2019-04-30T08:08:53-05:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-07-01 830279242 WYOMING MEDICAL CENTER INC WYOM 3075772211 1233 EAST SECOND STREET CASPER WY 82601 B YVONNE WIGINGTON SENIOR VP AND CFO 3075772211 2019-04-19 1 DARRYN MCGARVEY P00958683 6123764500 67.137.57.251 2019-04-19 08:56:43 PD P 487AB1A67A5D20F4613B23BD8ED7DDEFEAED86AA 809E54FA8C64BBE3CBB7CEA9C7808FE856DB1227 2017 2019-02-21 02:37:17Z MICHELE CHULICK 1233 EAST SECOND STREET CASPER WY 82601 270348590 0 X HTTPS://WYOMINGMEDICALCENTER.ORG X 1986 WY ADVANCE THE HEALTH AND WELLNESS OF OUR COMMUNITY BY PROVIDING EXCELLENT HEALTHCARE SERVICES. 11 10 1361 108 1251776 223304 1423448 606585 251101770 265711667 3564816 4645237 192472 -2302981 256282506 268660508 0 0 0 0 100828006 104713012 0 0 0 133559561 145196290 234387567 249909302 21894939 18751206 337145146 393287824 54537236 85685833 282607910 307601991 X WYOMING MEDICAL CENTER ("WMC") STRIVES TO ADVANCE THE HEALTH AND WELLNESS OF OUR COMMUNITY BY PROVIDING EXCELLENT HEALTHCARE SERVICES, PATIENT SAFETY AND EXPERIENCE AT REASONABLE COSTS. OUR HIGHLY SKILLED AND ENGAGED TEAM OF PHYSICIANS, STAFF AND VOLUNTEERS ENSURES PATIENTS ARE WELL CARED FOR WHILE AT WMC. 0 0 211643538 0 265711667 WYOMING MEDICAL CENTER IS THE LEADER IN HEALTH IN THE COMMUNITY AND PROVIDES CARE TO ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL WAS FORMED IN 1986 AS A NON-PROFIT CORPORATION TO PROVIDE HEALTH CARE TO THE RESIDENTS OF NATRONA COUNTY. SINCE THAT TIME WYOMING MEDICAL CENTER HAS GROWN INTO A LEVEL II TRAUMA CENTER THAT PROVIDES CRITICAL SERVICES TO NATRONA COUNTY AND TO THE ENTIRE STATE.WYOMING MEDICAL CENTER ATTENDED EVENTS IN SEVEN WYOMING COMMUNITIES IN FY 2018, INCLUDING A HEALTH FAIR SPANNING A 150-MILE RADIUS. IT ALSO RELEASED ITS REGULAR QUARTERLY PUBLICATION, THE PULSE, TO 10,000 HOMES IN NATRONA AND FREMONT COUNTIES AND EVERY PROVIDER OFFICE IN THE STATE OF WYOMING. WYOMING MEDICAL CENTER PROVIDED $7,925,000 IN CHARITY CARE SERVICES BASED ON TOTAL DIRECT AND INDIRECT COSTS. 211643538 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 247 0 1361 1 1 1 0 0 0 0 0 0 0 0 0 X 11 10 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X B YVONNE WIGINGTON 3075772211 1233 EAST SECOND STREET CASPER WY 82601 JOHN MASTERSON CHAIR 5.00 0.00 X X 0 0 0 EDITH SELBY VICE CHAIR 5.00 0.00 X X 0 0 0 JESSICA ODEN SECRETARY 5.00 0.00 X X 0 0 0 TOM CRULL BOARD MEMBER 5.00 0.00 X 0 0 0 MARK DOWELL MD BOARD MEMBER 5.00 0.00 X 0 0 0 MARY MACGUIRE MD BOARD MEMBER 5.00 0.00 X 0 0 0 CHRISTOPHER MUIRHEAD BOARD MEMBER 5.00 0.00 X 0 0 0 TOM SCARLETT BOARD MEMBER 5.00 0.00 X 0 0 0 W LEE WARREN MD BOARD MEMBER 5.00 0.00 X 0 0 0 KELLY WEIDENBACH BOARD MEMBER 5.00 0.00 X 0 0 0 BETH WORTHEN BOARD MEMBER 5.00 0.00 X 0 0 0 MICHELE CHULICK CEO 55.00 2.00 X 300479 0 1366 B YVONNE WIGINGTON SENIOR VP AND CFO 55.00 0.00 X 434166 0 44752 CHAD PEW SENIOR VP & COO (THROUGH MARCH 2018) 55.00 0.00 X 419382 0 40567 DAVID GARDNER SENIOR VP, PATIENT CARE & CNO 55.00 0.00 X 194128 0 19269 WAYNE WARREN MD NEUROSURGERY 45.00 0.00 X 1665690 0 40567 JAMES SHAFFER MD ORTHOPAEDICS 45.00 0.00 X 780312 0 14388 RICHARD STOWELL MD ORTHOPAEDICS 45.00 0.00 X 805173 0 40567 CLAYTON TURNER MD ORTHOPAEDICS 45.00 0.00 X 937225 0 40567 ROBERT NEFF MD NEPHROLOGY 45.00 0.00 X 514972 0 42952 VICKIE DIAMOND FORMER CEO 55.00 2.00 X 794139 0 44917 6845666 0 329912 124 1 1 0 MEDLINE INDUSTRIES INC DEPT 1080 PO BOX 121080 DALLAS TX 753211080 CONTRACT SERVICES 6319583 ABM HEALTHCARE SUPPORT SERVICES INC PO BOX 419860 BOSTON MA 022419860 CONTRACT SERVICES 5761958 BOSTON SCIENTIFIC CORPORATION & SUBSIDIA PO BOX 951653 DALLAS TX 75395 MEDICAL SERVICES 3948192 UHS OF WYOMING INC 2521 E 15TH ST CASPER WY 82609 MEDICAL SERVICES 3263416 CERNER HEALTHCARE SOLUTIONS INC PO