ST ALEXIUS MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: ST ALEXIUS MEDICAL CENTER (EIN 45-0226711)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-14
IRS object ID: 201441349349304554
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-14T13:04:14-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	450250958	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EIDE BAILLY LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	4310 17TH AVE S PO BOX 2545	AddressLine1
City	FARGO	City
State	ND	State
ZIP Code	581082545	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	450226711	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	St Alexius Medical Center	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	STAL	NameControl
Phone	7015307000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	900 East Broadway Avenue	AddressLine1
City	Bismarck	City
State	ND	State
ZIP Code	585014520	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Gary Miller	Name
Title	CEO/President	Title
Phone	7015307000	Phone
Date Signed	2014-05-13	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	LISA CHAFFEE CPA	Name
PTIN	P00193453	PTIN
Phone	7012398500	Phone
Date Prepared	2014-05-12	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Gary Miller	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	900 East Broadway Avenue	AddressLine1
City	Bismarck	City
State	ND	State
ZIP Code	585014520	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	294062940	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Group Exemption Number	0928	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	www.st.alexius.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1905	YearFormation
State Legal Domicile	ND	StateLegalDomicile
Activity Or Mission Description	Providing healthcare	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	2830	TotalNbrEmployees
Total Nbr Volunteers	262	TotalNbrVolunteers
Total Gross UBI	10692101	TotalGrossUBI
Net Unrelated Business Txbl Income	1589	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1197761	ContributionsGrantsPriorYear
Contributions Grants Current Year	1159046	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	280505258	ProgramServiceRevenuePriorYear
Program Service Revenue CY	283731137	ProgramServiceRevenueCY
Investment Income Prior Year	-2165730	InvestmentIncomePriorYear
Investment Income Current Year	-2407481	InvestmentIncomeCurrentYear
Other Revenue Prior Year	8855053	OtherRevenuePriorYear
Other Revenue Current Year	8936690	OtherRevenueCurrentYear
Total Revenue Prior Year	288392342	TotalRevenuePriorYear
Total Revenue Current Year	291419392	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	416797	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	453859	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	111305248	SalariesEtcPriorYear
Salaries Etc Current Year	120662800	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	780995	TotalFundrsngExpCurrentYear
Other Expense Prior Year	166799842	OtherExpensePriorYear
Other Expenses Current Year	172255586	OtherExpensesCurrentYear
Total Expenses Prior Year	278521887	TotalExpensesPriorYear
Total Expenses Current Year	293372245	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	9870455	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1952853	RevenuesLessExpensesCY
Total Assets BOY	272848189	TotalAssetsBOY
Total Assets EOY	277166394	TotalAssetsEOY
Total Liabilities BOY	112654080	TotalLiabilitiesBOY
Total Liabilities EOY	117889411	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	160194109	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	159276983	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	Based on the Gospel values and our own heritage of healing, the mission of St. Alexius Medical Center is to use our community presence as a means of touching and healing people in a Christ-like manner, and to always exhibit the hospitality as reflected in the rule of St. Benedict: "Let all be received as Christ."	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	33482663	Expense
Revenue	147038285	Revenue
Description	St. Alexius Medical Center began as a 20-bed hospital 128 years ago but has evolved into a 306-bed, full-service, certified Level II Trauma Acute Care Center that provides advanced healthcare services. St Alexius served 12,899 inpatients during the fiscal year ended June 30th, 2013. With over 1,400 births each year, two out of every three babies born in this region are born at St. Alexius Medical Center. Our family-focused care provides a wide range of services for mother and baby, and our specially trained nurses and physicians are prepared to handle every birthing experience with care. St. Alexius' 24-bed Level III NICU has served the region for more than 25 years, which is staffed by neonatal nurses, therapists, board-certified neonatologists, a pediatric neurologist and the region's only pediatric cardiologist. St. Alexius' Heart & Vascular Center provides comprehensive care to patients with cardiovascular, lung, and peripheral artery disease. We are comprised of an interventional radiologist, cardiologists, heart and vascular surgeons as well as other highly trained support personnel.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	37649448	Expense
Revenue	37022708	Revenue
Description	Specialty Clinics: The Clinics of St. Alexius is a unique multi-specialty group practice located mainly inside St. Alexius Medical Center. Over 26 providers in 14 different specialties work together to care for patients. Specialists must complete seven or more years of medical school and post-graduate training and then complete fellowships in their chosen specialties. All physicians are board eligible or board certified in one or more specialties. We provide clinic services in many off site satellite clinics and bring specialty services to the region. The Clinics of St. Alexius include Center for Family Medicine Mandan, Minot Medical Clinic, Infectious Disease, Children's Services, Infusion Center, Nephrology, Neurosurgery, Pain, Neurology, Adult Physical Medicine, Primary Care, Rheumatology, and Urology.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	191545743	Expense
Grants	453859	Grants
Revenue	97325653	Revenue
