2019-05-15T09:43:41-05:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-07-01 331007002 TRINITY HEALTH & AFFILIATES TRIN 7018575160 PO BOX 5020 MINOT ND 587025020 JOHN M KUTCH PRESIDENT/CEO 7018575160 2019-05-14 1 KURT BENNION P01469618 6123764500 2019-05-14 67.137.57.251 2019-05-14 10:51:35 PD P 92465E57DADAD6C24A7EB17F4905229B30516652 3C05182BCE949607266F40F8D21D5C2A178D6925 2017 2019-02-21 02:37:17Z JOHN M KUTCH PO BOX 5020 MINOT ND 587025020 345538420 1 0 3904 X WWW.TRINITYHEALTH.ORG X MEETING THE NEEDS OF THE WHOLE PERSON THROUGH QUALITY HEALTH CARE AND HEALTH RELATED SERVICES. 10 7 0 327 2460870 0 1000420 989846 324534819 339392091 2891532 4086064 -1517276 -1211712 326909495 343256289 305181 328506 0 0 130308766 130124828 0 0 1133876 155152561 159029946 285766508 289483280 41142987 53773009 253406674 669932345 41939113 481837654 211467561 188094691 X TRINITY HEALTH IS COMMITTED TO PRESERVING AND IMPROVING THE QUALITY OF HEALTH OF THE PEOPLE WE SERVE. OUR MISSION IS TO EXCEL AT MEETING THE NEEDS OF THE WHOLE PERSON THROUGH THE PROVISION OF QUALITY HEALTH CARE AND HEALTH RELATED SERVICES. 0 0 226221316 328506 318371603 TRINITY HEALTH & AFFILIATES PROVIDES HOSPITAL SERVICES TO CENTRAL AND NORTHWEST NORTH DAKOTA AND NORTHEASTERN MONTANA. TRINITY HOSPITALS IS THE LARGEST HOSPITAL PROVIDER IN NORTHWEST NORTH DAKOTA, WITH AN ACUTE CARE FACILITY THAT IS VERIFIED BY THE AMERICAN COLLEGE OF SURGEONS AS A LEVEL 2 TRAUMA CENTER. TRINITY SERVES AS A REFERRAL CENTER FOR THE FOLLOWING SERVICES: HEART, NEURO, GENERAL AND ROBOTIC SURGERY, CANCER AND CARDIAC CARE, OPHTHALMOLOGY AND RETINAL SURGERY, ADVANCED DIAGNOSTICS, NEWBORN INTENSIVE CARE, ORTHOPEDICS, SPORTS MEDICINE, INPATIENT REHABILITATION, BEHAVIORAL HEALTH, KIDNEY DIALYSIS AND LITHOTRIPSY. TRINITY HOSPITAL INCLUDES A JOINT REPLACEMENT AND GERIATRIC CENTER, CARDIAC CENTER, STROKE CENTER AND NEUROSURGERY CENTER. (SEE SCHEDULE O)TRINITY HOSPITAL - ST. JOSEPH'S INCLUDES AN INPATIENT REHABILITATION UNIT, KIDNEY DYALISIS UNIT, INPATIENT MENTAL HEALTH, OUTPATIENT BEHAVIORAL HEALTH, AND BOTH INPATIENT AND OUTPATIENT CHEMICAL DEPENDENCY UNITS. TRINITY'S NORTHSTAR CRITICAIR HELICOPTER PROVIDES CRITICAL CARE TRANSPORT WITHIN A 150-MILE RADIUS OF TRINITY HOSPITAL. TRINITY ALSO PROVIDES GROUND AMBULANCE SERVICES TO THE CITY OF MINOT AND THE SURROUNDING AREA THROUGH COMMUNITY AMBULANCE SERVICE OF MINOT, INC. 20593824 21020488 TRINITY HOMES IS A 230-BED HOSPITAL-BASED SKILLED NURSING FACILITY PARTICIPATING IN THE MEDICARE AND MEDICAID PROGRAMS. TRINITY HOMES INCLUDES AN ALZHEIMER'S SPECIAL CARE UNIT AND 13 RETIREMENT APARTMENTS. RESIDENTS OF TRINITY HOMES, UNDER THE DIRECTION OF THEIR PHYSICIAN, ARE ABLE TO RECEIVE SKILLED NURSING CARE, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, DIETETIC SERVICES, SOCIAL SERVICES, AND ACTIVITIES OF DAILY LIVING ASSISTANCE, SPIRITUAL CARE AND RECREATIONAL ACTIVITIES. 246815140 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 X TAYLOR WILSON 7018575160 PO BOX 5020 MINOT ND 58702 PATRICK HOLIEN CHAIRMAN 2.00 2.50 X X 0 0 0 STEVE LYSNE VICE CHAIRMAN 2.00 2.50 X X 0 0 0 KAREN KREBSBACH SECRETARY/TREASURER 2.00 2.50 X X 0 0 0 BORGI BEELER DIRECTOR 2.00 2.50 X 0 0 0 JOHN COUGHLIN DIRECTOR 2.00 2.50 X 0 0 0 SCOTT KNUTSON MD DIRECTOR 20.00 20.00 X 0 581454 22483 BRENT MATTSON DIRECTOR 2.00 2.50 X 0 0 0 CLARA SUE PRICE DIRECTOR 2.00 2.50 X 0 0 0 MARTIN ROTHBERG MD DIRECTOR 20.00 20.00 X 0 767651 13003 JOHN KUTCH PRESIDENT & CEO 20.00 20.00 X X 0 813059 22483 ALISON FRYE ASSISTANT SECRETARY 0.00 40.00 X 0 69167 19601 DENNIS EMPEY VICE PRESIDENT & CFO 20.00 20.00 X 0 355522 23983 RANDY SCHWAN VICE PRES. - MISSION INTEGRATION 32.00 8.00 X 0 210818 11369 PAUL SIMONSON VICE PRES. - HUMAN RESOURCES 32.00 8.00 X 0 267862 23983 THOMAS WARSOCKI VICE PRES. - PHYSICIAN OPERATIONS 0.00 40.00 X 0 207195 21651 DAVE KOHLMAN VICE PRES. - FACILITIES MANAGEMENT 28.00 12.00 X 0 194476 21703 KAREN ZIMMERMAN RN VICE PRES. & CNO 40.00 0.00 X 0 172760 5410 TRENT CHASTAIN VICE PRES - REVENUE CYCLE (THROUGH MARCH 2018) 28.00 12.00 X 0 170987 18637 RHONDA WALTER VICE PRES - VICE PRES. - NCF ADMINISTRATOR 40.00 0.00 X 0 175914 22699 PHILIP PATTERSON VICE PRES. & CAO (THROUGH FEB 2018) 36.00 4.00 X 0 251845 11203 GLEN TAYLOR WILSON VICE PRES. - CLINICAL INTEGRATION 20.00 20.00 X 0 265655 12418 0 4504365 250626 0 0 1 0 0 133101 5000 851745 173375 989846 NET PATIENT REVENUE 621110 329548642 329548642 OTHER PATIENT SERVICES 621110 5779798 5779798 DIETARY SERVICES 722320 1602781 1602781 ADMINISTRATIVE SERVICES 561000 1438992 1438992 OTHER UBIT SERVICES 900099 563146 563146 458732 458732 339392091 4083333 4083333 104279 2259105 -2154826 -2154826 -2154826 7459 4728 2731 2731 2731 2103 133101 18298 -16195 -16195 VENDOR REBATES 900099 959309 959309 959309 343256289 336931221 2460870 2874352 X 143600 143600 184906 184906 107593964 94101044 13261360 231560 3231630 2728450 498141 5039 11716316 10512087 1170736 33493 7582918 6732370 835279 15269 902742 902742 397287 397287 36979567 26839622 10139824 121 2930775 90752 2806518 33505 3157875 2474580 641685 41610 4309358 2714043 1561403 33912 10695111 5452555 5242556 225503 221498 2819 1186 326459 177133 149326 1089971 1089971 12556342 9641884 2907962 6496 688599 409550 279049 MEDICAL SUPPLIES / DRUG 59749464 59747095 2369 BAD DEBT EXPENSE 16861934 16842827 19375 -268 BOOKS & SUBSCRIPTIONS 3169441 2715432 393194 60815 FOOD 2192133 2184729 1277 6127 2797385 1811012 321362 665011 289483280 246815140 41534264 1133876 93068227 36591039 1828740 61922636 39522923 44520337 15741 15991 7587936 7709786 4619565 4860792 275538725 192292033 65027775 83246692 41685767 431015072 50000 50000 253406674 669932345 27061114 34685405 13140 10260 27200 21274 5407832 437223675 9429827 9897040 41939113 481837654 X 203655661 180065328 6269183 6486646 1542717 1542717 211467561 188094691 253406674 669932345 X 53773009 150536 -77296415 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 133528 133528 0 PART II-B, LINE 1: LOBBYING ACTIVITIES CONSIST OF A PORTION OF OUR ANNUAL MEMBERSHIP DUES IDENTIFIED UPON RENEWAL AS ASSOCIATED WITH LOBBYING ACTIVITY. ASSOCIATIONS INCLUDE NORTH DAKOTA HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, NORTH DAKOTA LONG TERM CARE