BOX 959156 ST LOUIS MO 631959156 IT CONTRACT SERVICES 3005949 146 115284 360581 130720 606585 NET PATIENT REVENUE 621110 256720119 256720119 JV INVESTMENT INCOME 621300 5001051 4464346 536705 NON-PATIENT NON-OPERATING 900099 2231489 2034778 196711 CAFETERIA SALES 722210 1250167 1132351 117816 REFERENCE LAB REVENUE 621500 402043 1499 400544 106798 106798 265711667 3754339 3754339 497357 496465 892 892 892 1801130 281385 920687 270930 880443 10455 890898 890898 LOSS ON DEBT RETIREMENT 900099 -2303873 -2303873 -2303873 268660508 264459891 1251776 2342256 X 2404014 2404014 77022052 64802518 12219534 5281728 4321240 960488 13971577 11402490 2569087 6033641 4936417 1097224 357621 357621 69403 69403 33373982 27332671 6041311 835104 115659 719445 3130620 1782292 1348328 6270773 228768 6042005 3064094 2477194 586900 318603 162290 156313 683952 683952 14984071 14898330 85741 2038104 2038104 UNRELATED INCOME TAXES 58712 58712 DRUGS & MEDICAL SUPPLIE 37822906 37822906 BAD DEBT EXPENSE 32202537 32202537 MISCELLANEOUS 3593149 525635 3067514 6392659 5910535 482124 249909302 211643538 38265764 0 50045921 45761101 17265 26996 46018570 47916719 1315099 1189203 4255880 5113769 4236021 2757447 358414172 243414317 111553908 114999855 107896175 145582717 11358306 9065904 20763093 448001 111020 337145146 393287824 15398828 18131848 29167 29167 16856327 15150641 337766 37245575 21915148 15128602 54537236 85685833 X 282534770 307533302 73140 68689 282607910 307601991 337145146 393287824 X 18751206 3487475 2755400 X 0 1 X 1 0 X 0 1 0 0 0 0 1 41216 0 1 16309 57525 0 PART II-B, LINE 1: WYOMING MEDICAL CENTER SPENT $41,216 IN REIMBURSED EXPENSES RELATED TO DIRECT COMMUNICATIONS WITH LEGISLATORS. WYOMING MEDICAL CENTER ALSO CONTRIBUTED $16,309 IN LOBBYING COSTS THROUGH ITS PAYMENT OF DUES TO THE AMERICAN HOSPITAL ASSOCIATION. 13356372 13356372 134308548 81032899 53275649 5160148 30677 5129471 183865250 151502497 32362753 21723854 10848244 10875610 114999855 PENSION LIABILITY 4348728 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 3487917 MALPRACTICE AND LITIGATION 6000000 DUE TO RELATED PARTY 1291957 15128602 X 230034004 6131455 6131455 223902549 44757959 44757959 268660508 216670793 1626326 1626326 215044467 34864835 34864835 249909302 PART X, LINE 2: THE HOSPITAL IS ORGANIZED AS A WYOMING NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). WHMG IS A SINGLE MEMBER LLC, WHOLLY OWNED BY THE HOSPITAL, AND IS THEREFORE TREATED FOR TAX PURPOSES UNDER THE HOSPITAL'S TAX EXEMPTION STATUS. THIS ENTITY IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THIS ENTITY 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. THIS ENTITY 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: ELIMINATED INTERCOMPANY REVENUES 1,626,326. LOSS ON DEBT REFINANCING 2,303,873. OTHER NET INCOME 2,126,785. NET ASSETS RELEASED FROM RESTRICTIONS 74,471. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 32,202,537. INVESTMENT INCOME 4,624,240. GAIN ON DISPOSAL OF FIXED ASSETS 10,455. GAINS ON INVESTMENTS IN SUBSIDIARIES AND JOINT VENTURES 5,047,420. CONTRIBUTIONS OF LONG-LIVED ASSETS 140,989. TEMPORARILY RESTRICTED CONTRIBUTIONS 70,020. EXPENSES INCLUDED IN OTHER INCOME 2,662,298. PART XII, LINE 2D - OTHER ADJUSTMENTS: ELIMINATED INTERCOMPANY EXPENSES 1,626,326. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 32,202,537. EXPENSES INCLUDED IN OTHER INCOME, NET 2,662,298. 