2018-11-13T16:53:33-06:00 2017-12-31 135565207 KPMG LLP 4200 WELLS FARGO CTR 90 S 7TH STREET MINNEAPOLIS MN 55402 990 2017-01-01 410811697 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC LAKE 9528836584 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 DOUGLAS E JOHNSON CFO 9528836584 2018-11-13 1 MONROE JORDAN GIERL P01413237 6123055000 198.174.110.146 2018-11-13 16:06:33 CS P BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2 BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2 2017 2019-02-21 02:37:17Z DOUGLAS E JOHNSON 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 119177037 0 X WWW.LAKEVIEW.ORG X 1880 MN SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS 15 10 1323 250 0 0 650454 97018 116751882 118951429 10121 95950 6265 596 117418722 119144993 165967 215963 0 0 53645203 60743721 0 0 0 47519148 48651581 101330318 109611265 16088404 9533728 65996525 88595814 19025211 18599527 46971314 69996287 X TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. 0 0 98709720 215963 117870497 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS 98709720 1 0 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1323 1 0 0 0 0 0 0 0 0 0 0 X 15 10 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X DOUGLAS JOHNSON 6514304581 927 CHURCHILL STREET WEST STILLWATER MN 55082 X SCOTT AEBISCHER DIRECTOR 0.50 49.50 X 0 742896 160633 CALVIN ALLEN DIRECTOR 0.50 39.50 X 0 683082 192419 REBECCA BILLINGSLEY DIRECTOR 0.58 X 0 0 0 ELIZABETH BRADSHAW SECRETARY & DIRECTOR 0.58 X 0 0 0 DWIGHT CUMMINS DIRECTOR 0.58 X 0 0 0 PHIL DONALDSON CHAIR & DIRECTOR 0.58 X 0 0 0 ANDREW ROLLWAGEN DIRECTOR 0.58 X 0 0 0 MEGAN REMARK DIRECTOR 0.50 49.50 X 0 659171 173822 JIM SCHUG VICE CHAIR & DIRECTOR 0.58 X 0 0 0 JOHN UPPGREN DIRECTOR 0.58 X 0 0 0 NICK MEYER MD DIRECTOR 0.58 X 0 0 0 DENISE PONTRELLI DIRECTOR 0.58 X 0 0 0 JULIE SCHMIDT DIRECTOR 0.58 X 0 0 0 KEVIN BJORK MD DIRECTOR 0.50 49.50 X 0 490159 52219 ANDREW E DORWART MD DIRECTOR 0.50 49.50 X 0 481126 36065 JOHN MISA MD DIRECTOR 0.50 59.50 X 0 553128 98995 MARTHA SANFORD MD DIRECTOR 0.50 39.50 X 0 294179 50319 KATHLEEN COONEY EXECUTIVE VP & CAO 0.50 55.00 X X 0 991272 229887 DOUGLAS JOHNSON DIRECTOR & CFO 4.00 51.00 X 366499 0 118683 TED WEGLEITNER DIRECTOR & CEO 1.00 52.00 X 0 555832 109748 ROBBI A HAGELBERG VP OF OPERATIONS & CNO 0.50 49.50 X 221834 0 19597 NATE PULSCHER VP ANCILLARY SERVICES 0.50 49.50 X 191070 0 38691 PAUL ERICKSON EXEC.DIR. DEVELOPMENT 51.00 2.00 X 127279 0 64906 THOMAS ANDERSON VP MEDICAL AFFAIRS 0.50 49.50 X 0 371740 31194 MICHAEL WEIS CRNA 40.00 X 206618 0 38501 JUSTIN CUSICK CRNA 40.00 X 203539 0 39904 BETTY BENDER CRNA 40.00 X 197688 0 33188 ANN RIPLEY QUALITY 40.00 X 197132 0 40854 MICHAEL KENNEDY CRNA 40.00 X 188245 0 36907 1899904 5822585 1566532 77 0 1 0 KRAUS-ANDERSON CONSTRUCTION CO 525 S 8TH ST MINNEAPOLIS MN 55404 CONSTRUCTION SERVICES 3673292 BOUTWELLS LANDING CARE CENTER 13575 58TH ST N OAK PARK HEIGHTS MN 55082 TRANSITIONAL CARE 478099 GEPHART ELECTRIC 3550 LABORE RD ST PAUL MN 55110 CONSTRUCTION SERVICES 417993 BWBR ARCHITECTS 380 ST PETER ST STE 600 ST PAUL MN 55102 ARCHITECTURAL SERVICES 387193 REGIONS HOSPITAL 640 JACKSON ST ST PAUL MN 551012595 ANCILLARY TESTING SERVICES 346287 20 93898 3120 97018 NET PATIENT REVENUE 623990 117870497 117870497 OTHER REVENUE 900099 586392 586392 CAFETERIA 722210 366212 366212 GIFT SHOP 453220 128328 128328 118951429 94950 94950 32640 32044 596 596 596 1000 0 1000 1000 1000 119144993 117870497 0 1177478 215963 215963 779403 779403 48756717 44710471 4046246 1882888 1699463 183425 6031591 5444013 587578 3293122 2972317 320805 68513 6550 61963 2770284 2326351 443933 114614 70153 44461 1009028 850767 158261 326418 176761 149657 1519872 1449333 70539 211443 204358 7085 84833 58873 25960 4367103 3856763 510340 332584 37129 295455 MEDICAL & PHARMACY SUPP 30449516 30340600 108916 EQUIPMENT & MAINTENANCE 2688434 1396224 1292210 OTHER EXPENSE 2511142 705593 1805549 TAXES & ASSESSMENTS 2009368 2009368 188429 178670 9759 109611265 98709720 10901545 0 19062723 16759254 11808536 11809169 1925420 1916046 161670 212727 77142491 20036058 32566017 57106433 472159 792185 65996525 88595814 11325733 10455928 3600 7699478 8139999 19025211 18599527 X 46971314 69996287 46971314 69996287 65996525 88595814 X 9533728 13491245 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 0 0 PART II-B, LINE 1: LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. 23760367 23760367 28540704 5418546 23122158 326621 165697 160924 22655623 13327966 9327657 1859176 1123849 735327 57106433 PENSION LIABILITIES 8139999 8139999 X PART X, LINE 2: LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2017 OR 2016 FOR UNRECOGNIZED TAX BENEFITS. 1 1 1 X 1 X 275.000000000000 1 1 1 0 0 1413484 1413484 0.01290 2414048 889735 1524313 0.01390 7100336 4849054 2251282 0.02050 10927868 5738789 5189079 0.04730 406871 24290 382581 0.00350 193273 5400 187873 0.00170 9101489 4177082 4924407 0.04490 256197 256197 0.00230 9957830 4206772 5751058 0.05240 20885698 9945561 10940137 0.09970 10050 10050 0.00010 10050 10050 0.00010 1 1908042 32899670 35156939 -2257269 X 1 1 1 1 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 927 CHURCHILL STREET W STILLWATER MN 55082 WWW.LAKEVIEWHEALTH.ORG/ 8029322 X X X LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA X 1 15 1 HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA 0 1 X 200.000000000000 275.000000000000 X X X 1 1 X X X 1 X HTTP://WWW.LAKEVIEWHEALTH.ORG/POLICIES X HTTP://WWW.LAKEVIEWHEALTH.ORG/CHARITY-CARE-APPLICATION X HTTP://WWW.LAKEVIEWHEALTH.ORG/POLICIES X X X X X X 1 X 0 X X X X 1 X 0 1 