2015-11-09T16:02:26-06:00 2014-12-31 990 2014-01-01 810231792 HOLY ROSARY HEALTHCARE HOLY 4062332600 2600 WILSON STREET MILES CITY MT 59301 RON OLDFIELD VP FINANCIAL SVS & CFO 4062332600 2015-10-16 2014 2016-03-07 17:11:31Z PAUL LEWIS 2600 WILSON STREET MILES CITY MT 59301 38652240 0 0928 X WWW.HOLYROSARYHEALTHCARE.ORG X 1961 MT WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THEPEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR ANDVULNERABLE. 11 10 414 60 0 0 1469666 515304 39830383 37572962 46355 136855 491442 427119 41837846 38652240 26390 135618 0 0 19993993 19501474 0 0 0 22090609 21016934 42110992 40654026 -273146 -2001786 24474041 27334076 3642837 8552047 20831204 18782029 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OFTHE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POORAND VULNERABLE. 0 0 33676006 135618 37880346 FOUNDED IN 1910, HOLY ROSARY HEALTHCARE IS EASTERN MONTANA'S HEALTHCARE DESTINATION. HOLY ROSARY OPERATES A COMPREHENSIVE ACUTE-CARE HOSPITAL, PHYSICIAN CLINICS, A RESIDENTIAL LIVING COMMUNITY, AND HOSPICE AND PALLIATIVE CARE SERVICES - PROVIDING A COMPLETE CONTINUUM OF CARE TO A 10-COUNTY REGION OF EASTERN MONTANA. AS PART OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, A FAITH-BASED, NONPROFIT HEALTH SYSTEM, HOLY ROSARY HAS DIRECT ACCESS TO BEST PRACTICES, RESOURCES, TECHNOLOGY, TALENT AND STRATEGIC CAPITAL. SERVICES INCLUDE SURGICAL, ONCOLOGY, AND MATERNITY SERVICES, AS WELL AS 24-HOUR EMERGENCY ROOM AND DIAGNOSTIC AND THERAPEUTIC SERVICES. THE EXTENDED CARE UNIT PROVIDES SHORT-TERM TRANSITIONAL CARE AFTER ILLNESS, INJURY, OR SURGERY, AS WELL AS LONG-TERM CARE FOR THOSE UNABLE TO LIVE INDEPENDENTLY.IN AUGUST 1910, THE PRESENTATION SISTERS OF ABERDEEN, SOUTH DAKOTA, ASSUMED MANAGEMENT AND OPERATION OF THE COUNTY HOSPITAL IN MILES CITY AT THE REQUEST OF THE COMMUNITY, THE MILWAUKEE RAILROAD AND THE DOCTORS ASSOCIATED WITH THE RAILROAD. IN 1915, THE SISTERS PURCHASED THE HOSPITAL, COMMITTING TO A RELATIONSHIP WITH THE COMMUNITY THAT WOULD EXTEND FOR DECADES.IN 1995, HOLY ROSARY HEALTHCARE OPENED A NEW COST EFFECTIVE FACILITY ON A 58-ACRE CAMPUS IN MILES CITY THAT ALLOWED PHYSICIANS AND OTHER CARE FACILITIES TO LOCATE IN THE NEW HOSPITAL BUILDING. THE BUILDING OF THE NEW FACILITY AND MOVING INTO THE NEW FACILITY WAS A COMMUNITY-WIDE EFFORT, AND WAS ACCOMPLISHED THROUGH THE CONTRIBUTIONS OF THE STAFF, PHYSICIANS, BOARD MEMBERS, COMMUNITY MEMBERS AND VOLUNTEERS.IN KEEPING WITH THE NEW COVENANT PROCESS, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) ASSUMED SPONSORSHIP OF HOLY ROSARY HEALTHCARE IN 1997. TODAY, THE 25-BED ACUTE CARE HOSPITAL, RESIDENTIAL LIVING COMMUNITY AND 16-PHYSICIAN CLINIC ALL IN A SINGLE BUILDING, SERVES AS A CENTRALIZED SETTING FOR COMPREHENSIVE HEALTH CARE FOR THE PEOPLE ACROSS EASTERN MONTANA. PHYSICIAN SPECIALTIES INCLUDE FAMILY MEDICINE, INTERNAL/ADULT MEDICINE, GENERAL SURGERY, VASCULAR SURGERY, WOMEN'S HEALTH, ORTHOPEDICS, OPHTHALMOLOGY (EYE), PSYCHOLOGY, AUDIOLOGY, CARDIOLOGY, NEUROLOGY, NEUROSURGERY, ORAL SURGERY, NEPHROLOGY (KIDNEY), DERMATOLOGY, AND SLEEP MEDICINE/PULMONOLOGY.TODAY, HOLY ROSARY HEALTHCARE SERVES SEVERAL EASTERN MONTANA COUNTIES, WHICH COVER OVER 20,000 SQUARE MILES OR APPROXIMATELY 13% OF MONTANA. MORE THAN HALF OF THE PEOPLE RECEIVING HEALTHCARE IN MILES CITY, WHICH HAS A POPULATION OF 11,000, ARE FROM OUTSIDE CUSTER COUNTY. THEREFORE, HOLY ROSARY HEALTHCARE'S IMPACT ON THE HEALTHCARE DELIVERY SYSTEM REACHES FAR BEYOND CITY AND COUNTY LINES. WITH A POPULATION DENSITY OF 1.4 PERSONS PER SQUARE MILE ACROSS THE SEVEN-COUNTY REGION AROUND HOLY ROSARY, CLEARLY THIS DEGREE OF CONTEMPORARY HEALTH CARE IS EXTRAORDINARY.DURING 2014, HOLY ROSARY HEALTHCARE HAD THE FOLLOWING RESULTS:ADMISSIONS - 1,294OUTPATIENT VISITS - 54,609BIRTHS - 287SURGERIES - 1,494LAB TESTS - 89,466AS PART OF THE MONTANA REGION OF SCL HEALTH, HOLY ROSARY IS AFFILIATED WITH ST. JAMES HEALTHCARE IN BUTTE AND ST. VINCENT HEALTHCARE IN BILLINGS, GIVING IT ACCESS TO SOME OF THE STATE'S MOST ADVANCED MEDICAL TECHNOLOGY. HOLY ROSARY HAS A HISTORIC COMMITMENT TO SERVING THE