1 1 X 1 X 1 X 275.000000000000 1 1 0 1 1 7823323 0 7823323 0.03590 17596489 10920379 6676110 0.03070 762190 201393 560797 0.00260 26182002 11121772 15060230 0.06920 465982 0 465982 0.00210 428421 42775 385646 0.00180 4389921 649412 3740509 0.01720 5284324 692187 4592137 0.02110 31466326 11813959 19652367 0.09030 849011 849011 0.00390 849011 849011 0.00390 1 32202537 0 67686891 69145386 -1458495 X 1 1 1 OUTPATIENT RADIOLOGY LLC IMAGING SERVICES 0.50000 0.00000 0.50000 2 CENTRAL WYOMING OUTPATIENT SURGERY CENTER LLC SURGICAL SERVICES 0.50000 0.25000 0.25000 3 NORTH PLATTE PATHOLOGY LLC PATHOLOGY SERVICES 0.50000 0.00000 0.50000 1 1 WYOMING MEDICAL CENTER 1233 EAST 2ND STREET CASPER WY 82601 WWW.WYOMINGMEDICALCENTER.ORG 15276 X X X WYOMING MEDICAL CENTER 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X HTTP://WYOMINGMEDICALCENTER.ORG/ABOUT/COMMUNITY-BENEFIT X 1 15 1 HTTP://WYOMINGMEDICALCENTER.ORG/ABOUT/COMMUNITY-BENEFIT 0 1 X 200.000000000000 275.000000000000 X X X 1 1 X X X X 1 X HTTP://WYOMINGMEDICALCENTER.ORG/PAYBILL X HTTP://WYOMINGMEDICALCENTER.ORG/PAYBILL X HTTP://WYOMINGMEDICALCENTER.ORG/PAYBILL X X X X X X 1 X 0 X X X X 1 X 0 0 WYOMING MEDICAL CENTER PART V, SECTION B, LINE 5: THE HOSPITAL INVITED DIRECTORS AND MANAGERS OF ORGANIZATIONS ACROSS THE COUNTY TO BE INVOLVED IN A SURVEY THAT WAS EVALUATED BY POPULATION HEALTH EXPERT DR. JAY WANT. PARTICIPANTS WERE THEN ASKED TO ATTEND A MEETING WITH DR. WANT IN ATTENDANCE, AND THREE GROUPS WERE FORMED BASED ON THE EVALUATION OF THE SURVEY DATA. PARTICIPANTS INCLUDED MANAGERS AND DIRECTORS OF THE FOLLOWING ORGANIZATIONS, IN ADDITION TO WYOMING MEDICAL CENTER: SENIOR PATIENT ADVOCATES, CASPER-NATRONA COUNTY HEALTH DEPARTMENT, WYOMING BEHAVIORAL INSTITUTE, WYOMING BUSINESS COALITION ON HEALTH, UNIVERSITY OF WYOMING FAMILY MEDICINE RESIDENCY PROGRAM, ELKHORN VALLEY REHABILITATION HOSPITAL, CASPER COLLEGE, MERCER FAMILY RESOURCE CENTER, BLUE ENVELOPE HEALTH FUND, CITY OF CASPER, WYOMING HEALTH FAIRS, WINHEALTH PARTNERS, CENTRAL WYOMING HOSPICE AND TRANSITIONS, PREVENTION MANAGEMENT ORGANIZATION - NATRONA COUNTY, NATRONA COUNTY SCHOOL DISTRICT, AND CENTRAL WYOMING COMMUNITY HEALTH CENTER. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 11: THREE GROUPS WERE IDENTIFIED IN THE FY2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND CONTINUE TO MEET SEVERAL TIMES PER YEAR TO ADDRESS ISSUES AND SOLUTIONS RELATED TO THE NEEDS IDENTIFIED. IN APPROACHING THE IMPLEMENTATION STRATEGY, IT WAS DECIDED TO BREAK THE ACTION TEAMS INTO FOUR GROUPS TO ADDRESS OBESITY, INFRASTRUCTURE BETWEEN MENTAL HEALTH AND PRIMARY CARE, COORDINATION OF CARE, AND HEALTH SYSTEM COST. WMC AND THE CASPER NATRONA COUNTY HEALTH DEPARTMENT ARE UNDERGOING A PROCESS TO IDENTIFY NEW HEALTH NEEDS THEN UPDATE THE CHNA IN FY 2019.IN FY2018 WMC HAS WORKED ON THE FOLLOWING:HEALTH ISSUE 1: UNHEALTHY BEHAVIORS ASSOCIATED WITH OBESITY AND SUICIDALITY.OBESITY - IN 2017 WMC HAS WORKED IN COLLABORATION WITH THE OUTSIDE ORGANIZATIONS TO ADDRESS THE OBESITY EPIDEMIC. THROUGH QUALITATIVE RESEARCH, THE ACTION TEAM WAS ABLE TO EXPLORE PROGRAMS THAT COULD BE ADOPTED BY LOCAL HEALTH CLUBS AND HEALTH AGENCIES. ONE PROGRAM IMPLEMENTED WAS A COMMUNITY HEALTH MEMBERSHIP THROUGH THE WMC WELLNESS CENTER. OBESITY AND BEHAVIORAL CHANGE IS BEING ADDRESSED BY PARTICIPATION IN A LIFESTYLE MEDICINE PROGRAMS. THIS MEMBERSHIPS WORKS IN CONJUNCTION WITH PRIMARY CARE PRACTICES AND OTHER PHYSICIAN CLINICS VIA REFERRAL PROCESS AND IS OPEN TO ANY INTERESTED COMMUNITY MEMBER. IN FY18, THE WELLNESS CENTER ADDED 70 COMMUNITY MEMBERS AND 123 WYOMING MEDICAL CENTER EMPLOYEES TO ITS PROGRAM. TWO WMC EMPLOYEES ALSO TOOK PART OF A TRAIN THE TRAINER PROGRAM CALLED HEALTHY U OFFERED BY THE UNIVERSITY OF WYOMING. THIS IS AN EVIDENCE BASED CHRONIC DISEASE MANAGEMENT PROGRAM THAT ORIGINATED THROUGH STANFORD UNIVERSITY. IN FY18, WMC OFFERED FOUR CLASSES TO 15 PARTICIPANTS. SUICIDALITY - WMC TEAMED UP WITH THE STATE OF WYOMING PREVENTION MANAGEMENT ORGANIZATION TO LEARN HOW TO FACILITATE QUESTION, PERSUADE, AND REFER (QPR) AND MENTAL HEALTH FIRST AID TRAINING. WMC TRAINED 5 EMPLOYEES TO TEACH QPR. QPR IS BASIC TRAINING ANY