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, PART V, SECTION B, LINE 5: AS PART OF THE DATA COLLECTION PROCESS FOR THE MOST RECENT CHNA THAT WAS CONDUCTED IN 2015, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) CONDUCTED TWO COMMUNITY CONVERSATIONS DURING THE SUMMER OF 2015 TO GATHER INPUT FROM VARIOUS GROUPS IN THE COMMUNITY, INCLUDING REPRESENTATIVES OF UNDERSERVED POPULATIONS. THESE CONVERSATIONS INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; FEDERAL, STATE OR LOCAL HEALTH DEPARTMENT OR AGENCIES WITH INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED, INCLUDING PUBLIC SCHOOL REPRESENTATION; AND LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN THE 2015 CHNA INCLUDED REGIONS HOSPITAL, HUDSON HOSPITAL, WESTFIELDS HOSPITAL, AMERY REGIONAL MEDICAL CENTER, AND PARK NICOLLET METHODIST HOSPITAL. LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, PART V, SECTION B, LINE 11: THE 2015 HEALTHPARTNERS CHNA CONDUCTED RESULTED IN THE FOLLOWING PRIORITIES:PRIORITY 1: MENTAL AND BEHAVIORAL HEALTHPRIORITY 2: ACCESS AND AFFORDABILITYPRIORITY 3: CHRONIC DISEASE AND ILLNESS PREVENTION PRIORITY 4: EQUITABLE CAREA FULL REPORT OF THE HOSPITAL'S 2015 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON THEIR WEBPAGE AT HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA WHICH PROVIDES A DETAILED DESCRIPTION OF ALL THE ACTIVITIES.ACTIONS THE HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITY AND HAS USED THE ABOVE FINDINGS AND HEALTH PRIORITIES TO CREATE A HOSPITAL SPECIFIC IMPLEMENTATION PLAN. THE HOSPITAL'S IMPLEMENTATION PLAN IDENTIFIES OBJECTIVES AND ACTION STEPS FOR EACH PRIORITY. EACH OBJECTIVE IDENTIFIES ONE WAY THAT THE HOSPITAL WILL POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY. THE ACTION STEPS DEMONSTRATE STRATEGIES THAT THE HOSPITAL WILL TAKE TO CARRY OUT EACH OBJECTIVE. LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS LISTED ON THE BACK OF THE PATIENT STATEMENT PER THE MINNESOTA ATTORNEY GENERAL (AG) AGREEMENT. LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, PART V, SECTION B, LINE 24: WHEN A PATIENT IS UNINSURED THERE HAVE BEEN INSTANCES WHERE A PORTION OF THE BALANCE IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINING BALANCE IS COVERED BY CHARITY CARE. EXAMPLE: AN UNINSURED PATIENT HAS $1,000 IN GROSS CHARGES FOR AN EMERGENCY ROOM VISIT. THE PATIENT QUALIFIES FOR CHARITY CARE AND ALSO IS ELIGIBLE FOR THE UNINSURED DISCOUNT. A PORTION OF THE GROSS CHARGES IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINDER BY CHARITY CARE, WHICH MAY TOTAL AN AMOUNT EQUAL TO THE GROSS CHARGE FOR THAT VISIT. PART I, LINE 7: ACTUAL COSTS WERE ESTIMATED USING A COST-TO-CHARGE RATIO AND EXCLUDING BAD DEBT. PART I, LINE 7E: COMMUNITY HEALTH IMPROVEMENT SERVICES LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY. THE HOSPITAL PROVIDED COMMUNITY ACTIVITIES AND PROGRAMS WHICH WERE SUBSIDIZED BY THE HOSPITAL IN ORDER TO IMPROVE COMMUNITY HEALTH. VARIOUS EVENTS INCLUDED, BUT WERE NOT LIMITED TO, THE FOLLOWING: DIABETES EDUCATION CLASSES, INCLUDING LIFE STEPS TO WEIGHT LOSS, STOMP OUT DIABETES, TAKING THE PRESSURE OFF AND HEALTHY WEIGHT FOR LIFE; POWERUP COOKING CLASSES; ADVANCED CARE PLANNING; SLEEP APNEA AND SLEEP CENTER TOURS; LADIES NIGHT OUT TO SUPPORT AND PROMOTE WOMEN'S HEALTH; HOPS FOR HEALTH TO SUPPORT MEN'S HEALTH; AND THE TEDDY BEAR CLINIC PROGRAM WHICH HELPS KINDERGARTNERS LEARN MORE ABOUT THE HEALTH CARE ENVIRONMENT, ALLEVIATING THE STRESS AND ANXIETY THAT IS SOMETIMES ASSOCIATED WITH COMING TO THE HOSPITAL. SUPPORT CLASSES INCLUDED: BREAST CANCER SUPPORT GROUP, MENOPAUSE SURVIVAL GUIDE, DIABETES SUPPORT GROUPS, FREEDOM FROM SMOKING, BREASTFEEDING AND CHILDBIRTH EDUCATION CLASSES, TAI CHI FOR ARTHRITIS, VEIN SCREENING, HAND AND WRIST ARTHRITIS, PELVIC HEALTH, AND VARIOUS OTHER EDUCATIONAL CLASSES FOR THE COMMUNITY. THE NET COST OF PROVIDING COMMUNITY HEALTH IMPROVEMENT AND OPERATIONS ASSOCIATED WITH OFFERING ALMOST 200 CLASSES IN 2017 WAS $357,487.THE HOSPITAL PROVIDED INTERPRETER SERVICES FOR PATIENTS AND VISITORS AT A COST OF $25,094 IN 2017. PART I, LINE 7F: HEALTH PROFESSIONS EDUCATION THE HOSPITAL COORDINATES AND SUPPORTS WEEKLY CONTINUING MEDICAL EDUCATION (CME) PROGRAMS FOR STAFF AND COMMUNITY EDUCATION. TOTAL DIRECT COSTS FOR STIPENDS, PURCHASED SERVICES, SUPPLIES, ROOM RENTALS AND INDIRECT COSTS FOR THE YEAR WERE $109,898.IN 2017, OUR STAFF PROVIDED 1,593 HOURS OF TIME AS PRECEPTORS TO STUDENT PROFESSIONAL INTERNS IN PHYSICAL THERAPY, PHARMACY, NURSING, AND MARKETING AND COMMUNICATIONS AT A NET COST OF $77,975. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES, EVEN AT A FINANCIAL LOSS. IN 2017, LOSS ON SERVICES FOR INPATIENT AND OUTPATIENT HEALTH SERVICES, INCLUDING CLINICAL DIABETES AND NUTRITION, LABOR AND DELIVERY SERVICES, NEONATAL NURSE PRACTITIONERS, AND HOMECARE SERVICES, TOTALED $4,924,400. PART I, LINE 7I: CONTRIBUTIONS FOR COMMUNITY BENEFIT ON BEHALF OF THE HOSPITAL, THE LAKEVIEW FOUNDATION ADMINISTERS GRANTS, WHICH ARE APPROVED BY THE HOSPITAL'S GRANT COMMITTEE. THE TWENTY-TWO GRANTS INCLUDED: ACRES FOR LIFE, AMERICAN DIABETES ASSOCIATION, CANVAS HEALTH (2), CENTURY COLLEGE FOUNDATION, COMMUNITY THREAD, ESR, FAMILYMEANS, JON FRANCIS FOUNDATION, OPERATION GRACE, OUR COMMUNITY KITCHEN, PROJECT LIFE, ST. ANDREW'S RESOURCE CENTER, GRIEF AND CARE SUPPORT THROUGH ST. CROIX CHAPLAINCY, TREEHOUSE-MAHTOMEDI, VALLEY OUTREACH, VITAL AGING PROGRAM OF WC, YOUNGLIFE, YOUTH ADVANTAGE AND YOUTH SERVICE BUREAU. THE HOSPITAL'S CASH DONATIONS TO COMMUNITY-BASED TAX-EXEMPT ORGANIZATIONS IN THE FORM OF SPONSORSHIPS, GRANTS OR SUPPLIES