ASSOCIATION, NORTH DAKOTA HOSPICE ORGANIZATION, HEALTH POLICY CONSORTIUM, NORTH DAKOTA ASSOCIATION FOR HOME CARE, AND NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION. 1 330942 21753 4793 347902 1 X 1692368 1692368 1679926 12442 1692368 1646618 380 55843 22915 1679926 133476 1433291 79851 1646618 105740 19211 8525 133476 0.00000 0.91160 0.08840 0 0 2655356 2655356 43130542 29564312 13566230 19447 19447 0 194654293 162708274 31946019 35079087 35079087 83246692 ESTIMATED 3RD PARTY SETTLEMENTS 9897040 9897040 X PART IV, LINE 1B: TO PROVIDE PUBLIC EDUCATION FOR HOSPICE CARE. PART IV, LINE 2B: RESIDENT TRUST FUNDS ARE HELD BY TRINITY HOMES. THESE FUNDS ARE TRACKED SEPARATELY FROM THE ORGANIZATIONS AND ARE HELD IN A SEPARATE BANK ACCOUNT. PART V, LINE 4: THE PURPOSE OF THE ENDOWMENT FUNDS IS TO SUPPORT STAFF EDUCATION AND SCHOLARSHIPS AND THE PURCHASE OF NEW EQUIPMENT. PART X, LINE 2: TRINITY HOSPITALS, TRINITY HOMES, TRINITY HEALTH FOUNDATION, TRINITY KENMARE HOSPITAL, AND COMMUNITY AMBULANCE SERVICE HAVE ALL BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS A NONPROFIT CORPORATION AS DESCRIBED IN SEC. 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SEC. 501(A) OF THE IRC. ALL UNRELATED BUSINESS INCOME GENERATED BY TRINITY IS SUBJECT TO FEDERAL INCOME TAX UNDER SECTION 511 OF THE IRC. TRINITY'S POLICY IS TO EVALUATE THE LIKELIHOOD THAT ITS UNCERTAIN TAX POSITIONS WILL PREVAIL UPON EXAMINATION BASED ON THE EXTENT TO WHICH THOSE POSITIONS HAVE SUBSTANTIAL SUPPORT WITHIN THE INTERNAL REVENUE CODE AND REGULATIONS, REVENUE RULINGS, COURT DECISIONS, AND OTHER EVIDENCE. IT IS THE OPINION OF MANAGEMENT THAT THE COMPANY HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION. TRINITY'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. NORTH AMERICA 0 0 OTHER - MINERAL RIGHTS 10421 0 0 0 0 0 0 10421 0 10421 0 0 0 0 0 0 SCHEDULE F, PART I, LINE 3 FOREIGN ACTIVITIES THE ORGANIZATION'S FOREIGN ACTIVITIES ARE LIMITED TO THE RECEIPT OF MINERAL RIGHTS FROM PROPERTY IN CANADA. BUILDING HOPE GOLF 100148 98859 1289 893 396 6768 571 2262 GOLF FOR LIFE 35056 34242 814 349 465 5906 688 135204 133101 2103 1242 861 12674 571 2950 18298 -16195 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 1251775 1251775 0.00460 18408180 18761186 0 0.00000 19659955 18761186 1251775 0.00460 367645 52795 314850 0.00120 16130 16130 0.00010 200 200 0.00000 383975 52795 331180 0.00130 20043930 18813981 1582955 0.00590 3956 3956 0.00000 3956 3956 0.00000 1 16862202 0 83191546 98825791 -15634245 X 1 1 3 1 TRINITY HOSPITAL ONE BURDICK EXPRESSWAY WEST MINOT ND 58701 WWW.TRINITYHEALTH.ORG 5055 X X X X 2 TRINITY HOSPITAL-ST JOSEPH'S 407 3RD STREET SE MINOT ND 58701 WWW.TRINITYHEALTH.ORG 5036 X X 3 TRINITY KENMARE HOSPITAL PO BOX 697 KENMARE ND 587460697 WWW.TRINITYHEALTH.ORG 5028 X X X TRINITY HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X WWW.TRINITYHEALTH.ORG/COMMUNITY X 1 15 0 1 0 1 X 250.000000000000 250.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 TRINITY HOSPITAL ST JOSEPH'S 2 0 0 1 X X X X X X X X X 15 1 1 0 1 X WWW.TRINITYHEALTH.ORG/COMMUNITY X 1 15 0 1 0 1 X 250.000000000000 250.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 TRINITY KENMARE HOSPITAL 3 0 0 1 X X X X X X X X X 15 1 1 0 1 X WWW.TRINITYHEALTH.ORG/COMMUNITY X 1 15 0 1 0 1 X 250.000000000000 250.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.TRINITYHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 TRINITY HOSPITAL PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") PROCESS PRIMARILY INVOLVED INTERVIEWS IN SPRING 2016 WITH VARIOUS COMMUNITY LEADERS, MEDICAL PROFESSIONALS, AND CITY AND COUNTY GOVERNMENT OFFICIALS. PARTICIPANTS INCLUDED THE CITY OF MINOT, FIRST DISTRICT HEALTH UNIT, MINOT AIR FORCE BASE, MINOT COMMISSION ON AGING, MINOT PUBLIC SCHOOL DISTRICT, WARD COUNTY JAIL, WARD COUNTY SHERIFF'S DEPARTMENT, AND WARD COUNTY SOCIAL SERVICES. TRINITY HOSPITAL ST. JOSEPH'S PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") PROCESS PRIMARILY INVOLVED INTERVIEWS IN SPRING 2016 WITH VARIOUS COMMUNITY LEADERS, MEDICAL PROFESSIONALS, AND CITY AND COUNTY GOVERNMENT OFFICIALS. PARTICIPANTS INCLUDED THE CITY OF MINOT, FIRST DISTRICT HEALTH UNIT, MINOT AIR FORCE BASE, MINOT COMMISSION ON AGING, MINOT PUBLIC SCHOOL DISTRICT, WARD COUNTY JAIL, WARD COUNTY SHERIFF'S DEPARTMENT, AND WARD COUNTY SOCIAL SERVICES. TRINITY KENMARE HOSPITAL PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") PROCESS PRIMARILY INVOLVED INTERVIEWS IN SPRING 2016 WITH VARIOUS COMMUNITY LEADERS, MEDICAL PROFESSIONALS, AND CITY AND COUNTY GOVERNMENT OFFICIALS. PARTICIPANTS INCLUDED THE CITY OF KENMARE, FIRST DISTRICT HEALTH UNIT, MINOT COMMISSION ON AGING, AND WARD COUNTY SOCIAL SERVICES. TRINITY HOSPITAL PART V, SECTION B, LINE 6A: TRINITY HOSPITAL CONDUCTED ITS CHNA IN COLLABORATION WITH TRINITY HOSPITAL-ST. JOSEPH'S AND TRINITY KENMARE HOSPITAL. BECAUSE OF THEIR IDENTICAL COMMUNITIES AND RELATIONSHIP WITHIN TRINITY HEALTH, TRINITY HOSPITAL AND TRINITY HOSPITAL-ST. JOSEPH'S PRODUCED A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. TRINITY HOSPITAL ST. JOSEPH'S PART V, SECTION B, LINE 6A: TRINITY HOSPITAL-ST. JOSEPH'S CONDUCTED ITS CHNA IN COLLABORATION WITH TRINITY HOSPITAL AND TRINITY KENMARE HOSPITAL. BECAUSE OF THEIR IDENTICAL COMMUNITIES AND RELATIONSHIP WITHIN TRINITY HEALTH, TRINITY HOSPITAL AND TRINITY HOSPITAL-ST. JOSEPH'S PRODUCED A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. TRINITY KENMARE HOSPITAL PART V, SECTION B, LINE 6A: TRINITY KENMARE HOSPITAL CONDUCTED ITS CHNA IN COLLABORATION WITH TRINITY HOSPITAL AND TRINITY HOSPITAL-ST. JOSEPH'S. TRINITY HOSPITAL PART V, SECTION B, LINE 11: IN THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, TRINITY HOSPITAL IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS: ACCESS, SUBSTANCE ABUSE, MENTAL HEALTH, AND OBESITY. IN A PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT, ILLNESS AND DISEASE WAS ALSO IDENTIFIED AS A SIGNIFICANT HEALTH NEED. DURING THE YEAR ENDED 6/30/2016, TRINITY HOSPITAL TOOK THE FOLLOWING ACTIONS TO ADDRESS THOSE NEEDS. ADDITIONALLY, THROUGH FY 2018, TRINITY HEALTH CONTINUED THESE EFFORTS AND STRATEGIES TO IMPROVE ON EACH TARGETED AREA.ACCESSAS IT WAS WITH MOST