INDIVIDUAL CAN TAKE TO HELP REDUCE SUICIDAL BEHAVIORS AND SAVE LIVES BY PROVIDING INNOVATIVE, PRACTICAL AND PROVEN SUICIDE TECHNIQUES/INTERVENTIONS. QPR IS ALSO PROVIDED TO ALL NEW EMPLOYEES DURING ON-BOARDING. IN ADDITION TO NEW EMPLOYEES, WMC STAFF PROVIDED TRAINING TO 75 COMMUNITY MEMBERS. WMC ALSO TRAINED 2 EMPLOYEES TO TEACH MENTAL HEALTH FIRST AID. WMC PROVIDED THE TRAINING TO 11 PROVIDERS IN PREVIOUS YEARS, AND IN FY18, OFFERED SIX CLASSES WITH 56 PARTICIPANTS. THE FOLLOWING PROCESSES WERE DEVELOPED AND IMPLEMENTED REGARDING SUICIDE IN FY18 AS PART OF OUR ZERO SUICIDE COMMITTEE. A NEW SUICIDE ASSESSMENT, PRECAUTIONS AND CARE CHECKLIST FORM WAS CREATED AND IMPLEMENTED. ED-SAFE SCREENING TOOL VOTED ON FOR ALL ADULT PATIENTS AND ASQ PEDIATRIC SUICIDE SCREENER VOTED ON FOR ALL UNDER THE AGE OF 18. BOTH SCREENING TOOLS WERE ENTERED INTO CERNER FOR EASE OF SCREENING ON ADMIT TO WMC, EVERY PATIENT EVERY TIME SCREENING TOOL. SAFE CARE FOR SUICIDE PATIENTS TRAINING WAS DEVELOPED AND ALL SITTERS AND 1:1 STAFF ATTENDED THIS TRAINING. A MECHANISM WAS PUT IN PLACE TO ALERT ALL STAFF PROVIDING PATIENT CARE OF SUICIDE RISK. CASE MANAGEMENT HAS IMPLEMENTED AN ENHANCED RISK SCREENING TOOL THE COLUMBIA SUICIDE SEVERITY RATING SCALE. THEY HAVE ALSO IMPLEMENTED THE STANLEY BROWN TOOL FOR HELPING THE PATIENT DEVELOP A SAFETY PLAN. CASE MANAGEMENT HAS CONTINUED TO ENHANCE OUR PROCESSES WITH CWCC AND WBI. WHMG HAS STARTED IMPLEMENTING THE ZS INITIATIVE AND SCREENING TOOLS AS WELL. WORKFORCE SURVEY SENT OUT TO ALL EMPLOYEES IN APRIL 2018 APPROXIMATELY 600 EMPLOYEES RESPONDED. HEALTH ISSUE 2: LACK OF NEEDED INFRASTRUCTURE RELATED TO MENTAL HEALTH AND PRIMARY CARE.WMC CONTINUES TO WORK WITH CENTRAL WYOMING COUNSELING CENTER AND WYOMING BEHAVIORAL INSTITUTE TO IMPLEMENT A PROGRAM TO PROVIDE BEHAVIORAL HEALTH SERVICES AT WMC TWO PRIMARY CARE CLINICS.IN FY18, WYOMING MEDICAL CENTER ENTERED INTO A CONTRACT WITH A VENDOR TO PROVIDE TELEMEDICINE SERVICES ACROSS THE STATE. AT LEAST FIVE ROBOTS WILL BE LAUNCHED AT SITES ACROSS WYOMING IN FY19 TO PROVIDE STROKE CARE INITIALLY, BUT THE EQUIPMENT WILL EVENTUALLY ALLOW ACCESS FOR PROVIDERS ACROSS A VARIETY OF SPECIALTIES TO OFFER THEIR SERVICES IN RURAL AREAS OF WYOMING. WMC ALSO CONTINUES TO OPERATE A TELEMEDICINE PROGRAM THROUGH THE UNIVERSITY OF WASHINGTON TO PROVIDE A MORE CONCENTRATED BEHAVIOR HEALTH SERVICE FOR ALL PATIENTS.GROUP 3: HEALTH CARE SYSTEM COSTS AND LACK OF COORDINATION OF CARE.WMC CONTINUES TO COORDINATE WITH VARIOUS CARE PROVIDERS ACROSS THE CONTINUUM OF CARE TO ADDRESS COST AND COORDINATION OF CARE. THIS INCLUDES THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT, COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, ELKHORN REHABILITATION HOSPITAL, CENTRAL WYOMING COUNSELING CENTER, WYOMING BEHAVIORAL INSTITUTE AND OTHERS. WMC ALSO OFFERS A FINANCIAL ASSISTANCE PROGRAM. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 13H: FINANCIAL ASSISTANCE IS AVAILABLE TO INDIVIDUALS FACING CATASTROPHIC MEDICAL BILLS. 10 1 - CENTRAL WY OUTPATIENT SURGERY CENTER 1201 E 3RD STREET CASPER WY 82601 SURGICAL CENTER 2 - OUTPATIENT RADIOLOGY 419 S WASHINGTON STREET SUITE 100 CASPER WY 82601 IMAGING SERVICES 3 - WY HEALTH MEDICAL GROUP MULTISPECIALTY 1233 E 2ND STREET CASPER WY 82601 PHYSICIAN PRACTICE 4 - NORTH PLATTE PATHOLOGY 111 S JEFFERSON STREET CASPER WY 82601 PATHOLOGY SERVICES 5 - IMMEDIATE CARE 3632 AMERICAN WAY CASPER WY 82601 QUICK-CARE CLINIC 6 - SAGE PRIMARY CARE 1020 S CONWELL CASPER WY 82601 PRIMARY CARE CLINIC 7 - THE SLEEP LAB 245 S FENWAY CASPER WY 82601 SLEEP LAB 8 - MESA PRIMARY CARE 3632 AMERICAN WAY CASPER WY 82601 PRIMARY CARE CLINIC 9 - WY HEALTH MEDICAL GROUP MULTISPECIALTY 6600 E 2ND STREET CASPER WY 82609 PHYSICIAN PRACTICE 10 - WYOMING MEDICAL CENTER - EAST CAMPUS 6550 EAST 2ND STREET CASPER WY 82609 EAST HOSPITAL CAMPUS PART I, LINE 3C: TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE MEDICAL CARE MUST BE EMERGENT OR MEDICALLY NECESSARY AND THE INDIVIDUAL'S HOUSEHOLD GROSS INCOME MUST BE BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINE THRESHOLDS. ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL BE EXTENDED TO A PERSON BASED ON HOUSEHOLD INCOME. PART I, LINE 7: EXPENSES REPORTED IN PART I, LINES 7A, 7B AND 7C ARE CALCULATED USING THE WORKSHEETS IN THE INSTRUCTIONS TO SCHEDULE H, INCLUDING UTILIZATION OF THE COST-TO-CHARGE RATIO. EXPENSES REPORTED IN PART I, LINES 7E, 7F AND 7G ARE BASED ON ACTUAL COSTS. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE THE WYOMING BEHAVIORAL INSTITUTE AND ENDOCRINE & DIABETES SERVICES. SUBSIDIZED HEALTH SERVICES INCLUDE $852,725 OF EXPENSES ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 32,202,537. PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY BY PROVIDING NEEDED SPECIALISTS AND PHYSICIANS AS WELL AS DETERMINING WHAT IS NEEDED BY THE RESIDENTS IN THE LOCAL COMMUNITY AND SURROUNDING AREA. WYOMING MEDICAL CENTER SPENT $849,011 IN RECRUITING PHYSICIANS FOR PEDIATRICS, OB/GYN, PRIMARY CARE, RADIOLOGY SERVICES, AND EMERGENCY CARE. PART III, LINE 2: SEE THE "PATIENT RECEIVABLES, NET" PARAGRAPHS IN NOTE 1 ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE EXPLANATION OF HOW WYOMING MEDICAL CENTER CALCULATES ITS BAD DEBT EXPENSE. PART III, LINE 3: WYOMING MEDICAL CENTER FOLLOWS HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. THEREFORE, BAD DEBT DOES NOT INCLUDE AMOUNTS THAT SHOULD BE ATTRIBUTABLE TO CHARITY CARE. PART III, LINE 4: SEE THE "PATIENT RECEIVABLES, NET" PARAGRAPHS IN NOTE 1 ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE EXPLANATION OF WYOMING MEDICAL CENTER'S BAD DEBT EXPENSE. PART III, LINE 8: WYOMING MEDICAL CENTER USED THE MEDICARE OPERATING COST-TO-CHARGE RATIO TO CALCULATE THE COSTS RELATING TO MEDICARE REVENUE APPLIED AGAINST ACTUAL RECEIPTS.THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES FOR THESE PATIENTS IN OUR COMMUNITY AND, THEREFORE, IS A DIRECT BENEFIT TO OUR POPULATION IN OUR COMMUNITY. PART III, LINE 9B: COLLECTION PRACTICES ARE ONLY PURSUED IF THE PATIENT IS DETERMINED TO NOT QUALIFY FOR CHARITY CARE OR DOES NOT QUALIFY FOR ANOTHER PROGRAM. THIS INCLUDES NOTIFICATION TO THE PATIENT VIA A LETTER 10 DAYS PRIOR TO ASSIGNMENT OF AN ACCOUNT TO COLLECTIONS. ONCE A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL COLLECTION PRACTICES ARE CEASED. PART VI, LINE 2: CONTINUOUS MONITORING OF PUBLIC AND OTHER INTERNAL DATA SOURCES SHOWS THE HOSPITAL WHICH HEALTH CONCERNS ARE OF THE GREATEST IMPACT TO OUR COMMUNITY. WYOMING MEDICAL CENTER USES PUBLIC DATA, INCLUDING THE HEALTHY PEOPLE 2020 STUDY FROM THE OFFICE OF DISEASE PREVENTION AND HEALTH PROMOTION, AS WELL AS DATA FROM REPORTING HOSPITALS OF THE WYOMING HOSPITAL ASSOCIATION. INTERNAL DATA FROM THE HOSPITAL AND ASSOCIATED CLINICS ALSO HELPS TO IDENTIFY AND FIND SOLUTIONS FOR MORE SPECIFIC NEEDS WITHIN THE COMMUNITY. WYOMING MEDICAL CENTER HAS ALSO PARTNERED WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT, WHICH GATHERS VARIOUS HEALTH-RELATED DATA FOR THE WHOLE STATE ON A COUNTY-BY-COUNTY BASIS. PART VI, LINE 3: WYOMING MEDICAL CENTER'S PLAIN LANGUAGE SUMMARY AND FULL POLICY ARE AVAILABLE UPON REQUEST. WYOMING MEDICAL CENTER HAS FINANCIAL COUNSELORS THAT MEET WITH SELF PAY INPATIENTS OR ANY PATIENT UPON REQUEST. PART VI, LINE 4: WYOMING MEDICAL CENTER HAS 235 BEDS ON TWO HOSPITAL CAMPUSES. WITH OVER 50 SPECIALTIES OFFERED, WYOMING MEDICAL CENTER OFFERS HUNDREDS OF STATEWIDE CLINICS EACH YEAR. A FULL SPECTRUM OF INTEGRATED HEALTHCARE SERVICES INCLUDES EMERGENCY CARE AND TRAUMA, INTENSIVE