2020-05-26T11:58:54-05:00 2019-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-10-01 450226729 St Aloisius Hospital STAL 7013244651 325 Brewster Street East Harvey ND 58341 Michael Zwicker CEO 7013244651 2020-05-20 1 Kim Hunwardsen CPA P00484560 6122536500 2020-05-20 216.147.181.47 2020-05-20 09:28:13 CD P 9EB6867304309B5BA7CF1F8994B8B429DCF961D0 9EB6867304309B5BA7CF1F8994B8B429DCF961D0 2018 2020-09-23 17:36:50Z St Aloisius Medical Center Michael Zwicker 325 Brewster Street East Harvey ND 58341 18348471 0 0928 X www.staloisius.com X 1938 ND Provide healthcare and healing services with special concern for the elderly and poor 7 7 296 33 0 0 49616 52923 15298837 18098405 138242 170943 125625 26200 15612320 18348471 0 0 0 0 9329211 10616095 0 0 0 6468823 7168565 15798034 17784660 -185714 563811 17511498 18365004 8424919 8625971 9086579 9739033 X St. Aloisius Medical Center, inspired by Jesus, in union with the Sisters of Mary of the Presentation, ministers health to all we serve. 1 0 15394575 18098405 CRITICAL ACCESS HOSPITAL DESIGNATIONSt. Aloisius is a 25-bed acute care hospital and 85-bed nursing facility located in Harvey, North Dakota. The Hospital was designated as a Critical Access Hospital in 2002. As a critical access hospital, our role is vital to the health and welfare of the community we serve. The patient and resident days for FY 2019 were as follows: 656 acute days, 1,185 swing-bed days, and 24,148 nursing home days. RESPONDING TO THE NEEDS OF THE POORThe Community Liason has continued assisting with the volunteer programs such as Hospice and Long Term Care. (Continued on Schedule O) The Medical Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The estimated costs of the charges foregone, based upon an overall cost-to-charge ratio calculation, for the years ended September 30, 2019 was $4,000.In addition, the Medical Center provides services to other medically indigent patients under certain government-reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Medical Center also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable.St. Aloisius provides a Senior Living Facility. This consists of 16 apartment units. Two of the one-bedroom apartments are handicap accessible. A noon meal is optional but is served 7 days per week. There is also a 24-hour emergency call system.St. Aloisius Long Term Care is an 85-bed skilled nursing facility licensed by the State of North Dakota. The facility provides occupational, physical and speech therapy and other activities offered 7 days per week. 15394575 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 36 0 1 296 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X Sandra Teubner 7013244651 325 Brewster Street East Harvey ND 58341 Daniel Stutlien Chair 0.50 0.00 X X 0 0 0 Susan Shearer Vice Chair 0.50 0.00 X X 0 0 0 Sr Elizabeth Rose Muscha Director (Until Sept) 0.50 1.30 X 0 0 0 Sr Marlyss Dionne Director 0.50 1.30 X 0 0 0 Chad Ziegler Director 0.50 1.30 X 0 0 0 Jason Schneider Director 0.50 0.00 X 0 0 0 Gordon Schmidt Director 0.50 0.00 X 0 0 0 Sr Debra Berry Director (as of Sept) 0.50 0.00 X 0 0 0 Sr Elaine Lange Secretary non-voting 0.50 0.00 X 0 0 0 Michael Zwicker President/CEO 40.00 0.00 X 0 231191 41632 Sandra Teubner CFO 40.00 0.00 X 0 152563 33097 Kimberly Thorson Nurse Practitioner 40.00 0.00 X 185272 0 5558 Toni Bromley Pharmacist 40.00 0.00 X 112664 0 3380 Rick Geier Physician 40.00 0.00 X 116354 0 0 414290 383754 83667 3 0 1 0 Sisters of Mary of the Presentation Heal 1202 Page Drive SW PO BOX 10007 Fargo ND 581060007 Administrative Fees 794316 Dakota Travel Nurses 1200 Collins Ave Mandan ND 58554 Contracted nursing 334638 CPSI PO Box 850309 Mobile AL 366850309 Maintenance/contract services 280156 CDFP PC 922 Lincoln Ave Harvey ND 58341 ER physician services 189800 Homestead Recruiters 821 Senior Ave Dickinson ND 58601 ER provider coverage 151918 5 26249 26674 52923 Patient service revenue 622110 17733836 17733836 Senior living 623990 105675 105675 Daycare services 624410 54149 54149 204745 204745 18098405 170943 170943 26200 0 26200 26200 26200 18348471 18098405 0 197143 X 8431021 7624489 806532 196501 177703 18798 1397325 1263653 133672 591248 533935 57313 60125 60125 2367631 1425048 942583 29594 29594 477530 342408 135122 428453 427199 1254 91793 48946 42847 9364 9364 405752 384433 21319 1093489 1036035 57454 81755 81755 Medical supplies 744061 744061 Repairs and maintenance 492397 412872 79525 Bad debt expense 486241 486241 Dietary food 352138 352138 48242 44295 3947 17784660 15394575 2390085 0 918787 1078687 1800163 2238805 152457 159861 131742 148558 22568818 14296240 8680079 8272578 5820324 6456033 7946 10482 17511498 18365004 1107219 1267890 1335 1106 7946 10482 7299419 7199493 9000 147000 8424919 