PROVIDERS ACROSS ND, ACCESS TO SERVICES WAS SIGNIFICANTLY IMPACTED BY WORKFORCE SHORTAGES. TRINITY HEALTH RESPONDED TO SHORTAGES IN ITS WORKFORCE BY SUCCESSFULLY RECRUITING SEVERAL PROVIDERS TO ITS MEDICAL STAFF, ADDING ALLIED HEALTH PROVIDERS TO AUGMENT PHYSICIAN ACCESS. TRINITY HEALTH ALSO DEPLOYED STRATEGIES TO IMPROVE INFORMATION AVAILABLE TO CONSUMERS BY DEVELOPING A ROBUST MOBILE DEVICES APPLICATION, LAUNCHING AN ELECTRONIC PATIENT PORTAL FEATURING SECURE MESSAGING AND APPOINTMENT REQUESTS WITH PROVIDERS, AND ENHANCING ITS PHYSICIAN REFERRAL SERVICE.TRINITY HEALTH CONTINUED TO AGGRESSIVELY RECRUIT MEDICAL PROVIDERS IN BOTH PRIMARY AND SPECIALTY CARE. THIS EFFORT TO IMPROVE ACCESS RESULTED IN NEW PROVIDERS TO OUR PHYSICIAN NETWORK, INCLUDING MENTAL HEALTH PROVIDERS IN WILLISTON AND MINOT. IN 2018, TRINITY HEALTH LAUNCHED ITS FIRSTCARE WALK-IN CLINIC IN DOWNTOWN MINOT. THIS WALK-IN CLINIC OFFERS EXPANDED HOURS, INCLUDING EVENING, HOLIDAY AND WEEKEND HOURS, AND ITS PROVIDERS SEE ALL PATIENT AGES. TO MANAGE CONSUMERS' EXPECTATIONS ABOUT WAITING TIMES AT THE WALK-IN CLINIC, TRINITY HEALTH INCLUDES AN ESTIMATED WAIT-TIME ON ITS INTERNET WEBSITE AND MOBILE DEVICE APPLICATION. TO HELP PATIENTS FIND THE SERVICES AND PROVIDERS THEY NEED, TRINITY HEALTH BEGAN DEVELOPMENT ON A NEW USER-FRIENDLY WEBSITE BY AUDITING THE EXISTING SITE, RESEARCHING BEST PRACTICES, SURVEYING USERS, AND LISTENING TO FEEDBACK. THE STRATEGY FOCUSED ON PUTTING CONSUMERS FIRST TO MEET THEIR NEEDS AND SIMPLIFY THEIR ACTIONS FROM ANY DEVICE THEY USE TO CONNECT WITH TRINITY HEALTH. SUBSTANCE ABUSE "BATTLING DRUG AND ALCOHOL ABUSE" WAS A COMMUNITY EDUCATION ACTIVITY TRINITY HEALTH PROVIDED IN THE REGION, AND THIS PRESENTATION WAS GIVEN IN AREA SCHOOLS. PROVIDERS ALSO VISITED AREA HIGH SCHOOL CLASSES TO PRESENT INFORMATION ABOUT SUBSTANCE ABUSE AND THE TRAGIC CONSEQUENCES THAT COMMONLY OCCUR, BASED ON THEIR EXPERIENCES IN THE LOCAL EMERGENCY ROOM. MENTAL HEALTHMANY PEOPLE WHO ARE AFFECTED BY SUBSTANCE ABUSE SUFFER FROM UNDERLYING MENTAL HEALTH ISSUES AS WELL. TRINITY HEALTH HAS EXPANDED ITS OUTREACH FOR MENTAL HEALTH SERVICES AND IMPROVED ACCESS BY ADDING PROVIDERS; FOR EXAMPLE, WE ADDED RESOURCES IN MINOT AND WILLISTON TO HELP ADDRESS A GROWING NEED FOR ACCESS. SUBSTANCE ABUSE AND MENTAL HEALTH CARE CANNOT BE ADDRESSED BY ANY ONE ORGANIZATION ALONE, AND TRINITY IS PARTNERING WITH OTHER AGENCIES IN THE REGION IN AN EFFORT TO COORDINATE EFFORTS, WORK THROUGH BARRIERS, AND BETTER SERVE ITS COMMUNITY. MEMBERS OF TRINITY HEALTH'S TEAM SUPPORTED EFFORTS IN THE COMMUNITY TO BETTER UNDERSTAND THE SCOPE OF OPIOID ABUSE IN OUR COMMUNITY AND HELPED TO DESIGN APPROACHES AIMED AT REDUCING THE RISKS LEADING TO ABUSE AND IMPROVING TREATMENT AWARENESS IN THE COMMUNITY. PARENTING EDUCATION WAS A TOPIC PRESENTED TO THE PUBLIC LAST YEAR, HELPING PARENTS NAVIGATE SOME OF THE MORE DIFFICULT SITUATIONS THEY FACE IN RAISING CHILDREN TODAY. AT-RISK HOUSEHOLDS, TYPICALLY REFERRED BY AREA SCHOOLS AND COURTS, WERE AMONG ITS TARGETED AUDIENCES.TRINITY HEALTH PARTICIPATED IN AN OUTREACH EFFORT IN PARTNERSHIP WITH AREA AGENCIES, INCLUDING COURT AND LAW ENFORCEMENT OFFICIALS, TO IMPROVE COMMUNICATION AND AWARENESS OF MENTAL HEALTH ISSUES RELATED TO ACCESS, PROCEDURES, AND MORE.TRINITY HEALTH PROVIDES NEWLY REMODELED SPACE IN THE HOSPITAL TO ACCOMMODATE A REGIONAL SANE (SEXUAL ASSAULT NURSE EXAMINERS) PROGRAM, WHERE SPECIALLY TRAINED NURSES INTERVIEW AND ADVOCATE FOR SEXUAL ASSAULT VICTIMS. THESE VICTIMS ARE NOW TREATED AND INTERVIEWED IN A MORE COMFORTABLE AND PRIVATE ENVIRONMENT. OBESITYOUR FOCUS CONTINUES TO BE ON CHILDREN, AND HOW TO HELP KIDS DEVELOP HEALTHY HABITS REGARDING NUTRITION AND EXERCISE. FOR EXAMPLE, TRINITY HEALTH SPONSORED A PROGRAM AT THE WEE LINKS GOLF COURSE TO ENCOURAGE AND INCENTIVIZE KIDS TO EXERCISE THROUGH ACTIVITY, IN THIS CASE, GOLF. TRINITY HEALTH USES NUTRITIONISTS AND OTHER HEALTHCARE PROFESSIONALS TO VISIT WITH THE KIDS AND THEIR PARENTS ABOUT AVOIDING OBESITY THROUGH HEALTHY LIFESTYLE CHOICES. TRINITY HEALTH ALSO SPONSORED ACTIVITIES TO COMBAT OBESITY. FOR EXAMPLE, OUR DIETICIANS LEAD AN ONGOING "GROCERY STORE TOUR" FOR ANYONE IN THE COMMUNITY TO JOIN AND LEARN HOW TO SHOP FOR BETTER HEALTH, AS WELL AS A COOKING CLASSES FOR PEOPLE TO LEARN HOW TO COOK IN HEALTHIER WAYS. THIS EFFORT WAS ENHANCED THIS YEAR THROUGH THE PURCHASE OF A "PORTABLE KITCHEN" TO HELP DEMONSTRATE THE TECHNIQUES BEING TAUGHT. TRINITY HEALTH PROMOTES WELLNESS THROUGH A NATIONALLY-KNOWN PROGRAM, FRANCHISING ITS OWN CROSSFIT PROGRAM. LED BY ONE OF OUR PHYSICIANS, THE THEME OF "EXERCISE IS MEDICINE" WAS PROMOTED TO THE COMMUNITY, COMPLETE WITH A PUBLIC INVITATION TO WALK AT A LOCAL PARK THROUGH THE WARM SEASON FEATURING A "DOC WALK," WHERE HEALTHCARE PROFESSIONALS LED THE COMMUNITY WALK EFFORT. ILLNESS AND DISEASETRINITY HEALTH ADDED A NUMBER OF ACTIVITIES AIMED AT IMPROVING HEART HEALTH AWARENESS THROUGH ITS HEALTHY HEARTS PROGRAM, TO PROVIDE A MECHANISM FOR COMMUNITY EDUCATION AND ACTIVITIES TO SUPPORT HEART HEALTH.IN AN EFFORT TO ENHANCE AWARENESS OF THE SIGNS AND SYMPTOMS OF STROKE, TRINITY HEALTH CONTINUED ITS STROKE AWARENESS CAMPAIGN, WHICH INCLUDED SOCIAL MEDIA, SIGNS AND BANNERS, PAID ADVERTISING, AND MEDIA RELEASES ABOUT STROKE STORIES AND TREATMENT. THE GOAL OF THE CAMPAIGN IS TO MAKE THE PUBLIC AWARE OF THE ACRONYM, FAST, TO ENCOURAGE INTERVENTION WHEN SOMEONE RECOGNIZES A POTENTIAL STROKE. TRINITY HEALTH MAINTAINS AN ANNUAL SCHEDULE OF NATIONAL OBSERVANCES TO BUILD AWARENESS OF IMPORTANT HEALTH TOPICS SUCH AS CHOLESTEROL, NUTRITION, BLOOD PRESSURE, VISION, HEARING, AND MANY MORE. IN ADDITION, A RANGE OF SCREENINGS ARE OFFERED AT LOW COST OR THROUGH FREE CLINICS TO PROMOTE EARLY DETECTION OF CERTAIN CANCERS. TRINITY HEALTH ALSO LAUNCHED A NEW SCREENING SERVICE AIMED TO IDENTIFY PATIENTS AT RISK FOR HEART ATTACK OR STROKE THROUGH SOME SIMPLE TESTS. THESE IMAGING EXAMS, AVAILABLE ON DEMAND WITH NO REFERRAL NEEDED, HELP PATIENTS AND THEIR PRIMARY CARE PROVIDERS TO ASSESS THEIR RISKS AND BETTER UNDERSTAND ANY BENEFIT FOR FURTHER INTERVENTIONS. THROUGH THIS PROGRAM, MYCHOICE HEALTH CHECKS, PATIENTS ARE EDUCATED ABOUT HOW THEY MIGHT IMPROVE THEIR RISKS OF HEART ATTACK AND STROKE THROUGH BETTER