POOR AND THOSE WITH LIMITED ACCESS TO HEALTHCARE. THE COMMITMENT IS TO THE WORTH AND DIGNITY OF THE WHOLE PERSON - SPIRITUAL, PSYCHOLOGICAL, AND MEDICAL.HOLY ROSARY IS CURRENTLY LICENSED BY THE STATE OF MONTANA AND IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTH CARE ORGANIZATIONS. HOLY ROSARY HAS 25 ACUTE CARE AND 86 EXTENDED CARE BEDS AND 24 PHYSICIAN OFFICES. MISSIONWE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.VISIONINSPIRED BY OUR FAITH: WE WILL BE DISTINGUISHED AS THE PREMIER PERSON-CENTERED HEALTH SYSTEM AND TRUSTED PARTNER. WE WILL SHARE ACCOUNTABILITY WITH CLINICIANS AND OTHER STAKEHOLDERS TO COORDINATE CARE ACROSS ALL SETTINGS AND IMPROVE ACCESS, QUALITY, HEALTH OUTCOMES, AND AFFORDABILITY. WE WILL GROW AS COMMUNITY-BASED HEALTH NETWORKS TO SERVE MORE PEOPLE IN PARTNERSHIPS WITH OTHERS WHO SHARE OUR VISION AND VALUES. VALUES CARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON. EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS. GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS. INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE. SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES. STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US.HOLY ROSARY HEALTHCARE HAS A VARIETY OF PROGRAMS AND SERVICES TO SERVE THE COMMUNITY:CANCER CAREFROM INITIAL DIAGNOSIS TO TREATMENT AND RECOVERY, PATIENTS AND THEIR FAMILIES CAN ACCESS AN EXCEPTIONAL LEVEL OF CARE CLOSE TO HOME. CARDIAC SERVICESFOR OPTIMAL CONVENIENCE, HOLY ROSARY OFFERS A CONTINUUM OF CARE - STRESS TESTING, PACEMAKER IMPLANTATION, AND CARDIAC REHABILITATION. CHILDREN'S CAREWE UNDERSTAND THE SPECIAL NEEDS OF CHILDREN AND OFFER EXPERIENCED AND SKILLED NURSES, A FAMILY-FRIENDLY EMERGENCY DEPARTMENT AND BOARD-CERTIFIED PEDIATRICIANS.CLINICLOCATED ON THE HOSPITAL CAMPUS, THE HOLY ROSARY HEALTHCARE CLINIC WAS DEVELOPED TO PROVIDE OUTSTANDING PRIMARY AND SPECIALTY CARE. DIABETES CARETHE HOLY ROSARY DIABETES CARE TEAM, CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION, OFFERS BOTH INPATIENT AND OUTPATIENT SERVICES TO ASSIST PATIENTS. EMERGENCY AND TRAUMA SERVICESHOLY ROSARY'S TEAM OF EMERGENCY PROVIDERS AND NURSES ADEPTLY ASSESS CONDITIONS RANGING FROM A CHILD'S RISING FEVER TO LIFE-THREATENING HEART ATTACKS.HOSPICE AND PALLIATIVE CAREALL PALLIATIVE AND HOSPICE CARE TEAM MEMBERS ARE AVAILABLE TO MAKE HOME VISITS, NURSING HOME VISITS, ASSISTED LIVING VISITS AND TO VISIT PATIENTS AT HOLY ROSARY HEALTHCARE.HOSPITALIST PROGRAMA HOSPITALIST'S PRIMARY PROFESSIONAL FOCUS IS THE TOTAL CARE OF A PATIENT FROM THE TIME OF ADMISSION UNTIL THE PATIENT LEAVES THE HOSPITAL. LAB SERVICESTHE LABCHECK PROGRAM HELPS ENCOURAGE PEOPLE TO SEEK PREVENTIVE MEDICINE, ALLOWING PATIENTS TO RECEIVE BLOOD TESTS TO DETECT ILLNESSES AND DISORDERS AT A REDUCED COST.RADIOLOGY AND IMAGING SERVICESHOLY ROSARY HEALTHCARE OFFERS INPATIENT AND OUTPATIENT DIAGNOSTIC AND INTERVENTIONAL (MINIMALLY INVASIVE RADIOLOGY) SERVICES. RESIDENTIAL LIVINGRESIDENTIAL LIVING OFFERS NURSING FOR SHORT-TERM, POST-ACUTE HOSPITAL STAYS TO LONG-TERM LIVING. SPORTS MEDICINEPRACTITIONERS WORK CLOSELY WITH ATHLETES, PARENT, AND COACHES TO EDUCATE AND PROVIDE INDIVIDUAL, AS WELL AS TEAM CONSULTATIONS. SURGICAL SERVICESSURGICAL TEAMS BRING A PERSONAL TOUCH WITH THE SOPHISTICATION OF ADVANCED MEDICINE. THERAPY AND REHABILITATION SERVICESHOLY ROSARY HEALTHCARE OFFERS A HOLISTIC APPROACH TO TREATMENT, WITH SPECIAL CONSIDERATION FOR A PATIENT'S AGE, PHYSICAL ABILITIES, RELIGIOUS AND ETHNIC BELIEFS. WALK IN CLINICHOLY ROSARY HEALTHCARE WALK-IN CLINIC SERVES ALL AGES AND IS OPEN EVERY DAY OF THE WEEK. WOMEN'S HEALTH SERVICESCOMPREHENSIVE WOMEN'S HEALTH CARE TEAM PROVIDING SERVICES TO WOMEN IN EASTERN MONTANA. 