FOR MEDICAL MISSION TRIPS TOTALED $215,963. THE HOSPITAL ALSO PROVIDED AN IN-KIND DONATION OF A HIP REPLACEMENT TO AN AFRICAN PATIENT AT THE COST OF $40,234. PART III, LINE 4: THE "ACTUAL COST" OF BAD DEBT INCLUDED IN COMMUNITY BENEFIT IS ESTIMATED. BAD DEBT EXPENSE REPRESENTS THOSE ACCOUNTS RECEIVABLE WRITTEN OFF FROM PATIENTS THAT HAVE THE ABILITY TO PAY, AS DETERMINED FROM CHARITY CARE APPLICATIONS AND OTHER DOCUMENTATION, BUT CHOOSE NOT TO. THE BAD DEBT AMOUNT IS THE RECEIVABLE AFTER INSURANCE PAYMENT AND ADJUSTMENTS HAVE ALREADY BEEN MADE, INCLUDING ADJUSTMENTS FOR SELF-PAY IN ACCORDANCE WITH THE AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL'S OFFICE. SINCE REDUCTIONS HAVE ALREADY BEEN MADE FOR DISCOUNTS AND OTHER ALLOWANCES, THE ENTIRE BALANCE IS CONSIDERED BAD DEBT AND NO FURTHER REDUCTIONS ARE CONSIDERED.THE PROVISIONS FOR BAD DEBT FOOTNOTE IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS IS INCLUDED IN SECTION 1, PART (P), PAGES 11 AND 12. PART III, LINE 8: THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:1) IT PROVIDES SERVICES TO A SIGNIFICANT PORTION OF OUR SERVICE POPULATION AT A NEGATIVE MARGIN; 2) THE HOSPITAL WOULD DISCONTINUE PROVIDING SERVICES TO MEDICARE PATIENTS IF THE DECISION WERE BASED STRICTLY ON A FINANCIAL BASIS; 3) THERE IS A COMMUNITY NEED TO PROVIDE THESE SERVICES LOCALLY; 4) IF THE HOSPITAL DID NOT PROVIDE THESE SERVICES; THEY WOULD BECOME THE OBLIGATION OF THE GOVERNMENT. PART III, LINE 9B: IN THE EVENT OF NONPAYMENT, THE HOSPITAL IS COMMITTED TO MAKING REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE BEFORE INITIATING COLLECTION ACTIONS. THE HOSPITAL'S BUSINESS OFFICE HAS THE AUTHORITY AND RESPONSIBILITY FOR DETERMINING WHETHER THE HOSPITAL HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE AND WHETHER THE HOSPITAL IS AUTHORIZED TO ENGAGE IN SPECIFIC COLLECTION ACTIONS WHICH ARE DESCRIBED IN THE HOSPITAL'S BILLING & COLLECTIONS POLICY FOUND ON THE PUBLIC WEBSITE, HTTP://WWW.LAKEVIEWHEALTH.ORG/CHARITY-CARE-APPLICATION. PART III, SECTION A, LINE 2: BAD DEBT EXPENSE METHODOLOGY SEE FINANCIAL STATEMENT FOOTNOTE PROVIDED IN RESPONSE TO PART III, SECTION A, LINE 4. PART VI, LINE 2: IN 2015, A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") COLLABORATION WAS CONDUCTED FOR HEALTHPARTNERS AND ITS HOSPITALS (REGIONS HOSPITAL, THE HOSPITAL, HUDSON HOSPITAL, WESTFIELDS HOSPITAL, AMERY REGIONAL MEDICAL CENTER, AND PARK NICOLLET METHODIST HOSPITAL) BY COMMUNITY HOSPITAL CONSULTING TO DETERMINE THE GREATEST HEALTH NEEDS IN THE COMMUNITIES THEY SERVE. THESE HOSPITALS SERVE SIMILAR COMMUNITIES AND HAVE OVERLAPPING STUDY AREAS. THE SYSTEM'S STUDY AREA IS DEFINED AS DAKOTA, HENNEPIN, RAMSEY, SCOTT, AND WASHINGTON COUNTIES IN MINNESOTA AND POLK AND ST. CROIX COUNTIES IN WISCONSIN. THE HOSPITAL'S SPECIFIC STUDY AREA IS DEFINED AS: - WASHINGTON COUNTY - ST. CROIX COUNTY - RAMSEY COUNTY DATA ELEMENTS REGARDING ALL SEVEN COUNTIES IN THE SYSTEM'S STUDY AREA ARE INCLUDED IN THIS REPORT FOR COMPARISON, AND ARE ALSO PROVIDED AS AN OPPORTUNITY FOR THE HOSPITALS TO WORK TOGETHER TO MEET THE NEEDS IDENTIFIED IN THE OVERLAPPING COUNTIES.- DEMOGRAPHICS: CHC CONSULTING ANALYZED THE MOST CURRENT DEMOGRAPHICS OF RESIDENTS IN WASHINGTON, ST. CROIX, AND RAMSEY COUNTIES INCLUDING: OVERALL POPULATION, POPULATION BY RACE AND ETHNICITY, MEDIAN AGE, MEDIAN HOUSEHOLD INCOME, POVERTY LEVELS, FOOD INSECURITY, AND EDUCATIONAL ATTAINMENT.- HEALTH DATA COLLECTION: CHC CONSULTING ANALYZED THE MOST CURRENT HEALTH DATA AVAILABLE PERTAINING TO RESIDENTS IN WASHINGTON, ST. CROIX, AND RAMSEY COUNTIES INCLUDING: MORTALITY RATES, CHRONIC CONDITIONS, HEALTH BEHAVIORS, MENTAL HEALTH, COMMUNICABLE DISEASES, PREVENTION AND FATALITY.- COMMUNITY INPUT: AS A PART OF COUNTY-WIDE ASSESSMENTS, SURVEYS AND LISTENING SESSIONS WERE CONDUCTED TO GATHER INPUT FROM COMMUNITY RESIDENTS. IN ADDITION, THE HOSPITAL CONDUCTED COMMUNITY CONVERSATIONS ON MAY 15, 2015 AND JULY 15, 2015 TO GAIN INSIGHT SURROUNDING SIGNIFICANT HEALTH NEEDS.- FINAL PRIORITIZED NEEDS - MENTAL AND BEHAVIORAL HEALTH - ACCESS AND AFFORDABILITY - CHRONIC DISEASE AND ILLNESS PREVENTION - EQUITABLE CAREA FULL REPORT OF THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN IS POSTED ON THEIR WEBPAGE AT HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA. PART VI, LINE 3: THE HOSPITAL DEFINES FINANCIAL ASSISTANCE AS THE COST OF CARE DELIVERED TO PATIENTS WHO HAVE A NEED FOR MEDICALLY NECESSARY TREATMENT BUT ARE UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY, PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER, AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION. THE HOSPITAL IS COMPLIANT WITH THE 501R FEDERAL REGULATIONS, AND PROVIDES EASY ACCESS TO THE FINANCIAL ASSISTANCE PROGRAM INCLUDING THE FINANCIAL ASSISTANCE POLICY (FAP), APPLICATION, AND PLAIN LANGUAGE SUMMARY. THE FINANCIAL ASSISTANCE PROGRAM AND LISTS OF PROVIDERS COVERED BY THE PROGRAM IS ALSO WIDELY PUBLICIZED AND AVAILABLE ON THE HOSPITAL'S WEBSITE. TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE POLICY, AND GOVERNMENT PROGRAMS, EACH PATIENT IS OFFERED AND PROVIDED WITH THE FINANCIAL ASSISTANCE PROGRAM POLICY AT REGISTRATION. THIS INFORMATION IS ALSO IS ALSO PROVIDED IN PUBLIC LOCATIONS, INCLUDING REGISTRATION, ON PATIENT STATEMENTS, AND LAKEVIEW'S PUBLIC WEBSITE, WWW.LAKEVIEWHEALTH.ORG.IN ADDITION TO FINANCIAL COUNSELING, THE HOSPITAL HAS STAFF SOCIAL WORKERS AND CASE MANAGERS TO HANDLE CRISIS INTERVENTIONS, EMERGENCY ROOM NEEDS, AND PATIENT AFTERCARE.TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE, EACH PATIENT BILLING STATEMENT AND COLLECTIONS