DIETS, EXERCISE, AND OTHER LIFESTYLE MODIFICATIONS. BECAUSE OF LIMITED RESOURCES, WE CANNOT RESPOND EFFECTIVELY TO EVERY IDENTIFIED HEALTH NEED. WE HAVE CHOSEN OUR RESPONSES BASED ON ANALYSIS OF OUR RESOURCES, OUR MISSION, OUR EXISTING SPECIALTIES, COMMUNITY PRIORITIES, AND EXISTING COMMUNITY RESOURCES. TRINITY HOSPITAL ST. JOSEPH'S PART V, SECTION B, LINE 11: IN THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, TRINITY HOSPITAL IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS: ACCESS, SUBSTANCE ABUSE, MENTAL HEALTH, AND OBESITY. IN A PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT, ILLNESS AND DISEASE WAS ALSO IDENTIFIED AS A SIGNIFICANT HEALTH NEED. DURING THE YEAR ENDED 6/30/2016, TRINITY HOSPITAL TOOK THE FOLLOWING ACTIONS TO ADDRESS THOSE NEEDS. ADDITIONALLY, THROUGH FY 2018, TRINITY HEALTH CONTINUED THESE EFFORTS AND STRATEGIES TO IMPROVE ON EACH TARGETED AREA.ACCESSAS IT WAS WITH MOST PROVIDERS ACROSS ND, ACCESS TO SERVICES WAS SIGNIFICANTLY IMPACTED BY WORKFORCE SHORTAGES. TRINITY HEALTH RESPONDED TO SHORTAGES IN ITS WORKFORCE BY SUCCESSFULLY RECRUITING SEVERAL PROVIDERS TO ITS MEDICAL STAFF, ADDING ALLIED HEALTH PROVIDERS TO AUGMENT PHYSICIAN ACCESS. TRINITY HEALTH ALSO DEPLOYED STRATEGIES TO IMPROVE INFORMATION AVAILABLE TO CONSUMERS BY DEVELOPING A ROBUST MOBILE DEVICES APPLICATION, LAUNCHING AN ELECTRONIC PATIENT PORTAL FEATURING SECURE MESSAGING AND APPOINTMENT REQUESTS WITH PROVIDERS, AND ENHANCING ITS PHYSICIAN REFERRAL SERVICE.TRINITY HEALTH CONTINUED TO AGGRESSIVELY RECRUIT MEDICAL PROVIDERS IN BOTH PRIMARY AND SPECIALTY CARE. THIS EFFORT TO IMPROVE ACCESS RESULTED IN NEW PROVIDERS TO OUR PHYSICIAN NETWORK, INCLUDING MENTAL HEALTH PROVIDERS IN WILLISTON AND MINOT. IN 2018, TRINITY HEALTH LAUNCHED ITS FIRSTCARE WALK-IN CLINIC IN DOWNTOWN MINOT. THIS WALK-IN CLINIC OFFERS EXPANDED HOURS, INCLUDING EVENING, HOLIDAY AND WEEKEND HOURS, AND ITS PROVIDERS SEE ALL PATIENT AGES. TO MANAGE CONSUMERS' EXPECTATIONS ABOUT WAITING TIMES AT THE WALK-IN CLINIC, TRINITY HEALTH INCLUDES AN ESTIMATED WAIT-TIME ON ITS INTERNET WEBSITE AND MOBILE DEVICE APPLICATION. TO HELP PATIENTS FIND THE SERVICES AND PROVIDERS THEY NEED, TRINITY HEALTH BEGAN DEVELOPMENT ON A NEW USER-FRIENDLY WEBSITE BY AUDITING THE EXISTING SITE, RESEARCHING BEST PRACTICES, SURVEYING USERS, AND LISTENING TO FEEDBACK. THE STRATEGY FOCUSED ON PUTTING CONSUMERS FIRST TO MEET THEIR NEEDS AND SIMPLIFY THEIR ACTIONS FROM ANY DEVICE THEY USE TO CONNECT WITH TRINITY HEALTH. SUBSTANCE ABUSE "BATTLING DRUG AND ALCOHOL ABUSE" WAS A COMMUNITY EDUCATION ACTIVITY TRINITY HEALTH PROVIDED IN THE REGION, AND THIS PRESENTATION WAS GIVEN IN AREA SCHOOLS. PROVIDERS ALSO VISITED AREA HIGH SCHOOL CLASSES TO PRESENT INFORMATION ABOUT SUBSTANCE ABUSE AND THE TRAGIC CONSEQUENCES THAT COMMONLY OCCUR, BASED ON THEIR EXPERIENCES IN THE LOCAL EMERGENCY ROOM. MENTAL HEALTHMANY PEOPLE WHO ARE AFFECTED BY SUBSTANCE ABUSE SUFFER FROM UNDERLYING MENTAL HEALTH ISSUES AS WELL. TRINITY HEALTH HAS EXPANDED ITS OUTREACH FOR MENTAL HEALTH SERVICES AND IMPROVED ACCESS BY ADDING PROVIDERS; FOR EXAMPLE, WE ADDED RESOURCES IN MINOT AND WILLISTON TO HELP ADDRESS A GROWING NEED FOR ACCESS. SUBSTANCE ABUSE AND MENTAL HEALTH CARE CANNOT BE ADDRESSED BY ANY ONE ORGANIZATION ALONE, AND TRINITY IS PARTNERING WITH OTHER AGENCIES IN THE REGION IN AN EFFORT TO COORDINATE EFFORTS, WORK THROUGH BARRIERS, AND BETTER SERVE ITS COMMUNITY. MEMBERS OF TRINITY HEALTH'S TEAM SUPPORTED EFFORTS IN THE COMMUNITY TO BETTER UNDERSTAND THE SCOPE OF OPIOID ABUSE IN OUR COMMUNITY AND HELPED TO DESIGN APPROACHES AIMED AT REDUCING THE RISKS LEADING TO ABUSE AND IMPROVING TREATMENT AWARENESS IN THE COMMUNITY. PARENTING EDUCATION WAS A TOPIC PRESENTED TO THE PUBLIC LAST YEAR, HELPING PARENTS NAVIGATE SOME OF THE MORE DIFFICULT SITUATIONS THEY FACE IN RAISING CHILDREN TODAY. AT-RISK HOUSEHOLDS, TYPICALLY REFERRED BY AREA SCHOOLS AND COURTS, WERE AMONG ITS TARGETED AUDIENCES.TRINITY HEALTH PARTICIPATED IN AN OUTREACH EFFORT IN PARTNERSHIP WITH AREA AGENCIES, INCLUDING COURT AND LAW ENFORCEMENT OFFICIALS, TO IMPROVE COMMUNICATION AND AWARENESS OF MENTAL HEALTH ISSUES RELATED TO ACCESS, PROCEDURES, AND MORE.TRINITY HEALTH PROVIDES NEWLY REMODELED SPACE IN THE HOSPITAL TO ACCOMMODATE A REGIONAL SANE (SEXUAL ASSAULT NURSE EXAMINERS) PROGRAM, WHERE SPECIALLY TRAINED NURSES INTERVIEW AND ADVOCATE FOR SEXUAL ASSAULT VICTIMS. THESE VICTIMS ARE NOW TREATED AND INTERVIEWED IN A MORE COMFORTABLE AND PRIVATE ENVIRONMENT. OBESITYOUR FOCUS CONTINUES TO BE ON CHILDREN, AND HOW TO HELP KIDS DEVELOP HEALTHY HABITS REGARDING NUTRITION AND EXERCISE. FOR EXAMPLE, TRINITY HEALTH SPONSORED A PROGRAM AT THE WEE LINKS GOLF COURSE TO ENCOURAGE AND INCENTIVIZE KIDS TO EXERCISE THROUGH ACTIVITY, IN THIS CASE, GOLF. TRINITY HEALTH USES NUTRITIONISTS AND OTHER HEALTHCARE PROFESSIONALS TO VISIT WITH THE KIDS AND THEIR PARENTS ABOUT AVOIDING OBESITY THROUGH HEALTHY LIFESTYLE CHOICES. TRINITY HEALTH ALSO SPONSORED ACTIVITIES TO COMBAT OBESITY. FOR EXAMPLE, OUR DIETICIANS LEAD AN ONGOING "GROCERY STORE TOUR" FOR ANYONE IN THE COMMUNITY TO JOIN AND LEARN HOW TO SHOP FOR BETTER HEALTH, AS WELL AS A COOKING CLASSES FOR PEOPLE TO LEARN HOW TO COOK IN HEALTHIER WAYS. THIS EFFORT WAS ENHANCED THIS YEAR THROUGH THE PURCHASE OF A "PORTABLE KITCHEN" TO HELP DEMONSTRATE THE TECHNIQUES BEING TAUGHT. TRINITY HEALTH PROMOTES WELLNESS THROUGH A NATIONALLY-KNOWN PROGRAM, FRANCHISING ITS OWN CROSSFIT PROGRAM. LED BY ONE OF OUR PHYSICIANS, THE THEME OF "EXERCISE IS MEDICINE" WAS PROMOTED TO THE COMMUNITY, COMPLETE WITH A PUBLIC INVITATION TO WALK AT A LOCAL PARK THROUGH THE WARM SEASON FEATURING A "DOC WALK," WHERE HEALTHCARE PROFESSIONALS LED THE COMMUNITY WALK EFFORT. ILLNESS AND DISEASETRINITY HEALTH ADDED A NUMBER OF ACTIVITIES AIMED AT IMPROVING HEART HEALTH AWARENESS THROUGH ITS HEALTHY HEARTS PROGRAM, TO PROVIDE A MECHANISM FOR COMMUNITY EDUCATION AND ACTIVITIES TO SUPPORT HEART HEALTH.IN AN EFFORT TO ENHANCE AWARENESS OF THE SIGNS AND SYMPTOMS OF STROKE, TRINITY HEALTH CONTINUED ITS STROKE AWARENESS CAMPAIGN, WHICH INCLUDED SOCIAL MEDIA, SIGNS AND BANNERS, PAID ADVERTISING, AND MEDIA RELEASES ABOUT STROKE STORIES AND TREATMENT. THE GOAL OF THE CAMPAIGN