2021-08-09T08:50:51-05:00 2020-09-30 411765929 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-10-01 410713914 Winona Health Services Inc WINO 5074543650 855 Mankato Avenue Winona MN 55987 Jan Brosnahan CFO 5074543650 2021-08-05 1 Kim Hunwardsen CPA P00484560 6122536500 2021-08-02 2019 2022-09-23 18:48:47Z Rachelle Heising-Schultz 855 Mankato Avenue Winona MN 55987 108838356 0 X www.winonahealth.org X 1894 MN Hospital Services 18 10 1398 327 1683374 0 1599654 10534136 106205668 97411793 673841 889183 0 0 108479163 108835112 44353 45143 0 0 66177394 63868493 0 0 0 45347873 42068066 111569620 105981702 -3090457 2853410 104498222 125104382 39580356 56342676 64917866 68761706 X Devoted to improving the health and well-being of our family, friends and neighbors. 1 0 90161061 45143 95728419 Winona Health Services (WHS), a 49-bed hospital, has provided care to its community and services from birth to death for 125 plus years. It is the sole community provider in the Winona, Minnesota area. In fiscal year 2020, WHS had 1,524 admissions; 207 births; 2,477 inpatient and outpatient surgeries; and 11,588 visits to the emergency room.To fulfill its mission of community service, the Corporation provides care to patients and residents who meet certain criteria under its charity care and community benefit policy without charge or at amounts less than its established rates. Because the Corporation does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient and resident service revenue.Charity Care: WHS provides medical care to the community regardless of an individual's ability to pay. The charity care cost based on charges foregone was approximately $794,354 for FY 2020. In furtherance of its charitable purpose, the Corporation provides a wide variety of benefits to the community. These services and donations account for a measurable portion of the Corporation's costs and serve to promote healthy life styles, community development, health education, and affordable access to care.The Corporation maintains records to identify and monitor the level of community benefit services it provides. Those records include management's estimate of the cost to provide charity care, the cost of services and supplies furnished for community benefit programs and costs in excess of program payments for treating Medical Assistance patients.In addition to community benefit costs, the Corporation provides additional community contributions such as services to Medicare and Medicaid patients below the costs for treatment, other uncompensated care, discounted pricing to the uninsured, and pays taxes and fees.During FY2020, many resources were dedicated to managing the covid 19 pandemic collaboratively within the community. Measures included expansion of virtual visit services, establishing a separate covid testing area, temporarily housing skilled nursing residents from a neighboring facility, and numerous workflow changes to ensure patient access and safety. Physical facility modifications such as creating negative pressure rooms, monitoring entrances and traffic flows, repurposing of space, were made in response to the pandemic. 90161061 1 1 0 0 0 0 0 0 0 1 1 1 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 1 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 109 0 1 1398 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 10 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Jan Brosnahan 5074543650 855 Mankato Avenue Winona MN 55987 Andrew Millis MD Orthopedic Physician 40.00 0.00 X 1003917 0 73135 Amarjit Virdi MD Anesthesiologist 40.00 0.00 X 650719 0 77608 Wayne Kelly MD ED/Urgent Care Physician 40.00 0.00 X 594122 0 66266 Alex Westenfield MD Radiologist 40.00 0.00 X 554081 0 55034 Kenneth Johnson MD Orthopedic Physician 40.00 0.00 X 527430 0 60641 Matthew Broghammer MD Director 40.00 2.00 X 518835 0 68544 Brett Whyte MD Director (Jan-Feb) 40.00 2.00 X 480902 0 72504 Rachelle Heising-Schultz President/CEO/Director 46.00 4.00 X X 442284 0 90036 Christopher Watras DO Former Key Employee 40.00 0.00 X 381094 0 59872 Katrina Hammel MD Director 40.00 2.00 X 340846 0 60187 Sarah Lallaman DO Pediatrician 40.00 0.00 X 304301 0 62080 Jan Brosnahan CFO/Treasurer 48.00 2.00 X 250668 0 56071 Nicholas Modjeski MD Director 40.00 2.00 X 246801 0 45921 E Allen Beguin MD Director (Feb-Sep) 40.00 2.00 X 229598 0 49286 Michael Donnenwerth Chief Medical Officer 40.00 0.00 X 227730 0 49488 Robin Hoeg VP Inpatient & Senior Serv 40.00 0.00 X 199289 0 35628 Sara Gabrick VP Surgical/Specialty Care 42.00 0.00 X 195495 0 44769 Rebecca Lamberty Chief Administrative Officer 40.00 0.00 X 170194 0 25827 Ken Mogren Chair 3.00 2.00 X X 0 0 0 Steve Blue Director 3.00 2.00 X 0 0 0 Hugh Miller Director 3.00 