Description	Outpatient:1. St. Alexius operates an outpatient family service program called Archway Family Services. This program offers sensitive and responsive services for individual, marital and family problems.This program is keeping with St. Alexius Medical Center's philosophy of being a leader in progressive and quality services to the people of North Dakota. Archway services are also provided in Hazen, Garrison and Linton, ND.2. Great Plains Rehabilitation Services is a division of St. Alexius Medical Center that provides Home Medical Equipment, Orthotic & Prosthetic, Home Respiratory Care, ADA Environmental, and Rehabilitation Technology services. Great Plains provides needed medical equipment and supplies to help individuals lead active and independent lives. Great Plains services all of North Dakota, Central and Eastern Montana, and Northern South Dakota.OTHER:-St. Alexius Medical Center served 12,899 inpatients, 127,087 outpatients, 28,323 emergency patients, and 16,360 Home Health Care patients during the fiscal year ended June 30, 2013.-St. Alexius Medical Center provided community activities and services at reduced or no cost. Those included:1. EMPLOYEE ASSISTANCE - 218 employer contracts servicing 40,338 employees by providing problem assessment, short term counseling and referral to appropriate resources for follow-up care. 2. EMPLOYEE ACTIVITIES - In keeping with the Medical Center's commitment to its employees:-Actively participated in the United Way fund campaign.-Journey Beyond Excellence program - we have seven teams that assist with our journey - behavioral standards, employer of choice, rewards & recognition, communications, patient satisfaction, physician satisfaction, & service recovery. These teams work together with our leadership to resolve challenges & engage all in our mission. -Nursing Education Council develops and implements a preceptor reward and recognition program.-The vacation donation program assisted employees who used 973.75 hours of donated vacation. Employees have donated 238 vacation hours.-The Employee Emergency Fund is for any St. Alexius employee who experiences a crisis or is directly affected by a crisis involving a family member. The funds are available to employees who are facing personal tragedies or hardships for reasons such as a loss of a spouse or child, catastrophic illness, loss of home by fire or flood, or other calamities. 3. ACUTE CARE FACILITY - St. Alexius is a partner with another acute care facility to operate a radiation therapy facility known as The Cancer Center. The Cancer Center helps to ensure that patients with cancer receive quality care and management of their disease without having to drive a long distance to receive the same type of care. 4. AWARDS/ACCOMPLISHMENTS--St. Alexius ranked among the top 5 percent in the nation and #1 in North Dakota for cardiac care. The ranking is based on the Tenth Annual HealthGrades Hospital Quality in America Study. HealthGrades is the leading healthcare ratings organization. Other outcomes from this study:-Ranked among the Top 5% in the Nation for Overall Cardiac Services-Ranked among the Top 5% in the Nation for Cardiac Surgery-Ranked among the Top 5% in the Nation for Coronary Interventional Procedures-Ranked among the Top 10% in the Nation for Cardiology Services-Ranked #1 in ND for Cardiac Care, Cardiac Surgery, Cardiology Services and Coronary Interventional Services-Five-Star Rated for Overall Cardiac Care, Cardiac Surgery, Cardiology Services, Coronary Bypass Surgery, Valve Replacement Surgery, Coronary Interventional Procedure, and Treatment for Heart Attack- "Best Hospital in North Dakota" - U.S. News & World Report Healthcare Data Service- "GWTG Silver Performance Award" - ACTION Registry- Rated "A" in patient safety - The Leapfrog Group- "Blue Distinction Center" designation for cardiac care - BCBS of ND- 5-star rated Transitional Care Unite- 5-diamond status in patient safety Kidney Dialysis units (Bismarck, Dickinson, Williston) - Renal Network of the Upper Midwest- "Blue Distinction Center +" designation for quality and efficiency - BCBS of ND - hip and knee replacement and spine surgery- "100 Greatest Hospitals in the Nation" - Becker's Hospital Review- "Certified Stroke Center" designation - The Joint Commission- "Community Value Five-Star Hospital" and "Community Value 100 Hospital" - Cleverly + Associates -St. Alexius Medical Center has met the criteria necessary to be designated a Blue Distinction Center for bariatric surgery, knee and hip replacement, and spine surgery. This designation means that St. Alexius has met or exceeded certain criteria that demonstrate reliability in delivering bariatric surgical care and better overall outcomes for patients.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	262677854	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	255	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	2830	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	8	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	0	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Gary Miller	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7015307610	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	900 East Broadway Avenue	AddressLine1
City	Bismarck	City
State	ND	State
ZIP Code	585014520	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
John Castleberry
Chair	3.00	X	X	11300	0	0
Sr Nancy Miller
President	3.00	X	X	0	0	0
Sr Thomas Welder
Vice President	3.00	X	X	0	0	0
Sr Gerard Wald
Secretary	3.00	X	X	0	0	0
Sr Rosanne Zastoupil
Treasurer	3.00	X	X	0	0	0
Sr JoAnn Krebsbach
Director	3.00	X		0	0	0
Pamela Schmidt
Director	3.00	X		2750	0	0
Charles Reichert
Director	3.00	X		6100	0	0
Robert Gayton
Director	3.00	X		6100	0	0
Vernon Dosch
Director	3.00	X		4600	0	0
Nicholas Neumann MD
Director	3.00	X		4900	0	0
John Giese
Director	3.00	X		7900	0	0
Ernest Godfread
Director	3.00	X		5800	0	0
Ben Roller
Director	3.00	X		4200	0	0
Michael Brown
Director	3.00	X		0	0	0
Sr Mariah Dietz
Director	3.00	X		0	0	0
Gary Miller
President/CEO	50.00	X	X	693754	0	15361
Shiraz Hyder
VP Medical Affairs	40.00			529530	0	30301	X
Rosanne Schmidt
VP & Chief Nursing Officer	40.00			275878	0	29897	X
Duwayne Schlittenhard
VP Professional Services	40.00			254760	0	15920	X
Wanda Pfaff
VP Human Resources	40.00			247339	0	27926	X
Frank Kilzer
VP Material & Facility Res	40.00			222376	0	27126	X
Kurt Waldbillig
VP Physician Services	40.00			205370	0	26306	X
Susan Sisk
VP Accounting & Finance	40.00			192294	0	26075	X
Eric Belanger
Neurosurgeon	40.00			1960032	0	24897		X
Steven Kraljic
Neurosurgeon	40.00			1575557	0	25301		X
Leslie Rainwater
Urologist	40.00			975299	0	25960		X
Brent Herbel
Interventional Radiologist	40.00			884977	0	25301		X
Robert Oatfield
Interventional Cardiologist	40.00			746355	0	36741		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	8817171	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	337112	TotalOtherCompensation
Number Individuals GT100 K	191	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Bismarck Radiology Associates
810 E Rosser Ave Ste 201	Bismarck	ND	58501	Radiology Services	5635691
Northern Plains Laboratory LLC
PO Box 2036	Bismarck	ND	58502	Pathology Services	4343455
DMS Health Technologies
PO Box 86	Minneapolis	MN	55486	Radiology Services	879986
CHG Companies Inc
PO Box 972 G51	Dallas	TX	75397	Locum Services	598310
Mayo Collaborative Services Inc
PO Box 9146	Minneapolis	MN	554809146	Laboratory Services	407218