LETTER PRODUCED BY THE HOSPITAL INCLUDE THE FOLLOWING NOTICE: "LAKEVIEW HOSPITAL OFFERS A FINANCIAL ASSISTANCE PROGRAM. FOR COPIES OF OUR APPLICATION, FINANCIAL ASSISTANCE POLICY, AND PLAIN LANGUAGE SUMMARY, WHICH INCLUDE INFORMATION ON ELIGIBILITY AND HOW WE CALCULATE FINANCIAL ASSISTANCE, PLEASE VISIT WWW.LAKEVIEWHEALTH.ORG. OUR PATIENT FINANCIAL SERVICES TEAM CAN HELP YOU ENROLL IN THIS PROGRAM. PLEASE CALL 651-430-4533." PART VI, LINE 4: THE HOSPITAL SERVES THE EASTERN TWIN CITIES' METRO AREA AND WESTERN WISCONSIN. THE HOSPITAL'S CORE SERVICE AREA INCLUDES STILLWATER, BAYPORT, LAKE ELMO, LAKELAND, AND MARINE ON ST. CROIX, MN ALONG WITH HOULTON AND SOMERSET, WI. PRIMARY SERVICE AREAS ARE HUDSON, NEW RICHMOND AND STAR PRAIRIE, WI, AND AFTON, MN. SECONDARY SERVICE AREAS ARE NEARBY CITIES IN EASTERN MINNESOTA AND WESTERN WISCONSIN.CENSUS FIGURES FOR 2013 SHOW THE FOLLOWING FOR WASHINGTON COUNTY:TOTAL POPULATION: 246,683- PERSONS UNDER 5 YEARS: 6.2%- PERSONS UNDER 18 YEARS: 25.4%- PERSONS 65 YEARS AND OVER: 12.3% IT IS ESTIMATED THAT THE 65 AND OLDER GROUP IN WASHINGTON COUNTY WILL GROW BY 350% BY 2030.- POPULATION CHANGE FROM 2010 TO 2013: +3.6%- FEMALES: 50.5%- WHITE PERSONS: 87.9%- PERSONS OF COLOR: 12.1%- LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 9.3%- HIGH SCHOOL GRADUATES: 95.9%- BACHELOR'S DEGREE OR HIGHER: 40.5%- PERSONS BELOW POVERTY LEVEL 2009 - 2013: 5.7%- MEDIAN HOUSEHOLD INCOME IN WASHINGTON COUNTY FROM 2009 - 2013 WAS $81,540. PART VI, LINE 5: THE HOSPITAL PROVIDED EDUCATION SCHOLARSHIPS TO PEOPLE WITH DIABETES THAT REQUIRED NUTRITION AND LIFE-STYLE EDUCATION; THE HOSPITAL ALSO PROVIDED FREE LAB AND PHARMACY SERVICES FOR PATIENTS OF THE ST. CROIX FAMILY MEDICAL CENTER, A LOCAL MEDICAL CLINIC THAT PROVIDES FREE AND DISCOUNTED SERVICES FOR INDIGENT AND LOW INCOME PATIENTS OF THE AREA. FOR ADDITIONAL DISCUSSION, SEE FORM 990, SCHEDULE O - "EXEMPT PURPOSE AND ACHIEVEMENTS". PART VI, LINE 6: AS A MEMBER OF STILLWATER HEALTH SYSTEM, THE HOSPITAL PARTICIPATES WITH THE MULTI-SPECIALTY CLINIC AND HEALTH SYSTEM LEADERSHIP WITHIN OUR OVERALL ORGANIZATION IN PROVIDING ACCESS TO CARE, SUPPORT GROUPS, EDUCATIONAL ACTIVITIES, AND FINANCIAL CONTRIBUTIONS TO THE MARKET AREA DESCRIBED ABOVE. THE MULTI-SPECIALTY CLINIC FURTHER PARTICIPATES IN MINNESOTA COMMUNITY MEASUREMENT, PRACTICES AND MEASURES PROVIDER, PERFORMANCE WITH SPECIFIC PREVENTIVE CARE METRICS AND SPECIFIC CHRONIC DISEASE MANAGEMENT METRICS. IN 2011, THE STILLWATER HEALTH SYSTEM AFFILIATED WITH HEALTHPARTNERS. THE MISSION OF HEALTHPARTNERS IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 PORTICO HEALTHNET 1690 UNIVERSITY AVE W STE 250 ST PAUL MN 55104 411814659 501 (C)(3) 55612 CASH AMOUNT PROGRAM SUPPORT FAMILY MEANS 1875 NORTHWESTERN AVENUE STILLWATER MN 55082 416045574 501 (C)(3) 30000 CASH AMOUNT PROGRAM SUPPORT CANVAS HEALTH 7066 STILLWATER BLVD N OAKDALE MN 55128 410955577 501 (C)(3) 15100 CASH AMOUNT PROGRAM SUPPORT YOUTH SERVICE BUREAU 101 W PINE ST STILLWATER MN 55082 411333578 501 (C)(3) 10000 CASH AMOUNT PROGRAM SUPPORT OPERATION GRACE MN 1769 LEXINGTON AVE N 204 ROSEVILLE MN 55113 471051919 501 (C)(3) 15000 CASH AMOUNT PROGRAM SUPPORT 5 PART I, LINE 2: LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH THE HOSPITAL'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO THE HOSPITAL'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. X X X X 0 1 0 0 0 0 0 0 0 SCOTT AEBISCHER DIRECTOR 0 365607 0 103924 0 273365 0 124486 0 36147 0 903529 0 243159 CALVIN ALLEN DIRECTOR 0 484091 0 162263 0 36728 0 156711 0 35708 0 875501 0 45414 MEGAN REMARK DIRECTOR 0 464292 0 138528 0 56351 0 139402 0 34420 0 832993 0 25086 KEVIN BJORK MD DIRECTOR 0 389833 0 0 0 100326 0 20250 0 31969 0 542378 0 0 ANDREW E DORWART MD DIRECTOR 0 383024 0 70427 0 27675 0 20250 0 15815 0 517191 0 0 JOHN MISA MD DIRECTOR 0 397709 0 85939 0 69480 0 72940 0 26055 0 652123 0 51124 MARTHA SANFORD MD DIRECTOR 0 154022 0 9625 0 130532 0 20250 0 30069 0 344498 0 0 KATHLEEN COONEY EXECUTIVE VP & CAO 0 597250 0 228611 0 165411 0 189710 0 40177 0 1221159 0 129768 DOUGLAS JOHNSON DIRECTOR & CFO 276955 0 60289 0 29255 0 89960 0 28723 0 485182 0 0 0 TED WEGLEITNER DIRECTOR & CEO 0 408444 0 110594 0 36794 0 75885 0 33863 0 665580 0 31729 ROBBI A HAGELBERG VP OF OPERATIONS & CNO 191829 0 27720 0 2285 0 11643 0 7954 0 241431 0 0 0 NATE PULSCHER VP ANCILLARY SERVICES 174327 0 16743 0 0 0 6293 0 32398 0 229761 0 0 0 PAUL ERICKSON EXEC.DIR. DEVELOPMENT 120935 0 6344 0 0 0 36183 0 28723 0 192185 0 0 0 THOMAS ANDERSON VP MEDICAL AFFAIRS 0 243730 0 16762 0 111248 0 0 0 31194 0 402934 0 0 MICHAEL WEIS CRNA 204165 0 2453 0 0 0 8319 0 30182 0 245119 0 0 0 JUSTIN CUSICK CRNA 202857 0 0 0 682 0 7333 0 32571 0 243443 0 0 0 BETTY BENDER CRNA 197688 0 0 0 0 0 5381 0 27807 0 230876 0 0 0 ANN RIPLEY QUALITY 178843 0 16864 0 1425 0 11095 0 29759 0 237986 0 0 0 MICHAEL KENNEDY CRNA 188245 0 0 0 0 0 6991 0 29916 0 225152 0 0 0 PART I, LINE 4B DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTORS AND OFFICERS: CALVIN ALLEN $ 58,382 KATHLEEN COONEY $ 59,031 SCOTT AEBISCHER $ 15,340 JOHN S. MISA, MD $ 47,964 TED WEGLITNER $ 36,634 MEGAN REMARK $ 25,490 990, SCHEDULE J, PART II, COLUMN F: PRIOR REPORTED COMPENSATION COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTOR: CALVIN ALLEN $ 45,414 SCOTT AEBISCHER $ 243,159 KATHLEEN COONEY $ 129,768 JOHN S. MISA, MD $ 51,124 TED WEGLITNER $ 31,729 MEGAN REMARK $ 25,086 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THESE PARTICIPANTS OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S. 990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS CORPORATE STRUCTURE, PURPOSE, GOVERNANCE LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (THE HOSPITAL) IS A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS ("HEALTHPARTNERS"). FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED SYSTEM OF HEALTH CARE DELIVERY AND HEALTH CARE FINANCING ORGANIZATIONS, AND IS ONE OF THE LARGEST CONSUMER-GOVERNED ORGANIZATIONS IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY, ALL AT THE SAME TIME. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA, WESTERN WISCONSIN AND EXPANDING TO SEVERAL OTHER MIDWESTERN STATES. HEALTHPARTNERS PROVIDES A FULL RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLANS SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,800 PHYSICIANS AND DENTISTS, SIX OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 100 OWNED AND LEASED PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND 25 DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA, WESTERN WISCONSIN AND EXPANDING TO OTHER MIDWESTERN STATES. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUND RAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN THE HEALTHPARTNERS FAMILY, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2017 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (SHS), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). SHS IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL. THE HOSPITAL AND SHS ARE PART OF THE LAKEVIEW HEALTH SYSTEM ALONG WITH THE LAKEVIEW MEMORIAL HOSPITAL FOUNDATION, A MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATION (THE FOUNDATION) AND STILLWATER MEDICAL GROUP (SMG), A MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATION. SHS IS ALSO THE SOLE CORPORATE MEMBER OF THE FOUNDATION AND SMG. HEALTHPARTNERS AND THE HOSPITAL ALSO PARTNER WITH OTHER PLANS, CARE PROVIDERS AND NON-PROFIT ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION; TO INCREASE ACCESS, CREATE AND DISSEMINATE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY AND COLLABORATE ON SYSTEM IMPROVEMENTS. THE HOSPITAL CONTINUES TO BE AN INTEGRAL PART OF THE STILLWATER COMMUNITY AND SURROUNDING AREA - A VITAL AND NECESSARY COMMUNITY RESOURCE SINCE 1880, THE FIFTH OLDEST HOSPITAL, AND SECOND OLDEST CONTINUALLY OPERATING HOSPITAL IN MINNESOTA. THE HOSPITAL CONVENES AND SUPPORTS MULTIPLE COMMUNITY COLLABORATIVES TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. THE HOSPITAL IS DESIGNATED A LEVEL 3 TRAUMA HOSPITAL AND HAS MEDICAL STAFF IN A VARIETY OF SPECIALTIES, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, OB/GYN WITH A LEVEL NURSERY, GENERAL SURGERY, ORTHOPEDICS, OTOLARYNGOLOGY, OCCUPATIONAL HEALTH, EMERGENCY MEDICINE, HOSPITAL MEDICINE, NEUROLOGY, ONCOLOGY, UROLOGY, CARDIOLOGY, SPORTS MEDICINE, GASTROENTEROLOGY, RADIOLOGY, PATHOLOGY AND ANESTHESIOLOGY. COURTESY AND CONSULTING STAFF PROVIDE ADDITIONAL SERVICES, INCLUDING PAIN MANAGEMENT, AND INFECTIOUS DISEASE, PULMONARY/SLEEP MEDICINE AND ORAL SURGERY. CHARITY CARE: CHARITY CARE IS DEFINED AS THE COST OF CARE DELIVERED TO PATIENTS WHO ARE WILLING, BUT UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES: PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY; PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER; AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES, OR SPECIAL FINANCIAL HARDSHIP, WARRANT SPECIAL CONSIDERATION. THE HOSPITAL PROVIDED $1,413,413 IN FREE OR DISCOUNTED CARE TO LOW-INCOME AND UNINSURED PATIENTS IN 2017. GOVERNMENT-SPONSORED MEANS-TESTED HEALTH CARE: THE HOSPITAL PROVIDED INPATIENT AND OUTPATIENT CARE, INCLUDING EMERGENCY DEPARTMENT SERVICES TO MEDICAID PATIENTS. PAYMENTS RECEIVED FOR THESE SERVICES WERE BELOW THE COST OF CARE PROVIDED. THE HOSPITAL'S EXPENSE TO COVER UNREIMBURSED MEDICAID COSTS FOR PATIENTS TOTALED $1,524,461. BENEFIT TO THE COMMUNITY: THE HOSPITAL WORKED IN COLLABORATIVE PARTNERSHIP WITH THE COMMUNITY TO IMPROVE HEALTH AND WELL-BEING. THE LAKEVIEW HEALTH SYSTEM ORGANIZATIONS, THE COMMUNITY AND THE HOSPITAL ACCOMPLISHED A GREAT DEAL IN 2017. THE HOSPITAL CONTINUES TO GROW ITS REPUTATION FOR EXCELLENT CLINICAL OUTCOMES AND SERVICE. 1. COMMUNITY HEALTH SERVICES: THE HOSPITAL CONVENED AND PARTICIPATED IN COMMUNITY-BASED COLLABORATIVE EFFORTS TO IMPROVE ACCESS TO COMMUNITY AND MENTAL HEALTH SERVICES, INCLUDING: THE COMMUNITY HEALTH ACTION TEAM (CHAT) FOCUSED DISCUSSION ON DENTAL HEALTH ACCESS AND OVERALL COMMUNITY NEEDS. THE HOSPITAL PROVIDED REPRESENTATION AT CONNECT COMMUNITY COLLABORATIVE FOR MENTAL AND CHEMICAL HEALTH. THE HOSPITAL ACTIVELY PARTICIPATED IN THE WASHINGTON COUNTY SUMMIT WHICH EXPLORES PRIORITY NEEDS IN THE AREA OF BEHAVIORAL/MENTAL HEALTH AND SUBSTANCE ABUSE. THE HOSPITAL TRAINED MORE THAN 200 MAKE IT OK ANTI-STIGMA CAMPAIGN AMBASSADORS FOR MENTAL HEALTH IN 2017. THE HOSPITAL SUPPORTED POWERUP, A COMMUNITY-WIDE HEALTH INITIATIVE THAT INSPIRES AND ENGAGES THE ENTIRE COMMUNITY TO PROMOTE BETTER EATING AND ACTIVE LIVES SO YOUTH CAN REACH THEIR FULL POTENTIAL. POWERUP HAS IMPLEMENTED A COMPREHENSIVE FRAMEWORK AND STRATEGY FOR THE INITIATIVE INCLUDING COMMUNITY ADVISORY COMMITTEES, COMMUNITY OUTREACH AND EDUCATION, AND PARTNERSHIPS WITH MULTIPLE COMMUNITY SECTORS TO CHANGE THE FOOD AND PHYSICAL ACTIVITY ENVIRONMENT. THE HOSPITAL HELD TWO AMERICAN RED CROSS BLOOD DRIVES IN 2017, ON THE HOSPITAL CAMPUS, WITH 50 STAFF AND COMMUNITY MEMBERS VOLUNTEERING FOR THIS CAUSE. CONTINUED FACILITATION OF THE LOCAL BREAST CANCER SUPPORT GROUP. THE HOSPITAL SPONSORED AND COORDINATED, FOR THE BENEFIT OF THE COMMUNITY, OVER 150 CLASSES, EVENTS AND SUPPORT GROUPS DURING THE YEAR AT A NET COST OF APPROXIMATELY $357,487. THE HOSPITAL PROVIDED INTERPRETER SERVICES FOR PATIENTS AND VISITORS AT A COST OF $25,094 IN 2017. FORM 990, PART III, LINE 4A THE HOSPITAL SUPPORTED THE ST. CROIX VALLEY FAITH COMMUNITY NURSE PROGRAM, WHICH IS A HEALTH CARE MINISTRY PROVIDING PHYSICAL, EMOTIONAL AND SPIRITUAL CARE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES SERVED BY LOCAL CONGREGATIONS. THE FAITH COMMUNITY NURSE PROGRAM, FUNDED BY THE FOUNDATION, PROMOTES A GREATER UNDERSTANDING OF HEALTH-RELATED ISSUES AND ADDRESSES THESE CONCERNS THROUGH INFORMATION AND EDUCATION. THE HOSPITAL SUPPORTED THE PRESCRIPTION ASSISTANCE PROGRAM, PROVIDING FREE AND LOW-COST MEDICATIONS FOR THOSE WITH FINANCIAL NEED. A STAFF MEMBER AT THE HOSPITAL, FUNDED BY THE FOUNDATION, ASSISTS PATIENTS WHO HAVE DIFFICULTY AFFORDING THEIR MEDICATIONS. 