2020-02-12T16:25:32-06:00 2019-03-31 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 558021926 990 2018-04-01 411724637 CUYUNA REGIONAL MEDICAL CENTER CUYU 2185467000 320 EAST MAIN STREET CROSBY MN 56441 KATIE BERG CFO 2185467000 2020-02-04 1 JULIE BOYER P01278549 2187275025 66.98.98.134 2020-02-04 11:48:57 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 930171E15D686EC555C78A932CEAB980F20E2170 2018 2020-09-23 17:36:50Z KYLE BAUER 320 EAST MAIN STREET CROSBY MN 56441 132528514 0 X WWW.CUYUNAMED.ORG X 1992 MN ACCOMMODATING YOU WITH CARE AND COMPASSION BY DEDICATING OURSELVES TO YOU EVERY DAY. 8 7 1130 60 0 0 229879 250873 128108044 131281634 140861 429630 577535 566377 129056319 132528514 0 0 0 0 59473989 62273619 0 0 0 64140601 67344262 123614590 129617881 5441729 2910633 101663372 120424119 54838579 70688693 46824793 49735426 X ACCOMMODATING YOU WITH CARE AND COMPASSION BY DEDICATING OURSELVES TO YOU EVERY DAY. 0 0 120181536 131281634 AS A COMMUNITY-BASED HOSPITAL AND HEALTH CARE PROVIDER, CRMC'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITY AND PROVIDE QUALITY HEALTH CARE SERVICES FOR ALL CITIZENS, REGARDLESS OF ABILITY TO PAY. EACH YEAR, CRMC GIVES BACK TO THE COMMUNITY THROUGH EDUCATION, HEALTH SERVICES, DONATIONS, AND FREE AND REDUCED COST HEALTH CARE TO ENSURE THAT FINANCIAL ISSUES DO NOT PREVENT PATIENTS FROM SEEKING OR RECEIVING CARE.CRMC MAKES SIGNIFICANT EFFORTS TO ENSURE CHARITY CARE IS GRANTED TO ALL PATIENTS WHO QUALIFY. A TOTAL OF $82,837 IN SERVICES WERE PROVIDED TO LOW-INCOME PATIENTS AT FREE OR REDUCED PRICES, AND WAS PROVIDED TO THOSE WHO HAVE EXHAUSTED THIRD PARTY RESOURCES, DO NOT QUALIFY FOR MEDICAID OR HAVE INSUFFICIENT INCOMES. CRMC ALSO EXPERIENCED A LOSS OF $2,143,175 IN THE UNPAID COSTS OF MEDICAID FOR LOW-INCOME INDIVIDUALS. THE CUYUNA LAKES AREA HAS A HIGH NEED FOR SEVERAL HEALTH CARE SERVICES THAT DO NOT GENERATE SUFFICIENT REVENUE TO COVER THE COST OF PROVIDING THEM. CRMC SUBSIDIZES A TOTAL OF $976,825 IN SERVICES TO ENSURE THEIR AVAILABILITY TO OUR COMMUNITY.THE ORGANIZATION ALSO PROVIDES HEALTH-RELATED EDUCATION TO THE COMMUNITY THROUGH EVENTS, CLASSES, LECTURES AND WELLNESS SCREENINGS COMPLETELY FREE-OF-CHARGE TO THE COMMUNITY. CRMC'S HEALTH AND WELLNESS EVENT ATTRACTED NEARLY 10,000 PARTICIPANTS IN 2018-19, AND OVER 1,000 LUNCHES WERE PROVIDED FOR YOUTH IN THE CUYUNA LAKES FREE SUMMER LUNCH PROGRAM. ANOTHER $5,000 WAS DONATED TO SUPPORT SUMMER LUNCHES FOR BRAINERD'S OPERATION SANDWICH PROGRAM. CRMC OFFERS YEAR-ROUND COURSES ON FIRST AID, CPR, CHILDBIRTH, BREASTFEEDING, AND DIABETES PREVENTION TOGETHER WITH SUPPORT GROUPS ON MEMORY LOSS, BRAIN INJURY AND STROKE, CANCER AND WEIGHT LOSS. CRMC ALSO SUPPORTS OTHER ORGANIZATIONS AND INITIATIVES THAT SHARE ITS GOAL TO IMPROVE THE HEALTH OF OUR COMMUNITY. IN 2018-19, THAT INCLUDED $1.1 MILLION IN CASH AND IN-KIND DONATIONS, CHARITY CARE, AND SUBSIDIZED SERVICES TO ORGANIZATIONS FOCUSED ON THE HEALTH, SOCIAL, CULTURAL, AND EDUCATIONAL NEEDS OF THE AREA. IN ADDITION, CRMC STAFF DONATES TIME, MATERIALS, AND LEADERSHIP TO MORE THAN 20 COMMUNITY GROUPS INCLUDING VARIOUS SCHOOLS; CUYUNA LAKES, BRAINERD LAKES AND NISSWA CHAMBERS OF COMMERCE; HALLETT COMMUNITY CENTER; NORTHLAND ARBORETUM; RACE FOR THE CURE; KINSHIP PARTNERS; CROSBY, IRONTON, CUYUNA AND DEERWOOD FIRE DEPARTMENTS AND OTHERS. BECAUSE FOOD INSECURITY IS A GREAT NEED FOR THE AREA, CRMC ANNUALLY INVESTS ABOUT $20,000 TOWARDS FREE SUMMER LUNCH AND HOLIDAY BREAK MEALS FOR STUDENTS, HEALTHY FOOD AT COMMUNITY EVENTS, AND STOCKING THE CUYUNA FOOD SHELF.CRMC ALSO INVESTS APPROXIMATELY $3 MILLION PER YEAR IN CAPITAL IMPROVEMENTS SUCH AS NEW EQUIPMENT, FACILITIES, AND TECHNOLOGY INFRASTRUCTURE. 