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	27	NumberOfContractorsGT100K
All Other Contributions	1159046	AllOtherContributions
Total Contributions	1159046	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
Patient Service Revenue	541900	274429228	272084737	2344491
Other Revenue	900099	7795891	7795891
Cafeteria	900099	1314804	1314804
Health and Education	900099	191214	191214

Field	Value	IRS element (for citing)
Total Program Service Revenue	283731137	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	211849	TotalRevenueColumn
Exclusion	$211,849	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	589080	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	589080	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	589080	TotalRevenueColumn
Exclusion	$589,080	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	24218	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	2643548	Securities
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-2643548	Securities
Other	24218	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-2619330	TotalRevenueColumn
Exclusion	-$2,619,330	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Unrelated Business RevenueUnrelatedBusinessRevenue
Community Pharmacy	446110	5922033	5922033
Northern Plains Lab	621500	1392769	1392769
Outside Lab	621500	821276	821276

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	211532	TotalRevenueColumn
Unrelated Business Revenue	211532	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	8347610	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	291419392	TotalRevenueColumn
Related Or Exempt Function Income	281386646	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	10692101	UnrelatedBusinessRevenue
Exclusion	-$1,818,401	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	453859	Total
Program Services	453859	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	3150886	Total
Management And General	3150886	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	93250135	Total
Program Services	80759371	ProgramServices
Management And General	12328085	ManagementAndGeneral
Fundraising	162679	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	3852738	Total
Program Services	3307356	ProgramServices
Management And General	539402	ManagementAndGeneral
Fundraising	5980	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	12367557	Total
Program Services	10448985	ProgramServices
Management And General	1898392	ManagementAndGeneral
Fundraising	20180	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	8041484	Total
Program Services	7005912	ProgramServices
Management And General	1023761	ManagementAndGeneral
Fundraising	11811	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	120592	Total
Management And General	120592	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	81308	Total
Management And General	81308	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	770162	Total
Program Services	215841	ProgramServices
Management And General	554321	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	30259505	Total
Program Services	21525072	ProgramServices
Management And General	8155910	ManagementAndGeneral
Fundraising	578523	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2665607	Total
Program Services	2178717	ProgramServices
Management And General	486890	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	1415762	Total
Program Services	1202131	ProgramServices
Management And General	213001	ManagementAndGeneral
Fundraising	630	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	3385613	Total
Program Services	3385613	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	20241553	Total
Program Services	20146688	ProgramServices
Management And General	94865	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1016640	Total
Program Services	1007842	ProgramServices
Management And General	8798	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
Medical Supplies	44450115	44450115
Physician Fees	42597635	42140413	457222
Pharmacy	20412047	20412047
Equipment Rental/Mainte	4839047	4037892	799963	1192

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	293372245	Total
Program Services	262677854	ProgramServices
Management And General	29913396	ManagementAndGeneral
Fundraising	780995	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	33077007	BOY
EOY	36847848	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	42277578	BOY
EOY	43111241	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	683709	BOY
EOY	1512528	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3899826	BOY
EOY	4325206	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1722864	BOY
EOY	1616784	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	331110350	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	190097267	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	144839696	BOY
EOY	141013083	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	34247461	BOY
EOY	34595058	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	10994415	BOY
EOY	12659380	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1105633	BOY
EOY	1485266	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	272848189	BOY
EOY	277166394	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	35670789	BOY
EOY	38350428	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	55739279	BOY
EOY	54514006	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	12821943	BOY
EOY	18427836	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	8422069	BOY
EOY	6597141	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	112654080	BOY
EOY	117889411	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	158678341	BOY
EOY	157517051	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1515768	BOY
EOY	1759932	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	160194109	BOY
EOY	159276983	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	272848189	BOY
EOY	277166394	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-1952853	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	978704	ReconciliationUnrealizedInvest
Reconcilation Other Changes	57023	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3654924	BeginningOfYearBalance
Contributions	958033	Contributions
Investment Earnings Or Losses	120568	InvestmentEarningsOrLosses
Other Expenditures	548054	OtherExpenditures
Administrative Expenses	16550	AdministrativeExpenses
End Of Year Balance	4168921	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3639568	BeginningOfYearBalance
Contributions	494559	Contributions
Investment Earnings Or Losses	137978	InvestmentEarningsOrLosses
Other Expenditures	601477	OtherExpenditures
Administrative Expenses	15704	AdministrativeExpenses
End Of Year Balance	3654924	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3419691	BeginningOfYearBalance
Contributions	448744	Contributions
Investment Earnings Or Losses	93749	InvestmentEarningsOrLosses
Other Expenditures	305526	OtherExpenditures
Administrative Expenses	17090	AdministrativeExpenses
End Of Year Balance	3639568	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3228718	BeginningOfYearBalance
Contributions	347995	Contributions
Investment Earnings Or Losses	50166	InvestmentEarningsOrLosses
Other Expenditures	202661	OtherExpenditures
Administrative Expenses	4526	AdministrativeExpenses
End Of Year Balance	3419692	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3007949	BeginningOfYearBalance
Contributions	415278	Contributions
Investment Earnings Or Losses	-7070	InvestmentEarningsOrLosses
Other Expenditures	176999	OtherExpenditures
Administrative Expenses	10440	AdministrativeExpenses
End Of Year Balance	3228718	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	1.00000	BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	11924183	OtherCostOrOtherBasis
Book Value	11924183	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	203019851	OtherCostOrOtherBasis
Depreciation	106794581	Depreciation
Book Value	96225270	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	109518242	OtherCostOrOtherBasis
Depreciation	80123159	Depreciation
Book Value	29395083	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6648074	OtherCostOrOtherBasis
Depreciation	3179527	Depreciation
Book Value	3468547	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	141013083	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
Capital lease obligations	$6,437,141
Insurance Liability	$160,000