CARE, SURGICAL, CARDIAC SERVICES, OBSTETRIC AND PEDIATRIC AND ORTHOPEDIC CARE. WYOMING MEDICAL CENTER ALSO OPERATES SEVERAL OUTPATIENT CLINICS IN CASPER.IN ADDITION TO WYOMING MEDICAL CENTER, CASPER CURRENTLY HAS TWO SPECIALTY HOSPITALS, A REHABILITATION HOSPITAL AND A BEHAVIORAL HEALTH CENTER.ACCORDING TO 2018 CENSUS DATA, NATRONA COUNTY IS HOME TO JUST OVER 79,000 RESIDENTS WITH 577,000 STATEWIDE. NATRONA COUNTY AND THE STATE OF WYOMING HAVE LOW POPULATION DENSITY, WITH 14.1 PERSONS PER SQUARE MILE AND 5.8 PERSONS PER SQUARE MILE, RESPECTIVELY. NATRONA COUNTY IS 94.1% WHITE, 1.2% BLACK, 1.4% AMERICAN INDIAN AND ALASKA NATIVE, 0.9% ASIAN, 0.1% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER, 2.3% OF PEOPLE REPORT TWO OR MORE RACES AND 8.4% ARE OF HISPANIC OR LATINO ORIGIN.ACCORDING TO CENSUS DATA, 11.1% OF PEOPLE IN NATRONA COUNTY ARE BELOW THE POVERTY LEVEL AND 11.3% ARE BELOW THE POVERTY LEVEL IN WYOMING. MEDIAN HOUSEHOLD INCOME IS $59,400 IN NATRONA COUNTY AND $60,938 IN WYOMING. PART VI, LINE 5: WYOMING MEDICAL CENTER IS A NOT-FOR PROFIT HOSPITAL. THE HOSPITAL IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS. OUR MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS AND ALLIED HEALTH PROFESSIONALS. THE FACILITY APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH. OUR EMERGENCY DEPARTMENT IS OPEN TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. WYOMING MEDICAL CENTER SUBSIDIZED $9,476,624 IN HEALTHCARE SERVICES THROUGH ITS OPERATION OF WYOMING HEALTH MEDICAL GROUP, LLC. SERVICES OFFERED INCLUDE NEUROSURGICAL CARE, ORTHOPEDIC, INTERNAL MEDICINE AND FAMILY PRACTICE, PULMONOLOGY, NEPHROLOGY, PAIN, ENDOCRINOLOGY AND PLASTIC/RECONSTRUCTIVE SURGERY CARE. ALL SPECIALTIES TREAT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.IN FISCAL YEAR 2018, WYOMING MEDICAL CENTER ACQUIRED MOUNTAIN VIEW REGIONAL HOSPITAL AND NOW RUNS THE HOSPITAL AT ITS EAST CAMPUS. A MEDICAL OFFICE BUILDING ALSO HOUSES SEVERAL PRACTICES WITHIN WHMG AS WELL AS OTHER PRIVILEGED PROVIDERS.WYOMING MEDICAL CENTER PROVIDES AIR TRANSPORTATION FOR PHYSICIANS TO DELIVER SERVICE TO CLINICS IN SEVERAL COMMUNITIES ACROSS WYOMING.WYOMING MEDICAL CENTER'S DIABETES EDUCATION IS A SELF-MANAGEMENT EDUCATION PROGRAM THAT INCLUDES A STAFF OF KNOWLEDGEABLE HEALTH PROFESSIONALS WHO PROVIDE PARTICIPANTS WITH COMPREHENSIVE INFORMATION ABOUT DIABETES MANAGEMENT. THE TEAM INCLUDES A MEDICAL DIRECTOR, DIRECTOR AND A HOST OF SPECIALLY TRAINED REGISTERED NURSES AND CERTIFIED DIABETES EDUCATORS.THE COMMUNITY DEVELOPMENT OFFICE MARKETS CLINICAL SERVICES THROUGHOUT THE AREA INCLUDING THE SECONDARY OUTREACH MARKETS. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, FREE EDUCATIONAL SEMINARS BY PHYSICIANS AND OTHER HEALTH PROFESSIONALS. WYOMING MEDICAL CENTER ADVERTISES SCREENING EVENTS AND SUPPORT GROUPS ON ITS WEBSITE AND IN LOCAL NEWSPAPERS.WYOMING MEDICAL CENTER WORKS WITH THE WYOMING MEDICAL CENTER FOUNDATION'S MASTERSON PLACE TO PROVIDE SLEEPING ROOMS TO PATIENTS AND THEIR FAMILIES AT REDUCED RATES, OR FREE, WHEN BEING TREATED AT THE HOSPITAL. IN FISCAL YEAR 2018, THE FOUNDATION SOLD MASTERSON PLACE AND BEGAN CONSTRUCTION OF A NEW FACILITY IN CLOSE PROXIMITY TO THE HOSPITAL. THE PROJECT IS EXPECTED TO BE COMPLETED IN SUMMER 2019.WMC'S CEO WORKS IN THE COMMUNITY TO PROVIDE COMMUNITY BENEFIT RELATIONSHIPS. THERE IS ALSO ON-GOING WORK PROVIDED BY WMC PERSONNEL ON THE COMMUNITY HEALTH NEEDS ASSESSMENT.WYOMING MEDICAL CENTER IS A TRAINING SITE FOR MANY SPECIALTIES. WE PROVIDE TRAINING FOR STUDENTS IN NURSING, PHLEBOTOMY, RESPIRATORY THERAPY, PARAMEDIC SERVICES, OCCUPATIONAL THERAPY ASSISTANTS, PHYSICAL THERAPIST, AND FAMILY PRACTICE RESIDENTS. WYOMING MEDICAL CENTER HAS BEEN INSTRUMENTAL IN IMPLEMENTING A TELEHEALTH STROKE PROGRAM FOR WYOMING. THIS