2. HEALTH PROFESSIONAL EDUCATION: THE HOSPITAL COORDINATED AND SUPPORTED WEEKLY CONTINUING MEDICAL EDUCATION (CME) PROGRAMS FOR STAFF AND COMMUNITY EDUCATION. TOTAL DIRECT COSTS FOR STIPENDS, PURCHASED SERVICES, SUPPLIES, ROOM RENTALS AND INDIRECT COSTS FOR THE YEAR WERE $109,898. IN 2017, OUR STAFF PROVIDED 1,593 HOURS OF TIME AS PRECEPTORS TO STUDENT PROFESSIONAL INTERNS IN PHYSICAL THERAPY, PHARMACY, NURSING, AND MARKETING AND COMMUNICATIONS AT A NET COST OF $77,975. 3. SUBSIDIZED HEALTH SERVICES: THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES, EVEN AT A FINANCIAL LOSS. IN 2017, LOSS ON SERVICES FOR INPATIENT AND OUTPATIENT HEALTH SERVICES, INCLUDING CLINICAL DIABETES AND NUTRITION, LABOR AND DELIVERY SERVICES, NEONATAL NURSE PRACTITIONERS, AND HOMECARE SERVICES, TOTALED $4,924,400. STILLWATER AREA SCHOOLS WELLNESS PROGRAM AND CENTER OPERATES AT THE LARGEST HIGH SCHOOL IN THE SERVICE AREA. THE WELLNESS CENTER IS A PHYSICAL SPACE IN THE HIGH SCHOOL IN COLLABORATION WITH FAMILYMEANS, YOUTH SERVICE BUREAU, THE HOSPITAL'S POWERUP INITIATIVE, LAKEVIEW HEALTH SYSTEM AND INDEPENDENT SCHOOL DISTRICT 834. THIS COLLABORATION PROVIDES K-12 STUDENTS WITH A WIDE RANGE OF INDIVIDUALIZED MENTAL HEALTH SERVICES THAT REDUCE BARRIERS TO OBTAINING HELP IN AN EASILY ACCESSIBLE, WELCOMING AND CONFIDENTIAL SETTING. THESE LOW TO NO COST SERVICES INCLUDE MENTAL HEALTH, CHEMICAL HEALTH AND NUTRITION ISSUES. IN 2017, THE WELLNESS CENTER PROGRAM EXPERIENCED 6,426 SCHOOL-BASED COUNSELING CONTACTS TO 527 UNIQUE INDIVIDUALS, MORE THAN DOUBLING BOTH MEASUREMENTS OF NEED AND RESPONSE FROM THE PREVIOUS YEAR. 4. FINANCIAL CONTRIBUTIONS: TO ADDRESS HEALTH CARE ACCESS FOR UNINSURED AND UNDER-INSURED PATIENTS, THE HOSPITAL PROVIDED FUNDING OF $40,000 TO PORTICO HEALTHNET, A NONPROFIT ORGANIZATION THAT ASSISTS PEOPLE WITH ENROLLING IN FREE OR LOW-COST HEALTH COVERAGE. ON BEHALF OF THE HOSPITAL, THE FOUNDATION ADMINISTERS GRANTS, WHICH ARE APPROVED BY THE HOSPITAL'S GRANT COMMITTEE. THE TWENTY-TWO GRANTS INCLUDED: ACRES FOR LIFE, AMERICAN DIABETES ASSOCIATION, CANVAS HEALTH (2), CENTURY COLLEGE FOUNDATION, COMMUNITY THREAD, ESR, FAMILYMEANS, JON FRANCIS FOUNDATION, OPERATION GRACE, OUR COMMUNITY KITCHEN, PROJECT LIFE, ST. ANDREW'S RESOURCE CENTER, GRIEF AND CARE SUPPORT THROUGH ST. CROIX CHAPLAINCY, TREEHOUSE-MAHTOMEDI, VALLEY OUTREACH, VITAL AGING PROGRAM OF WC, YOUNGLIFE, YOUTH ADVANTAGE AND YOUTH SERVICE BUREAU. GRANTS DISTRIBUTED IN 2017 TO THESE ORGANIZATIONS TOTALED $125,000. IN ADDITION, THE FOLLOWING ORGANIZATIONS AND PROGRAMS WERE SUPPORTED FOR OVERALL COMMUNITY BENEFIT: AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, AMERY REGIONAL MEDICAL CENTER FOUNDATION, BREAST CANCER AWARENESS, CAMP ODAYIN, CANVAS HEALTH, CHURCH OF ST. MARY, ESR, FAMILYMEANS, GLOBAL HEALTH MINISTRIES, GOOD SAMARITAN SOCIETY STILLWATER, HOPE HOUSE, MAHTOMEDI AREA EDUCATION FOUNDATION, MINNESOTA ORGANIZATION FOR FETAL ALCOHOL SYNDROME, MINNESOTA HOSPITAL ASSOCIATION, NORTHERN STAR COUNCIL BSA, PARTNERSHIP PLAN, RED CROSS, REGIONS HOSPITAL FOUNDATION, STILLWATER SUNRISE ROTARY, ST. ANNE CATHOLIC SCHOOL, STILLWATER HIGH SCHOOL, ST. CROIX COUNTY HEALTHIER TOGETHER, SISTER KENNEY FOUNDATION - COURAGE CENTER; UNITED WAY WASHINGTON COUNTY EAST, VALLEY CHAMBER CHORALE, AND YOUNGLIFE. THE TOTAL WAS $34,605. 5. COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL PROVIDES LEADERSHIP AND PARTICIPATES IN A NUMBER OF STRATEGIC COMMUNITY COLLABORATIONS AND INITIATIVES, INCLUDING: CHAT (COMMUNITY HEALTH ACTION TEAM): CONVENES NONPROFIT AND COMMUNITY LEADERS ON A MONTHLY BASIS TO COLLABORATE ON ADDRESSING PRIORITY COMMUNITY HEALTH NEEDS. CONNECT: COLLABORATIVE MISSION IS TO PREVENT AND REDUCE YOUTH ALCOHOL, TOBACCO AND OTHER DRUG USE THROUGH PARTNERSHIP, EDUCATION, INTERVENTION AND COMMUNITY CHANGE. WASHINGTON COUNTY COMMUNITY LEADERSHIP TEAM (CLT): THE HOSPITAL COLLABORATES ON BOTH TOBACCO CESSATION AND OBESITY INITIATIVES. HEALTHIER TOGETHER: FOCUSED ON A NUMBER OF HEALTH PRIORITIES, INCLUDING ALCOHOL AND SUBSTANCE ABUSE, IN ST. CROIX AND PIERCE COUNTIES IN WISCONSIN. THE HOSPITAL PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED ECONOMIC DEVELOPMENT, EMERGENCY PREPAREDNESS, LEADERSHIP DEVELOPMENT, COALITION BUILDING, HEALTH IMPROVEMENT ADVOCACY AND WORKFORCE DEVELOPMENT. $4,510 SAVED THROUGH RECYCLING, FOOD WASTE, AND OTHER DIVERSION METHODS. THE HOSPITAL COLLECTED 135.89 TONS OF MATERIALS WHICH WERE KEPT OUT OF THE LANDFILL; 6 TONS WERE DONATED AND 18.3 TONS WERE DIVERTED THROUGH THE "FOOD TO HOGS" PROGRAM. THIS PROGRAM ALLOWS THE HOSPITAL TO DONATE FOOD WASTE FROM THE CAFETERIA TO FEED PIG LIVESTOCK. THIS NOT ONLY REDUCES WASTE BUT ALSO REDUCES THE TAXES THE HOSPITAL PAYS ON GARBAGE BASED ON WEIGHT. THE HOSPITAL'S PHARMACIES COLLECTED 120 POUNDS OF MEDICATIONS THROUGH THE MED TAKE BACK PROGRAM FOR DISPOSAL IN 2017. THE HOSPITAL'S EMERGENCY MEDICAL SERVICES (EMS) DEPARTMENT PROVIDES EVENT COVERAGE IN THE SURROUNDING COMMUNITIES, WHICH SUPPORT COALTION BUILDING WITH COMMUNITY PARTNERS. EMS PROVIDED 305 HOURS OF COVERAGE AT A COST OF $10,050 AT VARIOUS COMMUNITY EVENTS IN 2017. 