IS TO MAKE THE PUBLIC AWARE OF THE ACRONYM, FAST, TO ENCOURAGE INTERVENTION WHEN SOMEONE RECOGNIZES A POTENTIAL STROKE. TRINITY HEALTH MAINTAINS AN ANNUAL SCHEDULE OF NATIONAL OBSERVANCES TO BUILD AWARENESS OF IMPORTANT HEALTH TOPICS SUCH AS CHOLESTEROL, NUTRITION, BLOOD PRESSURE, VISION, HEARING, AND MANY MORE. IN ADDITION, A RANGE OF SCREENINGS ARE OFFERED AT LOW COST OR THROUGH FREE CLINICS TO PROMOTE EARLY DETECTION OF CERTAIN CANCERS. TRINITY HEALTH ALSO LAUNCHED A NEW SCREENING SERVICE AIMED TO IDENTIFY PATIENTS AT RISK FOR HEART ATTACK OR STROKE THROUGH SOME SIMPLE TESTS. THESE IMAGING EXAMS, AVAILABLE ON DEMAND WITH NO REFERRAL NEEDED, HELP PATIENTS AND THEIR PRIMARY CARE PROVIDERS TO ASSESS THEIR RISKS AND BETTER UNDERSTAND ANY BENEFIT FOR FURTHER INTERVENTIONS. THROUGH THIS PROGRAM, MYCHOICE HEALTH CHECKS, PATIENTS ARE EDUCATED ABOUT HOW THEY MIGHT IMPROVE THEIR RISKS OF HEART ATTACK AND STROKE THROUGH BETTER DIETS, EXERCISE, AND OTHER LIFESTYLE MODIFICATIONS. BECAUSE OF LIMITED RESOURCES, WE CANNOT RESPOND EFFECTIVELY TO EVERY IDENTIFIED HEALTH NEED. WE HAVE CHOSEN OUR RESPONSES BASED ON ANALYSIS OF OUR RESOURCES, OUR MISSION, OUR EXISTING SPECIALTIES, COMMUNITY PRIORITIES, AND EXISTING COMMUNITY RESOURCES. TRINITY KENMARE HOSPITAL PART V, SECTION B, LINE 11: IN THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, TRINITY KENMARE HOSPITAL IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS: ACCESS TO HEALTHCARE AND SUBSTANCE ABUSE. DURING THE YEAR ENDED 6/30/2016, TRINITY KENMARE HOSPITAL TOOK THE FOLLOWING ACTIONS TO ADDRESS THOSE NEEDS. ADDITIONALLY, TRINITY HEALTH CONTINUED TO PURSUE THESE STRATEGIES THROUGH FY 2018. ACCESS TO HEALTHCAREKENMARE HOSPITAL UTILIZED A SYSTEM WHERE PATIENTS IN THE EMERGENCY ROOM WOULD BE MONITORED BY EMERGENCY MEDICINE PHYSICIANS VIA TELEMEDICINE EQUIPMENT (VIRTUAL ER), IN AN EFFORT TO AUGMENT LOCAL PROVIDERS WHEN NEEDED. AS IT WAS WITH MOST PROVIDERS ACROSS ND, ACCESS TO SERVICES CONTINUES TO BE SIGNIFICANTLY IMPACTED BY WORKFORCE SHORTAGES. TRINITY HEALTH RESPONDED TO SHORTAGES IN ITS WORKFORCE BY SUCCESSFULLY RECRUITING SEVERAL PROVIDERS TO ITS MEDICAL STAFF, ADDING ALLIED HEALTH PROVIDERS TO AUGMENT PHYSICIAN ACCESS. TRINITY HEALTH ALSO ENGAGED THE SERVICES OF SEVERAL TALENT-SEARCH FIRMS TO AUGMENT INTERNAL EFFORTS TO FILL KEY POSITIONS MORE QUICKLY. TRINITY HEALTH FOCUSED ON STRATEGIES TO IMPROVE INFORMATION AVAILABLE TO CONSUMERS BY ENHANCING ITS MOBILE DEVICES APPLICATION, BUILDING ON ITS ELECTRONIC PATIENT PORTAL FEATURING SECURE MESSAGING AND APPOINTMENT REQUESTS WITH PROVIDERS, AND ENHANCING ITS PHYSICIAN REFERRAL SERVICE. TO HELP PATIENTS FIND THE SERVICES AND PROVIDERS THEY NEED, TRINITY HEALTH BEGAN DEVELOPMENT ON A NEW USER-FRIENDLY WEBSITE BY AUDITING THE EXISTING SITE, RESEARCHING BEST PRACTICES, SURVEYING USERS, AND LISTENING TO FEEDBACK. THE STRATEGY FOCUSED ON PUTTING CONSUMERS FIRST TO MEET THEIR NEEDS AND SIMPLIFY THEIR ACTIONS FROM ANY DEVICE THEY USE TO CONNECT WITH TRINITY HEALTH. TRINITY HEALTH IMPROVED ITS APPOINTMENT REMINDER SOFTWARE SOLUTION, TO HELP PATIENTS KEEP THEIR MEDICAL APPOINTMENTS. FINALLY, TRINITY HEALTH CONTINUED TO AGGRESSIVELY RECRUIT MEDICAL PROVIDERS IN BOTH PRIMARY AND SPECIALTY CARE. THIS EFFORT TO IMPROVE ACCESS RESULTED IN TWO NEW PROVIDERS TO OUR KENMARE OPERATION, AND 6 PROVIDERS ADDED TO THE NETWORK TO SERVE AS A RESOURCE FOR OUTREACH CLINICS.SUBSTANCE ABUSE"BATTLING DRUG AND ALCOHOL ABUSE" WAS A COMMUNITY EDUCATION ACTIVITY TRINITY PROVIDED IN THE REGION, AND THIS PRESENTATION WAS GIVEN IN AREA SCHOOLS. PROVIDERS ALSO VISITED AREA HIGH SCHOOL CLASSES TO PRESENT INFORMATION ABOUT SUBSTANCE ABUSE AND THE TRAGIC CONSEQUENCES THAT COMMONLY OCCUR, BASED ON THEIR EXPERIENCES IN THE LOCAL EMERGENCY ROOM. BECAUSE OF LIMITED RESOURCES, WE CANNOT RESPOND EFFECTIVELY TO EVERY IDENTIFIED HEALTH NEED. WE HAVE CHOSEN OUR RESPONSES BASED ON ANALYSIS OF OUR RESOURCES, OUR MISSION, OUR EXISTING SPECIALTIES, COMMUNITY PRIORITIES, AND EXISTING COMMUNITY RESOURCES. TRINITY HOSPITAL PART V, SECTION B, LINE 13H: OTHER CRITERIA USED BY TRINITY HOSPITAL TO DETERMINE ELIGIBILITY UNDER THEIR FAP: 1. ELIGIBILITY FOR MEDICARE OR MEDICAID IS ALSO CONSIDERED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.2. TRINITY HOSPITAL MAY PRESUMPTIVELY DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR CHARITY CARE UNDER THIS POLICY WITHOUT A COMPLETED APPLICATION IF THE HOSPITAL IS ABLE TO VERFIY INCOME FROM A RELIABLE THIRD PARTY, I.E. SOCIAL SECURITY, MEDICAID, ETC. TRINITY HOSPITAL ST. JOSEPH'S PART V, SECTION B, LINE 13H: OTHER CRITERIA USED BY TRINITY HOSPITAL TO DETERMINE ELIGIBILITY UNDER THEIR FAP: 1. ELIGIBILITY FOR MEDICARE OR MEDICAID IS ALSO CONSIDERED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.2. TRINITY HOSPITAL MAY PRESUMPTIVELY DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR CHARITY CARE UNDER THIS POLICY WITHOUT A COMPLETED APPLICATION IF THE HOSPITAL IS ABLE TO VERFIY INCOME FROM A RELIABLE THIRD PARTY, I.E. SOCIAL SECURITY, MEDICAID, ETC. TRINITY KENMARE HOSPITAL PART V, SECTION B, LINE 13H: OTHER CRITERIA USED BY TRINITY HOSPITAL TO DETERMINE ELIGIBILITY UNDER THEIR FAP: 1. ELIGIBILITY FOR MEDICARE OR MEDICAID IS ALSO CONSIDERED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.2. TRINITY HOSPITAL MAY PRESUMPTIVELY DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR CHARITY CARE UNDER THIS POLICY WITHOUT A COMPLETED APPLICATION IF THE HOSPITAL IS ABLE TO VERFIY INCOME FROM A RELIABLE THIRD PARTY, I.E. SOCIAL SECURITY, MEDICAID, ETC. TRINITY HOSPITAL PART V, SECTION B, LINE 16J: PATIENTS IDENTIFIED AS POSSIBLE FINANCIAL ASSISTANCE CASES ARE ASKED TO COMPLETE A FINANCIAL ASSISTANCE FORM AND ARE REFERRED TO THE APPROPRIATE COUNSELOR. TRINITY HOSPITAL ST. JOSEPH'S PART V, SECTION B, LINE 16J: PATIENTS IDENTIFIED AS POSSIBLE FINANCIAL ASSISTANCE CASES ARE ASKED TO BE COMPLETE A FINANCIAL ASSISTANCE FORM AND ARE REFERRED TO THE APPROPRIATE COUNSELOR. TRINITY KENMARE HOSPITAL PART V, SECTION B, LINE 16J: PATIENTS IDENTIFIED AS POSSIBLE FINANCIAL ASSISTANCE CASES ARE ASKED TO BE COMPLETE A FINANCIAL ASSISTANCE FORM AND ARE REFERRED TO THE APPROPRIATE COUNSELOR. 