2.00 X 0 0 0 Mark Wagner Director 3.00 2.00 X 0 0 0 Toni Highum Director 3.00 2.00 X 0 0 0 Sandra Burke Director 3.00 2.00 X 0 0 0 Greg Evans Director 3.00 2.00 X 0 0 0 Brian Semling Director 3.00 2.00 X 0 0 0 Robert Williams Director 3.00 2.00 X 0 0 0 David Vaselaar Director 3.00 2.00 X 0 0 0 Fatima Said Director 3.00 2.00 X 0 0 0 Todd Paulson Director 3.00 2.00 X 0 0 0 Dave Gilmer Director 3.00 2.00 X 0 0 0 7318306 0 1052897 104 1 1 0 Cerner Corp PO Box 412702 Kansas City MO 64141 Services/Contracted 6401224 Concorde Staff Source Inc 735 N Water Street Milwaukee WI 53202 Contracted Physicians 892091 Mayo Collaborative Services Inc PO Box 9146 Minneapolis MN 55480 Contracted Laboratory 822725 Rehab Care Group Inc PO Box 503534 St Louis MO 63150 Contracted Therapy Services 701145 Locum Tenens Partners LLC 145 Technology Parkway NW Suite 20 Norcross GA 30092 Contracted Physicians 637686 23 847799 9684537 1800 24465 10534136 Patient Service Revenue 622110 83606376 83606376 Pharmacy Revenue 446110 8235827 6798668 1437159 Purchased Service Revenue 900099 3222697 3222697 Supporting Revenue 900099 2346893 2100678 246215 97411793 892427 892427 3244 -3244 -3244 -3244 108835112 95728419 1683374 889183 X 45143 45143 4317783 2915531 1402252 530511 508469 22042 45792542 40889719 4902823 1347976 1253676 94300 8730241 7272651 1457590 3149440 2763934 385506 62126 62126 102630 102630 29798 29798 10743756 8130889 2612867 272652 54962 217690 8595080 8130069 465011 2913103 258689 2654414 2832402 2802975 29427 369063 335225 33838 41590 41590 976662 742263 234399 3892246 2958107 934139 749122 569333 179789 Medical Supplies 5790891 5790891 Winona Clinic Pharmacy 3501281 3501281 MN Care Tax 1090856 1090856 Miscellaneous 104808 104808 105981702 90161061 15820641 0 7779609 27662817 507526 14261155 15115251 51246 13724 2765289 2733220 1030445 934774 92596504 61963644 31671055 30632860 31086382 31496586 12054727 11996316 2014538 2014538 1276250 2504296 104498222 125104382 10439584 11071527 4393585 16037062 15294231 6688511 6169705 6415199 19413628 39580356 56342676 X 64917866 68761706 64917866 68761706 104498222 125104382 2853410 990430 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 24524012 180653 1896815 1090846 25510634 24630482 285566 766745 1158781 24524012 24041725 275026 1701039 1387308 24630482 22588891 271119 2754232 1572517 24041725 21792871 259959 1958425 1422364 22588891 0.07270 0.83100 0.09630 0 1 1 5149492 5149492 54896998 36417381 18479617 30281065 24032443 6248622 2268949 1513820 755129 30632860 Defensive Equity Fund 6923317 F Global Equity Securities 5072999 F 11996316 Deferred Compensation Obligation 7058396 Payable to Affiliated Organizations 4463104 Deferred Revenue from Third Party Payor 7832639 Lease Liability 59489 19413628 X Part V, Line 4: Winona Health Foundation endowments have multiple purposes; all of which deliver on the mission to improve the health and well being of our family, friends and neighbors. The largest fund is the Ben & Adith Miller Patient Care Fund that pays the medical bills of Winona Health patients/residents who are under or uninsured. Other funds include the Senior Services Fund which is made up of the Glenn Fund for home care/hospice licensure and training, the Hospice Fund for general hospice services, the Alzheimer Fund for Alzheimer-related projects, and funds for unrestricted use by Winona Senior Services. There are also funds for general operating expenses. Part X, Line 2: The Corporation 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 Corporation 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 0 1 0 1 1 484000 484000 0.00460 20859474 17044488 3814986 0.03600 21343474 17044488 4298986 0.04060 1737 1737 0.00000 36632601 32219459 4413142 0.04160 374789 374789 0.00350 37009127 32219459 4789668 0.04510 58352601 49263947 9088654 0.08570 4129 4129 0.00000 4129 4129 0.00000 0 3878188 1551275 8479695 12744127 -4264432 X 1 1 1 Winona Area Ambulance Services Ambulance services 0.50000 0.00000 0.50000 1 1 Winona Health Services 855 Mankato Avenue Winona MN 55987 www.winonahealth.org 00701 X X X Urgent care & 2 provider based clinics Winona Health Services 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X See Part V, Section C X 1 18 1 See Part V, Section C 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X 1 X 0 X X X X 1 X 0 0 Winona Health Services Part V, Section B, Line 5: In fiscal year 2019 following the collection of the Community Health Needs Assessment survey data (both the standardized survey in English and the translated survey results), Winona Health in partnership with Live Well Winona and Winona County Human Services, facilitated several community listening sessions. These sessions were open to the