2241046 Pooled Investment Fund 3667730 F 3667730 Other receivables 29116 Interest in net assets of St. Andrew's Foundation 1016920 1046036 Estimated third party payor settlements 175000 175000 X 15762542 421127 421127 15341415 0 15341415 13433458 0 13433458 0 13433458 Part IV, Line 2b: St. Andrew's Hospital acts as custodian for the patients and holds patient security deposits. Part X, Line 2: The Health Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Health Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 1 0 1 1 11000 11000 0.00080 11000 11000 0.00080 2275003 1910534 364469 0.02730 2275003 1910534 364469 0.02730 2286003 1910534 375469 0.02810 1 279656 37754 6520590 6456030 64560 X 1 1 1 1 St Andrew's Hospital 316 Ohmer Street Bottineau ND 58318 www.standrewshealth.com 5005 X X X X 1 provider based rural health clinic St Andrew's Hospital 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X www.smphealth.org/standrews/resources/ X 1 18 1 www.smphealth.org/standrews/resources/ 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X www.smphealth.org/standrews/resources/ X www.smphealth.org/standrews/resources/ X www.smphealth.org/standrews/resources/ X X X X X 1 X 0 X X X X 1 X 0 0 St. Andrew's Hospital Part V, Section B, Line 5: Meetings were held with a wide variety of community leaders including public health, business leaders, and other interested individuals. St. Andrew's Hospital Part V, Section B, Line 6b: Public Health St. Andrew's Hospital Part V, Section B, Line 11: A number of needs were identified in the 2018 CHNA process conducted by the UND Center for Rural Health. During the final community group meeting, public health and other community leaders identified the following needs:1. Not enough jobs with livable wages2. Depression and anxietyIn fiscal year 2021 the following actions were taken to address the needs identified.Not Enough Jobs with Livable Wages within the Community1. Strive to provide community members, including the uninsured and working poor, access to jobs with livable wages.2. Continue to provide employment positions that are competitive in wages, therefore providing opportunities to earn a livable wage.3. Continue to be one of the largest employers in the county, continue to offer excellent benefit programs, continue to offer training reimbursement and job security. The goals:Utilize data available to pay competitive market wages for positions at the Hospital. St. Andrew's Hospital will continue to utilize the North Dakota Hospital Association wage and salary survey data to ensure that employment positions are within market value for each and every position. Market adjustments are made yearly to facility positions which increases the base wages for each position according to the NDHA data. Each employee will receive a yearly review, and upon successful review could have their wage or salary increase by a budgeted percentage. The timeline for this project is yearly assessments.FY 2021 update:St. Andrew's Executive Team will review the NDHA Wage and Salary Survey to determine if the survey truly equates to the true salary market in our region. Adjustments may be made based upon the review to make and keep St. Andrew's Hospital a viable option for healthcare professionals and ancillary department employees.Depression and anxiety1. Ensure all community members, including the uninsured and working poor, have access to mental health services.2. Offer professional services within the county that focus specifically on mental and emotional health.3. Work collaboratively with additional organizations to identify the specific needs within the area concerning mental and emotional health.The goals:Work with the Rural Mental Health Consortium.FY 2021 update:St. Andrew's Hospital will continue to partner with the Rural Mental Health Consortium. The Hospital will evaluate the need and feasibility of bringing in Medication Assisted Therapy to aid in decreasing opioid addiction in the region. St. Andrew's Hospital Part V, Section B, Line 13h: In addition to using 200% of the federal poverty guidelines to determine eligibility for providing discounted care to low income individuals, St. Andrew's Hospital also uses a sliding fee schedule based on income and family size. Depending on income and family size a patient could have 20%, 40%, 60%, 80% or 100% written off to charity care.Individuals with medical expenses in excess of 30% of their gross income who would otherwise not qualify for the Caring Program based on their earnings can qualify for catastrophic charity care and receive a reduction in the cost of their medical services. 