33676006 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 83 0 1 414 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X KYLE ENGMAN 3038135543 500 ELDORADO BLVD SUITE 4200 BROOMFIELD CO 80021 BILL BICKLE BOARD MEMBER 1.00 X 0 0 0 BILL OFTEDAL CHAIR 2.00 X X 0 0 0 JIM REGAN BOARD MEMBER 1.00 X 0 0 0 NIKI MUNROE BOARD MEMBER 1.00 X 0 0 0 PAUL LEWIS CHIEF EXECUTIVE OFFICER 50.00 X X 0 228032 70315 POLLY PETERSEN PHD SECRETARY 2.00 X X 0 0 0 RACHEL ARMSTRONG BOARD MEMBER 1.00 X 0 0 0 RONALD HATHAWAY BOARD MEMBER 1.00 X 0 0 0 SISTER KATHERINE FRANCHETT BOARD MEMBER 1.00 X 0 0 0 SISTER SHARON SMITH BOARD MEMBER 1.00 X 0 0 0 TAMMIE MCFARLAND VICE CHAIR 2.00 X X 0 0 0 CALVIN CAREY VP FIN SUPPORT SVCS 1/1-10/31 50.00 X 0 136026 27847 JASON BARKER PRESIDENT CEO MT REG 1/1-4/30 50.00 X 0 386722 12674 TRAVIS SCHEVING INTERIM VP FINANCE 50.00 X 0 122676 15567 CHRISTOPHER LIEB MD VP MEDICAL AFFAIRS 1/1-4/14 50.00 X 264871 0 11887 DARREN WALKER VP HUMAN RESOURCES 50.00 X 0 210694 50278 LISA SANFORD VP PATIENT CARE SERVICES 50.00 X 0 164525 44452 LISA ROSS MD PHYSICIAN FAMILY PRACTICE 50.00 X 376556 0 17349 JEFFERY WILLIAMS MD PHYSICIAN FAMILY PRACTICE 50.00 X 307885 0 29263 DOROTHY BRADBURY MD ED PHYSICIAN 50.00 X 293648 0 20898 MARK NICHOLS MD PHYSICIAN CLINIC SURGERY 50.00 X 261837 0 8202 RANDE SHORT MD ED MED DIRECTOR PHYS 50.00 X 242793 0 38352 1747590 1248675 347084 18 0 1 0 SYNAPTIC HEALTHCARE LLC 2600 WILSON STREET STOP 1 MILES CITY MT 59301 CLINICAL STAFFING 1333452 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 CONTRACT LABOR 494054 MEDEFIS INC 10826 OLD MILL RD STE 101 OMAHA NE 68154 CONTRACT LABOR 224998 TONY HAM 340 DEER PATH BOZEMAN MT 59718 MEDICAL SERVICES 223739 YELLOWSTONE ANESTHESIA ASSOCIATES PO BOX 1576 MILES CITY MT 59301 MEDICAL SERVICES 153640 10 515304 515304 PATIENT SERVICES REVENUE 622110 37572962 37572962 37572962 36274 36274 119735 0 119735 119735 119735 93881 6700 0 0 93881 6700 100581 100581 CAFETERIA 722310 298965 298965 DIETICIAN CONSULTING 900099 4919 4919 MANAGEMENT FEES 900099 3500 3500 307384 38652240 37880346 0 256590 135618 135618 1608323 1367074 241249 13776232 13168348 607884 830443 743741 86702 2232437 2181990 50447 1054039 1007496 46543 60771 60771 247 247 2895008 2825123 69885 114205 107717 6488 101718 99774 1944 672233 661878 10355 144754 113219 31535 21398 21398 1703931 1703931 388021 388021 SYSTEM ALLOCATION 5562263 5562263 MEDICAL SUPPLIES 4605528 4600963 4565 BAD DEBT EXPENSE 1505824 1505824 MAINTENANCE SERVICES 894170 887276 6894 2346863 2156615 190248 40654026 33676006 6978020 0 1511176 116410 111242 5714848 7654132 31782 13712 49295 48321 855677 912815 701812 678936 44609941 32221090 11906374 12388851 3591835 5520899 24474041 27334076 3642837 8552047 3642837 8552047 X 20831204 18782029 20831204 18782029 24474041 27334076 -2001786 -47389 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 247 247 0 PART II-B, LINE 1: HOLY ROSARY HEALTHCARE PAYS DUES TO THE MONTANA HOSPITAL ASSOCIATION AND LEADING AGE OF WHICH $247 IS ATTRIBUTED TO LOBBYING. 137825 364 138189 170833 233 33241 137825 157436 2655 13771 2500 529 170833 152032 8504 2500 600 157436 170256 -15721 2500 3 152032 1.00000 0 1 1 135510 135510 14308563 7902040 6406523 11745198 9323767 2421431 18134481 14995283 3139198 286189 286189 12388851 COST REPORT SETTLEMENT REC. 1254466 OTHER RECEIVABLE 1454467 INTERCOMPANY RECEIVABLE 2811966 5520899 PART V, LINE 4: THE INTENDED USE FOR THE KENNETH HOM TRUST ENDOWMENT FUND IS TO PROVIDE NURSING SCHOLARSHIPS. ENDOWMENT FUNDS ARE HELD BY THE HOLY ROSARY HEALTHCARE FOUNDATION. 1 1 X 1 X 1 X 1 1 0 1 1 1627502 1627502 0.04160 3407678 4171690 -764012 0.00000 5035180 4171690 863490 0.04160 34200 34200 0.00090 158105 158105 0.00400 2160 2160 0.00010 33299 33299 0.00090 227764 227764 0.00590 5262944 4171690 1091254 0.04750 1955 1955 0.00000 1271 1271 0.00000 3108 3108 0.00010 6334 6334 0.00010 1 1505824 0 11658052 11173063 484989 X 1 1 1 1 HOLY ROSARY HEALTHCARE 2600 WILSON STREET MILES CITY MT 59301 WWW.HOLYROSARYHEALTHCARE.ORG 13512 X X X HOLY ROSARY HEALTHCARE 1 0 0 1 X X X X X X X 12 1 0 1 1 X WWW.HOLYROSARYHEALTHCARE.ORG/ABOUT-US X 1 12 1 WWW.HOLYROSARYHEALTHCARE.ORG/ABOUT-US 0 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X X X X X X X X 1 X 0 X X X X 1 X 0 0 HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 5: THE MOST RECENT SURVEY WAS COMPLETED IN 2012. THIS ASSESSMENT STUDIED MILES CITY, MONTANA, AND THE NINE-COUNTY SURROUNDING AREA SERVED BY HOLY ROSARY. THE