Field	Value	IRS element (for citing)
Total Of Amounts	6597141	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	269054817	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	978704	NetUnrealizedGainsInvestments
Other Revenues	-7766732	OtherRevenues
Revenue Not Rptd F990	-6788028	RevenueNotRptdF990
Revenue Subtotal	275842845	RevenueSubtotal
Other Revenues Not Included	15576547	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	15576547	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	291419392	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	270471204	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	270471204	ExpensesSubtotal
Other Expenses Not Included	22901041	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	22901041	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	293372245	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Description of Intended Use of Endowment Funds:	Part V, Line 4:	The endowment is utilized to provide funding to continue to enhance patient care at St. Alexius Medical Center set forth in our mission, "Let all be received as Christ."
Description of Uncertain Tax Positions Under FIN 48:	Part X, Line 2:	St. Alexius is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). St. Alexius is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, St. Alexius is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. St. Alexius files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. St. Alexius believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. St. Alexius would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. St. Alexius' federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2008.
Part XI, Line 2d - Other Adjustments:		Income from subsidiary included in revenue for financial statements -7,466,732. Grant Expense included in income for financial statements -300,000.
Part XI, Line 4b - Other Adjustments:		Temporily restricted contributions 244,164. Revenues of Disregarded Entity-St. Alexius Heart and Lung 15,134,309. Contribution of Long-Lived Assets 198,074.
Part XII, Line 4b - Other Adjustments:		Expenses of Disregarded Entity-St. Alexius Heart and Lung 22,601,041. Grant Expense included in income for financials statements 300,000.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2191000	TotalCommunityBenefitExpense
Net Community Benefit Expense	2191000	NetCommunityBenefitExpense
Percent Of Total Expense	0.00750	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12837785	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10068151	DirectOffsettingRevenue
Net Community Benefit Expense	2769634	NetCommunityBenefitExpense
Percent Of Total Expense	0.00940	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15028785	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10068151	DirectOffsettingRevenue
Net Community Benefit Expense	4960634	NetCommunityBenefitExpense
Percent Of Total Expense	0.01690	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	176948	TotalCommunityBenefitExpense
Net Community Benefit Expense	176948	NetCommunityBenefitExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1945972	TotalCommunityBenefitExpense
Net Community Benefit Expense	1945972	NetCommunityBenefitExpense
Percent Of Total Expense	0.00660	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	57928572	TotalCommunityBenefitExpense
Direct Offsetting Revenue	41261562	DirectOffsettingRevenue
Net Community Benefit Expense	16667010	NetCommunityBenefitExpense
Percent Of Total Expense	0.05680	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	453859	TotalCommunityBenefitExpense
Net Community Benefit Expense	453859	NetCommunityBenefitExpense
Percent Of Total Expense	0.00150	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	60505351	TotalCommunityBenefitExpense
Direct Offsetting Revenue	41261562	DirectOffsettingRevenue
Net Community Benefit Expense	19243789	NetCommunityBenefitExpense
Percent Of Total Expense	0.06550	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	75534136	TotalCommunityBenefitExpense
Direct Offsetting Revenue	51329713	DirectOffsettingRevenue
Net Community Benefit Expense	24204423	NetCommunityBenefitExpense
Percent Of Total Expense	0.08240	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$10,694,538	BadDebtExpenseAmount
Amount Attributable To	1283345	AmountAttributableTo
Amount Reimbursed By Medicare	79635346	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	82512534	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2877188	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 Northern Plains Lab	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	Labratory Services	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.50000	OrganizationProfitOrOwnership
Physicans Profit Or Ownership	0.50000	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	2	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Teaching HospitalTeachingHospital	Er24 HoursEr24Hours	Critical Access HospitalCriticalAccessHospital
St Alexius Medical Center
1	900 East Broadway	Bismarck	ND	585065510	X	X	X	X
Turtle Lake Community Memorial Hospital
2	220 5th Ave	Turtle Lake	ND	58575	X	X			X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumber	CHNA ConductedCHNAConducted	Community DefinitionCommunityDefinition	Community DemographicsCommunityDemographics	Existing ResourcesExistingResources	How Data ObtainedHowDataObtained	Community Health NeedsCommunityHealthNeeds	Other Health IssuesOtherHealthIssues	Identifying ProcessIdentifyingProcess	Consulting ProcessConsultingProcess	Information GapsInformationGaps	Needs Assessment ConductedNeedsAssessmentConducted	Take Into AccountTakeIntoAccount	Other FacilitiesOtherFacilities	CHNA Widely AvailableCHNAWidelyAvailable	Own WebsiteOwnWebsite	On RequestOnRequest	Adopt Implement StrategyAdoptImplementStrategy	Execute Implement StrategyExecuteImplementStrategy	Include Operational PlansIncludeOperationalPlans	Adopt BudgetAdoptBudget	Prioritize Health NeedsPrioritizeHealthNeeds	Prioritize ServicesPrioritizeServices	All Needs AddressedAllNeedsAddressed	Organization Incur Excise TaxOrganizationIncurExciseTax	Eligibility Criteria ExplainedEligibilityCriteriaExplained	Uses FPG FreeUsesFPGFree	FPG Free PercentFPGFreePercent	Uses FPG DiscountedUsesFPGDiscounted	FPG Discount PercentFPGDiscountPercent	Explains BasisExplainsBasis	Income LevelIncomeLevel	Asset LevelAssetLevel	Medical IndigencyMedicalIndigency	Insurance StatusInsuranceStatus	Medicaid MedicareMedicaidMedicare	Explains Application MethodExplainsApplicationMethod	Includes Publicity MeasuresIncludesPublicityMeasures	Posted On WebsitePostedOnWebsite	Available On RequestAvailableOnRequest	Actions On NonpaymentActionsOnNonpayment	Collection ActivitiesCollectionActivities	Notify Upon AdmissionNotifyUponAdmission	Notify Before DischargeNotifyBeforeDischarge	Notified All PatientsNotifiedAllPatients	Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy	Used Other MethodUsedOtherMethod	Amounts Generally BilledAmountsGenerallyBilled	Gross ChargesGrossCharges
St Alexius Medical Center
1	1	X	X	X	X	X	X	X	X	X	12	1	0	1	X	X	X	X	X	X	X	X	0	0	1	1	200.000000000000	1	400.000000000000	1	X	X	X	X	X	1	1	X	X	1	0	X	X	X	1	X	0	0
Turtle Lake Community Memorial Hospital
2	1	X	X	X	X	X	X	X	X	X	12	1	0	1	X	X	X	X	X	X	X	X	0	0	1	1	100.000000000000	1	200.000000000000	1	X	X	X	X	X	1	1	X	X	1	0	X	X	X	1	X	0	0