29 1 - TRINITY HOMES 305 8TH AVENUE NE MINOT ND 58701 SKILLED NURSING HOME 2 - TRINITY HOSPITALS HOME HEALTHHOSPICE 1015 SOUTH BROADWAY SUITE 306 MINOT ND 58701 HOME HEALTH & HOSPICE 3 - TRINITY HOSPITALS HOSPITAL ROAD BELCOURT ND 58316 DIALYSIS SERVICES 4 - TCC-BELCOURT (KDU) 1310 HOSPITAL LOOP ROAD BELCOURT ND 58316 DIALYSIS SERVICES 5 - ORAL & FACIAL SURGERY CENTER-PLAZA 16 2815 16TH STREET SW MINOT ND 58702 ORAL & FACIAL SURGICAL SERVICES 6 - ORAL & FACIAL SURGERY CENTER-WILLISTON 2224 1ST AVE W WILLISTON ND 58801 ORAL & FACIAL SURGICAL SERVICES 7 - TRINITY REGIONAL EYECARE-WILLISTON 1321 W DAKOTA PARKWAY WILLISTON ND 55801 EYE HEALTH SERVICES 8 - TRINITY REGIONAL EYECARE-DEVIL'S LAKE 404 HWY 2 EAST DEVILS LAKE ND 58301 EYE HEALTH SERVICES 9 - VISION GALLERIA AT TRINITY - PLAZA 16 2815 16TH STREET SW MINOT ND 58702 OPTICAL AND CONTACT LENS DISPENSARY 10 - SAME DAY SURGERY CENTER 407 3RD ST SE MINOT ND 58701 SURGICAL SERVICES 11 - WESTERN DAKOTA SURGERY 1102 MAIN ST WILLISTON ND 58801 SURGICAL SERVICES 12 - TRINITY HEALTH CENTER-MEDICAL ARTS 400 BURDICK EXPRESSWAY EAST MINOT ND 58701 PROVIDER-BASED CLINIC 13 - TRINITY HEALTH CENTER-EAST 20 BURDICK EXPRESSWAY WEST MINOT ND 58701 PROVIDER-BASED CLINIC 14 - TRINITY HEALTH CENTER-WEST 101 3RD AVENUE SW MINOT ND 58701 PROVIDER-BASED CLINIC 15 - TRINITY REGIONAL EYECARE-MINOT CENTER 120 BURDICK EXPRESSWAY EAST MINOT ND 58701 PROVIDER-BASED CLINIC 16 - TRINITY HEALTH CENTER-RIVERSIDE 1900 8TH AVENUE SE MINOT ND 58701 PROVIDER-BASED CLINIC 17 - TRINITY HEALTH CENTER-TOWN & COUNTRY 831 SOUTH BROADWAY MINOT ND 58701 PROVIDER-BASED CLINIC 18 - MAIN MEDICAL BUILDING 315 SOUTH MAIN MINOT ND 58701 PROVIDER-BASED CLINIC 19 - TRINITY HEALTH SOUTH RIDGE 1500 24TH AVENUE SW MINOT ND 58701 PROVIDER-BASED CLINIC 20 - TCC-WESTERN DAKOTA 1321 WEST DAKOTA PARKWAY WILLISTON ND 58801 PROVIDER-BASED CLINIC 21 - TRINITY HEALTH CENTER-3RD STREET 420 3RD ST SE MINOT ND 58701 PROVIDER-BASED CLINIC 22 - TRINITY HEALTH CENTER-5TH AVENUE 307 5TH AVE SE MINOT ND 58701 PROVIDER-BASED CLINIC 23 - TRINITY COMMUNITY CLINIC KENMARE 307 1ST AVENUE NW KENMARE ND 58746 RURAL HEALTH CLINIC 24 - TCC-GARRISON PO BOX 1179 GARRISION ND 585401179 RURAL HEALTH CLINIC 25 - TCC-MOHALL 504 1ST ST SW MOHALL ND 58760 RURAL HEALTH CLINIC 26 - TCC-NEW TOWN PO BOX 1029 NEW TOWN ND 587631029 RURAL HEALTH CLINIC 27 - TCC-VELVA PO BOX 70 VELVA ND 587900070 RURAL HEALTH CLINIC 28 - TCC-WESTHOPE PO BOX 383 WESTHOPE ND 587930383 RURAL HEALTH CLINIC 29 - COMMUNITY AMBULANCE SERVICE OF MINOT PO BOX 2195 MINOT ND 58702 AMBULANCE SERVICES PART I, LINE 3C: TO BE ELIGIBLE FOR FREE CARE UNDER TRINITY HEALTH'S FINANCIAL ASSISTANCE POLICY, THE SERVICES MUST BE MEDICALLY NECESSARY, THE PERSON'S HOUSEHOLD INCOME MUST BE BELOW 250% OF FEDERAL POVERTY GUIDELINES, THEY MUST RESIDE WITHIN TRINITY HEALTH'S SERVICE AREA, THEY MUST EXHAUST OTHER FINANCIAL ASSISTANCE OPPORTUNITIES (E.G.: MEDICARE, MEDICAID), AND THEY MUST PROVIDE A COMPLETE FINANCIAL ASSISTANCE APPLICATION. SPECIAL CONSIDERATION IS GIVEN WHEN INCOME LEVELS EXCEED THE INCOME GUIDELINES FOR CHARITY CARE AND THE HEALTHCARE EXPENSES EXCEED A SIGNIFICANT MULTIPLE OF THE HOUSEHOLD'S ANNUAL INCOME. PART I, LINE 7: TRINITY'S COMMUNITY BENEFIT EXPENSES AND REVENUES WERE CALCULATED USING THE IRS WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO THE 2017 FORM 990, SCHEDULE H. PART I, LN 7 COL(F): $16,862,202 OF BAD DEBT EXPENSE WAS EXCLUDED IN CALCULATING THE PERCENTAGES REPORTED IN PART I, LINE 7, COLUMN F.IN FURTHERANCE OF ITS CHARITABLE PURPOSE, TRINITY PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY, INCLUDING OFFERING VARIOUS COMMUNITY-BASED SERVICE PROGRAMS SUCH AS FREE CLINICS, HEALTH SCREENINGS, IN-HOME CAREGIVER SERVICES, SOCIAL SERVICE AND SUPPORT COUNSELING FOR PATIENTS AND FAMILIES, PASTORAL CARE, CRISIS INTERVENTION, TRANSPORTATION TO AND FROM THE HOSPITAL CAMPUSES, AND THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS. ADDITIONALLY, A LARGE NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS, TELEPHONE INFORMATION SERVICES, AND COSTS RELATED TO PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. THE COST OF PROVIDING THE ABOVE SERVICES IS NOT INCLUDED IN TRINITY'S CHARITY CARE AMOUNT. PART III, LINE 2: TRINITY PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED CHARGE TO RESIDENTS OF ITS COMMUNITY THROUGH THE PROVISION OF CHARITY CARE. INCLUDED IN TRINITY'S DEFINITION OF CHARITY CARE ARE THE FOLLOWING: (A) SERVICES PROVIDED TO THE UNINSURED OR UNDERINSURED AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED TO BE UNABLE TO PAY BECAUSE OF SOCIOECONOMIC FACTORS.TRINITY MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THOSE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR CHARITY CARE.AMOUNTS DO NOT INCLUDE THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS OR THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES. TRINITY USES THE COST-TO-CHARGE RATIO TO DETERMINE THE AMOUNTS REPORTED IN LINE 2. PART III, LINE 3: TRINITY IS REPORTING $0 ON LINE 3 BECAUSE THE ORGANIZATION DOES NOT HAVE A RELIABLE ESTIMATE OF THE PORTION OF BAD DEBT EXPENSE ATTRIBUTABLE TO INDIVIDUALS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DID NOT COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE, NET NOTE ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS REPORTED ON PART III, LINE 6 WAS DERIVED USING TRINITY HOSPITALS AND KENMARE'S 2018 MEDICARE COST REPORTS. PART III, LINE 9B: IT IS THE POLICY OF TRINITY TO PROVIDE MEDICAL SERVICES TO THE COMMUNITY AND REGION REGARDLESS OF THE CUSTOMER'S ABILITY TO PAY THROUGH CONSISTENT BILLING PRACTICES. ACCOUNTS WILL BE MONITORED TO ENSURE THAT CUSTOMERS ARE BILLED FOR ONLY THOSE SERVICES PROVIDED. TRINITY, THROUGH VERIFICATION OF INFORMATION, IS REQUIRED TO PROVIDE TIMELY AND ACCURATE BILLING, COLLECTION, AND PATIENT ACCOUNT MAINTENANCE. INFORMATION REGARDING TRINITY'S BILLING AND PAYMENT GUIDELINES, WHICH INCLUDES FINANCIAL ASSISTANCE PROGRAMS, ARE AVAILABLE AT REGISTRATION AND BUSINESS SERVICES LOCATIONS. THIS INFORMATION IS COMMUNICATED VERBALLY OR THROUGH THE USE OF THE TRINITY BILLING & PAYMENT GUIDELINES BROCHURE. TO ENHANCE VERBAL COMMUNICATIONS, INTERPRETERS ARE PROVIDED AS NECESSARY. PART VI, LINE 2: TRINITY HEALTH COMPLETES A THOROUGH COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, IN COMPLIANCE WITH SECTION 501(R). TRINITY'S FIRST COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED DURING THE YEAR ENDED JUNE 30, 2013 AND SECOND WAS COMPLETED DURING THE YEAR ENDED JUNE 30, 2016. THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT FOR BOTH YEARS IS AVAILABLE ONLINE AT HTTP://WWW.TRINITYHEALTH.ORG/COMMUNITY. PART VI, LINE 3: TRINITY HEALTH'S HOSPITALS WIDELY PUBLICIZE FINANCIAL ASSISTANCE INFORMATION IN ALL OF THE METHODS REQUIRED UNDER SECTION 501(R) AND RELATED REGULATIONS. EXAMPLES INCLUDE INFORMATION ON BILLING STATEMENTS, INFORMATION POSTED IN ADMISSIONS AREAS AND EMERGENCY ROOMS, AND INFORMATION PROVIDED AT ADMISSION. IN ADDITION, PATIENT ACCESS AND BUSINESS OFFICE STAFF ATTEMPT TO IDENTIFY ALL CASES THAT WILL QUALIFY FOR FINANCIAL ASSISTANCE AT THE TIME OF ADMISSION. PATIENTS IDENTIFIED AS POSSIBLE FINANCIAL ASSISTANCE CASES ARE ASKED TO COMPLETE A FINANCIAL ASSISTANCE FORM AND ARE REFERRED TO THE APPROPRIATE COUNSELOR. PART VI, LINE 4: ALTHOUGH TRINITY HOSPITAL AND TRINITY HOSPITAL - ST. JOSEPH'S ARE LOCATED IN MINOT, NORTH DAKOTA, WE HAVE HISTORICALLY DEFINED OUR "COMMUNITY" AS A BROADER AREA THAT INCLUDES NORTHWESTERN NORTH DAKOTA AS WELL AS A PORTION OF NORTHEASTERN MONTANA. WITHIN THIS BROADER COMMUNITY, APPROXIMATELY TWO-THIRDS OF OUR INPATIENTS AND OUTPATIENTS RESIDE WITHIN IN AND IMMEDIATELY AROUND THE CITY OF MINOT AND WARD COUNTY. UNDERSTANDING OUR COMMUNITY REQUIRES AN UNDERSTANDING OF NORTH DAKOTA'S OIL RESERVES. UNDERLYING NORTHWESTERN NORTH DAKOTA IS A MASSIVE ROCK FORMATION, REFERRED TO AS THE BAKKEN SHALE, WHICH HOLDS AN ESTIMATED 18 BILLION BARRELS OF CRUDE OIL. WHEN THIS RESOURCE WAS FIRST DISCOVERED IN 1951, RECOVERING IT WAS FINANCIALLY UNFEASIBLE BECAUSE THE OIL WAS EMBEDDED IN THE STONE. THEN, AROUND 2008, EVERYTHING CHANGED. NEW DRILLING TECHNOLOGY CALLED HYDRAULIC FRACTURING, OR 'FRACKING', BECAME WIDESPREAD, AND OIL PRODUCTION TOOK OFF. AS OF 2013, THERE ARE MORE THAN 200 ACTIVE OIL RIGS IN NORTH DAKOTA, PRODUCING ABOUT 20 MILLION BARRELS OF OIL EVERY MONTH. THE RIGS AND SUPPORT SYSTEMS HAVE RESCULPTED THE LANDSCAPE, MILLIONS OF DOLLARS HAVE BEEN INVESTED ON INFRASTRUCTURE UPGRADES ACROSS THE AREA.AS THE PRICE OF OIL PEAKED IN 2015, THEN DROPPED, ALONG WITH SIGNIFICANT OUTFLOWS OF OIL FIELD WORKERS, THE PRICE HASA STABILIZED AND LEASES ARE NEARING RENEWAL, OIL FIELD WORKERS ARE NOW INFLOWING ONCE AGAIN. MAJOR OIL COMPANIES ARE ON THE REHIRE TRACE ONCE AGAIN (FOR APPROXIMATELY 800 WORKERS). ALTHOUGH MUCH OF THE OIL FIELD ACTIVITY OCCURS TO THE WEST OF MINOT, OUR COMMUNITY HAS BEEN SIGNIFICANTLY IMPACTED BY THE FLUCTUATION OF PEOPLE INTO AND OUT OF OUR COMMUNITY. DEMAND FOR ALMOST EVERY GOOD, FROM HOUSING TO CLOTHING TO FOOD, TO HUMAN CAPITAL HAS FLUCTUATED, AND OUR COMMUNITY HAS STRUGGLED WITH THESE FLUCTUATIONS. PART VI, LINE 5: IN FURTHERANCE OF ITS CHARITABLE PURPOSE, TRINITY PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY, INCLUDING OFFERING VARIOUS COMMUNITY-BASED SERVICE PROGRAMS SUCH AS FREE CLINICS, HEALTH SCREENINGS, IN-HOME CAREGIVER SERVICES, SOCIAL SERVICE AND SUPPORT COUNSELING FOR PATIENTS AND FAMILIES, PASTORAL CARE, CRISIS INTERVENTION, TRANSPORTATION TO AND FROM THE HOSPITAL CAMPUSES, AND THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS. ADDITIONALLY, A LARGE NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS, TELEPHONE INFORMATION SERVICES, AND COSTS RELATED TO PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. PART VI, LINE 6: THIS FORM 990 INCLUDES TRINITY HOSPITAL, TRINITY HOSPITAL-ST. JOSEPH'S, AND TRINITY KENMARE HOSPITAL. THESE THREE HOSPITALS ARE PART OF TRINITY HEALTH SYSTEM. TRINITY HEALTH IS THE PARENT ORGANIZATION. THE SYSTEM ALSO INCLUDES TRINITY HEALTH FOUNDATION, TRINITY HOMES, AND COMMUNITY AMBULANCE SERVICE OF MINOT, ALL OF WHICH ARE TAX-EXEMPT 501(C)(3) ORGANIZATIONS, AS WELL AS MEDICAL ARTS OUTPATIENT SERVICES INC. AND B&B DRUG INC., BOTH OF WHICH ARE FOR-PROFIT C CORPORATIONS. PART VI, LINE 7, REPORTS FILED WITH STATES ND 0 MINOT FAMILY YMCA 3515 16TH ST SW MINOT ND 58701 450237612 501(C)(3) 100000 SUPPORT OPERATIONS MINOT POLICE DEPARTMENT 515 2ND AVE SW MINOT ND 58701 450353644 MINOT POLICE DEPT 7000 SUPPORT K-9 PROGRAM NORTH DAKOTA STATE FAIR PO BOX 1796 MINOT ND 58702 450215346 501(C)(3) 18000 SUPPORT OPERATIONS 3 0 HARDSHIP ASSISTANCE 31 71317 CANCER ASSISTANCE 102 113589 PART I, LINE 2: TRINITY HEALTH & AFFILIATES DOES NOT HAVE A PROCEDURE FOR MONITORING USE OF GRANT FUNDS. 0 0 0 1 1 0 0 0 0 SCOTT KNUTSON MD DIRECTOR 0 541454 0 40000 0 0 0 4050 0 18433 0 603937 0 0 MARTIN ROTHBERG MD DIRECTOR 0 717651 0 50000 0 0 0 5550 0 7453 0 780654 0 0 JOHN KUTCH PRESIDENT & CEO 0 797156 0 14967 0 936 0 4050 0 18433 0 835542 0 0 DENNIS EMPEY VICE PRESIDENT & CFO 0 354586 0 0 0 936 0 5550 0 18433 0 379505 0 0 RANDY SCHWAN VICE PRES. - MISSION INTEGRATION 0 206020 0 3862 0 936 0 3200 0 8169 0 222187 0 0 PAUL SIMONSON VICE PRES. - HUMAN RESOURCES 0 260178 0 6748 0 936 0 5550 0 18433 0 291845 0 0 THOMAS WARSOCKI VICE PRES. - PHYSICIAN OPERATIONS 0 202375 0 3884 0 936 0 3218 0 18433 0 228846 0 0 DAVE KOHLMAN VICE PRES. - FACILITIES MANAGEMENT 0 189770 0 3770 0 936 0 4511 0 17192 0 216179 0 0 KAREN ZIMMERMAN RN VICE PRES. & CNO 0 171824 0 0 0 936 0 4169 0 1241 0 178170 0 0 TRENT CHASTAIN VICE PRES - REVENUE CYCLE (THROUGH MARCH 2018) 0 170051 0 0 0 936 0 204 0 18433 0 189624 0 0 RHONDA WALTER VICE PRES - VICE PRES. - NCF ADMINISTRATOR 0 174978 0 0 0 936 0 4266 0 18433 0 198613 0 0 PHILIP PATTERSON VICE PRES. & CAO (THROUGH FEB 2018) 0 251845 0 0 0 0 0 3750 0 7453 0 263048 0 0 GLEN TAYLOR WILSON VICE PRES. - CLINICAL INTEGRATION 0 264719 0 0 0 936 0 5489 0 6929 0 278073 0 0 PART I, LINE 3 JOHN KUTCH, PRESIDENT & CEO, IS COMPENSATED BY TRINITY HEALTH, A RELATED ORGANIZATION. TRINITY HEALTH USES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION FOR JOHN: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. FORM 990 OF OTHER ORGANIZATIONS 4. COMPENSATION SURVEY OR STUDY 5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 5 PHYSICIANS RECEIVE INCENTIVE COMPENSATION FROM TRINITY HEALTH, A RELATED ORGANIZATION, BASED ON MULTIPLE FACTORS INCLUDING THE NUMBER OF PATIENTS SERVED AND RELATIVE VALUE UNITS (RVUS), WHICH IS CLOSELY CONNECTED TO REVENUES. A WARD COUNTY NORTH DAKOTA 456002248 2017-09-27 56875000 REFUND SERIES 2006 BONDS; HOSPITAL CONSTRUCTION 0 0 0 B WARD COUNTY NORTH DAKOTA 456002248 394023EW8 2017-12-28 382748522 HOSPITAL CONSTRUCTION 0 0 0 A 2864500 56875000 510395 9960000 46404605 2019 1 0 0 1 B 382748522 24842000 29339094 3562519 4994451 377754070 2019 0 0 0 1 A 0 1 0 0 0.00630 0.00630 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 0 1 0 0 1 SEE PART VI 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WARD COUNTY, NORTH DAKOTA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/01/2018 SCHEDULE K, PART IV, LINE 5, COLUMN B: CAPITALIZED INTEREST FUND: WELLS FARGO SECURITIES, LLC; 2.0 YEARS; NO* PROJECT FUND: BAYERISCHE LANDESBANK; 2.6 YEARS; YES PROJECT FUND: NATIXIS FUNDING CORP; 2.6 YEARS; NO** DEBT SERVICE RESERVE FUND: TD SECURITIES; 2.6 YEARS; YES DEBT SERVICE RESERVE FUND: WELLS FARGO SECURITIES, LLC; 0.5 YEARS; YES *THE INVESTMENT IN THE CAPITALIZED INTEREST FUND DID NOT TECHNICALLY SATISFY THE SAFE HARBORS FOR GIC'S BECAUSE THE CONTRACT WAS AWARDD TO THE LOWEST BONA FIDE OFFER RATHER THAN TO THE HIGHEST YIELDING BONA FIDE OFFER. **THE PROJECT FUND INVESTMENT WAS SPLIT BETWEEN TWO CONTRACTS WITH SEPARATE PROVIDERS TO ACHIEVE DIVERSIFICATION OF COUNTERPARTY EXPOSURE. AS REQUIRED BY THE TERMS OF THE SOLICITATION, THE BID FROM BAYERISCHE LANDESBANK, AS THE WINNING BIDDER WITH RESPECT TO THE FIRST CONTRACT, WAS AUTOMATICALLY DISQUALIFIED WITH RESPECT TO THE SECOND CONTRACT. X 2 2625 FMV X 510 FMV X 93826 FMV X 4 704 FMV X GIFT CARDS 56 10866 FMV X MINERAL RIGHTS 1 10421 FMV X EQUIPMENT 1 1200 FMV 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPOSED OF THE OFFICERS OF THE BOARD OF DIRECTORS, EACH VESTED WITH FULL VOTING AUTHORITY. THEY MEET AS NEEDED TO PLAN FOR THE BOARD'S WORK AND TO FULFILL TASKS ASSIGNED TO THEM BY THE BOARD. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO ACT AND MAKE DECISIONS ON BEHALF OF THE ENTIRE BOARD WHEN URGENT MATTERS ARISE BETWEEN REGULARLY SCHEDULED BOARD MEETINGS. THE EXECUTIVE COMMITTEE IS OBLIGATED TO PRESENT ITS ACTIONS TO THE ENTIRE BOARD IF A DECISION HAS BEEN MADE IN ITS ABSENCE. FORM 990, PART VI, SECTION A, LINE 6 TRINITY HEALTH IS THE SOLE MEMBER OF EACH CORPORATION INCLUDED IN THIS GROUP RETURN. FORM 990, PART VI, SECTION A, LINE 7A AT EACH ANNUAL MEETING, THE SOLE MEMBER, TRINITY HEALTH, APPOINTS THE BOARD OF DIRECTORS. AT LEAST SEVEN OF THE BOARD OF DIRECTORS ALSO SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF TRINITY HEALTH. IN THE BYLAWS OF TRINITY HEALTH FOUNDATION, THIS OVERLAP ONLY NEEDS TO BE THREE. ANY DIRECTOR WHO CEASES TO BE A MEMBER OF THE TRINITY HEALTH BOARD OF DIRECTORS AUTOMATICALLY BECOMES DISQUALIFIED FROM SERVING AS A DIRECTOR OF THE AFFILIATES' BOARD AND IS REPLACED WITH ANOTHER BOARD MEMBER CURRENTLY SERVING ON THE BOARD OF TRINITY HEALTH, UNLESS THERE ARE AT LEAST A MINIMUM OF SEVEN (OR THREE IN THE CASE OF TRINITY HEALTH FOUNDATION) OTHER BOARD MEMBERS CURRENTLY SERVING AS A DIRECTOR OF TRINITY HEALTH. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE SOLE MEMBER, TRINITY HEALTH: (A) APPROVE THE APPOINTMENT OF OFFICERS; (B) APPROVE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS; (C) APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS; (D) APPROVE THE SELECTION OF AUDITORS AND LEGAL COUNSEL; (E) APPROVE ANY STRATEGIC PLANS ADOPTED; (F) APPROVE ANY UNBUDGETED BORROWING, ANY ENCUMBRANCE OF ASSETS, AND ANY EXPENDITURES FOR CAPITAL IMPROVEMENTS WHERE THE AMOUNT EXCEEDS FIVE PERCENT OF THE CAPITAL BUDGET PREVIOUSLY APPROVED; (G) CHANGE THE NUMBER OF DIRECTORS OF THE BOARD OF DIRECTORS; AND (H) APPROVE ANY ACTION THAT IS NOT IN THE ORDINARY COURSE OF BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO BEING FILED WITH THE IRS, A COPY OF THE FORM 990 WAS GIVEN TO THE GOVERNING BODY OF TRINITY HEALTH & AFFILIATES FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL SALARIED EMPLOYEES (AT MANAGER LEVEL AND ABOVE AS DETERMINED BY TRINITY) AND SUCH OTHER EMPLOYEES AS FROM TIME TO TIME MAY BE DIRECTED TO DO SO, ARE REQUIRED TO COMPLETE TRINITY HEALTH'S CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. ANY EMPLOYEE WHO HAS ASSUMED, OR IS ABOUT TO ASSUME, A FINANCIAL OR OTHER INTEREST OR RELATIONSHIP THAT MIGHT INVOLVE A CONFLICT OF INTEREST MUST IMMEDIATELY INFORM HIS/HER SUPERVISOR, A MEMBER OF THE COMPLIANCE COMMITTEE, OR THE COMPLIANCE OFFICER. ISSUES INVOLVING CONFLICT OF INTEREST SHALL BE REVIEWED AND A DETERMINATION OF EACH SHALL BE MADE BY THE TRINITY COMPLIANCE COMMITTEE. IF A CONFLICT EXISTS, THE CONFLICTED PERSON MUST ABSTAIN FROM DISCUSSION OF AND VOTING ON THE CONFLICTED TOPIC. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF TRINITY HEALTH REVIEWED COMPENSATION INFORMATION FOR THE CEO, WHICH HAD BEEN PREVIOUSLY PREPARED BY DELOITTE AND TOURCHE. DELOITTE AND TOUCHE ANALYZED FOUR COMPENSATION SURVEYS OF HEALTH CARE EMPLOYERS AND REVIEWED FORM 990 FILINGS FOR A PEER GROUP ANALYSIS. FORM 990, PART VI, SECTION C, LINE 19 ON OUR WEBSITE WWW.TRINITYHEALTH.ORG WE LIST OUR BOARD OF DIRECTORS, MISSION, VISION, VALUES AND OUR ANNUAL REPORT WHICH INCLUDES FINANCIAL INFORMATION. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL PROFESSIONALS: PROGRAM SERVICE EXPENSES 26,839,622. MANAGEMENT AND GENERAL EXPENSES 10,139,824. FUNDRAISING EXPENSES 121. TOTAL EXPENSES 36,979,567. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS -77,296,415. TRINITY HEALTH PO BOX 5020 MINOT ND 58702 450226558 HEALTHCARE ND 501(C)(3) LINE 12C, III-FI N/A 0 MEDICAL ARTS OUTPATIENT SERVICES INC 400 BURDICK EXPRESSWAY EAST MINOT ND 58701 450278212 RETAIL PHARMACY & DURABLE MEDICAL EQUIPMENT ND N/A C 0 B&B DRUG INC 20 BURDICK EXPRESSWAY EAST MINOT ND 58701 450260565 RETAIL DRUG STORE ND N/A C 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 1 0 TRINITY HOSPITALS PO BOX 5020 MINOT ND 58702 412002771 TRIN TRINITY KENMARE HOSPITAL PO BOX 697 KENMARE ND 58746 412002769 TRIN TRINITY HOMES PO BOX 5020 MINOT ND 58702 450404412 TRIN TRINITY HEALTH FOUNDATION PO BOX 5020 MINOT ND 58702 450215346 TRIN COMMUNITY AMBULANCE SERVICE OF MINOT INC PO BOX 2195 MINOT ND 58702 450363593 COMM