2 1 - St Andrew's Senior Housing 316 Ohmer Street Bottineau ND 58318 Senior housing 2 - St Andrew's Bottineau Clinic LLC 316 Ohmer Street Bottineau ND 58318 Family practice clinic until November 30, 2020 Part I, Line 3c: In addition to using 200% of the federal poverty guidelines to determine eligibility for providing discounted care to low income individuals, St. Andrew's Hospital also uses a sliding fee schedule based on income and family size. Depending on income and family size a patient could have 20%, 40%, 60%, 80% or 100% written off to charity care.Individuals with medical expenses in excess of 30% of their gross income who would otherwise not qualify for the Caring Program based on their earnings can qualify for catastrophic charity care and receive a reduction in the cost of their medical services.Part I, Line 6b:St. Andrew's Hospital makes its community benefit report available to the public by posting it on an internal bulletin board and on our website. Part I, Line 7: Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The amount of clinic bad debt expense removed from total expenses to determine the percentage was $88,246. Part III, Line 2: The amount on line 2 represents implicit price concessions and bad debts. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Bad debt reflects amounts that will not be paid by patients based on an adverse change in the patient's ability to pay. Part III, Line 3: The estimated amount of the organization's implicit price concessions and bad debts expense attributable to patients eligible under the organization's charity care policy is based on 13.5% of individuals living below the federal poverty level. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 12 and 13 of the attached audited financial statements. Part III, Line 8: St. Andrew's Hospital provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Fiscal year 2021 had a Medicare surplus. Any year there is a Medicare shortfall that would be considered a community benefit.Hospital services reimbursed on a fee schedule are not included in the Medicare calculation per the 990 instructions. Had this been reported the total loss from Medicare services would have been $899,389.Medicare fee schedule revenue $ 77,405Medicare estimated costs of care relating to payments (199,462)Net (Shortage) $ (122,058)Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicaid and Medicare Services. Part III, Line 9b: Individuals provided with charity discounts, financial assistance, or are on payment plans are not referred to a collection agency. After a determination of charity care, any personal portion due would follow the same collection procedures as other types of patients. Part VI, Line 2: In addition to the CHNA, the Hospital receives regular feedback on community needs from board members, other community organizations such as Economic Development Corporation and Chamber of Commerce, and from interested community members. Part VI, Line 3: Extensive signage is posted throughout the facility in the ER, waiting rooms, and the admissions/registration area. Patient statements include language regarding opportunity for financial assistance. The financial assistance policy and application for charity care/financial assistance are on the website. All collection related notices include encouragement to patients to explore financial assistance. The facility employs a full-time employee, the Community Resource Coordinator (CRC), who offers an array of services in searching for medical/dental coverage for those that are underinsured or uninsured. The number of uninsured and underserved is growing in Bottineau County. We are seeing an increase in the individual's out of pocket costs that remain following payments provided by their insurance carriers. With the rise in health care premiums and aging population, families have to make some difficult decisions. The lack of insurance or underinsured has a devastating effect on the people of our community. We are committed to the Catholic Healthcare Initiative on working towards insurance coverage issues for the uninsured and underinsured. Part VI, Line 4: St. Andrew's Hospital is a 25-bed acute care hospital and a senior apartment facility located in Bottineau, North Dakota. St. Andrew's Hospital serves approximately 6,500 individuals, encompassing a large part of Bottineau County. Bottineau County is located in rural, North Central North Dakota, next to the Canadian border. Our main patient base is of senior-citizen age, as the percentage of individuals over the age of 65 in Bottineau County is 24.3%. 