6. COMMUNITY BENEFIT OPERATIONS: THE HOSPITAL STAFF'S TIME TO COLLECT, ANALYZE AND REPORT COMMUNITY BENEFITS FOR 2017 WAS APPROXIMATELY 65 HOURS. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA); PLEASE REFER TO THE SCHEDULE H NARRATIVE IN THIS 990 REPORT. THE NET 2017 COMMUNITY BENEFIT CONTRIBUTION EQUALED $10,940,309 OR 10% OF TOTAL EXPENSES. THIS FIGURE IS REPORTED AT COST PER THE CATHOLIC HEALTH ASSOCIATION (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES. 7. ORGANIZATION AWARDS AND ACHIEVEMENTS: THE HOSPITAL WAS NAMED ONE OF THE NATION'S 100 TOP HOSPITALS BY TRUVEN HEALTH ANALYTICS/IBM WATSON HEALTH. FOR HOSPITALS IN THE SMALL COMMUNITY HOSPITAL CATEGORY, THE HOSPITAL RANKED IN THE TOP 20 OF THE 846 HOSPITALS. THE HOSPITAL WAS NAMED ONE OF THE 60 GREENEST HOSPITALS IN AMERICA BY BECKER'S HOSPITAL REVIEW. THE HOSPITAL EARNED ITS FOURTH "A" SAFETY GRADE RATING FROM LEAPFROG HOSPITAL SAFETY GRADE GROUP THE HOSPITAL CONTINUES TO PERFORM IN THE TOP DECILE FOR PATIENT EXPERIENCE. (SOURCE - NRC PICKER). RECIPIENT OF TWO 2017 GREENHEALTH PARTNER FOR CHANGE AWARDS BY PRACTICE GREENHEALTH: GREENHEALTH EMERALD FOR ACCELERATING GREEN HEALTHCARE AND GREENING THE OR. THE HOSPITAL ACHIEVED GOLD LEVEL STATUS ON THE ANTIBIOTIC STEWARDSHIP HONOR ROLL BY THE MINNESOTA DEPARTMENT OF HEALTH. THE HOSPITAL RECEIVED BOTH THE HOMECARE ELITE TOP AGENCY AND TOP 500 AGENCY DESIGNATIONS. THE HOSPITAL WAS RECERTIFIED AS A LEVEL 3 TRAUMA CENTER. FORM 990, PART VI, SECTION A, LINE 4 SHS, SMG, AND LMHA WILL MAINTAIN THEIR SEPARATE CORPORATIONS AND LEGAL STATUS, BUT EACH OF THE THREE BOARDS WILL BE COMPRISED OF THE SAME PERSONS AND THE BOARDS WILL MEET CONCURRENTLY, WITH NO NEED FOR SHS TO PROVIDE SEPARATE "MEMBER" APPROVAL FOR ACTIONS OF SMG OR THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS SHS. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER RATIFIES THE PERSONS ELECTED TO THE HOSPITAL BOARD, AT LEAST 75% OF WHOM MUST BE COMMUNITY LEADERS. THE CHIEF EXECUTIVE OFFICER OF THE SOLE MEMBER SERVES AS AN EX OFFICIO NON-VOTING HOSPITAL BOARD MEMBER. ADDITIONALLY, HEALTHPARTNERS AS THE SOLE MEMBER OF SHS APPOINTS ONE PERSON TO THE HOSPITAL BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS CUSTOMARY POWERS INCLUDING APPROVAL OF HIGHLY SIGNIFICANT ACTIONS OF THE HOSPITAL'S BOARD OF DIRECTORS. THESE INCLUDE AMENDMENT OF THE GOVERNING DOCUMENTS; APPROVAL OF STRATEGIC PLANS AND ANNUAL BUDGETS; MERGER, CONSOLIDATION OR SUBSTANTIAL AFFILIATION WITH ANOTHER ENTITY; APPOINTMENT OF THE PRESIDENT OF THE HOSPITAL; AND INCURRENCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 11B THE HOSPITAL'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE HOSPITAL, GHI'S INTERNAL LEGAL DEPARTMENT AND THE HOSPITAL'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE HOSPITAL MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THE HOSPITAL MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED TO THE FULL BOARD OF DIRECTORS IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT THE MEETING. THIS PROCESS IS DOCUMENTED IN THE WRITTEN MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES ("COVERED PERSONS") BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, COVERED PERSONS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE LEGAL DEPARTMENT OF HEALTHPARTNERS REVIEWS THE QUESTIONNAIRE RESPONSES AND DEVELOPS A REPORT DETAILING ANY POTENTIALLY MATERIAL CONFLICTS FOR THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD OR APPROPRIATE COMMITTEE, AND REINFORCES THE POLICY'S MANDATE THAT EACH PERSON IS OBLIGATED TO DISCLOSE ANY NEW POTENTIAL CONFLICTS AS THEY MAY ARISE THROUGHOUT THE YEAR. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY GROUP HEALTH PLAN, INC. (GHI), OR BY STILLWATER HEALTH SYSTEM (SHS), BOTH OF WHICH ARE RELATED ORGANIZATIONS OR BY THE HOSPITAL. GHI, SHS AND THE HOSPITAL HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE HOSPITAL'S PRESIDENT AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE GHI BOARD OF DIRECTORS (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, EITHER THE COMPENSATION COMMITTEE OF THE SHS OR THE COMPENSATION COMMITTEE OF GHI (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES ARE DETERMINED FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMMITTEES REVIEW AND APPROVE EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, THE COMMITTEES' MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEES MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. WITH THE HOSPITAL'S BOARD OF DIRECTORS INPUT, THE GHI EVP AND CHIEF ADMINISTRATIVE OFFICER CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH THE COMPENSATION COMMITTEE OF THE SHS'S APPROVAL, DETERMINES THE COMPENSATION OF THE HOSPITAL PRESIDENT. THE HOSPITAL BOARD HAS DELEGATED TO THE PRESIDENT THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL HOSPITAL-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE COMPENSATION COMMITTEE OF THE SHS. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE HOSPITAL OR HEALTHPARTNERS. THE HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. 