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	6	NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
St Alexius Mandan Clinic
403 Burlington Street SE	Mandan	ND	58554	Family Medicine Clinic
St Alexius Minot Clinic
1600 2nd Ave SW Ste 19	Minot	ND	58701	Family Medicine Clinic
Great Plains Rehabilitation Services
1212 East Main	Bismarck	ND	58501	Provide Home Medical Products to General Public
Medical Arts Surgery Center
810 East Rosser Ave	Bismarck	ND	58501	Ambulatory Surgery Center for Individuals Who Require Overnight Stay
St Alexius Heart & Lung Clinic
310 North 10th Street	Bismarck	ND	58501	Heart, Lung & Peripheral Vascular Disease Clinic
Mandan Clinic-East
2008 Twin City Drive	Mandan	ND	58554	Family Medicine Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

ExplanationExplanation	IdentifierIdentifier
Part I, Line 7: The charity care included in Part I, Line 7a is based on the average cost to gross charges calculated from internal cost system.The unreimbursed Medicaid in Part I, Line 7b is based on gross charges and claims from the Medicaid cost report.The community health services and education in Part I, Lines 7e and f are estimates.The contributions in Part I, line 71 are based on actual expenses.The subsidized health services in Part I, Line 7g are based on estimated costs from the internal cost accounting general ledger systems.
Part I, Line 7g: Subsidized health services includes $56,351,415 in costs attributable to physician clinics.
Part I, L7 Col(f): The amount of bad debt expense included in Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $10,694,538.
Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in Footnote 1 on page 12 of the attached financial statements. The estimated amount of the organization's bad debt expense that is attributable to patients eligible under the organization's charity care policy is approximately $1,283,345. This was based off the most recent community needs assessment reported in March 2011, which indicated that 12% of the population is below the Federal Poverty Guidelines. The 12% was applied to the amount of bad debt expense.Discounts and payments on accounts are applied directly to the principal of the account. The Hospital does not charge interest or fees related to the use of a collection agency to collect these payments.
Part III, Line 8: Medicare allowable cost is based on the Medicare cost report. The Medicare cost report is completed based on the rules & regulations set forth by the Centers for Medicare and Medicaid Services.St. Alexius Medical Center provides medically necessary care to all regardless of the ability to pay. Therefore the shortfall should be treated as a community benefit.
Part III, Line 9b: Reasonable efforts are taken for patients qualifying under financial assistance policy before turning over the account to a third party collector.Any individual who indicates the financial inability to pay a bill for a medically necessary service shall be evaluated for Charity Care assistance. The Financial Counselor along with the Social Work Department staff attempt to identify all inpatients prior to discharge and begin the discussion of available programs including, but not limited to, the charity care program. Determination of eligibility should be made prior to discharge or as close to the date of service as possible. However, retroactive determinations are also eligible. The Customer Service staff in Patient Financial Services discusses Charity Care options with patients after services are rendered, usually, after the patient has received their first statement and provided the necessary documentation.
Part V, Section B, Line 4: www.st.alexius.org	St. Alexius Medical Center
Part V, Section B, Line 4: www.communitymh.com	Turtle Lake Community Memorial Hospital
Part V, Section B, Line 7: 1. It was noted in the community health needs assessment that Alzheimer's disease in North Dakota had the 2nd highest per capita number of deaths related to Alzheimer's. Although we have offered education, memory screenings and support groups for Alzheimer's, the availability of medical specialists that treat Alzheimer's and other mental health issues is still a need. Recruitment efforts have not been completed thus far to meet the need, due to diminished availability of psychiatrists and/or neuropsychologists.2. Although Diabetes and Obesity associated issues were identified as being prevalent in our minority Native American population, we continue to see a lack of participation by Native Americans at free/low cost community health screenings that have been offered. The reasons why participation from this population is low requires further investigation.	St. Alexius Medical Center
Part V, Section B, Line 7: It was noted in our community needs assessment that the respondents would like to have more local access and availability to more specialized care. Turtle Lake Community Hospital has a few specialists that provide services locally. At present time we have an orthopedic specialist that visits Turtle Lake on a monthly basis. In the past we have had OB/GYN physician and a General Surgeon but due to the lack of patient numbers they no longer are willing to provide services in Turtle Lake. Community Memorial Hospital is located in a small community and the chances of getting specialists to provide on site services is cost prohibitive. We will explore offering more specialized services through tele-medicine.	Turtle Lake Community Memorial Hospital
Part V, Section B, Line 14g: In addition to having the full financial assistance policy available upon request or via website, St. Alexius contacts patients through pre-admissions and meets with them to discuss the policy prior to procedures. Patient financial staff is available during normal office hours to discuss patient payment options and explain were the full financial assistance policy is available.	St. Alexius Medical Center
Part V, Section B, Line 14g: In addition to having the full financial assistance policy available upon request or via website, Community Memorial Hospital contacts patients through pre-admissions and meets with them to discuss the policy prior to procedures. Patient financial staff is available during normal office hours to discuss patient payment options and explain were the full financial assistance policy is available.	Turtle Lake Community Memorial Hospital
Part V, Section B, Line 20d: The maximum amount charged to a patient by St. Alexius under the financial assistance policy for emergency and medically necessary care is 45% of the gross charges. The organization determines the amount generally billed using a blended rate of Medicare and non-government payors. This is calculated annually.	St. Alexius Medical Center
Part V, Section B, Line 20d: The maximum amount charged to a patient by Community Memorial Hospital under the financial assistance policy for emergency and medically necessary care is 94.68% of the gross charges. The organization determines the amount generally billed using a blended rate of Medicare and non-government payors. This is calculated annually.	Turtle Lake Community Memorial Hospital
Part VI, Line 2: The Organization completed a community health needs assessment during fiscal year 2013.
Part VI, Line 3: The charity care policy is available on our website. Currently patients are contacted through pre-admissions and they meet with patient financial staff that go through information prior to procedures. Patient Financial Services also works with patients that need assistance with their billings. Free copies of the policy and application are available by mail, phone, or at the hospital campus.