public, and many diverse organizations were included to represent different stakeholder perspectives. Winona Health Services Part V, Section B, Line 6b: The assessment was done collaboratively with Winona Health and Winona County Human Services. Winona Health Services Part V, Section B, Line 11: Priority 1: Address and help reverse/prevent the unhealthy behaviors that contribute to obesity/overweight and subsequent chronic disease.Priority 2: Strive for health equity given the current inequitable distribution of social determinants of health.Priority 3: Improve mental health.Winona Health has been a key leader in the Winona Community HUB (HUB), a community-based care coordination program that leverages community health workers (CHWs) in the field to address the complex economic and social needs of families experiencing barriers to wellbeing. A collaborative of area non-profits and government agencies identified that service provider coordination and communication was a key barrier it could directly impact. After listening to stakeholders, collecting data from primary and secondary sources, and researching national best practices, the HUB emerged as an ideal solution for supporting those experiencing barriers. Core elements of the HUB model include: Find: Identify individuals at greatest risk and provide a comprehensive assessment of health, social, and behavioral health risk factors, Treat: Ensure each identified risk factor is assigned to a specific pathway ensuring that risk factors are addressed with an evidence-based or best practice intervention (e.g., parenting education, housing, food, clothing), and Measure: Completion of each pathway confirms that risk factors have been successfully addressed. Though the HUBs initial focus areas have been on families experiencing food insecurity or mental health challenges, the pandemic brought to light issues of homelessness in the community. Having the HUB in place allowed the CHWs to pivot and provide support to Winona's homeless population at the onset of the pandemic, when community gathering places were shut down and people were required to quarantine.Winona Health continues to support Gr8 Kids, an eight-week wellness program for 4th grade students led by Live Well Winona in partnership with Winona State University. Classes promote age-appropriate education in proper nutrition and active living in an effort to combat the rise in childhood obesity. In 2019, a sixth step of "kindness" was incorporated to begin impacting mental health. Cumulative program data continue to support improvements of the data in exercise and nutrition. The pandemic similarly influenced the delivery of this education, and these two partners retooled the curriculum and structure to deliver this content virtually. Post pandemic, though much of this content will return to in person education, there will still be a place for this developed virtual content in the classroom.In addition to the above activities, Winona Health has also made a significant investment in the understanding and positively impacting health equity. Winona Health has partnered with a regional leader in diversity, equity, and inclusion, to expand intercultural capacity of its employees. In addition to the comprehensive training, Winona Health has expanded the social determinant of health screening across the organization and incorporated this information into the electronic medical record. It is important to mention that once a social determinant of health is identified, and if the patient expresses a willingness to receive support, he/she/they are referred to a social worker, and then potentially connected into the Winona Community HUB if they have more intensive needs. This level of screening and systemization ensures the community's most complex needs are addressed in an equitable, unduplicated and meaningful way. Schedule H, Part V, Line 7 and 10: https://www.winonahealth.org/wp-content/uploads/2019/09/WH-Community-Health-Needs-Assessment-2019.pdf Schedule H, Part V, Line 16a-c: https://www.winonahealth.org/patient-information/billing/financial-assistance-care-program/ 3 1 - Rushford Clinic 109 W Jessie St Rushford MN 55971 Primary Care Clinic 3 - Main Street Clinic 107 W 4th Street Winona MN 55987 Quick Care Clinic 8 - Winona Home Medical 930 Parks Avenue Winona MN 55987 DME Part I, Line 6a: The community benefit report is included in the annual report and community benefit information is listed in quarterly newsletters, both of which are posted on the Winona Health website: https://www.winonahealth.org/. Information is also included in the patient waiting rooms. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, and cash and in-kind donations, line 7i were actual expenses compiled using the CBISA software. The cost for subsidized health services reported on line 7g was determined using the Medicare cost report. Part III, Line 2: The corporation determines its estimate of implicit price concessions based on its historical collection experience with each class of patients and residents. Part III, Line 3: WHS estimates that 40% of implicit price concession accounts would likely qualify for the Organization's charity care guidelines if the patient would have been identified and followed through on the application process. This percentage is based on historical knowledge of those who were provided applications and those who completed and submitted application to qualify. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located on page 18 of the attached financial statements. Part III, Line 8: WHS 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. Therefore, the entire Medicare shortfall is considered a community benefit. The Organization reported only those allowable costs and Medicare reimbursements reported in the Medicare cost report for the year.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 Medicare and Medicaid Services. Part III, Line 9b: In keeping with the mission, vision and values of Winona Health Services, our Organization is committed to giving a patient every opportunity to pay their medical debt in full or to make arrangements based on organizational policy. When a patient is in the process of applying for financial assistance, whether charity care or an interest free payment plan, there will be no collection efforts. Collection efforts include phone contacts, letters, patient interviews and filing a judgement against the patient and potential garnishment of wages. After a determination of financial assistance, any personal portion due follows the same collection procedures as other accounts. Accounts will be recalled from collection if an application is completed within 240 days of the date of the first invoice. Part VI, Line 2: Winona Health Services (WHS) uses a variety of methods to listen to its customers, and the methodologies vary by customer groups. The development of most major services includes the meeting of a community advisory group to assess operations and plans and provide recommendations to the leadership team. WHS also uses point of care feedback comment cards, focus groups, advisory committees comprised of community individuals, and web and consumer newsletter surveys to capture feedback from patients/residents and community. Immediate feedback is obtained from patients/residents and community through pre- and post-service calls, rounding, and informal surveys. WHS also works with local non-profit organizations gathering feedback from local agencies and their boards to ensure community needs are being met. The entire report is available on the Winona Health website. Part VI, Line 3: WHS places pamphlets that contain information about our charity care programs and policies throughout the Organization, including all patient access areas. In addition, information can be found on our statement, website or by calling the WHS business office either locally or toll-free. WHS also has a plain language brochure which explains options for financial assistance, charity care, government program assistance, and our uninsured discount program. In addition, the WHS social services department and/or a contracted patient advocate may meet with in-house or recently discharged patients to go over all the payment options which include charity care, governmental programs, or other alternative payment options. WHS works with the county to help initiate a screening process for applying for governmental programs by offering the patients an opportunity to lock in an effective date for those programs if subsequently found eligible. WHS also is contracted with MNSure and has Certified Application Counselors onsite to assist patients in applying for insurance coverage through the State run exchange. Part VI, Line 4: WHS defines its primary service area as the zip code of Winona and the immediate surrounding area with a population base of approximately 35,000 residents. Its secondary service area encompasses a 20-mile radius from Winona representing another 12,000 residents. WHS is located between two large, well-known tertiary health care centers, Mayo and Gundersen Lutheran. WHS has focused on fulfilling its community need: a full primary care facility. WHS defines itself as a primary care health system and provides its patients and residents connections to tertiary level services to meet their needs regionally or nationally, as the patient chooses. In 2019, Winona had a median household income of $48,667 and 17.8% of persons were below the poverty level. The majority of our patients live in Winona which has a population of over 27,592 people. Approximately 17.2% of our patients are uninsured and/or Medicaid recipients. Part VI, Line 5: As a sole community provider, WHS offers emergency and urgent care, primary care for all ages, surgical and specialty care, inpatient care, and senior services. Our Board is comprised of physicians and primarily community members. The Board and medical staff are involved in our strategic planning which focuses on the health of our community members. To meet the needs of our community, the Hospital extends privileges to medical staff that are qualified through licensure in the state of Minnesota. In a normal year, staff actively participate in several on-site and off-site health fairs offering free blood pressure checks, glucose screenings and expertise on health questions, as well as offering free community health talks for community members on certain health topics. Due to the COVID pandemic in 2020, much of this activity was curtailed or transitioned to virtual delivery. Winona Health actively participated with other community resources to develop and carry out plans in response to the pandemic, including establishing a separate COVID testing site on our campus, and temporarily housing residents of a neighboring skilled nursing facility when it experienced a severe COVID outbreak.Additional programs that benefit the community include:Health Professional Training: Winona Health Services works closely with nurse and health professional education programs at Winona State University, St. Mary's University, Viterbo College, and Southeast Technical College. Along with training LPNs and RNs on site, other students going into fields of athletic training, social work, nutrition, lab, radiology, physical therapy, respiratory therapy and health administration are also educated and mentored on site. Students work with staff in the following departments: medical/surgical/pediatric unit, family birth center, intensive care unit, emergency department, lab, radiology, social workers, physical and occupational therapy. Preventive Care: WHS encourages preventive care through a number of resources. Winona Health Online is a free web-tool that allows patients to have access to their Winona Health Services records anytime, anywhere with an internet connection. Patients can document their health history, access diabetes and asthma management programs, receive lab test results, and track wellness activities. Winona Health Services offers a number of educational opportunities for the community, from CPR classes to free or low-cost screenings including prostate cancer, cholesterol, depression, skin cancer and mammograms. WHS is the main sponsor for a community-wide health and wellness expo. Community Health Talks provide individuals with educational information on a variety of health topics and are free throughout the year. The Winona Health Services Occupational Health department presents various preventive programs geared toward business leaders and HR professionals. The staff also participates in many community collaborative healthcare events.Employee Health: The Healthy U Program is a health management incentive initiative designed to support and encourage healthy activities for our employees and families. The program reinforces the emphasis on prevention, aiming to improve their health and well-being. Emergency Care: WHS provides 24-hour-a-day, 365-days-per-year emergency care to the community. It employs six full-time physicians and several mid-level providers as the service continues to grow. Winona Health Services has excellent relations with neighboring tertiary facilities and transports patients as needed to La Crosse and Rochester.Community Relations: WHS works with area nonprofit organizations to support health and youth-related activities. Presentations included topics such as stress management, career planning, men and women's health issues, joint pain and surgery, gastroesophageal reflux disease, nutrition, and weight management. Staff members are also involved in several non-profit committees, donating their time to support our community. Community Education: WHS's community education programming includes free or reduced-fee classes on childbirth and parenting, support groups for breastfeeding, cardio-pulmonary resuscitation, diabetes prevention, first aid, and smoking cessation. Staff conduct health screenings at free screenings events at Winona Health and other community health fairs. Winona Health Volunteers offer free healthcare directives educational sessions throughout the year.The Winona Health Community Care Network is