2020-07-30T11:43:02-05:00 2019-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-10-01 411804205 LifeCare Medical Center LIFE 2184632500 715 Delmore Drive Roseau MN 56751 Keith Okeson CEO/President 2184632500 2020-07-29 1 Kim Hunwardsen CPA P00484560 6122536500 2020-07-29 216.147.181.49 2020-07-29 09:57:59 CD P 5755687E6BF8D8D10BDE3B83E6631EF3D64C584D 5755687E6BF8D8D10BDE3B83E6631EF3D64C584D 2018 2020-09-23 17:36:50Z Keith Okeson 715 Delmore Drive Roseau MN 56751 54865415 0 X www.lifecaremedicalcenter.org X 1995 MN Promotion of Health 12 12 545 280 0 0 226702 918302 49965095 52305147 297671 566648 88496 102738 50577964 53892835 46558 41949 0 0 26427231 28243519 0 0 0 18507759 20629648 44981548 48915116 5596416 4977719 78693045 80886889 9236142 6462552 69456903 74424337 X To provide care for a healthy life. 0 0 41056383 41949 52305147 LifeCare Medical Center operates a 25-bed critical access hospital, including a 50-bed nursing facility, home health, hospice, and public health in Roseau, Minnesota. The organization also operates a 40-bed nursing home and 12 apartments of assisted living in Greenbush, Minnesota. The purpose of the organization is to own, maintain, and operate a hospital, nursing homes, furnish medical and surgical care to the sick, infirmed, or injured.Acute Care Hospital (Inpatient and Outpatient)Inpatient days: 1,509Outpatient visits: 44,209Long Term CareLifeCare Roseau Manor Resident Days: 17,000LifeCare Greenbush Manor Resident Days: 13,771Home Health/Public Health Visits: 6,921Hospice Clients Served: 25To fulfill its mission of community service, LifeCare 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. The amount of charges foregone, based on established rates, was $144,235 for the year ended September 30, 2019.LifeCare Medical Center was selected by The National Rural Health Association's Rural Health Policy Institute, iVantage Health Analytics and The Chartis Center for Rural Health as one of the top 100 Critical Access Hospitals in the country based on quality, customer surveys, and financial indicators. We are very proud of our staff in being selected in 2018 and again in 2020 for this honor. 41056383 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 68 0 1 545 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Cathy Huss 2184634763 715 Delmore Drive Roseau MN 56751 Corwin Vatnsdal Chair 1.00 X X 2700 0 0 Brenda Sather Vice Chair 1.00 X X 1400 0 0 Mark Wilson Secretary 1.00 X X 1700 0 0 Therese McBride Treasurer 1.00 X X 1100 0 0 Ralph Herseth MD Trustee 1.00 X 1400 0 0 Chuck Lindner Trustee 1.00 X 1900 0 0 Shayne Isane Trustee 1.00 X 700 0 0 Matthew Ulwelling Trustee 1.00 X 700 0 0 Beth Johnson Trustee 1.00 X 1200 0 0 Jessica Foss Trustee 1.00 X 1200 0 0 Dan Urness Trustee 1.00 X 1100 0 0 Mark Karl Trustee 1.00 X 1100 0 0 Keith Okeson CEO/President 40.00 X 353376 0 46552 Cathy Huss CFO 40.00 X 239273 0 26344 Gordon Streiff Pharmacy Director 40.00 X 170558 0 39712 Susan Lisell Senior Leader 40.00 X 200965 0 18285 Shannon D Carlson Senior Leader 40.00 X 169145 0 25240 Judy K Mattson Pharmacist 40.00 X 134813 0 27245 Kevin L Schumacher - Informa tion Systems Director 40.00 X 130414 0 26261 1414744 0 209639 24 0 1 0 Comstock Construction Inc 1003 Progress Drive Fergus Falls MN 56538 Commerical Construction 2344620 WAPITI Media Group Limited 107 Flynn Drive Milbank SD 57252 Locum Physician Tenens 1655615 Central Minnesota Diagnostic 150 10th St NW Milaca MN 56353 Imaging Services 649014 Shared Medical Technology 2020 W Newton St Rice Lake WI 54868 Echo Cardio Services 361377 IDEAcomCMA 30 W Water St St Paul MN 55107 Communication Equip/Tech 216822 14 787660 130642 918302 Net Patient Service Revenue 622110 51491840 51491840 Other Revenue 621500 813307 813307 52305147 580391 580391 402804 300066 102738 102738 102738 658771 672514 -13743 -13743 -13743 53892835 52305147 0 669386 X 33699 33699 8250 8250 760687 760687 21059876 17899182 3160694 778931 676635 102296 4107325 3417627 689698 1536700 1265494 271206 43171 43171 81830 81830 5042540 4579002 463538 132346 132346 1631727 898850 732877 915648 876736 38912 355430 301613 53817 63635 15285 48350 141223 141223 2948128 2651726 296402 163231 163231 Medical Supplies 5272937 5272937 Bad Debt Expense 1343766 1343766 Surcharge Fees 595022 595022 MN Care Tax 448974 448974 1450040 630362 819678 48915116 41056383 7858733 0 9022765 10082148 7771613 7263723 1185606 1417368 255280 190362 59177838 33179104 27046865 25998734 32973207 35492674 437709 441880 78693045 80886889 5341083 5801964 2814310 0 273576 270803 807173 389785 9236142 6462552 X 69456903 74424337 69456903 74424337 