120181536 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 73 0 1 1130 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 1 1 MN X KATIE BERG 2185467000 320 EAST MAIN STREET CROSBY MN 56441 ANDREA BEDARD DIRECTOR 1.00 X 0 0 0 KEVIN EGAN VICE CHAIR 1.00 X X 0 0 0 BRUCE KRAEMER FORMER DIRECTOR 1.00 X 0 0 0 DR SHAWN ROBERTS DIRECTOR 1.00 X 0 0 0 RICHARD SCHILLER CHAIR 1.00 X X 0 0 0 BART TAYLOR DIRECTOR 1.00 X 0 0 0 DENISE LAUDENBACH DIRECTOR 1.00 X 0 0 0 DR PETER MACKAY DIRECTOR 1.00 X 0 0 0 KYLE BAUER CEO 40.00 X X 391386 0 43471 AMY HART COO 40.00 X 246503 0 33250 KATIE BERG CFO 40.00 X 188288 0 14644 JOSHUA HOROWITZ PHYSICIAN 40.00 X 921849 0 28890 FAWN ATCHISON ANESTHESIOLOGIST 40.00 X 652840 0 28790 THOMAS LORENZ PHYSICIAN 40.00 X 435580 0 36393 LEAH KIPPES ANESTHESIOLOGIST 40.00 X 565223 0 43948 RAJESH BHARGAVA HOSPITALIST 40.00 X 496710 0 47142 3898379 0 276528 64 0 1 0 PREMIER SURGICAL ASSOCIATES PA 318 E MAIN STREET CROSBY MN 56441 PHYSICIAN FEES 7616352 CENTRAL LAKES PHYSICIANS PA 318 E MAIN STREET CROSBY MN 56441 PHYSICIAN FEES 4793578 RJ MECHANICAL 901 NORTH IND PARK RD MORA MN 55051 BUILDING CONTRACTOR 2809844 CENTRAL MN DIAGNOSTIC INC PO BOX 158 MILACA MN 56353 RADIOLOGY SERVICES 1774495 ALLINA HOSPITALS & CLINICS NW 7710 MINNEAPOLIS MN 554409383 COMPUTER SERVICES 1120534 36 250873 250873 PATIENT REVENUE 621500 122399171 122399171 PROFESSIONAL SERVICES 621500 5950417 5950417 RETAIL PHARMACY 446110 1706926 1706926 OTHER OPERATING REVENUE 900099 1225120 1225120 131281634 429630 429630 CAFETERIA 722210 566377 566377 566377 132528514 131281634 0 996007 X 675025 675025 49831890 49111093 720797 1818226 1818226 6619158 6619158 3329320 3256901 72419 213396 58431 154965 92843 92843 3169 3169 21314388 20710288 604100 467314 467314 2654784 2243081 411703 170547 170547 1776853 1645154 131699 539224 399535 139689 1616262 1616262 6629462 3891930 2737532 236021 2615 233406 MEDICAL SUPPLIES 10961817 10948661 13156 DRUGS 10131987 10131987 PROVISION FOR DOUBTFUL 2633384 2633384 REPAIRS & MAINTENANCE 2266982 2260579 6403 5635829 3812652 1823177 129617881 120181536 9436345 0 19198804 28920523 151361 52031 20765810 21333466 10303500 10303500 2803843 3105934 1879659 2505939 127157999 75605147 43955030 51552852 2448837 2649874 156528 0 101663372 120424119 8820133 11338457 14435 26511 14400000 14400000 31604011 44923725 54838579 70688693 X 46824793 49735426 46824793 49735426 101663372 120424119 2910633 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3169 3169 0 PART II-B, LINE 1: CUYUNA REGIONAL MEDICAL CENTER PAY DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 0 1 X 313640 313640 56685454 28623658 28061796 58554678 45249441 13305237 11604227 1732048 9872179 51552852 DUE TO CUYUNA RANGE HOSPITAL DISTRICT 43125493 DUE TO AFFILIATE 371094 THIRD PARTY PAYOR SETTLEMENTS 1427138 44923725 X 129026049 1888320 1888320 127137729 5390785 5390785 132528514 125749171 890699 890699 124858472 4759409 4759409 129617881 PART IV, LINE 2B: THE HOSPITAL IS A CUSTODIAN OF FUNDS FOR RESIDENTS. THE HOSPITAL HOLDS THESE FUNDS FOR PURCHASES MADE BY THE RESIDENTS. PART X, LINE 2: THE CENTER IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. NONPROFIT ORGANIZATIONS MAY BECOME SUBJECT TO INCOME TAXES IF QUALIFICATION AS A TAX-EXEMPT ENTITY CHANGES, IF UNRELATED BUSINESS INCOME IS GENERATED AND IN CERTAIN OTHER INSTANCES. NONPROFIT ORGANIZATIONS ARE REQUIRED TO ASSESS THE CERTAINTY OF THEIR TAX POSITIONS RELATED TO THESE MATTERS AND, IN SOME CASES, RECORD LIABILITIES FOR POTENTIAL TAXES, INTEREST AND PENALTIES ACCOMPANIED BY FOOTNOTE DISCLOSURES. THE CENTER HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE THE ACCRUAL OF AN INCOME TAX PROVISION. GENERALLY, THE CENTER IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: MINNESOTA RADIOLOGY INSTITUTE REVENUE 1,888,320. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 2,633,384. ELIMINATIONS RELATED TO MINNESOTA RADIOLOGY INSTITUTE 2,757,401. PART XII, LINE 2D - OTHER ADJUSTMENTS: MINNESOTA RADIOLOGY INSTITUTE EXPENSES 890,699. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 2,633,384. ELIMINATIONS RELATED TO MINNESOTA RADIOLOGY INSTITUTE 2,126,025. 1 1 X 1 X 175.000000000000 1 X 1 1 0 1 1 2780332 2780332 0.02190 21211935 11813589 9398346 0.07400 23992267 11813589 12178678 0.09590 17 2955 234154 234154 0.00180 5 252 119768 119768 0.00090 22 3207 353922 353922 0.00270 22 3207 24346189 11813589 12532600 0.09860 1 14945 14945 0.00010 1 800 34935 34935 0.00030 1 2582 3059 3059 0.00000 3 3382 52939 52939 0.00040 1 2633384 0 42759359 45362858 -2603499 X 1 1 1 1 CUYUNA REGIONAL MEDICAL CENTER 320 EAST MAIN STREET CROSBY MN 56441 385516 X X X X CUYUNA REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 17 1 0 1 1 X SEE PART V, PAGE 8 X 1 17 1 SEE PART V, PAGE 8 0 1 X 175.000000000000 200.000000000000 X X X 1 1 X X X X 1 X HTTPS://CUYUNAMED.ORG/PATIENT-INFORMATION X HTTPS://CUYUNAMED.ORG/PATIENT-INFORMATION X HTTPS://CUYUNAMED.ORG/PATIENT-INFORMATION X X X X X X 1 X 0 X X X X 1 X 0 0 CUYUNA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: CRMC USED DATA COLLECTED FROM A COMMUNITY HEALTH SURVEY CONDUCTED AT IT ANNUAL WOMEN'S WELLNESS EVENT AND ALSO USED INPUT FROM DISCUSSION AT A COMMUNITY KEY STAKEHOLDERS' FOCUS GROUP. INFORMATION FROM RESULTS OF THE 2016 CHNA DEVELOPED BY ESSENTIA HEALTH/ST. JOSEPH'S MEDICAL CENTER AS WELL AS THE 2017 CROW WING COUNTY COMMUNITY HEALTH SURVEY WAS ALSO UTILIZED. DATA FROM CRMC'S CLINIC PATIENT RECORDS, THE U.S. CENSUS, STATE OF MINNESOTA AND AREA PUBLIC SCHOOLS WAS ALSO INCLUDED. CUYUNA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: CROW WING COUNTY HEALTH DEPARTMENT CUYUNA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: OBESITY/OVERWEIGHT - CRMC HAS MADE HEALTHY FOODS AVAILABLE IN ITS EMPLOYEE LOUNGE AND IS PROVIDING HEALTHY OPTIONS AT ALL OF ITS COMMUNITY EVENTS AND INTERNAL MEETINGS. ROOTY THE CARROT WAS ADOPTED AS A MASCOT AND ENCOURAGED YOUTH AND ADULTS TO EAT VEGETABLES BY HANDING OUT SEEDS AT A COMMUNITY EVENT WHERE YOUTH COULD PLANT THEM AND TAKE THEM HOME. THE LOCAL FARMER'S MARKET WAS SPONSORED TOGETHER WITH A POWER OF PRODUCE PROGRAM FOR YOUTH. SEVERAL ACTIVITIES WERE PROVIDED FOR YOUTH THROUGH PARTNERSHIP WITH THE LOCAL HEALTH CLUB. EMPLOYEES WERE OFFERED REDUCED PRICE SUMMER ACTIVITY CAMPS FOR THEIR CHILDREN AND BICYCLES TO RIDE FOR FREE DURING THEIR BREAKS. LIVING WELL CLASSES THAT FOCUSED ON HEALTHY EATING AND ACTIVITY ARE PROVIDED TWICE A YEAR AT NO COST TO THE PARTICIPANTS. SUMMER YOUTH LUNCH PROGRAMS IN THE CUYUNA LAKES AND BRAINERD WERE SPONSORED TO PROVIDE HEALTHY BROWN BAG LUNCHES TO YOUTH WHO RECEIVE FREE MEALS DURING SCHOOL YEAR. FRUIT AND VEGETABLE VOUCHERS WERE DISTRIBUTED THROUGH THE SCHOOLS AND CUYUNA FOOD SHELF. DIETITIANS AND EXERCISE SPECIALISTS PROVIDED EDUCATION AT LOCAL SCHOOLS AND HEALTH FAIRS. FUN RUNS AND OUTDOOR RECREATION EVENTS WERE SPONSORED AND EMPLOYEES WERE ENCOURAGED TO PARTICIPATE. A COMMUNITY HEALTH CHALLENGE, MARCH THE MISSISSIPPI, WAS HELD TO ENCOURAGE ADULTS AND YOUTH TO BE ACTIVE.MENTAL HEALTH - CRMC HOSTED A MENTAL HEALTH FOR BUSINESS WORKSHOP. CRMC ALSO PARTNERED WITH THE UNITED WAY OF CROW