2021-04-30T12:14:10-05:00 2020-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2019-07-01 830279242 WYOMING MEDICAL CENTER INC WYOM 3075772211 1233 EAST SECOND STREET CASPER WY 82601 JEANNE EHLEBRACHT CFO 3075772211 2021-04-29 1 KURT BENNION CPA P01469618 4252506100 2021-04-29 2019 2022-09-23 18:48:47Z LANCE PORTER 1233 EAST SECOND STREET CASPER WY 82601 303025146 0 X HTTPS://WYOMINGMEDICALCENTER.ORG X 1986 WY ADVANCE THE HEALTH AND WELLNESS OF OUR COMMUNITY BY PROVIDING EXCELLENT HEALTHCARE SERVICES. 10 9 1619 126 1413178 785502 398106 1170148 303007311 286708937 7041065 5389762 -7125 218483 310439357 293487330 0 166359 0 0 116959607 117598453 0 0 0 175375334 166354850 292334941 284119662 18104416 9367668 409770674 446426215 83516519 105752176 326254155 340674039 X WYOMING MEDICAL CENTER ("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. 0 0 229227522 166359 285268441 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 REGIONAL TRAUMA CENTER THAT PROVIDES CRITICAL SERVICES TO NATRONA COUNTY AND TO THE ENTIRE STATE.WYOMING MEDICAL CENTER RELEASED ITS REGULAR QUARTERLY HEALTH PUBLICATION, THE PULSE, TO APPROXIMATELY 10,000 HOMES IN NATRONA AND FREMONT COUNTIES AND EVERY PROVIDER OFFICE IN THE STATE OF WYOMING. WYOMING MEDICAL CENTER PROVIDED $9,299,000 IN CHARITY CARE SERVICES BASED ON TOTAL DIRECT AND INDIRECT COSTS. 229227522 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 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 292 0 1 1619 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 X JEANNE EHLEBRACHT 3075777837 1233 EAST SECOND STREET CASPER WY 82601 WAYNE WARREN NEUROSURGEON THRU 3/24/20 45.00 0.00 X 1915611 0 40967 TODD HAMMOND ANESTHESIOLOGIST 45.00 0.00 X 750797 0 43207 MICHELE CHULICK CHIEF EXECUTIVE OFFICER 55.00 2.00 X 892551 0 63775 ROBERT NEFF NEPHROLOGY 45.00 0.00 X 546542 0 43352 CASEY COTANT NEPHROLOGY 45.00 0.00 X 510545 0 45898 JESSE COFFEY PLASTIC SURGEON 45.00 0.00 X 461915 0 12566 GREGORY RENNIRT ORTHOPEDIC SURGEON 45.00 0.00 X 443475 0 7224 MICHAEL STALEY CHIEF ADMINISTRATICE OFFICER 55.00 0.00 X 371870 0 31991 DAVID GARDNER SENIOR VP & CNO THRU 03/19 45.00 0.00 X 277630 0 9023 B YVONNE WIGINGTON CHIEF FINANCIAL OFFICER THRU 07/19 45.00 0.00 X 292504 0 72986 GARY ZMRHAL CHIEF FINANCIAL OFFICER 55.00 0.00 X 170471 0 138 MARK DOWELL MD BOARD MEMBER 5.00 0.00 X 625 0 0 JESSICA ODEN WMC BOARD CHAIR 5.00 0.00 X X 0 0 0 BETH WORTHEN WMC BOARD VICE CHAIR/TREASURER 5.00 0.00 X X 0 0 0 LISA BURRIDGE WMC BOARD SECRETARY 5.00 0.00 X X 0 0 0 TOM CRULL BOARD MEMBER 5.00 0.00 X 0 0 0 PAUL JONESMD BOARD MEMBER 5.00 0.00 X 0 0 0 JOHN LAWSON BOARD MEMBER 5.00 0.00 X 0 0 0 JOHN MASTERSON BOARD MEMBER 5.00 0.00 X 0 0 0 CHRIS MUIRHEAD BOARD MEMBER 5.00 0.00 X 0 0 0 MIKE REID BOARD MEMBER 5.00 0.00 X 0 0 0 6634536 0 371127 168 0 1 0 ABM HEALTHCARE SUPPORT SERVICES INC PO BOX 419860 BOSTON MA 022419860 CONTRACT SERVICES 6754267 MEDLINE INDUSTRIES INC DEPT 1080 PO BOX 121080 DALLAS TX 753211080 SUPPLIES & SERVICES 6387567 BOSTON SCIENTIFIC CORPORATION & SUBSIDIA PO BOX 951653 DALLAS TX 753951653 SUPPLIES & SERVICES 4186770 CERNER HEALTHCARE SOLUTIONS INC PO BOX 959156 ST LOUIS MO 631959156 IT CONTRACT SERVICES 3992174 UHS OF WYOMING INC 2521 E 15TH STREET CASPER WY 826094126 MEDICAL SERVICES 3908267 167 652309 70958 446881 1170148 NET PATIENT REVENUE 621110 271526850 271526850 NON-PATIENT NON-OPERATING 900099 10084417 9892273 192144 JV INVESTMENT INCOME 621300 3620157 2833655 786502 CAFETERIA SALES 722210 1142773 977501 165272 REFERENCE LAB REVENUE 621500 269260 269260 65480 65480 286708937 4718527 4718527 544069 298268 245801 245801 245801 9773292 137491 9230305 9243 542987 128248 671235 671235 LOSS ON REFINANCING 900000 -27318 -27318 -27318 293487330 285268441 1413178 5635563 X 166359 166359 3494306 1782096 1712210 88570116 75128917 13441199 3565833 2819408 746425 14784635 11689814 3094821 7183563 5679850 1503713 1620119 1620119 84404 84404 62427 62427 229757 229757 32504715 26437410 6067305 803162 1416 801746 3724050 1921079 1802971 7844721 284904 7559817 7816885 5664145 2152740 413457 130098 283359 1667430 1667430 16200739 16200739 2210861 2158922 51939 UBI TAXES 165755 1101 164654 DRUGS & MEDICAL SUPPLIE 36620823 36620823 BAD DEBT EXPENSE 35663989 35663989 OUTREACH SERVICES 8600025 354617 8245408 10121531 4854405 5267126 284119662 229227522 54892140 0 26584743 31262347 94099 3480 51945913 49169117 449508 431488 5120992 4673091 3419410 5935254 376464365 268407210 109071554 108057155 183375761 211920229 9540899 9701847 19820235 25051442 347560 220765 409770674 446426215 20970684 20280548 29167 33029167 14450209 13592117 37126928 34732375 10939531 4117969 83516519 105752176 X 326122776 340604598 131379 69441 326254155 340674039 409770674 446426215 X 9367668 -3983044 9035260 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 1 45751 0 1 16676 62427 0 PART II-B, LINE 1: WYOMING MEDICAL CENTER SPENT $45,751 IN REIMBURSED EXPENSES RELATED TO DIRECT COMMUNICATIONS WITH LEGISLATORS. WYOMING MEDICAL CENTER ALSO CONTRIBUTED $16,676 IN LOBBYING COSTS THROUGH ITS PAYMENT OF DUES TO THE AMERICAN HOSPITAL ASSOCIATION. 13226318 13226318 140776914 90128063 50648851 5269602 2135800 3133802 193359453 163440128 29919325 23832078 12703219 11128859 108057155 MALPRACTICE AND LITIGATION 1475000 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2642969 4117969 X 251463234 -3983044 5035471 1052427 250410807 43076523 43076523 293487330 251125766 4082113 4082113 247043653 37076009 37076009 284119662 PART X, LINE 2: THE HOSPITAL IS ORGANIZED AS A WYOMING NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) 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. WMC IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THIS ENTITY 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. 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 ARE INCURRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: ELIMINATED INTERCOMPANY REVENUES 4,068,990. LOSS ON DEBT REFINANCING 699,491. NET ASSETS RELEASED FROM RESTRICTIONS 266,990. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 35,663,989. INVESTMENT INCOME 1,276,453. GAIN ON DISPOSAL OF FIXED ASSETS 128,248. GAINS ON INVESTMENTS IN SUBSIDIARIES AND JOINT VENTURES 3,650,302. CONTRIBUTIONS OF LONG-LIVED ASSETS 740,459. TEMPORARILY RESTRICTED CONTRIBUTIONS 205,052. EXPENSES INCLUDED IN OTHER INCOME 1,412,020. PART XII, LINE 2D - OTHER ADJUSTMENTS: ELIMINATED INTERCOMPANY EXPENSES 4,082,113. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 35,663,989. EXPENSES INCLUDED IN OTHER INCOME, NET 1,412,020. 1 1 X 1 X 1 X 275.000000000000 1 1 1 0 1 1 9275630 9275630 0.03730 20752799 11676727 9076072 0.03650 785372 191968 593404 0.00240 30813801 11868695 18945106 0.07620 378299 378299 0.00150 70719 2500 68219 0.00030 4545706 573696 3972010 0.01600 142927 142927 0.00060 5137651 576196 4561455 0.01840 35951452 12444891 23506561 0.09460 710289 710289 0.00290 710289 710289 0.00290 1 35663989 0 69215982 73241042 -4025060 X 1 1 1 OUTPATIENT RADIOLOGY LLC IMAGING SERVICES 0.50000 0.00000 0.50000 2 CENTRAL WYOMING OUTPATIENT SURGERY CENTER LLC SURGICAL CENTER 0.50000 0.25000 0.25000 3 NORTH PLATTE PATHOLOGY LLC PATHOLOGY SERVICES 0.50000 0.00000 0.50000 1 1 WYOMING MEDICAL CENTER 1233 EAST 2ND STREET CASPER WY 82601 WWW.WYOMINGMEDICALCENTER.ORG 15315 X X X WYOMING MEDICAL CENTER 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X WWW.WYOMINGMEDICALCENTER.ORG/COMMUNITY-HEALTH X 1 18 1 WWW.WYOMINGMEDICALCENTER.ORG/COMMUNITY-HEALTH 0 1 X 200.000000000000 275.000000000000 X X X 1 1 X X X X 1 X HTTPS://WYOMINGMEDICALCENTER.ORG/PAYBILL X HTTPS://WYOMINGMEDICALCENTER.ORG/PAYBILL X HTTPS://WYOMINGMEDICALCENTER.ORG/PAYBILL X X X X X X 1 X 0 X X X X 1 X 0 0 WYOMING MEDICAL CENTER PART V, SECTION B, LINE 5: WYOMING MEDICAL CENTER WORKED VERY CLOSELY WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT FOR MORE THAN A YEAR ON GATHERING DATA TO PERFORM AN OVERALL HEALTH ASSESSMENT OF OUR COMMUNITY. THE COMMUNITY HEALTH STATUS REPORT REPRESENTS THAT WORK. WE USED A ROBUST METHODOLOGY FOR IDENTIFYING RELEVANT COMMUNITY HEALTH INDICATORS. THERE ARE A NUMBER OF RESOURCES THAT PROVIDE LISTS OF HEALTH INDICATORS RECOMMENDED FOR USE DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. WE CHOSE INDICATORS MOST COMMONLY USED FOR CHNAS, AND THEN CONTINUED TO DIG DEEPER INTO LOCAL DATA THAT WE HAD TO FURTHER CHARACTERIZE OUR COMMUNITY'S HEALTH. THE FULL DOCUMENT IS AVAILABLE ON OUR WEBSITE.OVER THE COURSE OF A YEAR, WE HELD THREE LARGER FORUMS WITH MANY KEY HEALTH STAKEHOLDERS IN THE COMMUNITY TO HELP US MOVE FORWARD WITH OUR IMPLEMENTATION STRATEGY. WE IDENTIFIED THE TOP 10 ISSUES IN OUR COUNTY BASED ON THE FINDINGS FROM THE CHNA AND PROVIDED A SURVEY TO KEY HEALTH STAKEHOLDERS ACROSS THE COUNTY. STAKEHOLDERS REPRESENTED VARIOUS ORGANIZATIONS INCLUDING LAW ENFORCEMENT, EDUCATORS, PHYSICIANS AND OTHER PROVIDERS, LOCAL HEALTH ADMINISTRATORS, AND MORE. ORGANIZATIONS INCLUDED, BUT ARE NOT LIMITED TO: CASPER AREA CHAMBER OF COMMERCE, WYOMING BUSINESS COALITION ON HEALTH, ELKHORN VALLEY REHABILITATION HOSPITAL, CITY OF CASPER, CASPER COLLEGE, PLATTE RIVER TRAILS, CENTRAL WYOMING HOSPICE, NATRONA COUNTY SCHOOL DISTRICT, SUMMIT MEDICAL CENTER, MOUNTAIN-PACIFIC QUALITY HEALTH, WYOMING HEALTH FAIRS, CASPER FAMILY YMCA, MERCER HOUSE, SENIOR PATIENT ADVOCATES, CASPER HOUSING AUTHORITY AND MORE. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 11: FOUR SIGNIFICANT COMMUNITY HEALTH NEEDS WERE IDENTIFIED IN THE CHNA CONDUCTED FOR THE YEAR ENDED JUNE 30, 2019:- HEALTHY EATING / ACTIVE LIFESTYLE- SAFE / AFFORDABLE HOUSING- SUBSTANCE ABUSE / OTHER USE- MENTAL HEALTH / SUICIDEFOUR GROUPS WERE IDENTIFIED IN THE FY2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND CONTINUE TO MEET SEVERAL TIMES PER YEAR TO ADDRESS ISSUES AND SOLUTIONS RELATED TO THE NEEDS IDENTIFIED. FY2019 WAS THE FIRST YEAR OF THE ASSESSMENT AND THE WAS A GOAL-SETTING YEAR. FY2020 PRESENTED CHALLENGES WITH IN-PERSON MEETINGS AND SOME GOALS DUE TO THE COVID-19 PANDEMIC. IN FY2020 WMC HAS WORKED ON THE FOLLOWING:HEALTHY LIVING / ACTIVE LIFESTYLE: THE GROUP HELD 16 "WALK WITH A DOC" TALKS BETWEEN JUNE AND DECEMBER 2020. WINTER WALKS WERE MOVED INDOORS AND WERE NOT WELL ATTENDED. SUMMER WALKS AVERAGED 30 PARTICIPANTS ON VARIOUS HEALTH TOPICS. WALKS WERE SUSPENDED UNTIL THE SPRING, AND DUE TO COVID-19, NO ADDITIONAL WALKS WERE SCHEDULED. WYOMING MEDICAL CENTER SIGNED A FIVE-YEAR LEASE WITH THE CASPER COMMUNITY GREENHOUSE PROJECT IN JANUARY 2020. THE NON-PROFIT HAS PLANNED AN URBAN GARDEN ON THE VACANT LAND AND STARTED CONSTRUCTION IN SUMMER 2020. SUBSTANCE ABUSE/OTHER USE: THE GROUP GOALS INCLUDE CREATING A MEDICATION DISPOSAL PROGRAM, CREATING AN INFORMATIONAL CAMPAIGN TO EDUCATE ON DISPOSAL AND COMMUNITY OPTIONS, INCREASING ACCESS TO OTHER COMMUNITY ENTITIES ENCOURAGING APPROPRIATE DISPOSAL, AND INSTITUTING MORE COMMUNITY ENTITIES PROVIDING DRUG DISPOSAL / DEACTIVTION BAGS WITH PRESCRIPTIONS. THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT CONTINUES TO WORK WITH COMMUNITY PARTNERS TO EDUCATE ABOUT THE DISPOSAL PROGRAM. MOST EVENTS WERE CANCELED OR POSTPONED DUE TO THE COVID-19 PANDEMIC AND HAVE BEEN PUT ON HOLD UNTIL A LATER DATE. MENTAL HEALTH/SUICIDE: WYOMING MEDICAL CENTER AND THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT ARE TRIALING A PROGRAM WITH HOPES OF EXPANDING IT TO OTHER ORGANIZATIONS IN OUR COMMUNITY. GOALS ARE TO CREATE A PROTOCOL, MATERIALS AND INFRASTRUCTURE FOR A CARING LETTERS PROGRAM, IMPLEMENT THE PROGRAM AT WMC AND EXPAND TO OTHER ORGANIZATIONS AND PROVIDE ONLINE VERSION FOR RESOURCES AND INFORMATION. CARING LETTERS GROUP OF VOLUNTEERS WERE PUT ON HOLD DUE TO COVID-19. WYOMING MEDICAL CENTER CONTINUES TO WORK ON A ZERO SUICIDE INITIATIVE WITH SEVERAL COMMUNITY PARTNERS. SAFE/AFFORDABLE HOUSING (EXPLORATORY GOAL): SINCE WYOMING MEDICAL CENTER AND THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT HAVE LITTLE DIRECT CONTROL OVER HOUSING, THEY HAVE COMMITTED TO SUPPORTING THE GOALS OF THE CASPER HOUSING AUTHORITY WHICH INCLUDE: CREATING LOW-INCOME HOUSING UNITS, CREATING WORKFORCE HOUSING UNITS AND CREATING AN ONLINE RESOURCE LIST. WYOMING MEDICAL CENTER CARE MANAGEMENT WORKS CLOSELY WITH THE CASPER HOUSING AUTHORITY TO HELP WITH PLACEMENT OF PATIENTS IN NEED. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 13H: AN APPLICANT MAY ONLY APPLY TO THIS PROGRAM ONCE PER ACCOUNT UNLESS THEY ENCOUNTER A CATASTROPHIC SITUATION WHICH CHANGES THE HOUSEHOLD GROSS INCOME AS DEFINED BY THE FEDERAL GOVERNMENT. 10 1 - CENTRAL WY OUTPATIENT SURGERY CENTER 1201 E 3RD STREET CASPER WY 82601 SURGICAL CENTER 2 - OUTPATIENT RADIOLOGY 419 S WASHINGTON STREET SUITE 100 CASPER WY 82601 IMAGING SERVICES 3 - WY HEALTH MED GROUP MULTISPECIALTY 419 S WASHINGTON STREET CASPER WY 82601 PHYSICIAN PRACTICE 4 - WY HEALTH MED GROUP MULTISPECIALTY 6650 E 2ND STREET CASPER WY 82609 PHYSICIAN PRACTICE 5 - NORTH PLATTE PATHOLOGY 111 S JEFFERSON STREET CASPER WY 82601 PATHOLOGY SERVICES 6 - SAGE PRIMARY CARE 1020 S CONWELL STREET CASPER WY 82601 PRIMARY CARE CLINIC 7 - MESA PRIMARY CARE 3632 AMERICAN WAY CASPER WY 82604 PRIMARY CARE CLINIC 8 - IMMEDIATE CARE 3632 AMERICAN WAY CASPER WY 82604 QUICK-CARE CLINIC 9 - RESPIRATORY SYMPTOMS SCREENING CLINIC 245 S FENWAY STREET CASPER WY 82601 QUICK-CARE CLINIC 10 - WOUND CARE CENTER 1201 E 3RD STREET CASPER WY 82601 WOUND CARE PART I, LINE 3C: TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE MEDICAL CARE MUST BE EMERGENT OR MEDICALLY NECESSARY AND THE INDIVIDUAL'S HOUSEHOLD GROSS INCOME MUST BE BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINE THRESHOLDS. ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL BE EXTENDED TO A PERSON BASED ON HOUSEHOLD INCOME. PART I, LINE 7: EXPENSES REPORTED IN PART I, LINES 7A, 7B AND 7C ARE CALCULATED USING THE WORKSHEETS IN THE INSTRUCTIONS TO SCHEDULE H, INCLUDING UTILIZATION OF THE COST-TO-CHARGE RATIO. EXPENSES REPORTED IN PART I, LINES 7E, 7F, 7G AND 7I ARE BASED ON ACTUAL COSTS. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE THE WYOMING BEHAVIORAL INSTITUTE AND ENDOCRINE & DIABETES SERVICES. SUBSIDIZED HEALTH SERVICES INCLUDE $913,123 OF EXPENSES ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 35,663,989. PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING ACTIVITIES PROMOTE THE 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 $710,289 IN RECRUITING PHYSICIANS FOR PEDIATRICS, OB/GYN, PRIMARY CARE, RADIOLOGY SERVICES, AND EMERGENCY CARE. PART III, LINE 2: SEE THE "PATIENT RECEIVABLES, NET" PARAGRAPHS IN NOTE 1 ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE EXPLANATION OF HOW WYOMING MEDICAL CENTER CALCULATES ITS BAD DEBT EXPENSE. PART III, LINE 3: WYOMING MEDICAL CENTER FOLLOWS HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. THEREFORE, BAD DEBT DOES NOT INCLUDE AMOUNTS THAT SHOULD BE ATTRIBUTABLE TO CHARITY CARE. PART III, LINE 4: SEE THE "PATIENT RECEIVABLES, NET" PARAGRAPHS IN NOTE 1 ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE EXPLANATION OF WYOMING MEDICAL CENTER'S BAD DEBT EXPENSE. PART III, LINE 8: WYOMING MEDICAL CENTER USED THE MEDICARE OPERATING COST-TO-CHARGE RATIO TO CALCULATE THE COSTS RELATING TO MEDICARE REVENUE APPLIED AGAINST ACTUAL RECEIPTS. 