78693045 80886889 4977719 -10285 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 7740 7740 42506897 21857822 20649075 15224463 10808681 4415782 1438738 512601 926137 25998734 Estimated Third Party Payor Settlements 389785 389785 X 52805151 -10285 -1377465 -1387750 54192901 -300066 -300066 53892835 47837717 300066 300066 47537651 1377465 1377465 48915116 Part IV, Line 2b: The Medical Center acts as custodian for the funds of the residents, holds resident security deposits, and holds employee voluntary withholdings. Funds for residents and others totaled $270,803 and $273,576 at September 30, 2019 and 2018. Part X, Line 2: The Medical Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The 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. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Recorded in Expenses on Form 990 -1,343,766. Grant Expense Recorded in Revenue for Financial Statements -33,699. Part XI, Line 4b - Other Adjustments: Rental Expense Recorded in Expense for Financial Statements -300,066. Part XII, Line 2d - Other Adjustments: Rental Expense Recorded in Revenue on Form 990 300,066. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Recorded in Revenue for Financial Statements 1,343,766. Grant Expense Recorded in Revenue for Financial Statements 33,699. 1 1 X 1 X 1 X 1 1 0 1 1 89000 89000 0.00190 8095774 7571863 523911 0.01100 8184774 7571863 612911 0.01290 436645 7455 429190 0.00900 118416 118416 0.00250 7024340 5203777 1820563 0.03830 84947 84947 0.00180 7664348 5211232 2453116 0.05160 15849122 12783095 3066027 0.06450 5277 5277 0.00010 60414 850 59564 0.00130 8600 8600 0.00020 15511 15511 0.00030 359491 134120 225371 0.00470 265107 265107 0.00560 714400 134970 579430 0.01220 0 1343766 5213 10139002 10205012 -66010 X 1 1 1 1 LifeCare Medical Center 715 Delmore Drive Roseau MN 56751 www.lifecaremedicalcenter.org 00579 X X X X X Urgent Care LifeCare Medical Center 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X www.lifecaremedicalcenter.org/about-us X 1 18 1 www.lifecaremedicalcenter.org/about-us 0 1 X 200.000000000000 250.000000000000 X X 1 1 X X X X 1 X https://lifecaremedicalcenter.org/financialassist/ X https://lifecaremedicalcenter.org/financialassist/ X https://lifecaremedicalcenter.org/financialassist/ X X X X X X 1 X 0 X X X X 1 X 0 0 LifeCare Medical Center Part V, Section B, Line 5: LifeCare Community Relations and LifeCare Public Health collected community input on the health needs of Roseau County through a series of meetings with targeted individuals and groups, which represented all age and geographic levels of our service area. There were 22 meetings in total, which occurred between January 2019 and April 2019. These meetings included the 3 largest employers in our service area: Marvin Windows & Doors, Central Boiler & Polaris. Meetings also included the following: Warroad, Roseau, Badger & Greenbush schools, Roseau & Greenbush Women of Today groups, 7 Clans Casino, Warroad & Roseau Chamber of Commerce, Altru Advanced Practice Providers, Roseau County Court, Sheriff's Dept, County Board, County Attorney, Roseau County Jail, Roseau Police Department, Roseau Ministerial Association, LifeCare HomeCare & Hospice team, LifeCare EMS/ED and LifeCare HealthCare Fund Advisory Committee. In addition, those who serve low-income and minority populations were represented by Roseau County Social Services, LifeCare Public Health, Northwest Community Action and HeadStart.The responses from the individual meetings were then compiled into a comprehensive list of community health needs for LifeCare Medical Center's service area. A survey was developed using the top health needs identified by five or more of the groups interviewed. This survey was distributed to community groups representing different areas and populations of Roseau County. They were asked to circle, not rank, the top 5 needs from the survey. The groups included: o Team EPIC - has members representing 12 sectors of the community including education, law enforcement, health care, social services, city and county officials o Northwest Community Action - Head Start, assistance programs, and other community development and outreach programs for low income families o LifeCare Board of Directors o LifeCare Department Directorso Altru Medical Staff LifeCare Medical Center Part V, Section B, Line 6b: We partnered with Roseau County Public Health, a department of LifeCare Medical Center. LifeCare Medical Center Part V, Section B, Line 11: LifeCare Medical Center's response to Community Health Needs identified in the most recent Community Health Needs Assessment for the most current tax period is as follows. Mental Health - An Integrative Behavioral Health Committee meets throughout the year to address community mental health issues, raise awareness, and reduce stigma. * Radio interviews with LifeCare staff were done during May which is also Mental Health awareness month. The following topics were covered: Stress Reduction, Local Resources, Crisis Response, and Ag related stress/resources. The radio interviews were also linked on our social media pages.