13.5% of our population base is living below the poverty level and the 2020 estimated median household income was $65,074. Unemployment in 2020 was 5.44% compared to 5.14% in North Dakota. The most common industries are health care and social assistance, educational services, and retail trade. Part VI, Line 5: St. Andrew's Hospital board is comprised of eight members: The President & CEO, two sisters from the Sisters of Mary of the Presentation, and five community members otherwise unaffiliated with the facility or Sisters of Mary of the Presentation. To meet the needs of our community, the Hospital extends privileges to medical staff that are qualified and licensed. In addition to regular planning for systematic replacement/enhancement of patient care equipment like CT scanners and patient beds, the organization periodically assesses additional needs for equipment and utilizes surplus funds as well as community donations to help meet those needs.St. Andrew's Hospital and its team of co-workers strive to increase their level of community involvement. Many of the employees of St. Andrew's Hospital serve on multiple local and regional committees working to improve the health and lives of the members of Bottineau County. St. Andrew's Hospital operates an emergency room available 24 hours a day and accepts all patients, regardless of ability to pay. We are the sole provider of emergency and inpatient services in our county. The Hospital operates a separate foundation which conducts fundraising activities and solicits funds that are utilized to further the programs of St. Andrew's Hospital. The Foundation makes regular contributions to the Hospital for items that directly improve patient care (minor and capital). We also work with the school system to provide volunteer opportunities for students to work in the Health Care Center.Beyond Charity CareIn addition to our free charity care, the Hospital has provided many other services to meet the needs of those in Bottineau County and service area: we provide access to clinical practice to the Bottineau and Minot region.A number of students job shadow in various departments as part of their education requirements. Over the past year we have had students job shadowing or completing internship hours for Pharmacy technician and Nurse Practitioner (NP) programs. We also have the school of nursing students from Dakota College Bottineau at the facility completing practicals during the college school year. We are happy to be a clinical site to Dakota College-Bottineau for the ADN/PN nursing program and UND for the NP program; we have a number of students that utilize St. Andrews Hospital for their clinicals on a day to day basis. St. Andrew's Hospital allows for time to educate high school students about potential career opportunities in health care and provides job shadowing opportunities for those interested. We work closely with the Health and Sciences Instructor from the local high school to provide health career access to the students. We also participate in a Scrubs Camp program for junior high students. This was coordinated through St. Andrew's Hospital and provides opportunities for students exploring health care options. We also participate in a number of other educational opportunities with students to generate a career in health care; EMT summer school, and 2nd grade tour, just to name a few. These weren't able to be completed this year due to COVID.We have provided presentations to members of our community and the surrounding areas/groups to educate them about the health and wellness issues. We have a regular Healthbeat article that is printed in our local newspaper. We also have a weekly radio spot to discuss current healthcare related issues. We expanded our service offerings to bring blood pressures and wellness profiles to the community of Bottineau again, options were limited due to COVID. Due to Covid, we offered numerous Covid vaccine clinics. Office space and a liaison are provided to the Rural Mental Health Consortium so that we can continue to offer behavioral health services to the community on an outpatient basis. The demand for behavioral health services in the State of North Dakota has grown substantially. We are very pleased to offer this service at the local level and are working strategically to tie this into the identified needs of the CHNA. St. Andrew's Hospital participates in a number of community events/activities that pertain to healthcare and our direct relations to our community; including wellness committee, bio terrorism group, disaster preparedness, co-sponsor a blood drive, blood pressures are offered during a variety of community events such as North Central Electric's annual meeting held in June, and our annual Hospital week celebration, just to name a few. We offer a free blood pressure screening day every Tuesday. This helps monitor the vascular health of 20 to 30 patients each week. Annually we impact about roughly 1,000 people. Blood pressure screenings will resume when visitation is allowed in our facility. St. Andrew's Hospital provides conference rooms for local non-profit organizations for meeting use. Will resume when visitation is allowed in our facility.Throughout the year we held food pantry drives and collected funds to give to the school system for children in need of money for milk at snack time. We also have an angel tree within the facility that has a range of ages of boys and girls that are in need of receiving some gifts at Christmas. We do this in collaboration