8625971 X 9004619 9667992 81960 71041 9086579 9739033 17511498 18365004 X 563811 106681 -18038 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 102501 102501 17488118 10522099 6966019 4671188 3513427 1157761 307011 260714 46297 8272578 SMPHS pooled investment funds 6456033 F 6456033 Estimated third-party payor settlements 147000 147000 X 17970211 106681 -484941 -378260 18348471 0 18348471 17298419 0 17298419 486241 486241 17784660 Part IV, Line 2b: The Medical Center hold funds under an agency relationship for the residents of the nursing facility. Funds held as of September 30, 2019 totaled $10,482. Part X, Line 2: The Medical Center is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Medical Center is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose, if applicable. The Medical Center has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Medical Center believes that it has appropriate support for any tax position taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 175.000000000000 1 1 0 1 1 4000 4000 0.00020 244172 197984 46188 0.00270 248172 197984 50188 0.00290 28 3328 464828 41030 423798 0.02450 1086134 952831 133303 0.00770 93 757 11682 330 11352 0.00070 121 4085 1562644 994191 568453 0.03290 121 4085 1810816 1192175 618641 0.03580 2 152 21101 175 20926 0.00120 2 152 21101 175 20926 0.00120 0 486241 55918 4333788 4413355 -79567 X 1 1 1 1 St Aloisius Medical Center 325 Brewster Street East Harvey ND 58341 www.staloisius.com 5023a X X X X St Aloisius Hospital 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X See Part V, Page 8 X 1 18 1 www.staloisius.com/resources-policies.html 0 1 X 100.000000000000 175.000000000000 X X 1 1 X X X X 1 X www.staloisius.com/resources-policies.html X www.staloisius.com/resources-policies.html X www.staloisius.com/resources-policies.html X X X X X X 1 X 0 X X X X 1 X 0 0 St. Aloisius Hospital Part V, Section B, Line 5: The CHNA addressed the broad interest of the community by identifying a committee that then identified individuals that met recommended criteria and 15 interviews were conducted by UND Rural Health Team. The committee working with the UND Rural Health team consisted of members from the local economic development office, City of Harvey, Ministerial Association, Wells County Social Services, Wells County District Health as well as business and community members. The time period that the CHNA was completed was May 1- through June-30. There was a community meeting with invitations for additional input provided by community members identified to expand the population diversity. Electronic surveys cards were distributed, and 87 surveys were completed in addition to community meetings and individual interviews.The focus group included members from the City of Harvey, the Economic Development Board in Harvey, Public Health, Wells County Social Services and many business and community members. St. Aloisius Hospital Part V, Section B, Line 6b: A Community Health Needs Assessment was performed in the summer of 2019 in collaboration with Wells County District Health to determine the most pressing health needs of Harvey area. St. Aloisius Hospital Part V, Section B, Line 11: A Community Health Needs Assessment ("CHNA") was performed in Summer 2019 in collaboration with Wells County District Health to determine the most pressing health needs of Harvey area. The following needs will be addressed over the next 3 years. Implementation of the needs was not started in the fiscal year due to the timing of when the CHNA was completed.1. Increase the access of mental health and addiction providers within our service area.2. Develop a resilient community and environmental health care approach for the community at large.Mental HealthImplementation of the Community Mental Health services to include counselors for adult mental health and addiction needs.The goals: 1. Phase 1: Both agencies will collaborate on a regular basis with Rural Mental Health (RMHC) FNP-Psych and Village Family services MLSW to increase awareness of services and the full plan for our community's Mental Health and addiction needs.2. Mental Health providers will meet with St. Aloisius Medical Center staff at a minimum of 2 times in the next year.Increase the number of practicing Mental Health primary care providers over a three-year period. (FY19-FY21). The goals: 1. Sustainable program with RMHC is being addressed by RMHC board of directors. St. Aloisius Medical Center currently does not employ Mental Health practitioner but is a board member on RMHC board of directors. St. Aloisius Medical Center is reviewing Telemedicine-Mental Health services.2. The Harvey area Community Cares Coalition has existed for the past 6 years and has developed a strong collaboration with Harvey Public school, City of Harvey, faith communities, St. Aloisius Medical Center, Wells County District Health Unit, Village Family Services, Harvey business, community members, Harvey Police and WC sheriff office. This group will continue to lead the Mental Health concerns of our communities.3. The area Interagency committee meets monthly and will be informed of Mental Health services and plans as developed. Members include the Central Prairie Social Services, HAV-IT, City of Harvey, WCDHU, St. Aloisius, SAAF, Positive Progressions therapy, Options, Harvey Chamber, Alzheimer's Association, RMHC.Community and Environmental Health Attracting and retaining young familiesCreating community Health programStrengthen relationship between school, health services and community leadersKey Objectives: 1. JDA/ City of Harvey and WCDHU with St. Aloisius Medical Center will coordinate on job openings in the community.2. Community Health will be addressed with Governor Burgum's Main Street Initiative that City of Harvey has been nominated to partake in.Implementation Strategies: St Aloisius Medical Center has been developing a Director of Human Resource's position.The goals: Hire a Human Resource Employee. This employee will coordinate with JDA/City of Harvey to coordinate open job positions at St. Aloisius in conjunction with other community workforce openingsScrubs Camp will be developed with Bismarck State College educator. Scrubs Camp curriculum to be provided to area upper elementary students.The Hospital will not address the following health needs identified in the CHNA as part of this Implementation Plan due to limited resources and the need to allocate significant resources to the two priority health needs identified above. Senior population Health concerns1. Cost of long-term care and nursing homesRates are set by the cost report, but St. Aloisius utilizes group purchasing contracts to keep supply costs competitive. 2. Availability of services to assist elderly to remain in their homeSenior Housing apartments are available for tenants to hire their own caregivers in a handicap apartment setting with one meal offered per day.Ensure a safe environment and address the effects of violent crimeBoth the City of Harvey and Wells County Sheriff's Departments have added positions to their departments.Threat concerns:1. Illegal drug useAddressed by the local community police and Wells County Sheriff.2. Child AbuseCommunity Health and Central Prairie Social Services are resources that will address the need. 3. Healthy eating education and health food choices Classes are conducted by Wells County District Health4. Youth alcohol use is being addressed through a grant to the Wells County District Health Unit. St. Aloisius Hospital Part V, Section B, Line 16j: A note is printed on monthly statements providing information regarding financial assistance. The financial assistance policy is provided to self-pay patients upon registration at the Hospital. It is not provided to all patients. The Uncompensated Care & Service Application and information regarding the financial assistance policy is available on our website and available upon request. Part V, Section B, Line 7a, CHNA website: www.staloisius.com/resources-policies.html 3 1 - St Aloisius Long Term Care 325 Brewster Street East Harvey ND 58341 Skilled nursing facility 2 - St Aloisius Senior Housing 325 Brewster Street East Harvey ND 58341 Senior housing units 3 - St Aloisius Medical Center Clinic 317 Brewster Street East Harvey ND 58341 Clinic Part I, Line 6a: The Organization's community benefit report can be found on its website at www.staloisius.com. Part I, Line 7: Charity care expense was converted to cost on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid was calculated using the costing methods to prepare the cost reports. Community health improvement services and cash and in-kind contributions are reported based on actual expenses recorded in the Organization's general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare cost report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $486,241. Part II, Community Building Activities: Our staff participated in community civic groups, boards and committees such as Kiwanis, Knights of Columbus, school board, Harvey Community Library Board, Relay for Life and Community Cares. Part III, Line 2: Before an account is written off to bad debt all discounts and payments are applied, including contractual allowances and discounts. Payments on accounts that were written off as bad debt reduces bad debt expense. Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 3: The estimated amount of the Organization's bad debt expense attributable to patients eligible under the organization's charity care policy is based on 11.5% of individuals living below the federal poverty level. The amount on line 3 is an estimate amount that could reasonably be attributable to patients who likely would have qualified for financial assistance under the charity care program if sufficient information had been obtained to make a determination of their eligibility. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 9 of the attached audited financial statements. Part III, Line 8: St. Aloisius Hospital provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the Medicare shortfall is considered a community benefit.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: Patients that are in the process of applying for charity care or have been approved for charity care will not have collection procedures brought on them. If a patient does not complete the Caring Program application within 120 days the account will follow the same collection procedure as other accounts. Accounts turned over to collections may be eligible for the Caring Program if the patient completes an application and is approved within an additional 120 days. After a determination of charity care, any personal portion due would follow the same collection procedures as other patients. Persons that have been granted bankruptcy by the courts are transferred to the Caring Program and written off as charity care. No collection procedures are pursued. Part VI, Line 2: St. Aloisius addresses needs throughout the community in addition to completing the CHNA. The Hospital employs a marketing/public relations individual that is active with the local schools and provides feedback on needs in the community. A community care program, named "Community Cares Coalition" was formed to address and assist with suicide prevention. The Hospital has other activities to assist families in need throughout the community. Part VI, Line 3: St. Aloisius has a Revenue Cycle Manager, RCM, who works in conjunction with the business office staff on reviewing patient accounts both with insurance and those who are self-pay. Our monthly billing statements include information regarding financial assistance. The financial assistance policy is provided to self-pay patients upon registration at the Hospital and Clinic. It is not provided to all patients. The application for Uncompensated Care and Services and information regarding the financial assistance policy is available on our website and available upon request.The hospital nurses ask the patient if they have any financial concerns about their hospital stay and if they do, the nurse calls the RCM or CFO to notify them that the patient has financial questions. The RCM or CFO will then follow up with the patient about their concerns. Part VI, Line 4: St. Aloisius Medical Center is a non-profit Critical Access Hospital located in central North Dakota. We serve more than 15 rural communities including Harvey where we are located. Our area of service is approximately 90 miles in diameter. Local doctors have clinics in Harvey, Fessenden (17 miles away) and Drake (23 miles away). In 2019, 32% of adults in Wells County were considered obese compared to 32% in North Dakota and 26% nationally. This is a decrease from 2017 of 33.2% in North Dakota. Adult smokers by percent of population in Wells County is 14% compared to 20% in North Dakota and 14% in the US. Excessive drinking was 20% in Wells County, 26% in North Dakota and 13% in the US. Injury Deaths were more prevalent in Wells County (77 deaths per 100,000 residents) than in the state overall (69 per 100,000 residents) and the top 10% of US Counties (57 per 100,000 residents). In Wells County, 50% of households have one or more seniors (60 and older). Unemployment in North Dakota in 2018 was 2.6%. The estimated median household income in Wells County for 2018 was $58,261. The estimated median household income was $61,843. Also, 11.5% of residents had income below the poverty level.Services offered include acute care, swing bed, surgery, clinic, senior housing and long-term care services. Our average acute/swing bed daily census is 5.8 patients. Our average clinic visits per month in FY19 was 574. Long term care average daily census was 72.4. St. Aloisius Medical Center has provided services in Harvey since 1938 with the Sisters of Mary of the Presentation Health System. With a special mission to serve the poor, the Sisters' have offered healing hospitality to all who come to us for care.The closest critical access hospitals are Heart of America Medical Center located in Rugby, ND approximately 42 miles away and Carrington Health Center located in Carrington, ND approximately 54 miles away. Part VI, Line 5: The Organization's governing body is