ASSESSMENT, COMPLETED BY A THIRD-PARTY FIRM SPECIALIZING IN RURAL COMMUNITY RESEARCH, INCLUDED COLLABORATIVE PARTNERSHIPS WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES AND THE CUSTER COUNTY PUBLIC HEALTH NURSING OFFICE; COMBINING EFFORTS WITH OTHER LOCAL HOSPITALS AND HEALTH CARE ORGANIZATIONS; AND CONDUCTING SURVEYS, FOCUS GROUPS, AND ASSESSMENTS WITH THE ASSISTANCE OF THE MONTANA OFFICE OF RURAL HEALTH AND THE NATIONAL RURAL HEALTH RESOURCE CENTER. COMMUNITY EDUCATION WAS COMPLETED UTILIZING THE MEDIA, INTERNET, AND MAILINGS TO BUILD AWARENESS AND ENCOURAGE PARTICIPATION IN THIS PROJECT. HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 11: HOLY ROSARY HEALTHCARE (HRH) HAS BEEN ADDRESSING THE TOP HEALTH NEEDS THROUGH COMMUNITY PARTNERSHIPS, A HOSPITAL-BASED GRANT PROGRAM, AND THROUGH BUSINESS DEVELOPMENT ACTIVITIES IN THE HOSPITAL. THE TOP COMMUNITY NEEDS AND PRIORITIES ARE: 1) ALCOHOL ABUSE 2) OVERWEIGHT/OBESITY 3) CANCER, 4) DRUG ABUSE (INCLUDING PRESCRIPTION) AND 5) LACK OF EXERCISE. ALCOHOL AND DRUG ABUSE -HRH IS REPRESENTED ON THE EASTERN MONTANA MENTAL HEALTH ADVISORY COUNCIL, WHICH IS A GROUP THAT REPORTS UP TO THE MONTANA MENTAL HEALTH OVERSIGHT AND ADVISORY COUNCIL. OVERWEIGHT/OBESITY/LACK OF EXERCISE - HRH CONTINUES TO SUPPORT THE HEALTHY LIFESTYLES PROGRAM WHICH IS BASED ON THE NATIONAL DIABETES PREVENTION PROGRAM WHERE PARTICIPANTS MEET IN A CLASSROOM SETTING WITH A REGISTERED DIETICIAN AND ATHLETIC TRAINER. BY JOURNALING PROGRESS AND MONITORING OF BLOOD LAB VALUES, PARTICIPANTS TYPICALLY LOSE WEIGHT. CLASSES ARE OFFERED AND PROMOTED TO THE COMMUNITY AND WILL BE PROVIDED AT NO COST TO THOSE IN NEED. WE HAVE DONE OUTREACH THROUGH TELEHEALTH TO COMMUNITIES WHICH ARE MORE REMOTE AND HARDER TO GET A GROUP IN THAT AREA. WE HAVE EXTENDED THE REACH OF THIS PROGRAM BY OFFERING HEALTHY LIFESTYLES VIA TELEHEALTH TO REMOTE, RURAL COMMUNITIES BY PARTNERING WITH LOCAL HEALTHCARE FACILITIES AS A REMOTE SITE. THIS HAS BEEN VERY WELL RECEIVED AND HAS ALLOWED ELEVATED SERVICES TO BE AVAILABLE IN RURAL/REMOTE AREAS.CANCER - RATES OF NEW CANCERS ARE A CONCERN FOR THIS COMMUNITY AND HRH IS DOING ITS PART TO ENSURE SCREENING AND TREATMENT SERVICES ARE MADE AVAILABLE TO THE COMMUNITY. THE HOSPITAL HOSTS QUARTERLY CANCER SCREENING EVENTS FOR BREAST AND IN 2014 PARTICIPATED IN ONE PROSTATE SCREENING EVENT WHICH PROVIDED LAB WORK AT NO CHARGE. WHILE THERE ARE NO RESIDENT ONCOLOGISTS IN THE COMMUNITY, A VARIETY OF MEDICAL SERVICES ARE MADE AVAILABLE SUCH AS MRI, BREAST BIOPSY AND OTHER IMPORTANT TESTING PROCEDURES. HRH ALSO HOSTS A 2 DAY A MONTH ONCOLOGY CLINIC STAFFED BY AN ONCOLOGIST IN BILLINGS. THIS PROVIDER IS ALSO USING TELEMEDICINE TO REMOTELY SEE PATIENTS. A PARTNERSHIP WITH ST. VINCENT IN BILLINGS AND THE AMERICAN CANCER SOCIETY ARE HELPING TO SERVE THE COMMUNITY. THROUGH AN AFFILIATION WITH A GENERAL SURGEON, WE OFFERED A FREE SKIN CANCER SCREENING CLINIC IN MAY 2014. WE ARE ALSO COLLABORATING WITH FRONTIER CANCER CENTER, A REGIONAL LEADER IN CANCER CARE. THE INTENT IS TO EXPAND THE CANCER SERVICE LINE AT HOLY ROSARY HEALTHCARE BY OFFERING NEW SERVICES CURRENTLY UNAVAILABLE IN THE REGION. FOR THE TOP NEEDS, A GRANT PROGRAM IS MADE AVAILABLE TO COMMUNITY ORGANIZATIONS. HRH THE HRH FOUNDATION FINANCIALLY SUPPORTED OVER 70 COMMUNITY-BASED, HEALTH-ENHANCING PROJECTS IN 2014. THE HRH COMMUNITY BENEFIT COMMITTEE, MADE UP OF COMMUNITY MEMBERS, HELD QUARTERLY MEETINGS TO REVIEW AND APPROVE OR DENY GRANT APPLICATIONS. GRANTS WERE RECEIVED FROM THE MONTANA COMMUNITIES WITHIN THE HOLY ROSARY PRIMARY AND SECONDARY SERVICE AREAS. AS A SMALL RURAL COMMUNITY, NOT ALL NEEDS CAN BE ADDRESSED BY HRH. OF THOSE, MENTAL HEALTH ISSUES RELATED TO DRUG AND ALCOHOL ABUSE WAS NOT DIRECTLY ADDRESSED DUE TO THE LACK OF RESOURCES IN PEOPLE AND FUNDING AT HRH. ADDITIONALLY, THE COMMUNITY WAS WITHOUT A DIRECTOR OF THE MENTAL HEALTH CLINIC WHICH MEANT SERVICES WERE DECREASED. HRH DOES ITS PART BY NEVER TURNING AWAY THOSE WITH MENTAL, DRUG OR ALCOHOL ISSUES - THEY ARE TREATED IN THE EMERGENCY DEPARTMENT OR ADMITTED AS NECESSARY. INTERVENTIONS BEING SOUGHT OUT INCLUDE IDENTIFICATION OF NEW RESOURCES AND TRANSPORTATION TO BILLINGS WHERE SERVICES ARE AVAILABLE. 