WING AND CASS COUNTIES TO HELP PUBLICIZE THE AREA'S MAKE IT OKAY PROGRAM. STAFF ATTENDED FIRST AID TRAINING AND A FACILITATOR WAS BROUGHT ON CAMPUS TO TRAIN THE LEADERSHIP TEAM. THE SAVING HEARTS SUICIDE PREVENTION WALK WAS SUPPORTED BY NUMEROUS STAFF. A SERIES OF MENTAL HEALTH EDUCATIONAL PROGRAMS WERE OFFERED FOR EMPLOYEES. CRMC ALSO SUPPORTED SMILES FOR JAKE SUICIDE PREVENTION EFFORTS IN THE COMMUNITY AND ITS BEHAVIORAL HEALTH PROVIDERS WERE PRESENT AT THEIR EVENTS.ADVANCED DIRECTIVES - CRMC THROUGH A PARTNERSHIP WITH SILOS TO CIRCLES EDUCATED THE PUBLIC ON THE NEED FOR ADVANCED DIRECTIVES WITH MONTHLY INDIVIDUAL AND GROUP MEETINGS. FREE FORMS WERE MADE AVAILABLE THROUGHOUT CRMC'S FACILITY AND CLINICS AND PROVIDERS WERE ENCOURAGED TO SHARE THEM WITH PATIENTS. A MEDIA CAMPAIGN WAS ISSUED AROUND NATIONAL DECISIONS DAY TO CREATE ADDITIONAL AWARENESS. PRIORITIES NOT SELECTED:MANY OF THE OTHER HEALTH ISSUES WERE NOT SELECTED BECAUSE EFFORTS IN THE THREE SELECTED AREAS WOULD ALSO IMPACT THOSE ISSUES. FOR EXAMPLE, IF CRMC IS SUCCESSFUL IN REDUCING THE OBESITY AND OVERWEIGHT RATES, IT WILL ALSO BE ADDRESSING THE LACK OF NUTRITIOUS FOODS, NOT MEETING ACTIVITY GUIDELINES, DIABETES, HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL IN ADDRESSING MENTAL HEALTH ISSUES, CRMC WILL ALSO TACKLE SUBSTANCE ABUSE, DEPRESSION, ANXIETY, PANIC ATTACKS, AND STRESS. BY ENCOURAGING INDIVIDUALS TO HAVE AN ADVANCED DIRECTIVE IN PLACE, CRMC IS ADDRESSING THE AGING POPULATION. PART V, LINE 7A, CHNA - HOSPITAL'S WEBSITE HTTPS://WWW.CUYUNAMED.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 10, IMPLEMENTATION PLAN WEBSITE: HTTPS://WWW.CUYUNAMED.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 3 1 - BAXTER CLINIC 13205 ISLE DRIVE BAXTER MN 56425 FREE-STANDING CLINIC 2 - LONGVILLE CLINIC 180 JORDAN LANE LONGVILLE MN 56655 RURAL HEALTH CLINIC 3 - CARE CENTER 320 EAST MAIN CROSBY MN 56441 SKILLED NURSING FACILITY PART I, LINE 7: COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED MEDICARE COST REPORT. PART I, LN 7 COL(F): BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $2,633,384. PART II, COMMUNITY BUILDING ACTIVITIES: CRMC PROMOTED THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH THE FOLLOWING COMMUNITY BUILDING PROJECTS. CRMC FINANCIALLY SUPPORTED THE BRAINERD LAKES AREA ECONOMIC DEVELOPMENT CORPORATION TO HELP FOSTER THE CREATION OF NEW JOBS, ATTRACT NEW INDUSTRY TO THE REGION AND ASSIST AREA BUSINESSES. IT ALSO SUPPORTS THE BRAINERD LAKES, CUYUNA LAKES, AND NISSWA CHAMBERS OF COMMERCE AND THEIR COMMUNITY EVENTS TO ASSIST IN BUILDING HEALTHY AND SUCCESSFUL BUSINESS COMMUNITIES. HEALTH OF THE COMMUNITY WAS IMPROVED THROUGH NUMEROUS HEALTH AND WELLNESS EDUCATIONAL CLASSES AND EVENTS AND SUPPORT GROUPS. CRMC ALSO COORDINATED A CUYUNA CHRISTMAS AND MUSIC IN THE PARK COMMUNITY EVENTS BY PROVIDING HEALTHY FOOD, OFFERING PHYSICAL ACTIVITIES, AND DISTRIBUTING FREE KNIT HATS AND T-SHIRTS TO THOSE IN NEED. FOOD WAS ALSO PROVIDED TO ECONOMICALLY INSECURE FAMILIES THROUGH THE CUYUNA LAKES LUNCH BUNCH AND BRAINERD'S OPERATION SANDWICH PROGRAMS WHERE LUNCHES ARE GIVEN TO YOUTH IN THE SUMMER WHEN SCHOOL FREE LUNCHES ARE NOT AVAILABLE. FRUIT AND VEGETABLE VOUCHERS WERE DISTRIBUTED THROUGH THE PUBLIC SCHOOLS AND CUYUNA FOOD SHELF.TO ENCOURAGE STUDENTS TO SEEK A HEALTH CARE CAREER, CRMC SUPPORTED BRIDGES ACADEMY CAREER DAY, AN EVENT WHERE AREA HIGH SCHOOL STUDENTS COME TO THE LOCAL COMMUNITY COLLEGE TO HEAR FROM PROFESSIONALS ABOUT THEIR SPECIFIC JOBS. SEVERAL FIELD TRIPS TO THE FACILITIES ARE HOSTED BY THE HOSPITAL'S VARIOUS DEPARTMENTS AND EMERGENCY MEDICAL SERVICES