* Newspaper article was written with the same topics that were covered in the radio interviews and published in the local papers.* A television commercial is being developed with the goal of reducing mental health stigma. - LifeCare continues to be involved with a Community Care Team which focuses on the transition process for people coming out of jail. The plan includes having a mental health worker and public health nurse going into the jail.- Mental Health First Aid training for the Ag Community was held. This was presented by Tim Denney, Level 5 Services.- 2 mental health trainings called "ASK, LISTEN, HELP" were developed and planned for healthcare providers and nursing staff for March 2020 to help them understand the phenomenon of suicide, including risk factors and warning signs. Tim Denney will be contracted to present these trainings in the future.- LifeCare is planning to host an Adolescent Mental Health First Aid training in fiscal year 2020. - LifeCare hosted a free community speaker event featuring Mark Scharenbroich, a top-rated keynote speaker in America. His message, "NICE BIKE-The Power of Making Connections", was heard by approximately 700 people in our service area. Planning to host another community speaker event in September 2020.- LifeCare participates in the H.O.P.E. Coalition, a group of individuals and organizations committed to ending death by suicide in Northwest Minnesota through Help, Outreach, Prevention and Education. Our Director of Behavioral Health is involved in the Post-Vention training and education development for our region.Obesity/Healthy Eating/Physical Activity- LifeCare continues to offer 24-hour on-site wellness centers in Roseau, Warroad and Greenbush.- Utilized our social media and blog posts for communicating online options and education on healthy living. - An online wellness program, Wellbeats, is being offered to LifeCare employees. Wellbeats offers a variety of exercise classes, nutrition information and mental health education.- Trained staff are available for health fairs at local employers and community events to provide nutrition and exercise related topics.- Matter of Balance classes are available in each community to encourage better balance and enable older adults to remain active. - Tai Ji Quan exercise classes to help older adults increase mobility and decrease falls were offered. - LifeCare continues to partner with the Roseau Diabetes Center to provide the "I Can Prevent Diabetes" class.- LifeCare continues to look for grants available to not-for-profit organizations and also consider grant applications to the LifeCare Health Care Fund that focus on ways to keep families active. We support projects with area partners like fitness equipment in the park, splash parks and others. - The Annual Walk/Run event and Health Fair in partnership with the Diabetes Center.- Two staff members are currently certified through Wellcoaches as Health & Wellness Coaches.- Registered Dietician is available through Rehab services for Nutrition Consultations.- Continue to partner with area schools to add fresh fruit into the backpacks that are provided to some students so that they will have food to eat during the weekends. -LifeCare is working with the City of Roseau Parks & Rec Dept on signage for the walking paths that were part of the Walkable Communities Workshop grant.-LifeCare continues to participate on the Roseau County Workplace Wellness collaborative to educate and network with other worksites in the surrounding communities.-Plans are in place to offer S.A.I.L. (Stay Active and Independent for Life) at LifeCare.-Self Defense training was held for the community.Tobacco Use/Vaping/Drug Use/Alcohol Use-Reduce the use of nicotine products through the following activities:* Public Health planned to conduct educational checks at all businesses selling tobacco in Roseau County by June 2020.* Public Health received a "Clear the Air" mini grant to look into current school policies surrounding alternatives to youth school suspension or citations as a result of tobacco/nicotine use. * MOU signed with the American Lung Association to be a pilot program for the N.O.T. (Not on Tobacco) Program for fall 2020 at the Roseau School.