Part VI, Line 4: St. Alexius provides outreach services across its service area of central and western North Dakota. St. Alexius operates the Garrison Memorial Hospital in Garrison, North Dakota and manages the Community Memorial Hospital in Turtle Lake. St. Alexius owns and operates clinics in Mandan, Minot, Garrison, and Washburn. North Dakota's population is 672,591 of which 61,272 reside in the city of Bismarck. The population is 90.0% white, 5.4% Native American, and the remaining 4.6% being African American, Asian, and Hispanic. By the year 2020, 45 of the 53 counties will have more than 22% of their population age 65 or older. From 2000-2005 our state had a 15% decrease in the number of youth and a 13.8% increase in the minority population which was primarily Native American Reservations. North Dakota has 12% of their population living in poverty. The leading causes of death in Burleigh county ranked in order are Diseases of the Heart, Alzheimers, Respiratory Cancer, Accidental, Cerebrovascular Disease, COPD, Diabetes, Breast Cancer, and Colorectal Cancer. Health related behaviors influence cardiovascular diseases such as smoking, physical inactivity, poor nutrition, and unhealthy weight status. Hypertension is a chronic disease associated with aging that has a high risk factor for heart disease and stroke. In North Dakota, 26% adults have high blood pressure. North Dakota adults are a part of the national trend towards increased obesity. 63% of the adults here have an unhealthy weight/BMI. Some of the health screenings that St. Alexius is conducting throughout the service region are vascular, wellness, memory, sleep apnea, and chronic obstructive pulmonary disease. Those individuals that are being screened at no or minimal cost are being alerted of health risks that might go undetected. Through screenings, it is our hope that these individuals seek further treatment and are empowered to make healthier lifestyle choices.
Part VI, Line 5: The governing body is comprised of people in the community who are knowledgeable to advise the organization and are compensated for their expertise and time (see Part VII of Form 990).The organization extends medical staff privileges to Primecare physicians. The organization applies surplus funds, if available, to their reinvestment in equipment and facilities to improve patient care.The Hospital provides serveral services at reduced or no costs. Those included are as follows:1. INTERACTIVE NETWORK - Consists of twenty five communities located in Montana, South and North Dakota covering 70,000 square miles are serviced by the St. Alexius Medical Center network. INTERACTIVE NETWORK provides electrocardiogram management, interactive cardiac management, remote cardiac monitoring, electroencephalogram monitoring, fetal monitoring, biomedical services, dialysis and infant pneumocardiograms to patients in western and central North Dakota. These services might not be provided if not for the Hospital servicing these areas.2. OTHER ACTIVITES INCLUDED ON PART 1, LINE 7E: - In keeping with the Hospital's commitment to serve all members of its community St. Alexius Medical Center: -participated in health fairs-provided patient educational materials and classes-provided patient support groups for different diseases-conducted health screenings-sponsored "Wellness" type programs ranging from Lamaze instruction and parenting to babysitting to diet and weight control to social issues.-operated a Hospice Program-has telemedicine capabilities set-up in several rural communities-provides PAC's (radiology) services and radiology reading to many rural communities 3. OTHER ACTIVITES INCLUDED ON PART 1, LINE 7E: - Services are provided to Standing Rock Sioux Indian Reservation with emphasis focused on improving the quality of care in the area of maternal and child nursing and mental health with a goal to reduce infant mortality. The program consists of support from a OB trained physician to provide prenatal and ongoing care in the Fort Yates community. Also in that community a bi-monthly newsletter is distributed that addresses the following topics:-Pregnancy and prenatal care-Labor and delivery-Infant nutrition-Teen pregnancy-Self esteem-Suicide prevention-Drug and alcohol abuse 4. St. Alexius manages a non-profit critical access hospital in Turtle Lake North Dakota. St. Alexius offers administrative expertise and purchasing economies that it passes on to this facility. This allows the facility to continue to provide health care services and operate more efficiently. Turtle Lake also provides primary care providers to clinics in McClusky and Washburn, ND.5. St. Alexius manages a non-profit critical access hospital in Garrison North Dakota. Garrison Memorial Hospital operates a 22 bed acute care hospital and a 26 bed skilled nursing facility. They also operate a 24 hour, Level IV Certified Emergency Room.6. St. Alexius operates a Telemedicine network, known as The Telecare Network. It is a service St. Alexius Medical Center and affiliated physicians offer in cooperation with 27 healthcare providers throughout the Dakotas. The service features telemedicine consultations between rural physicians and specialists in Bismarck using real time video and audio telepresence equipment. Consultations of both urgent and routine nature are available.7. St. Alexius provides support to other rural communities like Hettinger, North Dakota to help maintain needed primary care physician coverage in rural communities.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
ND-SD Medical Transport
8295 7th Avenue SE	Linton	ND	58552	272849014	501(c)(3)	50000	Support Angel Air Care Helicopter EMS Program
Sakakawea Medical Center
510 8th Ave NE	Hazen	ND	58545	450308379	501(c)(3)	75000	Outreach Care Grant
West River Regional
1000 Highway 12	Hettinger	ND	58639	450340688	501(c)(3)	300000	Rural Healthcare Support Grant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	3	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedure for Monitoring Grants in the U.S.:	Identifier
Return Reference	Part I, Line 2:	ReturnReference
Explanation	Schedule I, Part I, Line 2: St. Alexius makes donations to entities with charitable missions to ensure that our donations are used for the purposes intended.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Gary Miller
President/CEO	503716	0	190038	0	0	0	10000	0	7596	0	711350	0	0	0
Shiraz Hyder
VP Medical Affairs	387657	0	141873	0	0	0	10000	0	20872	0	560402	0	0	0
Rosanne Schmidt
VP & Chief Nursing Officer	199605	0	76273	0	0	0	10000	0	18405	0	304283	0	0	0
Duwayne Schlittenhard
VP Professional Services	186267	0	68493	0	0	0	9987	0	10040	0	274787	0	0	0
Wanda Pfaff
VP Human Resources	181586	0	65753	0	0	0	9689	0	17519	0	274547	0	0	0
Frank Kilzer
VP Material & Facility Res	161430	0	60946	0	0	0	8979	0	19749	0	251104	0	0	0
Kurt Waldbillig
VP Physician Services	149833	0	55537	0	0	0	8409	0	13327	0	227106	0	0	0
Susan Sisk
VP Accounting & Finance	139345	0	52949	0	0	0	7274	0	13287	0	212855	0	0	0
Eric Belanger
Neurosurgeon	1330264	0	629768	0	0	0	10000	0	15519	0	1985551	0	0	0
Steven Kraljic
Neurosurgeon	1330106	0	245451	0	0	0	10000	0	15512	0	1601069	0	0	0
Leslie Rainwater
Urologist	517025	0	458274	0	0	0	9809	0	14438	0	999546	0	0	0
Brent Herbel
Interventional Radiologist	739468	0	145509	0	0	0	10000	0	14783	0	909760	0	0	0
Robert Oatfield
Interventional Cardiologist	636324	0	95049	0	14982	0	10000	0	14577	0	770932	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference

ExplanationExplanation

Part I, Line 1a

President/CEO is allowed up to annual maximum executive benefit allowance of $10,000 for expenses incurred for: airline, club memberships, wellness/fitness programs, financial planning and tax preparation services, membership in community club, and cell phone and wireless connectivity. The amount of benefit used is included in taxable income.