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 4 STATEMENT AND A LETTER NOTIFYING THEM OF EXTRAORDINARY COLLECTION ACTIVITIES 30 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: CONTINUOUS MONITORING OF PUBLIC AND OTHER INTERNAL DATA SOURCES SHOWS THE HOSPITAL WHICH HEALTH CONCERNS ARE OF THE GREATEST IMPACT TO OUR COMMUNITY. WYOMING MEDICAL CENTER USES PUBLIC DATA, INCLUDING THE HEALTHY PEOPLE 2020 STUDY FROM THE OFFICE OF DISEASE PREVENTION AND HEALTH PROMOTION, AS WELL AS DATA FROM REPORTING HOSPITALS OF THE WYOMING HOSPITAL ASSOCIATION. INTERNAL DATA FROM THE HOSPITAL AND ASSOCIATED CLINICS ALSO HELPS TO IDENTIFY AND FIND SOLUTIONS FOR MORE SPECIFIC NEEDS WITHIN THE COMMUNITY. WYOMING MEDICAL CENTER HAS ALSO PARTNERED WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT, WHICH GATHERS VARIOUS HEALTH-RELATED DATA FOR THE WHOLE STATE ON A COUNTY-BY-COUNTY BASIS. PART VI, LINE 3: WYOMING MEDICAL CENTER'S PLAIN LANGUAGE SUMMARY AND FULL POLICY ARE AVAILABLE ONLINE AND UPON REQUEST VIA EMAIL, MAIL OR IN-PERSON. WYOMING MEDICAL CENTER HAS FINANCIAL COUNSELORS THAT MEET WITH SELF-PAY INPATIENTS OR ANY PATIENT UPON REQUEST. PART VI, LINE 4: WYOMING MEDICAL CENTER HAS 249 BEDS ON TWO HOSPITAL CAMPUSES. 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 TWO SPECIALTY HOSPITALS, A REHABILITATION HOSPITAL AND A BEHAVIORAL HEALTH CENTER.ACCORDING TO JUNE 30, 2019 U.S. CENSUS DATA, NATRONA COUNTY IS HOME TO JUST OVER 79,000 RESIDENTS WITH 578,000 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 93.7% WHITE, 1.4% BLACK, 1.5% AMERICAN INDIAN AND ALASKA NATIVE, 0.9% ASIAN, 0.1% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER, 2.4% OF PEOPLE REPORT TWO OR MORE RACES AND 8.7% ARE OF HISPANIC OR LATINO ORIGIN.ACCORDING TO CENSUS DATA, 9.9% OF PEOPLE IN NATRONA COUNTY ARE BELOW THE POVERTY LEVEL AND 10.1% ARE BELOW THE POVERTY LEVEL IN WYOMING. MEDIAN HOUSEHOLD INCOME IS $62,772 IN NATRONA COUNTY AND $64,049 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 $15,528,536 IN HEALTHCARE SERVICES THROUGH ITS OPERATION OF WYOMING HEALTH MEDICAL GROUP (WHMG), LLC. SERVICES OFFERED INCLUDE NEUROSURGICAL CARE, INTERNAL MEDICINE AND FAMILY PRACTICE, URGENT CARE, PULMONOLOGY, NEPHROLOGY, PAIN AND ENDOCRINOLOGY. ALL SPECIALTIES TREAT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN MARCH 2020, WHMG ALSO OPENED A RESPIRATORY SYMPTOM SCREENING CLINIC IN RESPONSE TO THE COVID-19 PANDEMIC. IN FISCAL YEAR 2020, WYOMING MEDICAL CENTER AND WYOMING HEALTH MEDICAL GROUP OPENED A NEW PRIMARY CARE CLINIC, COLE CREEK PRIMARY CARE, AND A NEW URGENT CARE CLINIC, URGENT CARE EAST. BOTH CLINICS ARE HOUSED ON THE EAST CAMPUS. WHMG IS ALSO PREPARING TO LAUNCH URGENT CARE VIDEO APPOINTMENTS IN FY2021. 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 ADVERTISES SCREENING EVENTS AND SUPPORT GROUPS ON ITS WEBSITE AND IN LOCAL NEWSPAPERS.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. IN FISCAL YEAR 2018, THE FOUNDATION SOLD MASTERSON PLACE AND BEGAN CONSTRUCTION OF A NEW FACILITY IN CLOSE PROXIMITY TO THE HOSPITAL. THE PROJECT WAS COMPLETED IN SUMMER 2019 AND THE 14-ROOM FACILITY IS FULLY OPERATING. 