2026-08-12T17:17:43-05:00 2025-09-30 423603499 Eide Bailly Advisory LLC 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2024-10-01 450226426 St Andrew's Hospital STAN 7012289300 316 Ohmer Street Bottineau ND 58318 Christopher Albertson President & CEO 7012289300 2026-08-12 1 1 Kim Hunwardsen P00484560 6122536500 2026-08-12 2024 2025-03-06 01:10:19Z SMP Health - St Andrew's Christopher Albertson 316 Ohmer Street Bottineau ND 58318 18044842 0 0928 X https://smphealth.org/standrews/ X 1913 ND Acute care critical access hospital 8 7 119 10 0 0 67986 107959 16753439 17836578 100680 100305 0 0 16922105 18044842 0 0 0 0 8003060 8703608 0 0 0 8761965 7822968 16765025 16526576 157080 1518266 13071122 15003060 2054820 2114013 11016302 12889047 X St. Andrew's Health Center, in union with the Sisters of Mary of the Presentation, works for the glory of God by bringing the Word and Healing of Jesus Christ to all, with a special concern for the poor and elderly. Through the shared ministry with the laity, St. Andrew's Health Center participates in the health care mission in the work of healing which is the work of God. Our individual inspiration is Jesus and His Gospel message. Permeated with the Charism of the Sisters of Mary of the Presentation, we minister to one another and to all who come to us for care. 0 0 13570558 17836578 SMP Health St. Andrew's (Health Center) is a 25-bed acute care hospital and a senior apartment facility located in Bottineau, North Dakota. SMP Health - St. Andrew's has been a part of the community since 1913. Our mission is to provide services to all who come to us for care; this is something that we are very proud of. Our ability to better the lives of those most in need is the core of our beliefs and knowing that we can make a difference in the lives of those we serve. In addition, we believe that through our leadership and presence in the community that we have been and will continue to be an essential part of the healthcare delivery team. Statement continued on Schedule O.St. Andrew's Hospital is designated as a Critical Access Hospital and has had the designation since July 2001. There were 435 acute patient days and 5,185 swing-bed days. The percent of occupancy was 61.6%.We continue to utilize "The Guide for Planning and Reporting Community Benefit" book that was prepared by the Catholic Health Care Association to help determine what qualifies as a community benefit. We attend a variety of educational opportunities throughout the year to provide direction in reporting on our benefits to the community.The Health Center provides healthcare services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Health Center does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was $30,000 for the year ended September 30, 2025, calculated by multiplying the ratio of cost to gross charges for the Health Center by the gross uncompensated charges associated with providing charity care to its patients.The Health Center also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable. 13570558 1 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 119 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X Christopher Albertson 7012289300 316 Ohmer Street Bottineau ND 58318 Christopher Albertson President & CEO 40.00 3.00 X X 0 345103 58383 Tyrone Berentson MD Family Medicine Physician 40.00 0.00 X 281565 0 31604 Robert Hamilton MD Family Medicine Physician 40.00 0.00 X 263252 0 31041 Laurie Thompson Pharmacist 40.00 0.00 X 177310 0 25211 Courtney Vandal CFO 40.00 2.00 X 0 142652 40741 Brenda McIntyre RN 40.00 0.00 X 136221 0 26250 Karla Spence DON 40.00 0.00 X 150436 0 4698 Jeremi Tweed Chair 0.30 0.00 X X 0 0 0 Melissa Block Vice Chair until July 0.30 0.00 X X 0 0 0 Rick Gustafson - Director then Vice Chair as of Aug 0.30 0.00 X X 0 0 0 Sr Debra Berry Director 0.30 1.50 X 0 0 0 Sr Anne Germaine Picard Director 0.30 1.50 X 0 0 0 Brent Christenson Director 0.30 0.00 X 0 0 0 Matt Glasner Director 0.30 0.00 X 0 0 0 Warren Emmer Director as of Aug 2025 0.30 0.00 X 0 0 0 1008784 487755 217928 11 0 1 0 Sisters of Mary of the Presentation Heal PO Box 10007 Fargo ND 58106 Administrative Services 760085 Cerner Corporation 2800 Rockcreek Parkway Kansas City MO 64117 Software Maintenance 599679 Medical Solutions LLC PO Box 850737 Minneapolis MN 55485 Travel Nursing Staff 360627 National Medical Resources 2792 E Broadway Ave Bismarck ND 58501 Travel Provider Staff 270634 DMS Health Technologies 728 East Beaton Drive Suite 101 West Fargo ND 58078 Nuclear Medicine, Ultrasound Purchased S 186501 13 33720 74239 107959 Patient Service Revenue 621110 17171453 17171453 Pharmacy Revenue 621300 346600 346600 Congregate Housing 623990 134687 134687 183838 183838 17836578 100305 100305 18044842 17836578 0 100305 X 7057895 6276733 781162 177174 157565 19609 971189 863699 107490 497350 442304 55046 16648 16648 48000 48000 2949866 2007309 