Part I, Line 7

At the beginning of each fiscal year, the Compensation Committee establishes a financial threshold which must be met before any awards are paid and establishes guidelines defining the size of any awards available to participants. At the end of the plan year, the Committee decides whether to make any awards to participants and how large any award shall be, in accordance with the guidelines established at the beginning of the plan year. Incentive compensation is earned as a percent of base salary. Base salary is defined as the annualized rate of pay (summation of monthly base salary for the plan year).

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
City of Garrison
A	456002076	2007-12-20	3200000	2007-Improvements to the Infrastructure Relating to Energy Management	0	0	0
Burleigh County
B	456002204	2010-05-27	8156220	Building Construction	1	0	0
Burleigh County
C	456002204	2010-11-16	6119852	Building Construction	1	0	0
Burleigh County
D	456002204	2011-03-31	8159645	Building Construction	1	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceeds	Capital ExpendituresCapitalExpenditures	Year Of Subst CompletionYearOfSubstCompletion	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Amount Bond DefeasedAmountBondDefeased	Capitalized InterestCapitalizedInterest	Issuance Costs From ProceedsIssuanceCostsFromProceeds
A	3200000	3200000	2008	1	1
B	8377663	8221443	2010	1	1	8000000	221443	156220
C	6270931	6151079	2011	1	1	6000000	151079	119852
D	8380327	8222682	2011	1	1	8000000	220682	157645

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	0	0	0	0.00000	0.00000	0.00000	0	0	0
B	0	0	0	0	0.00000	0.00000	0.00000	0	0	0
C	0	0	0	0	0.00000	0.00000	0.00000	0	0	0
D	0	0	0	0	0.00000	0.00000	0.00000	0	0	0

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
US Bank NA
A	0	0	0	0	0	1	10.000000000000	0	0	0	0	0
(no name)
B	0	0	0	0	0	0				0	0	0
(no name)
C	0	0	0	0	0	0				0	0	0
(no name)
D	0	0	0	0	0	0				0	0	0

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	0
B	0
C	0
D	0

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	Burleigh County	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	456002204	IssuerEIN
CUSIP Number	120906DR0	CUSIPNumber
Date Issued	2012-01-31	DateIssued
Issue Price	40208479	IssuePrice
Description Of Purpose	Bond Refinance for 12/01/98, 4/15/09, 5/27/10, 11/16/10 and 3/31/11 Bonds	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Amount Retired	885000	AmountRetired
Total Proceeds	40210338	TotalProceeds
Refunding Escrow	7514823	RefundingEscrow
Issuance Costs From Proceeds	798251	IssuanceCostsFromProceeds
Other Spent Proceeds	16451448	OtherSpentProceeds
Current Refunding	1	CurrentRefunding
Advance Refunding	1	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test	0	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs	0	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiled
Rebate Not Due Yet	0	RebateNotDueYet
Exception To Rebate	0	ExceptionToRebate
No Rebate Due	0	NoRebateDue
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	0	ProcToUndertkCorrectiveAction