990, PART VII, SECT A, LN 1A, COL B: AVERAGE HOURS - RELATED ORGANIZATION AVERAGE WEEKLY HOURS: THE COMPENSATED BOARD MEMBERS AND OFFICERS OF THE HOSPITAL ARE EMPLOYED AND COMPENSATED BY THE HOSPITAL, GHI OR PARK NICOLLET. THE COMPENSATED BOARD MEMBERS AND OFFICERS DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE - SMG -5,334,931. TRANSFER OF INVESTMENTS 21,100,000. CHANGE IN PENSION LIABILITY VALUATION -2,139,151. TRANSFER TO AFFILLIATE -295,900. TRANSFER FROM LHF 161,227. HEALTHPARTNERS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411693838 HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4) N/A 0 RH-WISCONSIN 8171 33RD AVE S PO BOX 1309 MPLS MN 554401309 202287016 CORPORATE PLANNING AND OVERSIGHT WI 501(C)(3) 509(A)(3) TYPE I HPI - RAMSEY 0 HPI-RAMSEY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411793333 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 GROUP HEALTH PLAN INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410797853 STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC 0 HEALTHPARTNERS INSTITUTE 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411670163 HEALTHCARE EDUCATION AND RESEARCH MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 CAPITOL VIEW TRANSITIONAL CARE CENTER 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 412011453 TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410956618 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411888902 PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY 0 RHSC INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411891928 HEALTHCARE STAFFING AND INTENSE REHAB SERVICES MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 0 PHYSICIANS NECK AND BACK CLINICS 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 270684883 SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC 0 HUDSON HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390804125 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 0 HUDSON HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391279567 PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH WI 501(C)(3) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC 0 LAKEVIEW MEMORIAL HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411386635 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 509(A)(3) TYPE II STILLWATER HEALTH SYSTEM 0 STILLWATER MEDICAL GROUP 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 830379473 CLINIC STAFF AND FACILITIES MN 501(C)(3) 509(A)(3) TYPE I STILLWATER HEALTH SYSTEM 0 STILLWATER HEALTH SYSTEM 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 300221189 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 0 WESTFIELDS HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390808442 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 0 WESTFIELDS HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391770913 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 170(B)(1) (A)(VI) WESTFIELDS HOSPITAL INC 0 RAMSEY INTEGRATED HEALTH SERVICES 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411503090 HOME CARE AND HOSPICE MN 501(C)(3) 509(A)(2) HPI - RAMSEY 0 PARK NICOLLET HEALTH SERVICES 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55426 363465840 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(2) HEALTHPARTNERS INC 0 PARK NICOLLET FOUNDATION 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55426 237346465 SUPPORT TO RELATED ENTITIES AND COMMUNITY TO IMPROVE HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) PARK NICOLLET HEALTH SERVICES 0 PARK NICOLLET METHODIST HOSPITAL 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55426 410132080 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) PARK NICOLLET HEALTH SERVICES 0 PARK NICOLLET HEALTH CARE PRODUCTS 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55426 010638901 DURABLE MEDICAL EQUIPMENT , PHARMACY AND OTHER HEALTH CARE RETAIL SALES MN 501(C)(3) 509(A)(3) TYPE I PARK NICOLLET HEALTH SERVICES 0 PARK NICOLLET CLINIC 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55426 410834920 CLINIC SERVICES MN 501(C)(3) 170(B)(1) (A)(III) PARK NICOLLET HEALTH SERVICES 0 PNMC HOLDINGS 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55426 411741792 HEALTHCARE REAL ESTATE MN 501(C)(3) 509(A)(3) TYPE I PARK NICOLLET HEALTH SERVICES 0 AMERY REGIONAL MEDICAL CENTER INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390908320 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 0 AMERY REGIONAL MEDICAL CENTER FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391726539 PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH WI 501(C)(3) 170(B)(1) (A)(VI) AMERY REGIONAL MEDICAL CENTER INC 0 HEALTHPARTNERS ADMINISTRATORS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411629390 THIRD PARTY ADMINISTRATOR MN HEALTHPARTNERS INC C 0 HEALTHPARTNERS ASSOCIATES INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 522365151 MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC C 0 HEALTHPARTNERS SERVICES INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411683568 MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC C 0 HEALTHPARTNERS INSURANCE COMPANY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411683523 MEDICAL AND DENTAL INSURANCE MN HEALTHPARTNERS ADMINISTRATORS INC C 0 DENTAL SPECIALTIES INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 451297583 PROFESSIONAL DENTAL SERVICES MN HEALTHPARTNERS ADMINISTRATORS INC C 0 HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411236798 MEDICAL CLINIC STAFFING MN HEALTHPARTNERS ADMINISTRATORS INC C 0 PARK NICOLLET ENTERPRISES 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55426 411656735 REAL ESTATE FOR RELATED ORGANIZATIONS MN PARK NICOLLET HEALTH SERVICES C 0 1 0 0 0 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES L 4402933 CASH AMOUNT