a service available to community members who would like help with managing a chronic health condition. Its goal is to support and improve the overall health of individuals who are at high risk for frequent emergency department visits and hospital admissions. Part VI, Line 7, Reports Filed With States MN 1 Winona Health Foundation 855 Mankato Avenue Winona MN 55987 411879744 35000 Memorials 1 0 Part I, Line 2: Winona Health Services will review solicitations from other legally recognized, tax-exempt nonprofit organizations whose work benefits the community based on the following: A. The request addresses a community health or wellness issue. B. The request benefits area youth in the areas of health and wellness. C. The request supports a project directly benefiting the community and aligned with Winona Health Services' Missions/Vision/Values. D. The request supports key Winona Health Services business and marketing strategies. E. Priority will be given to local nonprofit organizations. F. Typically, only one request will be awarded to a nonprofit in a given year. X X X X X 0 1 0 0 0 0 0 0 0 Andrew Millis MD Orthopedic Physician 635879 0 364314 0 3724 0 49234 0 26566 0 1079717 0 0 0 Amarjit Virdi MD Anesthesiologist 633838 0 0 0 16881 0 45410 0 34864 0 730993 0 0 0 Wayne Kelly MD ED/Urgent Care Physician 583525 0 0 0 10597 0 43619 0 25312 0 663053 0 0 0 Alex Westenfield MD Radiologist 498437 0 6734 0 48910 0 39963 0 17736 0 611780 0 0 0 Kenneth Johnson MD Orthopedic Physician 527430 0 0 0 0 0 41104 0 22203 0 590737 0 0 0 Matthew Broghammer MD Director 440206 0 61965 0 16664 0 34164 0 37046 0 590045 0 0 0 Brett Whyte MD Director (Jan-Feb) 468439 0 0 0 12463 0 38521 0 36648 0 556071 0 0 0 Rachelle Heising-Schultz President/CEO/Director 425943 0 0 0 16341 0 37296 0 52740 0 532320 0 0 0 Christopher Watras DO Former Key Employee 366037 0 15057 0 0 0 25426 0 37067 0 443587 0 0 0 Katrina Hammel MD Director 340432 0 0 0 414 0 25832 0 36703 0 403381 0 0 0 Sarah Lallaman DO Pediatrician 302041 0 0 0 2260 0 22807 0 41409 0 368517 0 0 0 Jan Brosnahan CFO/Treasurer 240735 0 0 0 9933 0 19929 0 37904 0 308501 0 0 0 Nicholas Modjeski MD Director 245308 0 0 0 1493 0 18498 0 29110 0 294409 0 0 0 E Allen Beguin MD Director (Feb-Sep) 229598 0 0 0 0 0 17206 0 33669 0 280473 0 0 0 Michael Donnenwerth Chief Medical Officer 227730 0 0 0 0 0 17244 0 33832 0 278806 0 0 0 Robin Hoeg VP Inpatient & Senior Serv 186784 0 0 0 12505 0 19976 0 17007 0 236272 0 0 0 Sara Gabrick VP Surgical/Specialty Care 188442 0 0 0 7053 0 15300 0 30820 0 241615 0 0 0 Rebecca Lamberty Chief Administrative Officer 152939 0 0 0 17255 0 23766 0 3215 0 197175 0 0 0 Part I, Line 4b The following individuals received employer contributions to a supplemental non-qualified 457(f) retirement plan, which is available to executive, physicians, and mid-level providers as determined by the Board of Directors. It is funded by employer contributions, and employees are vested within five years. An alternative plan is available which is funded by employee contributions and not subject to forfeiture. CY2019 FY2020 Andrew Millis, MD 28,880 31,102 Kenneth Johnson, MD 20,750 6,189 Amarjit Virdi, MD 25,056 26,214 Wayne Kelly, MD 23,212 18,349 Matthew Broghammer, MD 13,810 16,183 Brett Whyte, MD 18,167 15,290 Katrina Hammel, MD 5,479 5,479 Alex Westenfield, MD 19,610 8,913 Christopher Watras, DO 5,073 5,073 Sarah Lallaman, DO 2,245 2,245 Anne Marie Olsen Wagner 1,305 2,507 A City of Winona 416005651 975232CE7 2012-05-04 19887849 Refund revenue bonds issued 7/16/2004 0 0 0 A 4412849 19887849 1555683 356781 17975385 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: City of Winona Date the Rebate Computation was Performed: 09/27/2016 Part I, Line B, Column (f): Refunding of prior revenue bonds originally issued 8/1/2000 and 7/1/2004 and renovation and acquisition of property on Sarnia Street and Parks Avenue. Part II, Line 11(A): The amount reported on Line 11 represents the amount of proceeds used to refund prior bonds issued in 2004. Alex Westenfield Employee Recruitment incentive X 20000 4432 1 0 1 Andrew Millis Employee Recruitment incentive X 50000 9292 0 0 1 13724 Ann Marie Olsen Wagner Spouse of Board Member Mark Wagner 89671 Employee compensation & benefits 0 Form 990, Part III, line 2 Opened Main Street Clinic in June 2020. The off campus location provides Quick Care Services, cash based medical exams for limited diagnosis, under a newly formed LLC entity. Eye Care services are also provided at this location by Winona Health (as a second location option), and commonly used over the counter healthcare supplies are available for purchase. Urology Services were added through an outreach agreement with Mayo Clinic. The covid 