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 THERAPISTS, 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 SENSITIVE CARE. IN FISCAL YEAR 2018, WYOMING MEDICAL CENTER ENTERED INTO A CONTRACT WITH INTOUCH TO PROVIDE TELEHEALTH SERVICES IN HOSPITALS ACROSS THE STATE AND NOW HAS AGREEMENTS WITH NINE REMOTE LOCATIONS ACROSS WYOMING. 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 FY2020 WYOMING MEDICAL CENTER HAD NEARLY 54,000 PATIENT DAYS AND OVER 32,000 EMERGENCY DEPARTMENT VISITS. WYOMING MEDICAL CENTER HOUSES THE SAFE KIDS PROGRAM WITH THE HELP OF DONATIONS AND GRANTS FROM VARIOUS SOURCES. THE PROGRAM FOCUSES ON INJURY PREVENTION AND IN ADDITION TO THE OTHER COMMUNITY EDUCATION AND OUTREACH, OFFERS REGULAR CAR SEAT CHECKS AND PROVIDES CAR SEATS TO THOSE WHO CANNOT AFFORD THEM. CAR SEATS ARE PROVIDED THROUGH A VOUCHER PROGRAM ADMINISTERED THROUGH THE DEPARTMENT OF FAMILY SERVICES (DFS) AND THE WOMEN, INFANTS AND CHILDREN (WIC) PROGRAMS. ADDITIONALLY, SAFE KIDS PROVIDES ALL BABIES WHO LEAVE THE HOSPITAL A CAR SEAT IF NEEDED WITHOUT A VOUCHER. 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 FOR WEIGHT LOSS, DIABETES, STROKE, MENTAL HEALTH, FIRST AID, 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. WYOMING MEDICAL CENTER RELEASED ITS REGULAR QUARTERLY PUBLICATION, THE PULSE, TO 10,000 HOMES IN NATRONA AND FREMONT COUNTIES AND EVERY PROVIDER OFFICE IN THE STATE OF WYOMING. PART VI, LINE 7, REPORTS FILED WITH STATES WY 1 NATRONA COUNTY 200 N CENTER STREET CASPER WY 82601 836000113 NATRONA COUNTY 0 166359 BOOK VALUE BUILDING GENERAL BUSINESS USE OF BUILDING BY NATRONA COUNTY 1 0 PART I, LINE 2: WMC DONATED A BUILDING TO NATRONA COUNTY WHO IN TURN DONATED THE BUILDING TO THE IRIS CLUB HOUSE, A LOCAL 501(C)(3) ORGANIZATION. NO ADDITIONAL MONITORING IS NECESSARY DUE TO THE NATURE OF THE GRANT. X 1 1 X X X X 1 0 0 0 0 1 1 0 0 WAYNE WARREN NEUROSURGEON THRU 3/24/20 1841485 0 73574 0 552 0 11200 0 29767 0 1956578 0 0 0 TODD HAMMOND ANESTHESIOLOGIST 750437 0 0 0 360 0 11200 0 32007 0 794004 0 0 0 MICHELE CHULICK CHIEF EXECUTIVE OFFICER 707176 0 173600 0 11775 0 28646 0 35129 0 956326 0 0 0 ROBERT NEFF NEPHROLOGY 508280 0 37902 0 360 0 11200 0 32152 0 589894 0 0 0 CASEY COTANT NEPHROLOGY 484369 0 25936 0 240 0 11200 0 34698 0 556443 0 0 0 JESSE COFFEY PLASTIC SURGEON 460331 0 0 0 1584 0 11200 0 1366 0 474481 0 0 0 GREGORY RENNIRT ORTHOPEDIC SURGEON 443199 0 0 0 276 0 0 0 7224 0 450699 0 0 0 MICHAEL STALEY CHIEF ADMINISTRATICE OFFICER 336683 0 33603 0 1584 0 0 0 31991 0 403861 0 0 0 DAVID GARDNER SENIOR VP & CNO THRU 03/19 59004 0 0 0 218626 0 940 0 8083 0 286653 0 0 0 B YVONNE WIGINGTON CHIEF FINANCIAL OFFICER THRU 07/19 239193 0 52950 0 361 0 53080 0 19906 0 365490 0 0 0 GARY ZMRHAL CHIEF FINANCIAL OFFICER 169615 0 0 0 856 0 0 0 138 0 170609 0 0 0 PART I, LINE 1A MICHELE CHULICK - CASPER COUNTRY CLUB - $3,550 THE CASPER COUNTRY CLUB DUES WERE INCLUDED IN MICHELE CHULICKS'S 2019 TAXABLE W-2 WAGES. PART I, LINE 4A DAVID GARDNER, FORMER SENIOR VP & CNO RECEIVED SEVERANCE PAYMENTS OF $218,534 DURING 2019. PART I, LINE 6 WYOMING MEDICAL CENTER, INC HAS