composed of representatives from Harvey and surrounding local communities in addition to representatives from the Sisters of Mary of the Presentation. The group is diverse, as it includes lay people, religious representatives and business men and women. This diversity represents the rural population we serve. Five Board Members are from the city of Harvey and the other two Board Members reside outside of Harvey.This facility extends medical staff privileges to those qualified practitioners based on an established credentialing process. We are not a research facility. Any excess funds are reinvested into funded depreciation for future capital projects for the facility. As a critical access facility, there have not been many years with excess funds, but when there is, the facility has made improvements in building infrastructure to increase quality and efficiency for our patients and residents we serve. We have hired additional staff in our therapy department and sent them to educational training to expand service offerings to patients such as dry needling this past year and lymphedema treatments in FY20. We are also currently training a radiology technologist into Ultrasound so that we will employ our own ultrasound technician rather than paying a contract vendor.St. Aloisius Medical Center is very supportive of community organizations. The following are examples of services St. Aloisius has provided to the community at large for a total of $456,076.1. The facility has a 24/7 emergency room available to patients regardless of ability to pay.2. Sponsored weekly radio spots where health issues are addressed3. 24/7 Pastoral Care services.4. Provided our exercise/fitness area for the community in our cardiac rehab center. This year there were 213 people who used the wellness center visits for 2,069 encounters.5. Provided lab services to 940 patients during our spring and fall Wellness Days.6. Provided Natural Family Planning services to the community with four couples participating this past year.7. Our Diabetic Educator hosted DEEP classes on diabetic education with 15 participants as well as counseled 39 acute and swing bed patients.8. With our new Cardiac Ready Community Project, we conducted blood pressure screenings for 1,378 patients, where six were referred to their providers for further follow up. We also trained 407 community members on hands only CPR.9. We provided sports physicals to 49 area athletes and their payments for the physicals of $980 was donated to Wells County Booster club.10. Provided Suicide prevention education to the schools in the county and worked with the Community Cares on suicide prevention events.11. Provided donations to local school projects and other community groups, memorial services, child protection referrals.12. Presented bi-weekly "Did You Know" health information in the local newspaper. 13. Provided office space (in kind) for Hearing Aid Services and Rural Mental Health consortium staff/clients in our outpatient services building. There were 152 people served with 428 encounters by the Rural Mental Health staff.14. Provided cable television, internet and phone to our patients and residents which is non-reimbursable on our cost report.15. Provided the use of the Presentation Center for meetings/celebrations.16. Sent outdated supplies to local missionaries for distribution in the Philippines. Part VI, Line 6: We are an affiliate of the Sisters of Mary of the Presentation Health Corporation. St. Aloisius Medical Center operates in accordance with the mission, vision, and values of the Sisters of Mary of the Presentation Health Corporation. Our annual budgeting process includes an assessment of how our budget demonstrates a commitment to the values of the system and the system works to ensure we are always mindful of our duty to care for the poor and those in need. St. Aloisius Medical Center has a Strategic Plan developed from themes set forth by the health system for all affiliates. The strategic plan is an active document which St. Aloisius Medical Center works on continuously and reports back to the health system on our progress toward established goals which again, align with the mission, vision, and values of the organization. We met in December 2019 to establish a new three-year plan, as our previous plan was completed in less than three years (about 2 years). 