19 pandemic impacted delivery of services in many ways. Synchronous virtual care options were added for primary and specialty care services, in addition to urgent care and hospice settings. Asynchronous care (SmartExam) offerings were expanded to include a no cost COVID screening tool. Telephone services (visits) were expanded to include more areas across the organization. Negative pressure rooms were created, staff and patient monitoring processes were put in place, traffic and work flows were reviewed and altered for both clinical and support areas, a separate covid testing clinic site was established, remote work options were greatly expanded. Lake Winona Manor temporarily housed SNF residents from Sauer Health Care while that facility was impacted by an outbreak of Covid 19. Form 990, Part VI, Section A, line 1 The Executive Committee has the authority to act on behalf of the governing board in between board meetings. The Executive Committee consists of the Board Chair, the chair of each Standing Committee, the President/CEO of the organization. Form 990, Part VI, Section A, line 2 The following individuals have business relationships: Hugh Miller and Todd Paulson Matt Broghammer, Nicholas Modjeski and E. Allen Beguin Steve Blue and David Vaselaar Form 990, Part VI, Section A, line 4 WH Bylaws were changed to reflect a change in the Medical Staff Bylaws regarding medical staff elections for Chief of Staff, Vice Chief of Staff, and at-large physician board positions. Form 990, Part VI, Section B, line 11b The return is reviewed initially by the CFO and CEO. It is then reviewed by the Executive Committee before it is filed. In addition, the Form 990 is available to the full governing board prior to filing with the IRS. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers Senior Leaders, Directors, Officers and Board Committee Members. The policy is signed annually and reviewed by the CEO for conflicts. Any conflicts are brought to the Board for discussion. If a Board Member has a potential conflict, they must abstain from voting. Form 990, Part VI, Section B, line 15 The Executive Committee has a process in place for determining annual compensation for the CEO based on results of a compensation study, which is completed by an independent consultant every 3 years. An annual review is conducted and documented, with final decisions made by the full board. The same consultant provides market reviews and recommendations for the senior leadership team. This is reviewed by the executive compensation committee; however, the CEO is responsible for adjustments made for this team. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available upon request. The financial statements are also attached to the Form 990. Form 990, Part IX, line 11g Collection Agency Fees: Program service expenses 441,769. Management and general expenses 0. Fundraising expenses 0. Total expenses 441,769. Consulting Fees: Program service expenses 227,842. Management and general expenses 0. Fundraising expenses 0. Total expenses 227,842. Contracted Physician Fees: Program service expenses 1,354,804. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,354,804. Contracted Services: Program service expenses 4,643,143. Management and general expenses 2,279,000. Fundraising expenses 0. Total expenses 6,922,143. Provider Recruiting: Program service expenses 62,713. Management and general expenses 0. Fundraising expenses 0. Total expenses 62,713. Repair and Maintenance: Program service expenses 1,037,784. Management and general expenses 13,766. Fundraising expenses 0. Total expenses 1,051,550. Purchased Services: Program service expenses 362,834. Management and general expenses 0. Fundraising expenses 0. Total expenses 362,834. Consulting Fees: Program service expenses 0. Management and general expenses 320,101. Fundraising expenses 0. Total expenses 320,101. Main Street Clinic LLC 855 Mankato Ave Winona MN 55987 834680257 Clinic Services MN 8103 -80207 Winona Health Services Inc Winona Senior Services Inc 855 Mankato Avenue Winona MN 55987 411936536 Long-term care MN 501(c)(3) Line 3 Winona Health Services 1 Winona Health Foundation 855 Mankato Avenue Winona MN 55987 411879744 Fundraising MN 501(c)(3) Line 7 Winona Health Services 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 Winona Senior Services Inc O 175906 Due to/from net change in balance Winona Senior Services Inc S 19280688 Due to/from net change in balance Winona Senior Services Inc R 15416654 Due to/from net change in balance Winona Health Foundation O 82133 Due to/from net change in balance Winona Health Foundation S 750000 Due to/from net change in balance Winona Health Foundation C 847799 Due to/from net change in balance