AN INCENTIVE PLAN FOR ALL LEVELS OF THE ORGANIZATION INCLUDING INDIVIDUAL CONTRIBUTORS. THE AMOUNT OF INCENTIVE AWARDED EACH FISCAL YEAR IS DETERMINED AND APPROVED BY THE BOARD COMPENSATION COMMITTEE BASED ON ACHIEVEMENT OF ORGANIZATIONAL GOALS RELATED TO FOUR (4) PILLARS; PEOPLE, QUALITY/SERVICE, EFFICIENCY (FINANCIAL STEWARDSHIP) AND GROWTH. THE GOALS ARE APPROVED BY THE BOARD AND WEIGHTED BASED ON THE PRIORITY ESTABLISHED BY THE BOARD; PEOPLE (25%), QUALITY/SERVICE (25%), EFFICIENCY (FINANCIAL STEWARDSHIP) (30%), AND GROWTH (20%). A NATRONA COUNTY WYOMING 836000113 638813CB9 2011-02-28 20039910 CONSTRUCTION OF NEW WEST TOWER 0 0 0 B NATRONA COUNTY WYOMING 836000113 638813CR4 2017-07-26 13504227 REFUND SERIES 2011 BONDS 0 0 0 A 19220000 20044228 1667185 4070049 257480 18119563 2014 0 0 1 1 B 140000 13504227 200286 13303941 2017 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 0 B 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: NATRONA COUNTY, WYOMING DATE THE REBATE COMPUTATION WAS PERFORMED: 09/15/2015 WYOMING NEUROLOGIC ASSOCIATES DR. DAVID WHEELER, FORMER BOARD MEMBER, OWNS 50% 654853 PHYSICIAN AND ON-CALL SERVICES 0 ROCKY MOUNTAIN INFECTIOUS DISEASES DR. MARK DOWELL, BOARD MEMBER, OWNS 51% 255634 INFECTIOUS DISEASE MEDICAL SERVICES 0 MEDICAL PROPERTY HOLDING COMPANY LLC SUSAN MCMURRY, FORMER BOARD MEMBER, OWNS 63% 457708 RENT AND UTILITY COSTS 0 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR, VICE CHAIR, SECRETARY OF THE BOARD AND THE CEO. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR CARRYING OUT THE DIRECTIVES OF THE BOARD 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 B, LINE 11B THE WMC BOARD WAS DISSOLVED PRIOR TO THE FILING OF THE RETURN. ON 10/1/20, BANNER HEALTH BECAME THE PARENT COMPANY TO WYOMING MEDICAL CENTER. THE FORM 990 WAS PRESENTED TO MEMBERS OF BANNER HEALTH'S CORPORATE ACCOUNTING AND TAX TEAMS. FORM 990 WAS ALSO REVIEWED IN DEPTH BY WMC CFO AND CORPORATE ACCOUNTANT. FORM 990, PART VI, SECTION B, LINE 12C WYOMING MEDICAL CENTER'S CONFLICT OF INTEREST POLICY APPLIES TO ALL EMPLOYEES, INCLUDING MANAGERS, DIRECTORS, EXECUTIVES, AND THE BOARD OF DIRECTORS. ADDITIONALLY, THE BOARD OF DIRECTORS HOLDS TO ADDITIONAL CONFLICT OF INTEREST STATEMENTS BUILT INTO THE BOARD BYLAWS. 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 EXCLUDED FROM VOTING ON ANY COMPENSATION MATTERS INVOLVING OTHER PHYSICIANS. IF THEY ARE UNABLE TO DETERMINE IF A CONFLICT EXISTS, THEY SHALL CONTACT THE COMPLIANCE OFFICER FOR ASSISTANCE. 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. THE COMPENSATION REVIEW PROCESS WAS LAST CONDUCTED IN 2019. 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 IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 26,437,410. MANAGEMENT AND GENERAL EXPENSES 6,067,305. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,504,715. FORM 990, PART XI, LINE 9: CHANGE IN PENSION LIABILITY 9,035,260. PART XII, LINE 2C THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNT HAS NOT CHANGED FROM THE PRIOR YEAR. 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