7 HOLY ROSARY FAMILY PRACTICEINT MED 2600 WILSON STREET MILES CITY MT 59301 FAMILY PRACTICE/INT MED CLINIC HOLY ROSARY HOSPITAL EMERGENCY 2600 WILSON STREET MILES CITY MT 59301 EMERGENCY CLINIC HOLY ROSARY RURAL HEALTH CLINIC PEDIAT 2600 WILSON STREET MILES CITY MT 59301 PEDIATRIC CLINIC HOLY ROSARY RURAL HLTH CLINIC WOMEN CLIN 2600 WILSON STREET MILES CITY MT 59301 WOMEN'S CLINIC HOLY ROSARY RURAL HEALTH FAMILY PRACTICE 2600 WILSON STREET MILES CITY MT 59301 FAMILY PRACTICE CLINIC HOLY ROSARY SURGICAL SERVICES 2600 WILSON STREET MILES CITY MT 59301 SURGICAL CLINIC MTRH GENERAL SURGERY 2600 WILSON STREET MILES CITY MT 59301 SURGICAL CLINIC PART I, LINE 6A: THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREAPRES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. 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 $ 1,505,824. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES, THOSE THAT ENHANCE EXISTING EFFORTS OR FILL GAPS OF COMMUNITY NEED, INCLUDE PROGRAMS THAT SUPPORT THOSE IN THE COMMUNITY WHO ARE LIVING AT OR BELOW POVERTY. ADMINISTRATIVE LEADERSHIP AND ITS EMPLOYEES PERFORMED CIVIC ACTIVITIES IN WHICH THE SOCIAL AND PHYSICAL HEALTH OF THE COMMUNITY WAS ADVOCATED AS A PRIORITY BY THE HOSPITAL. IN 2014, HRH ADMINISTRATION AND EMPLOYEES PARTICIPATED IN THE FOLLOWING COMMUNITY MEETINGS: PHLEBOTOMY ADVISORY COUNCIL, ADULT PROTECTIVE SERVICES, CHILD PROTECTIVE SERVICES, BUSINESS ADVISORY COUNCIL, MILES CITY HISTORIC PRESERVATION, AREA HEALTH EDUCATION COUNCIL, EASTERN MONTANA INDUSTRIES BOARD MEETINGS, KIWANAS CLUB BOARD MEETINGS, MILES CITY AIRPORT BOARD MEETING, MONTANA HEALTH NETWORK BOARD, ROTARY CLUB, AND ECONOMIC DEVELOPMENT COUNCIL.PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE TO HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE ORGANIZATIONS FINANCIAL STATEMENTS THAT DESCRIBE THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL COLLECTION EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE MODIFICATIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS INCLUDES A RESERVE FOR BOTH UNINSURED PATIENTS AND BALANCES DUE FROM PATIENTS AFTER INSURANCE. PART III, LINE 8: THERE WAS NO SHORTFALL REPORTED ON SCHEDULE H, PART II, LINE 7 IN 2014. PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. PART VI, LINE 2: AS PART OF OUR ORGANIZATIONAL MISSION TO RESPOND TO THE HEALTH NEEDS OF THE PEOPLE AND COMMUNITIES SERVED, HOLY ROSARY HEALTHCARE (HRH) TAKES STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. HRH HAS REGULARLY PARTICIPATED IN COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY.HRH CONTINUOUSLY ASSESSES THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. IN 2012, WE ADDED A NEW APPROACH TO IDENTIFY COMMUNITY HEALTH NEEDS BY CREATING THE CONSENSUS BUILDING FORUM: IDENTIFYING PRIORITIES IN HEALTHCARE DELIVERY IN EASTERN MONTANA. THIS IS PROVING TO BE AN INFORMATIVE APPROACH TO IDENTIFYING ISSUES AND PRIORITIZING SOLUTIONS WITH LEADERS IN OUR COMMUNITY. PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. THE FINANCIAL ASSITANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICYY AND APLLICATION ARE ALSO AVAILBLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: LOCATED IN EASTERN MONTANA, HOLY ROSARY IS A FEDERALLY-DESIGNATED CRITICAL ACCESS HOSPITAL PROVIDING CARE TO THE COMMUNITIES OF MILES CITY, MONTANA, AND THE SURROUNDING AREAS. HOLY ROSARY IS THE LARGEST HEALTHCARE FACILITY BETWEEN BILLINGS, MONTANA, AND BISMARCK, NORTH DAKOTA, AND PROVIDES A COMPLETE CONTINUUM OF CARE THROUGH OUR 25-BED ACUTE CARE HOSPITAL, 87-BED EXTENDED CARE LIVING COMMUNITY, OUTPATIENT MEDICAL ARTS CENTER, AND IS SUPPORTED BY OUR HOSPICE AND PALLIATIVE CARE PROGRAMS. WHILE THE ORGANIZATION DRAWS PATIENTS FROM A 13-COUNTY REGION, HOLY ROSARY'S PRIMARY AND SECONDARY SERVICE AREAS INCLUDE A NINE-COUNTY CORE REGION WITH APPROXIMATELY 45,000 PEOPLE. HOLY ROSARY PROVIDES OVER 60% OF ITS INPATIENT CARE TO PATIENTS LIVING IN THE CITY OF MILES CITY, FOLLOWED BY A HIGH CONCENTRATION OF PATIENTS