with a service group in our community.We continue to maintain the Community Resource Coordinator (CRC); this person offers assistance to those in need. The CRC offers an array of services in searching for medical/dental coverage for those that are underinsured or uninsured. The CRC maintains our blanket hugs program providing free blankets for pediatric patients in need of comforting. The CRC also helps individuals complete the Caring Program paperwork. Without the resource, many of these individuals would have gone with needs unmet. Part VI, Line 6: We are an affiliate of the Sisters of Mary of the Presentation Health Corporation. St. Andrew's Hospital operates in accordance with the mission, vision, and values of the Sisters of Mary of the Presentation Health Corporation. Our annual budgeting process includes an assessment of how our budget demonstrates a commitment to the values of the system and the system works to ensure we are always mindful of our duty to care for the poor and those in need. St. Andrew's Hospital has a Strategic Plan developed from themes set forth by the Health System for all affiliates. The strategic plan is an active document which St. Andrew's Hospital works on continuously and reports back to the health system on our progress toward established goals which again, align with the mission, vision, and values of the organization. 0 1 0 0 0 0 0 0 0 Robert Hamilton MD Family Medicine Physician 279733 0 0 0 0 0 8738 0 19094 0 307565 0 0 0 Alfred Sams Former President & CEO 0 217115 0 23200 0 6862 0 17610 0 30480 0 295267 0 0 Christopher Albertson President & CEO 0 207007 0 15781 0 9326 0 22846 0 32720 0 287680 0 0 Jessica Skjolden MD Family Medicine Physician 242090 0 0 0 0 0 7609 0 18566 0 268265 0 0 0 Steve Lindemann Former CFO 0 154465 0 13000 0 152 0 9774 0 29520 0 206911 0 0 Steve Arnold NP Nurse Practitioner 155682 0 0 0 0 0 5093 0 17725 0 178500 0 0 0 Cory Miller MD Family Medicine Physician 152227 0 0 0 0 0 4892 0 14698 0 171817 0 0 0 Part I, Line 3 St. Andrew's Hospital does not pay compensation to the President & CEO or CFO. These positions are compensated by Sisters of Mary of the Presentation Health System, a related organization, for services to the Hospital. Sisters of Mary of the Presentation Health System uses one or more of the methods in Part I, question 3 to determine compensation. Part I, Line 4b SMP Health has a nonqualified deferred compensation plan that complies with Section 409A of the IRC. SMP Health begins contributions into the plan after the employee's first year of service. The employee is vested based on a 20 year vesting schedule or becomes fully vested in the event of death, disability or reaching the age of 65. Employee name and amounts included on Schedule J are as follows: Name Part II, column B (iii) Part II, column C Alfred Sams 862 1,638 Chris Albertson 3,326 8,113 Courtney Vandal 625 Steven Lindemann 152 1,348 Form 990, Part III, line 3 Prior to November 30, 2020, the Health Center held a 51% interest in St. Andrew's Bottineau Clinic (Clinic). Effective December 1, 2020, the Clinic became a wholly owned, provider based rural health clinic and a department of the Health Center. Form 990, Part VI, Section A, line 6 The sole member of the organization is the Sisters of Mary of the Presentation Health System dba SMP Health. Form 990, Part VI, Section A, line 7a The member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The member is also entitled to one vote on every other matter to be voted on by the member. Votes cast on behalf of the member are cast by the Chief Executive Officer of SMP Health. The member has the exclusive right to elect or remove Directors. Form 990, Part VI, Section A, line 7b The authority to act on the following matters are exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer. Form 990, Part VI, Section A, line 8b The Organization does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is made available to the governing body before it is filed. The Organization's President & CEO and CFO review the Form 990. Form 990, Part VI, Section B, line 12c Each Director and Officer must submit in writing to the Chair of the Board and the President & CEO a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chair of the Board reviews the statements of the Directors and the Vice Chair of the Board reviews the statement filed by the Chair. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chair of the Board has authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chair, the Vice Chair has authority to require the Chair remove himself in the same manner. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he will not participate in the deliberations or vote on it. Form 990, Part VI, Section B, line 15 The Organization's President & CEO and CFO are compensated by SMP Health. The compensation process is determined by SMP Health. The SMP Health's Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. The SMP Health's Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990. Form 990, Part IX, line 11g Purchased services: Program service expenses 2,153,214. Management and general expenses 72,212. Fundraising expenses 0. Total expenses 2,225,426. Professional Fees: Program service expenses 0. Management and general expenses 41,961. Fundraising expenses 0. Total expenses 41,961. Management services: Program service expenses 0. Management and general expenses 438,034. Fundraising expenses 0. Total expenses 438,034. Form 990, Part XI, line 9: Equity transfer to related party -10,580. Change in interest in net assets of St. Andrew's Health Center Foundation 168,154. Form 990, Part XII, Line 2c: The governing board of Sisters of Mary of the Presentation Health System assumes responsibility for oversight of the audit for St. Andrew's Hospital. St Andrew's Bottineau Clinic LLC 316 Ohmer Street Bottineau ND 58318 450451306 Provision of health care services ND -45714 276091 St Andrew's Hospital Sisters of Mary of the Health Ministry 1202 Page Drive SW Fargo ND 58106 813757471 Supports SMP Health and the related entities ND 501(c)(3) Canonical Entity N/A 0 Sisters of Mary of the Presentation Health System dba SMP Health 1202 Page Drive SW Fargo ND 58103 450359620 Support related ND Catholic Health Care System ND 501(c)(3) Line 12a, I SMP Health Ministry 0 St Aloisius Medical Center dba SMP Health - St Aloisius 325 E Brewster St Harvey ND 58341 450226729 Provision of health care services ND 501(c)(3) Line 3 SMP Health 0 St Andrew's Hospital Foundation dba SMP Health St Andrew's Foundation Inc 316 Ohmer St Bottineau ND 58318 450413201 Support SMP Health - St. Andrew's ND 501(c)(3) Line 12a, I SMP Health 0 Presentation Medical Center dba SMP Health - St Kateri 213 2nd Ave NE Rolla ND 58367 450227391 Provision of health care services ND 501(c)(3) Line 3 SMP Health 0 Sisters of Mary of the Presentation Prairieland Home Care dba Prairieland H 1102 Page Drive SW Fargo ND 58106 450391192 Home health and supportive services ND 501(c)(3) Line 10 SMP Health 0 Sisters of Mary of the Presentation Long Term Care dba SMP Health - Long Te 1202 Page Drive SW Fargo ND 58106 752999939 Provide extended care and medically related services ND 501(c)(3) Line 10 SMP Health 0 St Margaret's Hospital Foundation 600 E 1st St Spring Valley IL 61362 364042262 Support SMP Health - St. Margaret's IL 501(c)(3) Line 12a, I SMP Health 0 SMP Illinois Region Health System dba St Margaret's Health 600 E 1st St Spring Valley IL 61362 842023121 Support related Illinois health care entities IL 501(c)(3) Line 12a, I SMP Health 0 IV HealthCorp Inc 925 W St Peru IL 61354 371211890 Support SMP affiliated entities IL 501(c)(3) Line 12a, I St Margaret's Health 0 St Margaret's Health - Spring Valley 600 E 1st St Spring Valley IL 61362 362167884 Provision of health care services IL 501(c)(3) Line 3 St Margaret's Health 0 Illinois Valley Community Hospital Foundation 925 W St Peru IL 61354 371211780 Support IV HealthCorp, Inc. IL 501(c)(3) Line 12a, I IV HealthCorp Inc 0 Hygienic Institute Fro LaSalle Peru and Oglesby 925 West Street Peru IL 61354 362167742 Provide primary health care servcies IL 501(c)(3) Line 10 IV HealthCorp Inc 0 St Margaret's Health - Peru 925 W St Peru IL 61354 362852553 Provision of health care services IL 501(c)(3) Line 3 IV HealthCorp Inc 0 St Andrew's Bottineau Clinic LLC 316 Ohmer Street Bottineau ND 58318 450451306 Provision of health care services ND St Andrew's Hospital Related -45714 276091 0 0 1.00000 Valley Regional Health Services L3C 4391 Venture Drive Peru IL 613541014 273891281 Outpatient oncology services IL N/A 0 1 SMP Enterprises PO Box 10007 Fargo ND 581060007 363486506 Collection Agency ND N/A C 0 SMP Enterprises - IL 600 East 1st Street Spring Valley IL 61362 363456566 Healthcare Management IL N/A C 0 Valley Health Enterprises 925 W St Peru IL 61354 363476877 Home medical equipment IL N/A C 0 Illinois Valley Health Services Inc 925 W St Peru IL 61354 364050682 Inactive IL N/A C 0 Health Care Building Corp 925 W St Peru IL 61354 363306917 Inactive IL N/A C 0 IVCH General Professional Liability Loss Fund 925 W St Peru IL 61354 366673231 Inactive IL N/A T 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 0 Schedule R, Part III: Prior to November 30, 2020, the Health Center held a 51% interest in St. Andrew's Bottineau Clinic (Clinic). Effective December 1, 2020, the Clinic became a wholly owned, provider based rural health clinic and a department of the Health Center. Financial information is reported based on the final 2020 K-1 for Part III. The results of the operations subsequent to November 30, 2020 have been included in the accompanying financial statements. The Health Center did not pay anything to its business partner to purchase the remaining 49% of the Clinic but did assume any remaining liabilities of the Clinic.