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (14 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Blue Cross Blue Shield
Gary Miller BCBS board member	1657926	Insurance services	0
Wells Fargo
John Giese is Wells Fargo CEO	282585	Banking and insurance services	0
Lynn Dosch
Spouse of Board Member	20923	Employee	0
Martha Reichert
Daughter of Board Member	40992	Employee	0
David Gayton
Brother of Board Member	408038	Employee	0
Kari Emery
Daughter of Board Member	55884	Employee	0
Skylar Dosch
Daughter-in-law of Board Member	47650	Employee	0
UND School of Medicine
Nicholas Neumann is Associate Dean	375541	Resident/CME Program	0
Karen Brown
Spouse of Board Member	328979	Employee	0
Adam Miller
Son of CEO	17714	Employee	0
Eric Kilzer
Son of Key Employee	74986	Employee	0
Joleen Waldbillig
Spouse of Key Employee	33927	Employee	0
Jarin Sprecher
Stepson of Key Employee	11691	Employee	0
Michael Anderson
Stepson of Key Employee	29911	Employee	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Form 990, Part VI, Section A, line 2	John Giese and Gary Miller have a business relationship.
Form 990, Part VI, Section A, line 6	Members: The corporation shall have one class of members, which shall consist of members of the monastic community known as the Benedictine Sisters of the Annunciation, BMV, who have made their perpetual monastic profession and who have been elected to or appointed to the Sponsorship Group of the Benedictine Sisters of the Annunciation, BMV.
Form 990, Part VI, Section A, line 7a	Joint Powers of Members and Board of Directors: The following powers shall be reserved jointly to the members of the corporation and the board of directors: 1. Approve a new candidate appointed to serve as President/Chief Executive Officer of the corporation. 2. Approve any person to be elected to serve on the board of directors. 3. Remove any director if this action is indicated. The power of the board of directors to act on any of these matters is subject to the requirement that the members of the corporation shall approve such action prior to the submission of the matter to a vote of the board of directors.
Form 990, Part VI, Section A, line 7b	Powers Reserved to Members: Exercise of the following powers shall be reserved exclusively to the members of the corporation to: 1. Change the sponsorship, reserved powers or mission of the corporation as an institution founded on Gospel values, the Benedictine heritage of healing and the healing ministry of Jesus. 2. Make any major policy change on ethical issues. 3. Authorize the sale or encumbrance of all or substantially all of the assets or property of the corporation. 4. Merge, liquidate or dissolve the corporation. 5. Change the name of the corporation. 6. Change or amend the structure of the board of directors of the corporation. 7. Amend, alter or repeal the articles of incorporation and/or the bylaws of the corporation. 8. Approve or disapprove a proposed course of action which could reasonably be anticipated to adversely affect the sponsorship or mission of the corporation as an institution founded on Gospel values, the Benedictine heritage of healing and the healing ministry of Jesus.
Form 990, Part VI, Section A, line 8b	There are no committees with the authority to act on behalf of the board of directors.
Form 990, Part VI, Section B, line 11	Internal staff will present to the audit and compliance committee and that committee recommends approval to the board. A draft is presented at a board meeting.
Form 990, Part VI, Section B, line 12c	Annually all employees are asked conflict of interest questions at evaluation time. Employees are responsible for disclosing potential conflicts of interest by completing a disclosure form. Each year the compliance officer initiates a review of all conflicts of interests within the medical center. The following annually complete a disclosure form: board members, President/CEO, Vice Presidents, Directors/Managers, other employees with significant decision making authority or who are in a position to influence decisions. The forms are reviewed by the compliance officer and if a conflict is "new" or requires review, the CEO and the Audit & Compliance Committee discuss the conflict and determine appropriate course of action.
Form 990, Part VI, Section B, line 15	Compensation is reviewed annually by an independent group using comparability data and recommendations are presented to the President/CEO and/or Board of Directors for approval.
Form 990, Part VI, Section C, line 19	An annual report is available to the public that includes financial statements.
Form 990, Part XI, line 9:	Fair Value of Interest Rate Swap 57,024. Rounding -1.	Changes in Net Assets or Fund Balances:
Form 990, Part III	-The St. Alexius Medical Center Rehabilitation Center has been accredited from the Commission on Accreditation of Rehabilitation Facilities (CARF). This accreditation represents the highest level of accreditation that can be awarded to an organization and shows the organization's substantial conformance to the standards established by CARF. -St. Alexius was awarded the 100 Top Hospital Cardiovascular Benchmarks for Success Study, 9th Edition per Thomson Healthcare. Thomson Healthcare developed the 100 Top Cardiovascular Hospitals' study to identify high-performing cardiovascular hospitals nationally and to set performance targets for improving clinical outcomes and management of the high-risk, high-cost cardiovascular service line. To qualify, hospitals must achieve high scores across eight equally weighted performance criteria that reflect clinical processes and outcomes, volume, efficiency and cost. -St. Alexius received a health care quality award for our own overall performance on the Centers for Medicare & Medicaid Services quality measures. The award is based on the hospital's performance and degree of improvement on the quality measures for the treatment of acute myocardial infarction, heart failure, pneumonia, and surgical care. This award is a reflection of the commitment we have made to provide quality health care to the patients we serve. -One of our Emergency Room physicians earned the Best Doctor in America award. The Best Doctors in America database is the result of a survey of more than 40,000 physicians in the United States. Only those doctors recognized to be in the top 3-5% of their specialty earn the honor of being named one of the Best Doctors in America. The only way to be recognized as one of the best Doctors in America is for a doctor to earn high marks for clinical ability from his or her peers. -St. Alexius was the first in western ND to offer non-surgical treatment of atrial septal defect (ASD). ASD is a hole between the two upper chambers of the heart and is most commonly diagnosed in infants and children. If the defect is large and doesn't close patients may be more susceptible to colds, pneumonia and other infectious diseases. Left untreated, ASD can lead to heart arrhythmias, heart failure, high blood pressure, stroke and even death. Traditionally, the only treatment for ASD was open heart surgery. With the AMPLATZER device, it allows a less invasive, non-surgical approach to treat our patients with ASD. By using this device, most patients leave the hospital within 24 hours and resume normal activity soon thereafter. -The Noninvasive Cardiovascular Lab has accreditation in the area of Extracranial Cerebrovascular Testing and Peripheral Venous Testing by the Intersocietal Commission for the Accreditation of Vascular Laboratories. -St. Alexius has been awarded an accreditation by the Commission on Laboratory Accreditation of the College of American Pathologists (CAP). The CAP accreditation program is recognized by the federal government as being equal to or more stringent than the government's own inspection program. The inspectors examine the laboratory's records and quality control of procedures for the preceding two years. This stringent inspection program is designed to specifically ensure the highest standard of care for the laboratory's patients. -St. Alexius performed our first carotid stent procedure utilizing the current FDA approved Embolic Protection System. This procedure provides a minimally invasive treatment alternative to conventional open carotid artery surgery to patients who are at high surgical risk. The embolic protection system is designed to capture and remove particles of plaque that might be dislodged during the procedure, which could potentially lead to stroke and other complications. -St. Alexius was only one of fourteen hospitals in the entire United States to gain an award for Patient Safety, Patient Quality and Patient satisfaction from the HealthGrades Rating organization. -St. Alexius provides and supports an inpatient Psychiatric Unit and a Partial Psych outpatient unit. -St. Alexius was recently named a Top 50 Hospital by Becker's Hospital Review	Statement of Program Service Accomplishment Continuance:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	St Alexius Heart & Lung Clinic LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	900 East Broadway Avenue	AddressLine1
City	Bismarck	City
State	ND	State
ZIP Code	58501	ZIPCode

Field	Value	IRS element (for citing)
EIN	861123162	EIN
Primary Activities	Speciality Clinic-Cardiology, etc.	PrimaryActivities
Legal Domicile State	ND	LegalDomicileState
Total Income	-7466732	TotalIncome
EOY Assets	2988973	EOYAssets
Direct Controlling Entity NA	N/A	DirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
Garrison Memorial Hospital
407 3rd Ave SE	Garrison	ND	58540	450227752	Hospital	ND	501(c)(3)	Line 3	St Alexius Medical Center	0
Benedictine Sisters of the Annunciation BMV
7520 University Drive	BISMARCK	ND	58504	450261530	Religious Purposes	ND	501(c)(3)	Line 1		0	N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	St Alexius Health Services Inc	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	900 East Broadway Ave	AddressLine1
City	Bismarck	City
State	ND	State
ZIP Code	58501	ZIPCode

Field	Value	IRS element (for citing)
EIN	450402817	EIN
Primary Activity	General Business Purpose	PrimaryActivity
Legal Domicile State	ND	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	St Alexius Medical Center	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C	TypeOfEntity
Share Of EOY Assets	1263	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership
Controlled Org	0	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg