2020-04-28T14:16:48-05:00 2019-06-30 450250958 EIDE BAILLY LLP 200 E 10TH ST STE 500 SIOUX FALLS SD 571046375 990 2018-07-01 460228038 MADISON COMMUNITY HOSPITAL MADI 6052566551 323 SW 10TH ST MADISON SD 57042 TAMARA MILLER CEO 6052566551 2020-04-27 1 LAURIE HANSON P00851848 6053391999 2020-04-27 67.130.171.59 2020-04-27 10:12:56 CD P C5ADF3E96DC5FD5E5884512D59AB882B10EDFEC1 F7BA031C655DF5D2BE7843B8A6CBF62E51E7FB61 2018 2020-11-19 02:30:22Z MADISON REGIONAL HEALTH SYSTEM TAMARA MILLER 323 SW 10TH ST MADISON SD 57042 30485319 0 X WWW.MADISONREGIONALHEALTH.ORG X 1955 SD PROVIDE HEALTH CARE SERVICES TO AREA RESIDENTS. 11 11 324 49 0 0 82631 51044 28622605 30121365 30773 165668 142444 147242 28878453 30485319 0 0 0 0 14901278 15563854 0 0 0 13453341 13921691 28354619 29485545 523834 999774 49542421 49467370 33393423 32318598 16148998 17148772 X MADISON COMMUNITY HOSPITAL, D/B/A MADISON REGIONAL HEALTH SYSTEM SERVES AS A COMMUNITY HEALTH FOCAL POINT THROUGH THE PROVISION AND MAINTENANCE OF A PROGRESSIVE, EFFICIENT, AND WELL MANAGED HEALTHCARE INSTITUTION, COMMITTED TO QUALITY MEDICAL PRACTICE, AND HIGH ETHICAL STANDARDS.MADISON COMMUNITY HEALTH SYSTEM SERVES AS A COMMUNITY AND SERVICE AREA BASED PRIMARY CARE INSTITUTION WITH BASIC SECONDARY CARE SUPPORT SERVICES, AND FACILITIES PROVIDED TO MEET DEMONSTRATED NEEDS WHICH CAN BE MET WITHIN THE FINANCIAL AND RESOURCE CONSTRAINTS OF THE ORGANIZATION. 0 0 24874309 30121365 MADISON REGIONAL HEALTH SYSTEM (HOSPITAL) IS A 22-BED ACUTE CARE HOSPITAL LOCATED IN MADISON, SOUTH DAKOTA. FOR THE YEAR ENDED JUNE 30, 2019: ACUTE PATIENT DAYS =1,221; NEWBORN DAYS = 109; SKILLED DAYS =2,171; AND INTERMEDIATE DAYS =127. 24874309 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 0 0 0 0 1 14 0 1 324 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X TAMARA MILLER 6052566551 323 SW 10TH ST MADISON SD 57042 LAURA JOHNSON VP THRU OCT 2018; PRESIDENT 0.50 X X 0 0 0 BRAD WILKENS PRES. THRU OCT 2018; TRUSTEE 0.50 X X 0 0 0 ROBERT VAN LIERE VICE PRESIDENT 0.50 X X 0 0 0 ABBY OFTEDAL SECRETARY 0.50 X X 0 0 0 CHRIS LEMAIR TREASURER 0.50 X X 0 0 0 DAN BROWN TRUSTEE 0.50 X 0 0 0 ROBIN SCHWEBACH TRUSTEE 0.50 X 0 0 0 LOIS NIEDERT TRUSTEE 0.50 X 0 0 0 LORI HANSEN TRUSTEE 0.50 X 0 0 0 DAN TALLEY TRUSTEE 0.50 X 0 0 0 STEVEN SERSHEN TRUSTEE 0.50 X 0 0 0 TAMARA MILLER CEO 40.00 X 265310 0 25350 TERESA MALLETT CFO 40.00 X 106879 0 25434 ROBERT SUMMERER SURGEON 40.00 X 581891 0 32961 BENJAMIN LISCANO MD OF FAMILY MEDICINE 40.00 X 420911 0 33201 LAURA HOEFERT MD OF FAMILY MEDICINE 40.00 X 346152 0 26778 JUSTIN CLEM MD OF FAMILY MEDICINE 40.00 X 372187 0 33338 MITCHELL POPPENS PHYSICIAN ASSISTANT 40.00 X 318586 0 27626 2411916 0 204688 19 0 1 0 AVERA RADIOLOGY GROUP PO BOX 86370 SIOUX FALLS SD 57118 RADIOLOGIST PROFESSIONAL FEES 389571 SANFORD LABORATORIES PO BOX 5056 SIOUX FALLS SD 57117 LABORATORIES SERVICES 294214 JERRY ZWAK ANESTHESIA 811 9TH ST SW PIPESTONE MN 56164 CRNA SERVICES 247511 SANFORD HEALTH NETWORK PO BOX 5074 SIOUX FALLS SD 57117 OUTREACH SERVICES 202339 AVERA ECARE 3900 WEST AVERA DRIVE SIOUX FALLS SD 57108 ESERVICES 194566 11 27780 23264 51044 PATIENT SERVICE REVENUE 624210 29004304 29004304 PHARMACY REVENUE 621110 874775 874775 MEALS 621110 209521 209521 32765 32765 30121365 152801 152801 147242 0 147242 147242 147242 12867 0 12867 12867 12867 30485319 30121365 0 312910 433341 433341 12790268 11091239 1699029 572866 497878 74988 758735 619983 138752 1008644 848480 160164 1316767 518369 798398 98315 98315 1181096 907190 273906 431036 372928 58108 28755 28755 83288 56762 26526 1072548 927957 144591 3214924 2781229 433695 198244 198244 MEDICAL SUPPLIES 4010809 4010809 BAD DEBTS 1519465 1519465 OUTREACH 588476 588476 MAINTENANCE AND REPAIRS 28798 28798 149170 75991 73179 29485545 24874309 4611236 0 10930763 8588661 3828007 5434456 133535 79960 524911 463125 233377 235128 43300744 14063123 31727800 29237621 1870388 5131251 293640 297168 49542421 49467370 1912661 2086732 31119762 29270866 361000 961000 33393423 32318598 X 16098083 17131178 50915 17594 16148998 17148772 49542421 49467370 999774 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25543180 4823581 20719599 3913880 1038088 2875792 13843684 8201454 5642230 29237621 CLAIMS RESERVES 961000 961000 X 28952987 -1519465 -1519465 30472452 12867 12867 30485319 27953213 0 27953213 1532332 1532332 29485545 PART X, LINE 2: THE SYSTEM 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 SYSTEM 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. THE SYSTEM HAS DETERMINED THAT IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT SYSTEM BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFICATION OF BAD DEBT EXPENSES -1,519,465. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF GAIN ON SALE FOR 990 12,867. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF BAD DEBT EXPENSES 1,519,465. RECLASSIFICATION OF GAIN ON SALE FOR 990 12,867. 1 1 X 1 X 1 X 1 1 1 0 0 190000 190000 0.00680 676527 534399 142128 0.00510 866527 534399 332128 0.01190 8460 8460 0.00030 7558967 5546560 2012407 0.07200 7567427 5546560 2020867 0.07230 8433954 6080959 2352995 0.08420 0 1519465 179297 9987551 10041719 -54168 X 1 1 1 1 MADISON COMMUNITY HOSPITAL 323 SW 10TH ST MADISON SD 57042 WWW.MADISONREGIONALHEALTH.ORG 49870 X X X MADISON COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE PART V SECTION C X 1 18 1 SEE PART V SECTION C 0 1 X 150.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTP://WWW.MADISONREGIONALHEALTH.ORG/CUSTOM/FINANCIAL-ASSISTANCE X HTTP://WWW.MADISONREGIONALHEALTH.ORG/CUSTOM/FINANCIAL-ASSISTANCE X HTTP://WWW.MADISONREGIONALHEALTH.ORG/CUSTOM/FINANCIAL-ASSISTANCE X X X X X 1 X 0 X X X X 1 X 0 0 MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: MADISON REGIONAL HEALTH SYSTEM (MRHS) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH ASSISTANCE FROM EIDE BAILLY, LLP, AN ACCOUNTING AND CONSULTING FIRM SPECIALIZING IN FINANCIAL, OPERATIONAL, AND HEALTH-NEED CONSULTING WITH HEALTHCARE ORGANIZATIONS. QUALITATIVE AND QUANTITATIVE INFORMATION FROM LOCAL, STATE, AND FEDERAL SOURCES, AND INPUT FROM PERSONS THAT REPRESENT A BROAD RANGE OF INTERESTS IN THE COMMUNITY, PERSONS WITH PUBLIC HEALTH KNOWLEDGE AND EXPERTISE, AND PERSONS REPRESENTING MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS WAS USED IN DEVELOPING THE REPORT. MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED DURING THE TAX YEAR AND AS SUCH THE HOSPITAL HAS NOT TAKEN SPECIFIC ACTIONS WITH RESPECT TO THE CURRENT IMPLEMENTATION STRATEGY. THE FOLLOWING COMMUNITY HEALTH AREAS WERE IDENTIFIED AND THE FOLLOWING ACTIONS WILL BE TAKEN BY THE HOSPITAL DURING FUTURE YEARS.MENTAL AND BEHAVIORAL HEALTH EDUCATION, ACCESS AND AFFORDABILITY- CONTINUE RELATIONSHIP WITH COMMUNITY COUNSELING SERVICES IN MADISON.- EXPLORE SERVICE CAPABILITY TO BETTER MEET CUSTOMER NEEDS.- FURTHER RESEARCH UNIVERSITY OF SOUTH DAKOTA'S EMERGENCY DEPARTMENT PSYCHIATRY RESIDENCY TELEMEDICINE PROGRAM.- EXPLORE PRESCRIBER OUTREACH SERVICES WHICH WOULD FURTHER INCREASE CAPACITY AND CAPABILITY TO MEET MENTAL AND BEHAVIORAL HEALTH NEEDS IN THE COMMUNITY.- BRING MORE AWARENESS TO AVAILABLE MENTAL AND BEHAVIORAL HEALTH RESOURCES IN THE COMMUNITY AND PROVIDE MORE EDUCATION AROUND WHAT PEOPLE CAN DO TO MAINTAIN MENTAL AND BEHAVIORAL HEALTH.POST-ACUTE CARE, LONG-TERM CARE, AND THE SENIOR LIVING CONTINUUM- CONTINUE TO OFFER HOME HEALTH SERVICES ALONG WITH SWING BED PROGRAMMING THAT INCLUDES SKILLED AND INTERMEDIATE CARE.- CONTINUE TO COLLABORATE WITH BETHEL LUTHERAN HOME, A NURSING HOME IN MADISON, SD THAT OFFERS A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING.- ENHANCE MARKETING EFFORTS AROUND WHAT SERVICES ARE OFFERED AND AVAILABLE IN THE COMMUNITY TO EXPAND THE COMMUNITY'S KNOWLEDGE OF AVAILABLE RESOURCES AND THE PRESENCE OF A FULL CONTINUUM OF SENIOR SERVICES.SPECIALTY SERVICES ACCESS, AWARENESS, RECRUITING, AND GAPS- CONTINUE TO PROMOTE SPECIALTY SERVICES THAT ARE OFFERED LOCALLY.- CONTINUE RECRUITING EFFORTS FOR REPLACEMENT AND ADDITIONAL SPECIALTY PROVIDERS.- INCREASE AWARENESS AROUND OTOLARYNGOLOGY AND FAMILY MEDICINE.DIABETES AND OBESITY RELATED HEALTH ISSUES: AWARENESS, EDUCATION, SERVICES AND NEW PROGRAMMING- FOCUS ON EDUCATION AND AWARENESS IN THE COMMUNITY, SPECIFICALLY AROUND THE RECENTLY DEVELOPED ROBUST DIABETES PREVENTION PROGRAM (DPP).- DIABETIC EDUCATOR STAFF WILL PARTICIPATE IN MARKETING EFFORTS ALONG WITH MRHS STAFF TO BOOST COMMUNITY AWARENESS AND PARTICIPATION.AFFORDABILITY, AN IDENTIFIED NEED, WILL NOT BE ADDRESSED AT THIS TIME. MRHS IS NOT EQUIPPED TO ADDRESS ISSUES RELATED TO INSURANCE PREMIUMS, DEDUCTIBLES, AND COPAYS. MRHS IS A LOW-COST PROVIDER AND DOES HAVE AN INCOME-BASED FINANCIAL ASSISTANCE PROGRAM WHICH CAN BE ACCESSED IN PERSON OR ON MRHS' WEBSITE.MANY OF THESE ACTIVITIES ARE CONTINUATIONS OF ACTIVITIES THE HOSPITAL HAS BEEN CONDUCTING RELATED TO THE PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT. MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 13B: HOUSEHOLD SIZE MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 24: THE HOSPITAL FINANCIAL ASSISTANCE POLICY DOES NOT COVER ELECTIVE PROCEDURES. THE HOSPITAL MAY HAVE CHARGED FAP ELIGIBLE PATIENTS GROSS CHARGES FOR SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY. PART V. SECTION B, LINE 7A THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ATWWW.MADISONREGIONALHEALTH.ORG/CUSTOM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V. SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST AND ATWWW.MADISONREGIONALHEALTH.ORG/CUSTOM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART I, LINE 3C: PRESUMPTIVE ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY MAY BE USED IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINE 7B AND LINE 7G WERE DETERMINED USING THE MEDICAID AND MEDICARE COST REPORTS, RESPECTIVELY. LINE 7G INCLUDES PROVIDER BASED CLINIC REVENUE OF $4,065,789, EXPENSE OF $4,838,807, FOR A NET COMMUNITY BENEFIT OF $773,018. LINE 7E WAS DETERMINED USING THE GENERAL LEDGER. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $1,519,465 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. PART III, LINE 2: BAD DEBT RECOVERIES AND DISCOUNTS APPLIED DURING THE COLLECTION PROCESS ARE POSTED IN A SEPARATE ACCOUNT ON THE GENERAL LEDGER. THIS ACCOUNT IS COMBINED WITH THE BAD DEBT EXPENSE ACCOUNT TO RESULT IN A NET BAD DEBT EXPENSE AMOUNT ON THE AUDITED FINANCIAL STATEMENT. THE BAD DEBT ALLOWANCE AND EXPENSE TAKES CONTRACTUAL ALLOWANCES INTO ACCOUNT. THE AMOUNT OF BAD DEBT SHOWN IS BASED ON CHARGES. PART III, LINE 3: THE HOSPITAL APPLIED THE MOST RECENT POVERTY LEVEL PERCENTAGE PER THE U.S. CENSUS BUREAU FOR ITS AREA TO THE TOTAL AMOUNT SENT TO COLLECTIONS DURING THE FISCAL YEAR ENDED JUNE 30, 2019 TO DETERMINE AN ESTIMATE OF ELIGIBLE CHARITY CARE REPORTED AS BAD DEBT. PART III, LINE 4: FOOTNOTE FROM FINANCIAL STATEMENT: PLEASE SEE PAGES 8-9 OF THE ATTACHED FINANCIAL STATEMENT FOR THE PATIENT RECEIVABLES FOOTNOTE. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR THE FISCAL YEAR ENDING 06/30/2019.MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY. PART III, LINE 9B: ACCOUNTS THAT MEET THE CRITERIA FOR THE FINANCIAL ASSISTANCE POLICY WILL BE WRITTEN OFF IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS THAT DO NOT MEET THE CRITERIA FOR FINANCIAL ASSISTANCE WILL PROCEED THROUGH THE COLLECTION PROCESS. IF, DURING THE COLLECTION PROCESS, IT IS DETERMINED THAT AN ACCOUNT IN COLLECTION BELONGS TO A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT WILL BE REMOVED FROM COLLECTION AND RETURNED TO THE HOSPITAL FOR RESOLUTION. PART VI, LINE 2: MADISON REGIONAL HEALTH SYSTEM CONDUCTS PATIENT SURVEYS OF MANY LEVELS OF CARE. MRHS HAS MANY WORKING COMMITTEES THAT DISCUSS THE NEEDS OF THE COMMUNITY (ANTIBIOTIC STEWARDSHIP, OPIOID EPIDEMIC COMMITTEE, ETC). PART VI, LINE 3: A SUMMARY OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE, ATTACHED TO BILLING INVOICES, POSTED IN THE EMERGENCY ROOM OR WAITING ROOMS, POSTED IN THE ADMISSIONS OFFICE, GIVEN TO PATIENTS ON ADMISSION, AND UPON REQUEST. DISCHARGE PLANNING PERSONNEL IN THE BUSINESS OFFICE COUNSEL PATIENTS UPON ADMISSION AND THROUGH THE DISCHARGE PLANNING PROCESS ON MEDICAID, COUNTY WELFARE PROGRAMS, CHARITY CARE, ETC. FINANCIAL ASSISTANCE PROGRAMS ARE DETAILED EITHER IN PERSON OR THROUGH A BROCHURE THAT EXPLAINS THE HOSPITAL'S FINANCIAL ASSISTANCE AND PAYMENT REQUIREMENTS. COVERED VS NON-COVERED CHARGES ARE DISCUSSED WITH THE PATIENT. A PATIENT ASSESSMENT, INCLUDING A DISCUSSION ON FINANCIAL RESPONSIBILITIES, CONCERNS, AND GOVERNMENT PROGRAMS, IS COMPLETED ON EACH INPATIENT BY DISCHARGE PLANNING. A FINANCIAL COUNSELOR MEETS