ALLOWS CASPER PHYSICIANS TO VIEW AND TREAT PATIENTS FROM A REMOTE LOCATION GIVING THE PATIENT TIME SENSITIVE CARE. IN FISCAL YEAR 2018, WYOMING MEDICAL CENTER ENTERED INTO A CONTRACT WITH INTOUCH TO PROVIDE TELEHEALTH SERVICES IN HOSPITALS ACROSS THE STATE AND EXPECTS TO INSTALL ROBOTS IN FIVE REMOTE LOCATIONS IN WYOMING IN FISCAL YEAR 2019.WYOMING MEDICAL CENTER PROVIDES WOMEN SERVICES TO WOMEN WHO ARE PREGNANT OR WANT TO BECOME PREGNANT. THIS INCLUDES PRENATAL AND POST DELIVERY EDUCATION AND SUPPORT TO MOTHERS. WE ALSO PROVIDE DIABETES EDUCATION AND WEIGHT MANAGEMENT PROGRAMS. DURING FY 2018 WYOMING MEDICAL CENTER HAD NEARLY 54,000 PATIENT DAYS AND NEARLY 33,000 EMERGENCY DEPARTMENT VISITS.WYOMING MEDICAL CENTER HOUSES THE SAFE KIDS AND SAFE COMMUNITIES PROGRAMS WITH THE HELP OF DONATIONS AND GRANTS FROM VARIOUS SOURCES. BOTH PROGRAMS FOCUS ON INJURY PREVENTION AND IN ADDITION TO THE OTHER COMMUNITY EDUCATION AND OUTREACH, OFFER MONTHLY CAR SEAT CHECKS AND PROVIDE CAR SEATS TO THOSE WHO CANNOT AFFORD THEM.THE HOSPITAL PROVIDES SERVICES FOR SEXUALLY ASSAULTED VICTIMS THROUGH THE SANE PROGRAM IN THE EMERGENCY DEPARTMENT. THE HOSPITAL PROVIDES A VARIETY OF HEALTH IMPROVEMENT OPTIONS FOR THE COMMUNITY AND ITS PATIENTS. FOR EXAMPLE, THE HOSPITAL PROVIDES EDUCATION FOR WEIGHT LOSS, DIABETES, STROKE, MENTAL HEALTH, FIRST AID, AND SMOKING CESSATION. THE COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH OF THE COMMUNITY BY PROVIDING NEEDED SPECIALISTS AND PHYSICIANS AS WELL AS DETERMINING WHAT IS NEEDED BY THE RESIDENTS IN THE LOCAL COMMUNITY AND SURROUNDING AREA. WYOMING MEDICAL CENTER RELEASED ITS REGULAR QUARTERLY PUBLICATION, THE PULSE, TO 10,000 HOMES IN NATRONA AND FREMONT COUNTIES AND EVERY PROVIDER OFFICE IN THE STATE OF WYOMING. PART VI, LINE 7, REPORTS FILED WITH STATES WY X 1 1 X X X X 0 0 0 0 0 0 0 0 0 MICHELE CHULICK CEO 260827 0 0 0 39652 0 0 0 1366 0 301845 0 0 0 B YVONNE WIGINGTON SENIOR VP AND CFO 367364 0 66250 0 552 0 10800 0 33952 0 478918 0 0 0 CHAD PEW SENIOR VP & COO (THROUGH MARCH 2018) 353772 0 65250 0 360 0 10800 0 29767 0 459949 0 0 0 DAVID GARDNER SENIOR VP, PATIENT CARE & CNO 150938 0 15058 0 28132 0 0 0 19269 0 213397 0 0 0 WAYNE WARREN MD NEUROSURGERY 1665330 0 0 0 360 0 10800 0 29767 0 1706257 0 0 0 JAMES SHAFFER MD ORTHOPAEDICS 780210 0 0 0 102 0 0 0 14388 0 794700 0 0 0 RICHARD STOWELL MD ORTHOPAEDICS 804933 0 0 0 240 0 10800 0 29767 0 845740 0 0 0 CLAYTON TURNER MD ORTHOPAEDICS 816351 0 119842 0 1032 0 10800 0 29767 0 977792 0 0 0 ROBERT NEFF MD NEPHROLOGY 511796 0 2936 0 240 0 10800 0 32152 0 557924 0 0 0 VICKIE DIAMOND FORMER CEO 644538 0 142000 0 7601 0 28800 0 16117 0 839056 0 0 0 PART I, LINE 1A VICKIE DIAMOND - CASPER COUNTRY CLUB - $3,000 MICHELE CHULICK - CASPER COUNTRY CLUB - $942 THE CASPER COUNTRY CLUB DUES WERE INCLUDED IN VICKIE DIAMOND'S 2017 TAXABLE W-2 WAGES AND MICHELE CHULICKS'S 2017 TAXABLE W-2 WAGES. A NATRONA COUNTY WYOMING 836000113 638813CB9 2011-02-28 20039910 CONSTRUCTION OF NEW WEST TOWER 0 0 0 B NATRONA COUNTY WYOMING 836000113 638813CR4 2017-07-26 13504227 REFUND SERIES 2011 BONDS 0 0 0 A 17775000 20044228 1667185 4070049 257480 18119563 2014 0 0 1 1 B 140000 13504227 200286 13303941 2017 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 1 A 0 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: NATRONA COUNTY, WYOMING DATE THE REBATE COMPUTATION WAS PERFORMED: 09/15/2015 WYOMING NEUROLOGIC ASSOCIATES DR. DAVID WHEELER, FORMER BOARD MEMBER, OWNS 50% 743298 PHYSICIAN AND ON-CALL SERVICES 0 3RD STREET MEDICAL LLC SUSAN MCMURRY, FORMER BOARD MEMBER, OWNS 50% 182523 RENT 0 MEDICAL HOLDING PROPERTY COMPANY LLC SUSAN MCMURRY, FORMER BOARD MEMBER, OWNS 50% 512794 RENT AND UTILITY COSTS 0 ROCKY MOUNTAIN INFECTIOUS DISEASES DR. MARK DOWELL, BOARD MEMBER, OWNS 51% 201078 INFECTIOUS DISEASE MEDICAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR, VICE CHAIR, SECRETARY OF THE BOARD AND THE CEO. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR CARRYING OUT THE DIRECTIVES OF THE BOARD BETWEEN REGULAR BOARD MEETINGS AND IS EMPOWERED TO MAKE SUCH DECISIONS OR TAKE SUCH ACTIONS. ALL SUBSTANTIVE DECISIONS MADE OR ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE ARE REPORTED TO THE BOARD OF DIRECTORS IN THE CHAIR'S STANDING REPORT AT THE FOLLOWING REGULAR BOARD MEETING, AND ACCEPTANCE OF THE REPORT CONSTITUTES RATIFICATION BY THE BOARD OF DIRECTORS OF SUCH DECISIONS OR ACTIONS. FORM 990, PART VI, SECTION A, LINE 2 MICHELE CHULICK AND YVONNE WIGINGTON HAVE A BUSINESS RELATIONSHIP THROUGH THEIR LEADERSHIP POSITIONS AT WYMEDCO VENTURES, INC., A WHOLLY-OWNED FOR-PROFIT SUBSIDIARY OF WYOMING MEDICAL CENTER, INC. FORM 990, PART VI, SECTION B, LINE 11B BEFORE IT WAS FILED, THE FORM 990 WAS PRESENTED IN ITS ENTIRETY TO THE BOARD OF DIRECTORS. THE FULL FORM 990 WAS GIVEN TO EACH BOARD MEMBER AND THE CFO WENT THROUGH A DETAILED REVIEW WITH THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C WYOMING MEDICAL CENTER'S CONFLICT OF INTEREST POLICY APPLIES TO DIRECTORS, THE PRINCIPAL OFFICER AND ANY MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS. WMC OFFICERS, DIRECTORS, AND KEY EMPLOYEES WILL ALSO FOLLOW THE CORPORATE COMPLIANCE CONFLICT OF INTEREST POLICY. EACH INDIVIDUAL GOVERNED BY THE POLICY ANNUALLY SIGNS A CONFLICT OF INTEREST STATEMENT. PERIODIC REVIEWS ARE CONDUCTED TO ENSURE THAT WMC OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST. MEMBERS OF THE COMMITTEES WITH BOARD DELEGATED POWERS CONSIDER THE PROPOSED TRANSACTION OR ARRANGEMENT AFTER DISCLOSURE OF THE FINANCIAL INTEREST, ALL MATERIAL FACTS AND AFTER DISCUSSION WITH THE INTERESTED PERSON. THE INDIVIDUAL WITH THE CONFLICT LEAVES THE BOARD OR COMMITTEE MEETING WHILE THE FINAL DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. A VOTING MEMBER OF THE BOARD OR ANY COMMITTEE WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM WMC IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. PHYSICIAN BOARD MEMBERS ARE PRECLUDED FROM VOTING ON ANY COMPENSATION MATTERS INVOLVING OTHER PHYSICIANS. FORM 990, PART VI, SECTION B, LINE 15 WYOMING MEDICAL CENTER'S EXECUTIVE COMPENSATION POLICY HAS THE PRIMARY OBJECTIVE OF PROVIDING A TOTAL COMPENSATION PROGRAM THAT RECOGNIZES INDIVIDUAL PERFORMANCE AND EXPERIENCE AND CURRENT MARKET VALUE OF THE POSITION BASED ON THE SKILLS, KNOWLEDGE AND BEHAVIORS REQUIRED OF A FULLY COMPETENT INCUMBENT. THE COMPENSATION OF THE PRESIDENT & CEO IS UNDER THE AUTHORITY OF THE COMPENSATION REVIEW COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION OF THE OTHER OFFICERS IS UNDER THE AUTHORITY OF THE PRESIDENT & CEO, WHO IS ACCOUNTABLE TO THE BOARD OF DIRECTORS. ANNUALLY, THE EMPLOYEE SERVICES DEPARTMENT COMPLETES A THOROUGH MARKET ANALYSIS FOR ALL EXECUTIVE POSITIONS. THIS MARKET REVIEW CONSIDERS EQUIVALENT POSITIONS IN THE INDUSTRY AND COMPARABLE ORGANIZATIONS AT THE LOCAL, REGIONAL AND NATIONAL LEVELS. THIS ANALYSIS IS PROVIDED TO THE COMPENSATION REVIEW COMMITTEE. THIS PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION. THE COMPENSATION REVIEW PROCESS WAS LAST CONDUCTED IN 2017. FORM 990, PART VI, SECTION C, LINE 19 WYOMING MEDICAL CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE ATTACHED TO THE PUBLIC DISCLOSURE COPY OF THE FORM 990. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 27,332,671. MANAGEMENT AND GENERAL EXPENSES 6,041,311. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,373,982. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY & POST-RETIREMENT BENEFITS 2,755,400. 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