PROVIDED NUMEROUS DEMONSTRATIONS. CRMC ALSO SPONSORED SCRUBS CAMP WHICH ENCOURAGES YOUTH TO ENTER A MEDICAL FIELD. PART III, LINE 2: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ONGOING ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH MAJOR PAYOR SOURCE CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE (INCLUDING COPAYMENT AND DEDUCTIBLE AMOUNTS FROM PATIENTS), THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH PRIVATE-PAY PATIENTS, THE CENTER RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.THE CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE REVISED AS NEEDED IN FUTURE PERIODS. THE CENTER HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEAR 2019. THE CENTER DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. PART III, LINE 3: AT CUYUNA REGIONAL MEDICAL CENTER BAD DEBT IS CONSIDERED THE UNWILLINGNESS TO PAY, WHILE CHARITY CARE AND FREE CARE ARE INABILITY TO PAY. PART III, LINE 4: SEE FOOTNOTE 1 ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6. PART III, LINE 9B: IT IS OUR GOAL TO PROVIDE AFFORDABLE HEALTHCARE SERVICES TO ALL PATIENTS REGARDLESS OF THE ABILITY TO PAY AND ASSIST UNINSURED OR UNDERINSURED PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE.WE ALLOW PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE TO PAY WHAT THEY ARE WILLING AND ABLE TO PAY BUT WE DO NOT REQUEST PAYMENT. PATIENT ASSISTANCE IS NOT CONSIDERED TO BE A SUBSTITUTE FOR PERSONAL RESPONSIBILITY. PATIENTS MUST COOPERATE WITH CRMC PROCEDURES FOR OBTAINING FINANCIAL ASSISTANCE. PATIENTS ARE EXPECTED TO CONTRIBUTE TO THE COST OF THEIR CARE BASED ON THEIR ABILITY TO PAY. INDIVIDUALS WITH THE FINANCIAL MEANS TO PURCHASE HEALTH INSURANCE SHALL BE URGED TO DO SO. THIS ASSURES ACCESS TO HEALTH CARE SERVICES AND PROTECTS THEIR ASSETS.CUYUNA REGIONAL MEDICAL CENTER'S PAYMENT AND COLLECTION POLICY STATES:PURPOSE: CRMC HAS ESTABLISHED A STRONG MISSION OF MEETING THE MEDICAL NEEDS OF THE COMMUNITIES IT SERVES. A SOUND PAYMENT AND COLLECTION POLICY IS A FUNDAMENTAL COMPONENT OF THIS MISSION. CRMC WILL MAINTAIN A POLICY OF COMMUNICATING FINANCIAL RESPONSIBILITY TO OUR PATIENTS WITH THE EXPECTATION OF PAYMENT AT TIME OF SERVICE. CRMC WILL ASSIST PATIENTS IN ALIGNING THEM WITH RESOURCES NEEDED TO FACILITATE THE PROMPT PAYMENT OF ANY PATIENT BALANCE. THE POLICY WILL KEEP IN MIND THE PATIENT'S UNIQUE FINANCIAL SITUATION AND PRESERVE THE DIGNITY OF THOSE INVOLVED.RESPONSIBILITY: CFO, DIRECTOR OF FINANCE AND DESIGNATED PERSONNEL ARE RESPONSIBLE FOR THE CREATION, REVISION AND ENFORCEMENT OF THIS POLICY.DEFINITIONS: 1. PATIENT FINANCING OPTIONS: CUYUNA REGIONAL MEDICAL CENTER WILL PROVIDE THE FOLLOWING PAYMENT OPTIONS:A. CASH PAYMENTSI. THE EXPECTATION OF CRMC IS SELF PAY BALANCES WILL BE PAID ON DATE OF SERVICE OR PRIOR TO SERVICE. INQUIRIES INTO PROCEDURE COSTS AND PAYMENT ARRANGEMENTS ARE DIRECTED TO THE DIRECTOR OF FINANCE OR REPRESENTATIVE. SELF PAY BALANCES SHOULD BE PAID WITHIN 15 DAYS OF RECEIPT OF FIRST STATEMENT.B. CREDIT CARDSI. CRMC WILL ACCEPT CREDIT CARD PAYMENTS FOR PATIENT'S SELF-PAY PORTION OF BALANCES. MOST MAJOR CREDIT CARDS ARE ACCEPTED.C. MEDICAID ELIGIBILITY & OTHER FUNDING SOURCESI. THE BUSINESS OFFICE OF CRMC WORKS CLOSELY WITH THE STATE MEDICAID ELIGIBILITY PROGRAM TO ENSURE PATIENTS HAVE ACCESS TO AVAILABLE PROGRAMS. NON-INSURED PATIENTS ARE REFERRED TO THE STATE MEDICAID PROGRAM FOR A PROBABILITY OF ELIGIBILITY ASSESSMENT. APPLICATIONS ARE AVAILABLE FROM THE BUSINESS OFFICE. SERVICE ITEMIZATIONS ARE AVAILABLE UPON REQUEST FOR SUBMISSION TO FLEX ACCOUNTS OR HSA'S.D. UNCOMPENSATED CAREI. APPLICATIONS ARE AVAILABLE FROM THE