ORIGINATING FROM THE COMMUNITIES OF BAKER, GLENDIVE AND FORSYTH. COMBINED, PATIENTS FROM MILES CITY AND THESE THREE OTHER COMMUNITIES REPRESENT ABOUT FOUR FIFTHS OF HOLY ROSARY'S DISCHARGES. THE PRIMARY SERVICE AREA IS COMPRISED OF 10 ZIP CODES COMPRISING CUSTER COUNTY (4 ZIP CODES) AND PORTIONS OF ROSEBUD COUNTY (4 ZIP CODES) AND PRAIRIE COUNTY (2 ZIP CODES). THE SECONDARY SERVICE AREA IS REPRESENTED BY ANOTHER 10 ZIP CODES AND INCLUDES PORTIONS OF DAWSON COUNTY (2 ZIP CODES), FALLON COUNTY (3 ZIP CODES), GARFIELD COUNTY (2 ZIP CODES), POWDER RIVER COUNTY (2 ZIP CODES) AND PRAIRIE COUNTY (1 ZIP CODE). WITHIN HOLY ROSARY'S PRIMARY SERVICE AREA THERE ARE THREE CRITICAL ACCESS HOSPITALS. HOLY ROSARY, ROSEBUD HEALTH CARE CENTER LOCATED IN FORSYTH (A NOT-FOR-PROFIT INSTITUTION) AND PRAIRIE COMMUNITY HOSPITAL LOCATED IN TERRY (GOVERNMENT OWNED). THERE ARE TWO CRITICAL ACCESS HOSPITALS IN THE SECONDARY SERVICE AREA, GLENDIVE MEDICAL CENTER (NOT-FOR-PROFIT) LOCATED IN GLENDIVE AND GARFIELD COUNTY HEALTH CENTER (GOVERNMENT OWNED) LOCATED IN JORDAN. FOR MORE SPECIALIZED HEALTHCARE NEEDS, IT IS COMMON FOR PATIENTS IN THESE SERVICE AREAS TO TRAVEL THE 150 MILES TO BILLINGS TO SEEK CARE AT ANOTHER ONE OF OUR SCLHS FACILITIES IN BILLINGS, ST. VINCENT HOSPITAL AND/OR THE BILLINGS CLINIC.THE DEMOGRAPHIC MAKE-UP OF OUR PRIMARY AND SECONDARY SERVICE AREAS INCLUDES: OVERALL FLAT POPULATION CHANGES. LARGE GEOGRAPHIC AREA WITH SPARSE POPULATION, AVERAGING 1.4 PEOPLE/SQUARE MILE.AGING POPULATION WITH AVERAGE AGE OF 46 AND AVERAGE LIFE EXPECTANCY OF 80; EXCEPTION IS ROSEBUD COUNTY WITH AVERAGE AGE OF 39. PRIMARY INDUSTRIES ARE AGRICULTURE, STATE/LOCAL GOVERNMENT, AND RETAIL. AVERAGE HOUSEHOLD INCOME IS $51,000, WHICH IS $17,000 BELOW THE NATIONAL AVERAGE. PART VI, LINE 5: WE EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY BUILDING ACTIVITIES DEMONSTRATE THIS COMMITMENT. IN 2014, THE MOST SIGNIFICANT EXPENSE IN COMMUNITY BUILDING ACTIVITIES CONTINUED TO BE THE COST OF PHYSICIAN RECRUITMENT TO OUR MEDICALLY UNDERSERVED AREA. WE ARE ALSO INVOLVED IN MANY COMMUNITY ORGANIZATIONS THAT VARY IN SCOPE INCLUDING CRITICAL INCIDENT STRESS MANAGEMENT, COMMUNITY HEALTH ALLIANCE (WHICH PARTNERS WITH ALL LOCAL HEALTH ORGANIZATION TO CREATE COMMUNITY HEALTH IMPROVEMENT), AND OTHER CIVIC MINDED ORGANIZATIONS. WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. OUR BOARD OF DIRECTORS INCLUDES MEDICAL AND BUSINESS PROFESSIONALS WHO LIVE AND WORK IN OUR COMMUNITY AND WHO ARE NOT EMPLOYEES OF HOLY ROSARY. AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN HOLY ROSARY HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES BY ENCOURAGING THEM TO VOLUNTEER WITH COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS, AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS FOOD DRIVES, RELAY FOR LIFE (AMERICAN CANCER SOCIETY), SCHOOL SUPPLY DRIVES FOR LOCAL IN-NEED CHILDREN BEFORE EVERY SCHOOL YEAR, AND MANY OTHERS. HRH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL OR SOME OF THE HOSPITAL'S DEPARTMENTS.WE ARE GOOD CITIZENS BY PARTNERING WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY. HOLY ROSARY IS REPRESENTED ON A NUMBER OF COMMUNITY-BASED ORGANIZATIONS AND BOARDS INCLUDING: COMMUNITY HEALTH ALLIANCE, MONTANA HEALTH NETWORK, MILES CITY AREA ECONOMIC DEVELOPMENT, KIWANIS, ROTARY, EASTERN MONTANA INDUSTRIES, MILES COMMUNITY COLLEGE, EASTERN MONTANA AREA HEALTH EDUCATION, AMERICAN CANCER SOCIETY RELAY FOR LIFE, KEEP AMERICA BEAUTIFUL-MILES CITY CHAPTER, MILES CITY COMMUNITY GARDEN, AND A NUMBER OF ADDITIONAL NOT-FOR-PROFIT, COMMUNITY-FOCUSED, CHARITABLE ORGANIZATIONS. IN 2014, HOLY ROSARY EMPLOYEES PROVIDED OVER 1,50O HOURS OF VOLUNTEER EFFORT TO THE COMMUNITY. PART VI, LINE 6: HOLY ROSARY HEALTHCARE IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE." WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITIES, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES EIGHT HOSPITALS, FOUR SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES 15,000 FULL-TIME ASSOCIATES AND MORE THAN 500 EMPLOYED PROVIDERS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEMWIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.HOLY ROSARY HEALTHCARE PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION AND REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES, AND MISSION INTEGRATION. 