* Freedom From Smoking classes continue to be offered at Marvin Windows in Warroad. -Prevention of the use of nicotine products, especially amongst youth is being addressed through the following:* We continue to work with Roseau County on a 5-year Drug-Free Communities grant that was awarded by the US Department of Health and Human Services. LifeCare continues to work with community partners and the youth of Roseau County to decrease the use of alcohol, tobacco, and drugs through the TEAM EPIC program which has become successful throughout Roseau County. The youth groups created through the grant, work to create positive role models in youth and adults and other prevention efforts.* Nicotine education has been integrated into annual education provided to 2nd grade and 5th grade students.-Increased education on current drug issues and prevention is being addressed through the following:* LifeCare has designated employees that attend and participate in the Opioid Task Force meetings coordinated by Rachel Pearce, N.P. at Altru.* Drug Take Back Events were held in Warroad, Roseau, and Greenbush. Plans are being made to make this an annual event.-Prevention of youth alcohol use and decrease of binge drinking will be addressed by:* Working with Team EPIC to offer Responsible Beverage Server Training annually to establishments with a liquor license in Roseau County.* LifeCare continues to provide meeting space for AA meetings.* LifeCare has a Licensed addiction counselor on staff. LifeCare Medical Center Part V, Section B, Line 16j: In addition to providing the full policy upon request, the Hospital also summarizes the policy on its website, billing invoices, as well as brochures summarizing the policy in the emergency rooms and admissions office. 3 1 - LifeCare Roseau Manor 715 Delmore Drive Roseau MN 56751 Skilled Nursing Facility 2 - LifeCare Greenbush Manor 19120 290th Street Greenbush MN 56726 Skilled Nursing Facility and Assisted Living Facility 3 - LifeCare Home Care and Hospice 715 Delmore Drive Roseau MN 56751 Home Health and Hospice Part I, Line 7: Charity care was converted to cost by multiplying the ratio of cost to gross charges by the gross uncompensated charges associated with providing charity care to its patients. Community health improvements and cash and in-kind contributions are calculated at actual costs recorded in the general ledger. Education costs are based on estimated time and wages to manage students and interns at the facilities. Subsidized health services and Medicaid are converted to cost according to costs allocated to the relevant cost centers on 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 $1,343,766. Part II, Community Building Activities: Community support includes donations to local community organizations and employee staff time donated to local community committees, as well as employee staff time spent on disaster preparedness beyond legal requirements.Coalition building includes EMT and CPR training for area First Responders and Fire Departments, as well as time donated to the Roseau Area Diabetes Center.Community health improvement advocacy includes staff time on healthcare related boards that advocate for healthcare, as well as time spent on discussions on proper prescription drug disposals, med alerts, chronic disease management, time spent in local correctional facilities on prescription drug abuse and on the Roseau County Committee on Aging. By being involved in the community through the above activities, we are able to increase health awareness.Roseau County is considered a Health Professional Shortage Area and therefore is including the costs of recruitment in workforce development. This promotes better care for our patients. The costs include physician recruitment, career fairs and workforce development committees. Part III, Line 2: Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Part III, Line 3: The estimated amount of bad debt expense attributable to patients eligible under the organization's charity care policy is calculated by using gross charity care at charges as a percentage of total gross hospital revenue. It is reasonable to assume that charity care as a percentage of gross revenue can also be applied to bad debt. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expense can be found on page eight and nine of the audited financial statement. Part III, Line 8: Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. 