BUSINESS OFFICE. DOCUMENTATION OF INCOME AND MEDICAID ELIGIBILITY MAY BE REQUIRED. FEDERAL POVERTY GUIDELINES MAY BE UTILIZED IN DETERMINING UNCOMPENSATED CARE REDUCTIONS.2. SELF PAY DISCOUNTS: A. CRMC IN COOPERATION WITH THE MN ATTORNEY GENERAL AGREEMENT HAS AGREED TO INITIATE A DISCOUNT EQUAL TO ITS LARGEST COMMERCIAL PAYER TO ANY PATIENT WITHOUT HEALTH INSURANCE. A PAYMENT IN FULL DISCOUNT MAY BE OFFERED TO PATIENTS WITH A SELF-PAY ACCOUNT BALANCE ABOVE $500 WHEN PAID WITHIN THE FIRST BILLING CYCLE. SERVICES EXCLUDED FROM THESE DISCOUNTS MAY INCLUDE: LONG TERM CARE, HOME CARE SPEND DOWNS, ASSISTED LIVING SERVICES, LIFE LINE, AND OTHER CONTRACTED ANCILLARY SERVICES. 3. COLLECTION OF CO-PAYS, DEDUCTIBLES AND CO-INSURANCE:A. COLLECTION OF CO-PAYS, DEDUCTIBLES, AND CO-INSURANCE MAY BE COLLECTED FROM PATIENTS AT THE TIME OF SERVICE OR PRIOR TO SERVICE WHEN THE BENEFIT LEVELS HAVE BEEN VERIFIED. 4. PAYMENT CONTRACTS:A. PATIENTS THAT CANNOT PAY THEIR BALANCE IN FULL MAY ESTABLISH A PAYMENT CONTRACT. CRMC PROMOTES ACHIEVING PATIENT BALANCES AT ZERO WITHIN 6 MONTHS FROM DATE OF SERVICE. IN THE EVENT THAT EXTENDED ARRANGEMENTS NEED TO BE MADE, CONSULTATION WITH THE DIRECTOR OF FINANCE OR REPRESENTATIVE WILL BE REQUIRED. CRMC WILL ESTABLISH REASONABLE PAYMENT ARRANGEMENTS BUT NO LESS THAN A MINIMAL PAYMENT OF 4% OF PATIENT'S BALANCE OR $20 PER MONTH WHICHEVER IS GREATER FOR A MAXIMUM PAYMENT CONTRACT OF 24 MONTHS PER ACCOUNT BALANCE. CRMC WILL NOT PROMOTE CONSOLIDATING ACCOUNTS AND WILL WORK WITH PATIENTS TO ENSURE UNDERSTANDING OF ACCOUNTS BALANCES DUE.5. BILLING CONCERNS:A. OUR BUSINESS OFFICE IS OPEN MONDAY THROUGH FRIDAY FROM 7:30 AM UNTIL 4:30 PM TO ANSWER ANY BILLING QUESTIONS. PLEASE HAVE YOUR ACCOUNT NUMBER AVAILABLE WHEN REQUESTING ACCOUNT INFORMATION.6. ESTIMATES:A. PROCEDURE ESTIMATES MAY BE OBTAINED BY CONTACTING THE DIRECTOR OF MANAGED CONTRACTS.POLICY STATEMENT: CUYUNA REGIONAL MEDICAL CENTER'S (CRMC) PAYMENT AND COLLECTION POLICY IS THAT PAYMENT IS DUE WHEN SERVICES ARE RENDERED. HOWEVER, AS A COURTESY, CRMC WILL SUBMIT THIRD PARTY CLAIMS FOR OUR PATIENTS. ANY SELF-PAY PORTION IS DUE AT THE TIME OF SERVICE UNLESS PRIOR ARRANGEMENTS HAVE BEEN MADE WITH THE BUSINESS OFFICE. FOR THE PURPOSES OF THIS POLICY, SELF-PAY PORTION IS DEFINED AS CO-PAYMENTS, DEDUCTIBLES, AND NON COVERED SERVICES (IF KNOWN AT THE TIME OF SERVICE.) SELF-PAY PORTION ALSO REFERS TO AMOUNTS OWED BY INDIVIDUALS WITHOUT INSURANCE. PART VI, LINE 2: NEEDS ASSESSMENT:AS A HOSPITAL, CUYUNA REGIONAL MEDICAL CENTER IS CONSTANTLY ASSESSING THE HEALTH OF THE COMMUNITY. A LARGE PART OF ASSESSING THE COMMUNITY'S NEEDS IS A NEWLY-IMPLEMENTED ANNUAL WELLNESS PROCESS. THE GOAL OF CUYUNA REGIONAL MEDICAL CENTER IS TO REDUCE HEALTH RISKS AND PROMOTE OVERALL WELLNESS AMONG EMPLOYEE GROUPS AND INDIVIDUALS IN THE CUYUNA LAKES AND ITS SURROUNDING COMMUNITIES. CRMC EMPHASIZES PREVENTION, SELF-RESPONSIBILITY, SELF-EMPOWERMENT, AND AWARENESS. WE ALSO OFFER CLASSES, SUPPORT GROUPS AND COMMUNITY EVENTS DESIGNED TO EMPOWER INDIVIDUALS WHO WANT TO TAKE AN ACTIVE ROLE IN THEIR OWN HEALTH CARE TO MAKE POSITIVE, HEALTHY, AND LONG-LASTING LIFESTYLE CHANGES. FOR ADDITIONAL INFORMATION ABOUT CRMC'S WELLNESS PROGRAM VISIT THE WEBSITE AT: HTTPS://WWW.CUYUNAMED.ORG/WELLNESS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:WE PROVIDE A COURTESY PHONE CALL AFTER THE FIRST STATEMENT. AT THAT TIME THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED. WE ALSO HAVE FINANCIAL ADVISORS AVAILABLE DURING NORMAL BUSINESS HOURS IN THE FACILITY. WE ALSO MAIL OUT THE FINANCIAL ASSISTANCE POLICY AND APPLICATION PRIOR TO SENDING A PATIENT TO COLLECTIONS. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE THROUGHOUT OUR FACILITIES AND ONLINE AT: HTTPS://WWW.CUYUNAMED.ORG/PATIENT-INFORMATION. PART VI, LINE 4: COMMUNITY INFORMATION:A COMMUNITY-BUILT FACILITY, CUYUNA REGIONAL MEDICAL CENTER SERVES APPROXIMATELY 30,000 PEOPLE IN THE BRAINERD LAKES, AN AREA KNOWN AS MINNESOTA'S VACATION DESTINATION BECAUSE OF ITS BEAUTIFUL LAKES AND WOODLANDS OFFERING A VARIETY OF OUTDOOR RECREATION OPPORTUNITIES. WITH AN AVERAGE DAILY CENSUS OF 18 PATIENTS, CRMC SERVES APPROXIMATELY 1,600 INPATIENTS AND 185,000 OUTPATIENTS ANNUALLY AND HAS NEARLY 10,000 ER VISITS AND ABOUT 200 BIRTHS. THE MAJORITY OF CRMC'S PATIENTS, 65 PERCENT, RESIDE IN BRAINERD, BAXTER, LONGVILLE, AITKIN, ONAMIA AND THEIR SURROUNDING AREAS. ANOTHER 35 PERCENT OF ITS PATIENTS LIVE IN THE HOSPITAL DISTRICT OF BAY LAKE, CROSBY, CUYUNA, DEAN LAKE, DEERFIELD, DEERWOOD, EMILY, FAIRFIELD, FIFTY LAKES, LITTLE PINE, RABBIT LAKE, RIVERTON, TROMMALD, AND WOLFORD. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:CRMC FURTHERS ITS MISSION BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH PROGRAMS AND ACTIVITIES THAT FOSTER HEALTH, HEALING AND WELLNESS. CRMC KNOWS THAT MUCH OF WHAT INFLUENCES HEALTH HAPPENS OUTSIDE OF THE HOSPITAL OR DOCTOR'S OFFICE IN OUR SCHOOLS, WORKPLACES AND NEIGHBORHOODS. JUST AS ITS CARE TEAMS DEVOTE THEMSELVES TO MEETING THE NEEDS OF PATIENTS, CRMC IS DRIVEN TO ADDRESS ITS SPECIFIC COMMUNITY HEALTH NEEDS WITH WELLNESS SCREENINGS, HEALTH EDUCATION, HEALTH FAIRS AND OTHER COMMUNITY OUTREACH. CRMC PRO-ACTIVELY RECRUITS THE PHYSICIANS AND SPECIALISTS NEEDED TO MEET THE COMMUNITY'S HEALTHCARE NEEDS AND WORKS HARD TO RETAIN ITS MEDICAL STAFF. CRMC STRIVES TO KNOW WHAT KIND OF PHYSICIANS ARE GOING TO BE NEEDED AND THEN PLANS AND ALLOCATES RESOURCES ACCORDINGLY. THE ORGANIZATION ALSO ASSESSES THE DEMOGRAPHICS AND PRACTICE PATTERNS OF CURRENT STAFF TO SHOW POTENTIAL RECRUITING CANDIDATES THAT THERE IS A NEED FOR THEIR SERVICES. CRMC IS GOVERNED BY A NINE-MEMBER, NON-PROFIT BOARD OF DIRECTORS CONSISTING OF FOUR LEADERS WHO LIVE IN AREAS GEOGRAPHICALLY REPRESENTATIVE OF CRMC'S SERVICE AREA, TWO DISTRICT BOARD MEMBERS, TWO MEDICAL STAFF AND THE CEO. THE BOARD'S PRIMARY RESPONSIBILITY IS TO ASSURE THE SERVICES PROVIDED BY CRMC MEET COMMUNITY STANDARDS, PROMOTE PATIENT SAFETY AND ENSURE THE HOSPITAL IS PROVIDING THE HIGHEST QUALITY OF HEALTH CARE SERVICES TO THE COMMUNITIES CRMC SERVES. CRMC ALSO HAS AN 18-MEMBER GOVERNING BOARD ELECTED BY RESIDENTS OF ITS COMMUNITIES. MEMBERS OF THIS GROUP ASSURE THAT PAYMENT ON THE OUTSTANDING DEBT AND OTHER OBLIGATIONS OF CRMC ARE SATISFIED. CRMC INVESTS APPROXIMATELY $3 MILLION PER YEAR IN CAPITAL IMPROVEMENTS TO ENSURE ITS STAFF CAN CONTINUE TO PROVIDE COMPASSIONATE, PATIENT-CENTERED CARE UTILIZING THE MOST ADVANCED TREATMENTS AND TECHNOLOGIES AVAILABLE. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:N/A PART VI, LINE 7, REPORTS FILED WITH STATES MN X X X 0 0 0 0 0 0 0 0 0 KYLE BAUER CEO 391206 0 0 0 180 0 13750 0 29721 0 434857 0 0 0 AMY HART COO 245987 0 0 0 516 0 13231 0 20019 0 279753 0 0 0 KATIE BERG CFO 188180 0 0 0 108 0 9935 0 4709 0 202932 0 0 0 JOSHUA HOROWITZ PHYSICIAN 921741 0 0 0 108 0 13750 0 15140 0 950739 0 0 0 FAWN ATCHISON ANESTHESIOLOGIST 652660 0 0 0 180 0 13750 0 15040 0 681630 0 0 0 THOMAS LORENZ PHYSICIAN 434056 0 0 0 1524 0 13750 0 22643 0 471973 0 0 0 LEAH KIPPES ANESTHESIOLOGIST 565103 0 0 0 120 0 13750 0 30198 0 609171 0 0 0 RAJESH BHARGAVA HOSPITALIST 495918 0 0 0 792 0 13750 0 33392 0 543852 0 0 0 CARLA CARLSON SISTER-IN-LAW OF ANDREA BEDARD, DIRECTOR 