1 HOLY ROSARY FOUNDATION 2600 WILSON STREET MILES CITY MT 59301 202270238 501(C)(3) 112161 SUPPORT MISSION RURAL HEALTH DEVELOPMENT INC 11 S 7TH STREET NO 241 MILES CITY MT 59301 363769758 501(C)(3) 5300 PROMOTE HEALTH IN COMMUNITY 2 0 PART I, LINE 2: THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASON FOR SUCH SUPPORT. ELIGIBILITY FOR FUNDING IS DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO THE ORGANIZATION'S MISSION. 0 1 0 0 0 0 0 1 0 PAUL LEWIS CHIEF EXECUTIVE OFFICER 0 196944 0 18925 0 12163 0 45729 0 24586 0 298347 0 0 CALVIN CAREY VP FIN SUPPORT SVCS 1/1-10/31 0 124823 0 10706 0 497 0 7186 0 20661 0 163873 0 0 JASON BARKER PRESIDENT CEO MT REG 1/1-4/30 0 225590 0 155879 0 5253 0 6809 0 5865 0 399396 0 0 CHRISTOPHER LIEB MD VP MEDICAL AFFAIRS 1/1-4/14 79467 0 181048 0 4356 0 6445 0 5442 0 276758 0 0 0 DARREN WALKER VP HUMAN RESOURCES 0 189693 0 19821 0 1180 0 33611 0 16667 0 260972 0 0 LISA SANFORD VP PATIENT CARE SERVICES 0 133420 0 11000 0 20105 0 27428 0 17024 0 208977 0 0 LISA ROSS MD PHYSICIAN FAMILY PRACTICE 348504 0 5000 0 23052 0 7404 0 9945 0 393905 0 0 0 JEFFERY WILLIAMS MD PHYSICIAN FAMILY PRACTICE 301615 0 5000 0 1270 0 18945 0 10318 0 337148 0 0 0 DOROTHY BRADBURY MD ED PHYSICIAN 255959 0 18511 0 19178 0 13000 0 7898 0 314546 0 0 0 MARK NICHOLS MD PHYSICIAN CLINIC SURGERY 228181 0 30000 0 3656 0 0 0 8202 0 270039 0 0 0 RANDE SHORT MD ED MED DIRECTOR PHYS 240652 0 0 0 2141 0 17056 0 21296 0 281145 0 0 0 PART I, LINE 4B A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) FOR EXECUTIVES TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. PRIOR TO 2014, THE RELATED ORGANIZATION'S NQDC PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. IN 2014, THE RELATED ORGANIZATION'S NQDC PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. THE RELATED ORGANIZATION HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. FOR SOME OF THE PARTICIPANTS, AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE FEDERAL AND STATE GOVERNMENTS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2014 WERE: NONE. FOR CONTRIBUTIONS MADE IN 2014, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2014. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. IN ADDITION, FOR AMOUNTS CONTRIBUTED PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE PLAN IN 2014 WERE: NONE. PART I, LINE 7 THE AT RISK COMPENSATION PLAN WAS ESTABLISHED TO ENABLE THE HEALTH CARE SYSTEM AND ITS CARE SITES TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION, VISION, STRATEGIC PRIORITIES AND KEY INITIATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND IS FUNDED EACH YEAR BY MEETING THRESHOLD LEVELS OF OPERATING INCOME. TARGET AWARD AMOUNTS ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR SPECIFIC ROLE AT THE HEALTH CARE SYSTEM. ACTUAL AWARDS ARE PAID OUT BASED ON ATTAINMENT OF OPERATING INCOME AND OTHER PLAN PERFORMANCE STANDARDS. AWARDS ARE BASED ON HOW WELL THE HEALTH CARE SYSTEM OR THE CARE SITE PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED BY THE CARE SITE CEO OR THE HEALTH CARE SYSTEM SERVICES SENIOR EXECUTIVE LEADERSHIP TEAM FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLANS ARE BASED ON A COMBINATION OF PERFORMANCE MEASURES. PERFORMANCE MEASURES INCLUDE PATIENT EXPERIENCE, PATIENT SAFETY, EMPLOYEE SAFETY, COMMUNITY BENEFIT AND OPERATING INCOME. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. ADDITIONAL OFFICER AND BOARD DISCLOSURES THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF NINE HOSPITALS, TEN FOUNDATIONS AND FOUR CLINICS IN FOUR STATES. SCLHS AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARD OF DIRECTORS (BOARD) IS COMPENSATED FOR THAT SERVICE. SCLHS' BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED BY SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH SYSTEM. HOWEVER, PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. LISA ROSS MD HIGHEST PAID EMPLOYEE RETENTION LOAN X 40000 13712 0 1 1 CHRISTOPHER LIEB MD KEY EMPLOYEE RETENTION LOAN X 45000 0 0 1 1 13712 YELLOWSTONE ANESTHESIA SEE PART V 153640 SEE PART V 0 FORM 990, SCHEDULE L, PART IV BOARD MEMBER, RACHEL ARMSTRONG'S SPOUSE OWNS 33% OF YELLOWSTONEANESTHESIA ASSOCIATES, INC. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF HOLY ROSARY HEALTHCARE. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF HOLY ROSARY HEALTHCARE, APPOINTS MEMBERS OF HOLY ROSARY HEALTHCARE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE BYLAWS REGARDING APPOINTMENT OF BOARD MEMBERS. SCLHS ALSO HAS EXTENSIVE RESERVE POWERS OVER ANY CHANGE IN MISSION, CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS, ACQUISITION OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, AND APPOINTMENT OF AUDITORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE ORGANIZATION'S EXECUTIVES, DIRECTORS, MANAGERS, BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL EXECUTIVE COMMITTEE (MEC) MEMBERS AND OTHER PHYSICIANS IN DECISION MAKING ROLES OR SERVING ON COMMITTEES, COMPLETE A NEW CONFLICT OF INTEREST (COI) DISCLOSURE FORM EACH YEAR. A COPY OF THE POLICY IS DISTRIBUTED ALONG WITH THE COI FORMS. IN THE EVENT OF A CHANGE OF CIRCUMSTANCE, EACH INDIVIDUAL WHO HAS ALREADY SIGNED A COI IS EXPECTED TO NOTIFY THE ORGANIZATION OF THE CHANGE AND UPDATE THE CONFLICT OF INTEREST INFORMATION. THE STATEMENTS ARE REVIEWED AND COI ISSUES ARE ADDRESSED BY THE ORGANIZATION'S RESPONSIBILITY OFFICE (ORO) AND LEADERSHIP AT THE APPROPRIATE LEVEL: BOARD MEMBERS - BY BOARD CHAIR PHYSICIANS - BY THE MEC PRESIDENT EXECUTIVES - BY THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. DIRECTORS AND MANAGERS - BY ADMINISTRATION THE SIGNED COI FORMS ARE MAINTAINED IN ADMINISTRATION AND IN COMPLIANCE. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS FOR THE EXECUTIVES ARE MAINTAINED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AT THE BEGINNING OF BOARD AND BOARD COMMITTEE MEETINGS, THE QUESTION OF COI IS ASKED OF THOSE IN ATTENDANCE. WHEN AN ACTUAL CONFLICT IS IDENTIFIED, THE INDIVIDUAL IS EXCUSED FROM PARTICIPATING IN THE DISCUSSIONS AND DECISION-MAKING. FORM 990, PART VI, SECTION B, LINE 15B THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION, THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) SCLHS' PROCESS FOR DETERMINING COMPENSATION FOR THE TOP MANAGEMENT AND SENIOR LEADERSHIP IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE. THIS COMMITTEE IS COMPOSED OF THREE OR MORE MEMBERS WHO ARE NOT CURRENT EMPLOYEES OF SCLHS, OR FORMER EMPLOYEES WITH NO ACTIVE INTEREST IN THE SCLHS' COMPENSATION PROGRAM, INCLUDING AT LEAST TWO MEMBERS OF THE SCLHS BOARD. SCLHS BELIEVES THAT THE INDEPENDENCE OF THESE MEMBERS IS VITAL TO THE INTEGRITY OF THE PROCESS. THE WORK OF THIS COMMITTEE INCLUDES BEING CONSTANTLY AWARE OF THE CURRENT COMPETITIVE MARKET FOR MANAGEMENT AND SENIOR LEADERS, AS WELL AS COMPILING AND MAINTAINING RECORDS OF COMPARABLE COMPENSATION AND BENEFITS DATA, INCLUDING SURVEYS AND OTHER ANALYSES, TO SUPPORT SCLHS' TOTAL COMPENSATION TO EACH INDIVIDUAL. AS PART OF THE REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF TOP MANAGEMENT AND SENIOR LEADERSHIP. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH THE MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. MINUTES ARE KEPT CONTEMPORANEOUSLY FOR EACH MEETING OF THE COMMITTEE. LIKEWISE, THE COMMITTEE IS RESPONSIBLE FOR ENSURING THAT NO "EXCESS BENEFIT" IS CONFERRED ON AN INDIVIDUAL, OR THAT SUCH COMPENSATION DOES NOT CONSTITUTE PROHIBITED INUREMENT. THIS PROCESS IS COMPLETED FOR ALL SENIOR LEADERSHIP, AT THE AFFILIATE AND SYSTEM LEVEL, AND THE COMMITTEE'S RECOMMENDATION IS THEN SUBMITTED TO THE SCLHS BOARD FOR APPROVAL. THE CHARGE OF THIS COMMITTEE ADHERES TO SCLHS' CORE VALUE OF STEWARDSHIP, ENSURING THAT THE MINISTRY'S RESOURCES HELD IN TRUST ARE NOT WASTED OR MISUSED, AND ARE DEPLOYED TO EFFECTIVELY AND EFFICIENTLY ADVANCE THE MISSION. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. 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