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.Medicare allowable costs of care are based on 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: If a patient is known to qualify for financial assistance, or if the patient begins the financial assistance process, all collection actions cease until the application is completed. Part VI, Line 2: LifeCare Medical Center provides the Public Health functions for Roseau County. Part VI, Line 3: We have financial counselors who have phone conversations with patients during our collections process. We guide patients to other financial programs as well as our own charity care program. Brochures are available in the admitting area which is in the same location as the Emergency Room. Information is also sent to our patients via patient bills. Our website has the charity care application and brochure, as well as the contact information for our financial counselors, available to patients. Part VI, Line 4: Roseau County is a rural area with a population of approximately 17,000 people. We are the sole hospital located in Roseau County and the nearest tertiary hospital is two hours away. We are a federally-designated medically underserved area. In 2009, approximately 12.7% of the population was age 65 or older. The average per capita income is 23,061 and approximately 9.7% of the population is below the federal poverty level. Part VI, Line 5: The organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay.As a not-for-profit organization LifeCare Medical Center has made a promise to give back to its community. As a regional healthcare leader, LifeCare strives to respond to healthcare needs by partnering with local leaders, educators, government officials and others.The community benefit report summarizes how this leadership role has made a difference to the people of the area. Included are highlights describing how LifeCare has played an integral role in enhancing the health and overall well-being of the community.Trusted PartnershipsLifeCare's commitment to quality care extends beyond its walls and into the community where strong partnerships have been built to maintain and improve the health and overall well-being of its neighbors. LifeCare EMS personnel are proud of their trusted relationships with regional emergency response groups. Area fire fighters, police, and others participate in disaster training sessions where a disaster is staged and responded to as if it were a real life situation. This type of training helps prepare all groups involved.Education for a Healthy FuturePart of LifeCare's mission is to help educate the next generation of health care professionals. LifeCare Directors work closely with many regional high school and post-secondary educational facilities to bring students into our organization through job shadowing, internships, rural scholar and other programs. Through these programs, students get a firsthand look at specific health care careers as they learn from our staff for a day, week, month or several months based on their program. Students often times focus on rural healthcare employment opportunities that may be available to them once they have completed their education.Charity CareLifeCare recognizes that circumstances arise where a patient is simply unable to pay a hospital bill. In these situations, LifeCare offers a program called Charity Care, in which LifeCare forgives the bills of deserving families and individuals who meet set income guidelines. Great appreciation has been voiced by many who received a helping hand from this program. In fiscal year 2019, LifeCare granted over $144,000 in Charity Care based on charges foregone.A Healthy Awareness and Community OutreachLifeCare employees know the importance of educating the public about a healthy lifestyle. And sometimes the best way to provide awareness is to venture outside the facility. That's why LifeCare is involved with many initiatives throughout our communities. By reaching out to the public through nutrition and exercise programs, civic projects, health and safety awareness, health fairs, and other methods, they are able to educate and strengthen the community.Fifth grade tours have become a favorite for students throughout Roseau County. A hospital tour is coupled with a mini health fair where students learn their blood type. The goal of this program is to influence young students into making healthy lifestyle decisions, in addition to introducing them to careers in healthcare.Funding Essential ServicesLifeCare's commitment to community needs is exemplified by its contribution to subsidized services. In fiscal year 2019, LifeCare absorbed over $2,150,000 in costs in order to sustain services that rely on funding from other sources, in particular the Medicaid program. These departments include home health care, hospice, public health, ambulance clinic space, behavioral health, OB, and the two nursing homes.LifeCare Medical Center distributed over $3.7 million based on cost in Community Benefits in fiscal year 2019 as reported on Schedule H Part I, II and III. Part VI, Line 7, Reports Filed With States MN 1 Roseau County 606 5th Ave SW Roseau MN 56751 416005889 Roseau County 32699 Valley Med Flight: pay for half of the expense to cover all costs not paid by insurance for each person that lives in Roseau County that needs to take a flight to another hospital. Roseau Fire Department 604 5th Avenue Roseau MN 56751 416005499 City of Roseau 1000 General Support 2 0 Scholarships 7 8250 Part I, Line 2: The Medical Center does not specifically monitor the use of funds once the funds are provided to the individual or entity. They provide funds to Roseau based on their application for grants. The Organization provides scholarships to both high school students and students currently enrolled in a higher education program. The student must be pursuing a health care related field. If the recipient is a high school student the Organization pays the scholarships directly to the college or university they are attending. If the recipient is currently attending college they will pay the funds to the recipient or the college. X X X 0 0 0 0 0 0 0 0 0 Keith Okeson CEO/President 323586 0 27978 0 1812 0 11000 0 36480 0 400856 0 0 0 Cathy Huss CFO 224916 0 12545 0 1812 0 9135 0 18136 0 266544 0 0 0 Gordon Streiff Pharmacy Director 166677 0 1685 0 2196 0 7067 0 33541 0 211166 0 0 0 Susan Lisell Senior Leader 194367 0 2317 0 4281 0 7863 0 11323 0 220151 0 0 0 Shannon D Carlson Senior Leader 165613 0 2100 0 1432 0 6812 0 19317 0 195274 0 0 0 Judy K Mattson Pharmacist 133185 0 190 0 1438 0 5743 0 22113 0 162669 0 0 0 Kevin L Schumacher - Informa tion Systems Director 127596 0 1600 0 1218 0 5416 0 21675 0 157505 0 0 0 Form 990, Part VI, Section A, line 1 The Executive Committee consists of the Chair, Vice-Chair, Treasurer, Secretary, and at least one other director (who shall be selected annually.) The President/CEO will be a non-voting member of the committee. The President/CEO will be excused for matters relating to compensation and evaluation. The Executive Committee shall meet as often as necessary at the call of the Chair, Vice-Chair, or at the request of any two of its members. A majority of the Executive Committee shall constitute a quorum. The Executive Committee's specific responsibilities are to: * Exercise the authority of the board in the management of the business of the corporation between regularly scheduled meetings. * Report to the board any official actions it has taken at the next board meeting. * Review and approve the compensation program for the senior leaders of the organization that is designed to allow the organization to recruit and retain superior talent. * Responsible for conducting on an annual basis the process of establishing goals, evaluating the performance and establishing the compensation of the President/CEO. Form 990, Part VI, Section B, line 11b The return is reviewed initially by the CFO. The return is made available to the Board of Trustees before it is filed. Form 990, Part VI, Section B, line 12c All officers, trustees, and key employees are required to complete a conflict of interest form annually. The form is reviewed by the Board of Trustees to determine if any conflicts exist. If there are any conflicts, the Board of Trustees will discuss the restrictions that should be placed on the person with the conflict. Restrictions are typically related to voting and discussion of matters related to the conflict. Form 990, Part VI, Section B, line 15 The compensation for the CEO and CFO is approved by the Executive Committee based on comparability data. The CEO and CFO both have employment contracts. The deliberation and discussion of compensation is documented in the board meeting minutes. This process takes place on an annual basis. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part IX, line 11g Physician Fees: Program service expenses 1,893,366. Management and general expenses 18,500. Fundraising expenses 0. Total expenses 1,911,866. Service Related Fees: Program service expenses 2,432,157. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,432,157. Other Professional Fees: Program service expenses 253,479. Management and general expenses 445,038. Fundraising expenses 0. Total expenses 698,517.