35868 EMPLOYMENT 0 CHRIS CARLSON BROTHER TO ANDREA BEDARD, DIRECTOR 31534 EMPLOYMENT 0 JODI BEDARD DAUGHTER-IN-LAW OF ANDREA BEDARD, DIRECTOR 51310 EMPLOYMENT 0 FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND CEO WILL REVIEW THE FINAL 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL EMPLOYEES COMPLETE A CONFLICT OF INTEREST FORM. IT'S REVIEWED BY OUR HUMAN RESOURCES, AND ANY CONCERNS ARE BROUGHT TO THE COMPLIANCE OFFICERS AND THE SENIOR LEADERSHIP TEAM. 1. DUTY TO DISCLOSE: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. 2. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS: AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS BY MAJORITY VOTE. 3. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: A. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. B. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY UNANIMOUS VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. 4. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: A. IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. B. IF, AFTER HEARING THE MEMBER'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE DETERMINES THE MEMBER HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. RECORDS OF PRECEDINGS: THE MINUTES OF THE GOVERNING BOARD AND ALL COMMITTEES WITH BOARD DELEGATED POWERS SHALL CONTAIN: 1. THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE GOVERNING BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THE PROCEEDINGS. COMPENSATION: 1. A VOTING MEMBER OF THE GOVERNING BOARD WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE ORGANIZATION FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 2. A VOTING MEMBER OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE ORGANIZATION FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 3. NO VOTING MEMBER OF THE GOVERNING BOARD OR ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE ORGANIZATION, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING COMPENSATION. ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: 1. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, 2. HAS READ AND UNDERSTANDS THE POLICY, 3. HAS AGREED TO COMPLY WITH THE POLICY. PERIODIC REVIEWS: TO ENSURE THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH PUBLIC HOSPITAL DISTRICT REQUIREMENTS, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION AND THE RESULT OF ARM'S LENGTH BARGAINING. 2. WHETHER PARTNERSHIPS, JOINT VENTURES AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE ORGANIZATION'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15A A COMMITTEE MADE UP OF INDEPENDENT BOARD MEMEBERS REVIEWED COMPENSATION AND MARKET DATA TO DETERMINE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND THE FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 13,421,881. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,421,881. OTHER FEES: PROGRAM SERVICE EXPENSES 888,239. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 888,239. OTHER FEES FOR SERVICES (NON-EMPLOYEES): PROGRAM SERVICE EXPENSES 6,400,168. MANAGEMENT AND GENERAL EXPENSES 604,100. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,004,268. LONGVILLE DEVELOPMENT LLC 320 EAST MAIN STREET CROSBY MN 56441 411724637 LEASE REVENUE MN 233239 11555168 CUYUNA REGIONAL MEDICAL CENTER CUYUNA LAKES PHARMACY LLC 320 EAST MAIN STREET CROSBY MN 56441 411999938 RETAIL PHARMACY MN 1706926 403909 CUYUNA REGIONAL MEDICAL CENTER MINNESOTA RADIOLOGY INSTITUTE 320 EAST MAIN STREET CROSBY MN 56441 203803271 RADIOLOGY SERVICE CENTER MN CUYUNA REGIONAL MEDICAL CENTER RELATED 629373 280924 0 0 0.63250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0