0 0 0 0 0 0 0 0 0 Michael Zwicker President/CEO 0 199875 0 25220 0 6096 0 16271 0 28313 0 275775 0 0 Sandra Teubner CFO 0 137085 0 13060 0 2418 0 7735 0 27283 0 187581 0 0 Kimberly Thorson Nurse Practitioner 185272 0 0 0 0 0 5558 0 330 0 191160 0 0 0 Schedule J, Part I, Question 3: St. Aloisius Medical Center does not pay compensation to the CEO. This individual is compensated by Sisters of Mary of the Presentation Health System, a related organization, for services at the Hospital. Sisters of Mary of the Presentation Health System uses one or more of the methods on Part I, question 3 to determine compensation. Form 990, Part III, line 2 A Free Standing Physician clinic began operations 8/6/2018. Form 990, Part VI, Section A, line 2 Mark Zwicker and Sandra Teubner have a business relationship. Form 990, Part VI, Section A, line 6 The sole member of the Organization is the Sisters of Mary of the Presentation Health System. Form 990, Part VI, Section A, line 7a The member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The member is also entitled to one vote on every other matter to be voted on by the member. Votes cast on behalf of the member are cast by the Chief Executive Officer of Sisters of Mary of the Presentation Health System. Form 990, Part VI, Section A, line 7b The authority to act on the following matters are exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer. Form 990, Part VI, Section A, line 8b The Organization does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing Board before it is filed. The Organization's CEO and CFO review the 990. Form 990, Part VI, Section B, line 12c Each Director must submit in writing to the Chairperson of the Board and the Chief Executive Officer a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chairperson of the Board reviews the statements of the Directors and the Vice Chairperson of the Board reviews the statement filed by the Chairperson. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chairperson of the Board has authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chairperson, the Vice Chairperson has authority to require the Chairperson remove himself in the same matter. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he will not participate in the deliberations or vote on it. Form 990, Part VI, Section B, line 15 The Organization's CEO and CFO are both compensated by Sisters of Mary of the Presentation Health System, a related organization. The compensation process is determined by the related organization. The Sisters of Mary of the Presentation Health System Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. The Sisters of Mary of the Presentation Health System Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990. Form 990, Part IX, line 11g Purchased services: Program service expenses 1,038,968. Management and general expenses 58,905. Fundraising expenses 0. Total expenses 1,097,873. Professional fees: Program service expenses 386,080. Management and general expenses 883,678. Fundraising expenses 0. Total expenses 1,269,758. Form 990, Part XI, line 9: Equity transfer to related party -18,038. Form 990, Part XII, Line 2C: The governing Board of Sisters of Mary of the Presentation Health System assumes responsibility for oversight of the audit for St. Aloisius Hospital. Sisters of Mary of the Presentation Health System 1202 Page Drive SW Fargo ND 58103 450359620 Facilitates management and operations of ten related facilities ND 501(c)(3) Line 12b, II SMP Health Ministry 0 Presentation Medical Center 213 2nd Avenue NE Rolla ND 583670759 450227391 Provision of health care services ND 501(c)(3) Line 3 SMP Health System 0 St Margaret's Hospital 600 East First Street Spring Valley IL 61362 362167884 Provision of health care services IL 501(c)(3) Line 3 SMP Health System 0 St Andrew's Hospital 316 Ohmer Street Bottineau ND 58318 450226426 Provision of health care services ND 501(c)(3) Line 3 SMP Health System 0 Sisters of Mary of the Presentation Long Term Care 1202 Page Drive SW Fargo ND 581060007 752999939 Provide extended care and medically related services ND 501(c)(3) Line 11 SMP Health System 0 St Andrew's Hospital Foundation 316 Ohmer Street Bottineau ND 58318 450413201 Assist St. Andrew's Hospital in fund raising and fund management ND 501(c)(3) Line 12b, II SMP Health System 0 Prairieland Home Care 1102 Page Drive SW Fargo ND 581060007 450391192 Home health and supportive services ND 501(c)(3) Line 11 SMP Health System 0 St Margaret's Hospital Foundation 600 East First Street Spring Valley IL 61362 364042262 Provide support to St. Margaret's Hospital IL 501(c)(3) Line 12b, II SMP Health System 0 St Andrew's Bottineau Clinic LLC 316 Ohmer Street Bottineau ND 58318 450451306 Provision of health care services ND N/A Valley Regional Health Services L3C 4391 Venture Drive Peru IL 613541014 273891281 Outpatient oncology services IL N/A SMP Enterprises PO Box 10007 Fargo ND 581060007 363486506 Collection Agency ND N/A C 0 SMP Enterprises - IL 600 East 1st Street Spring Valley IL 61362 363456566 Healthcare Management IL N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 0