ONE-ON-ONE WITH PATIENTS PRIOR TO DISCHARGE TO GO OVER INSURANCE COVERAGE AND WHAT TO EXPECT ONCE INSURANCE IS PROCESSED. PART VI, LINE 4: MADISON REGIONAL HEALTH SYSTEM IS THE ONLY HOSPITAL IN THE SERVICE AREA. EIGHT PHYSICIANS AND FIVE PHYSICIAN EXTENDERS PRACTICE IN THE COMMUNITY. THE SERVICE AREA FOR MRHS INCLUDES 14 ZIP CODE COMMUNITIES THAT ARE WITHIN A 21-MILE RADIUS OF THE HOSPITAL. IT INCLUDES ALL OF LAKE COUNTY AND PORTIONS OF BROOKINGS, KINGSBURY, MINER, MOODY, MCCOOK AND MINNEHAHA COUNTIES. TOTAL SERVICE AREA POPULATION IS APPROXIMATELY 32,000. ESTIMATED MEDIAN HOUSEHOLD INCOME IS $63,179 ACCORDING TO THE U.S CENSUS BUREAU. PART VI, LINE 5: THE GOVERNING BODY OF MRHS IS COMPRISED OF COMMUNITY MEMBERS, NONE OF WHOM ARE EMPLOYEES OR CONTRACTORS OF THE HOSPITAL. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE USED TO IMPROVE PATIENT CARE AND FACILITIES. THE HOSPITAL OPERATES AN EMERGENCY ROOM WHICH IS AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS THROUGH RESIDENCIES AND INTERNSHIPS FOR NURSING STUDENTS, THERAPY STUDENTS, PHYSICIANS AND PHYSICIAN'S EXTENDERS. THE HOSPITAL PARTICIPATES IN SEVERAL GOVERNMENT SPONSORED HEALTH PROGRAMS, INCLUDING BUT NOT LIMITED TO: MEDICARE, MEDICAID, VA, TRI-CARE, AND ALL-WOMEN-COUNT. THE HOSPITAL OFFERS VOLUNTEER OPPORTUNITIES TO MEMBERS OF THE COMMUNITY. X X X 0 0 0 0 0 0 0 0 0 TAMARA MILLER CEO 265310 0 0 0 0 0 13501 0 12973 0 291784 0 0 0 ROBERT SUMMERER SURGEON 581891 0 0 0 0 0 13750 0 20008 0 615649 0 0 0 BENJAMIN LISCANO MD OF FAMILY MEDICINE 388629 0 0 0 32282 0 13750 0 20546 0 455207 0 0 0 LAURA HOEFERT MD OF FAMILY MEDICINE 309276 0 0 0 36876 0 13750 0 14084 0 373986 0 0 0 JUSTIN CLEM MD OF FAMILY MEDICINE 335311 0 0 0 36876 0 13750 0 20644 0 406581 0 0 0 MITCHELL POPPENS PHYSICIAN ASSISTANT 318586 0 0 0 0 0 13750 0 14679 0 347015 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL HAVE THE BOARD PRESIDENT AS ITS CHAIRMAN AND FOUR APPOINTED MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE FACILITY DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF TRUSTEES AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND CHIEF FINANCIAL OFFICER REVIEW THE 990 IN DETAIL. AFTER THEIR REVIEW, THE 990 IS PROVIDED TO EACH BOARD MEMBER. THE CEO PRESENTS THE 990 TO THE BOARD OF DIRECTORS AT THE MEETING HELD PRIOR TO ITS FILING IF SO REQUESTED BY ANY BOARD MEMBER. WHETHER PRESENTED IN A BOARD MEETING OR NOT, THE 990 IS NOT FILED UNTIL EACH BOARD MEMBER HAS BEEN GIVEN A COPY OF IT AND GIVEN AMPLE TIME TO REVIEW IT. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS AND OFFICERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE BOARD WILL REVIEW ACTUAL CONFLICTS AND MAKE DETERMINATIONS WHETHER A CONFLICT EXISTS. THE RESTRICTIONS ARE IMPOSED ON A CASE BY CASE BASIS BASED ON THE BOARD'S DETERMINATION. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION AND BENEFITS ARE REVIEWED ON AN ANNUAL BASIS IN EXECUTIVE SESSION AT THE BOARD OF TRUSTEE MEETING. THE BOARD OF TRUSTEES APPROVES THE SALARY AND BENEFITS COMPENSATION. SDAHO SALARY SURVEY AND OTHER FACILITY 990'S ARE USED TO DETERMINE CEO'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.