942557 27146 27146 565655 414893 150762 426696 379787 46909 88356 70560 17796 6097 6097 20674 17822 2852 409225 352762 56463 99830 99830 Medical Supplies 2038778 2038529 249 Repairs and maintenance 811566 277226 534340 Food 152053 152053 162378 13389 148989 16526576 13570558 2956018 0 793985 1988252 3100582 4565420 477937 426323 285228 290753 11685345 9296412 2436897 2388933 4136802 3476345 1839691 1867034 13071122 15003060 1291698 1502930 2748 2247 83990 57376 34796 8743 641588 542717 2054820 2114013 X 9882677 11647730 1133625 1241317 11016302 12889047 13071122 15003060 X 1518266 246787 107692 X X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 118981 118981 7128693 6025186 1103507 4316345 3160985 1155360 121326 110241 11085 2388933 Pooled Investment Fund 3476345 F 3476345 Int in Net Asset of SAHC Foundation 1240817 Third Party Settlements 412000 Operating lease assets 214217 1867034 Finance lease liabilities 328500 Operating lease liabilities 214217 542717 X 18291629 246787 246787 18044842 0 18044842 16526576 0 16526576 0 16526576 Part IV, Line 2b: St. Andrew's Hospital acts as custodian for the patients and holds patient security deposits. Part X, Line 2: The Health Center 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. The Health Center 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. 1 1 X 1 X 1 X 1 1 0 1 1 30000 30000 0.00180 30000 30000 0.00180 289029 171686 117343 0.00710 289029 171686 117343 0.00710 319029 171686 147343 0.00890 1 613082 46594 8533244 8549986 -16742 X 1 1 1 1 St Andrew's Hospital 316 Ohmer Street Bottineau ND 58318 www.standrewshealth.com 5005 X X X X 1 provider based rural health clinic St Andrew's Hospital 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X https://www.standrewshealth.com/resources/ X 1 24 1 https://www.standrewshealth.com/resources/ 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X https://www.standrewshealth.com/resources/ X See Line 16a. X See Line 16a. X X X X X 1 X 0 X X X X 1 X 0 0 St. Andrew's Hospital Part V, Section B, Line 5: In March 2025, the SMP Health - St. Andrew's partnered with Cycle of Business to initiate a Community Health Needs Assessment (CHNA). Cycle of Business began by collecting data and input from the community to develop a survey designed to inform both the CHNA and the Community Health Improvement Plan (CHIP). An initial meeting was held in June of 2025, with community members, including representatives from the healthcare sector and individuals focused on the county's demographic makeup. This engagement ensured a wide range of voices and perspectives were considered in the assessment process.The CHNA survey was given to members of the committee to distribute throughout the community to try to get a broad and diverse response. The goal was to ensure SMP Health - St. Andrew's understood the health needs and desires of the community. SMP Health - St. Andrew's took special care to find individuals who could help define the healthcare needs of the community representing the youth, the elderly, and varied demographics. The information from the survey was utilized in the creation of the hospital CHNA and CHIP.The individuals involved in the initial meeting were asked to review the survey, the community demographics, and give their input on the health and wellness needs of the community. Additional efforts were made to reach out to the community in general for input on the survey. A link to the survey was sent out to the major employers in the area, emailed to community partners, and disbursed via social media to extend the reach as far as possible. After a couple of months, the survey received responses from the community representing all demographics. That information was then brought back to the hospital and community members to discuss what was most important to the community and what the hospital could do to help improve the health and availability of healthcare in the community. St. Andrew's Hospital Part V, Section B, Line 11: The most recent CHNA completed in 2024 identified three primary areas as priorities for action:1. Recruit Primary Care Providers2. Strengthen Access to Preventative Care3. Build a Stronger Value-Based Care ProgramWhile important, three areas have been identified for postponed exploration at a later time:Expanding mental health counseling services.Assessing the feasibility of providing infusion services.Exploring opportunities to offer cardiac calcium scoring for preventative cardiology.By prioritizing its resources, St. Andrew's can focus on the areas of greatest immediate impact, while leaving the door open to explore these additional services as demand and capacity allow.Due to timing of the completion of the CHNA, the following needs will be addressed over the next 3 years.1. Recruiting Primary Care ProvidersOne of the most urgent needs identified through the survey is the recruitment of additional primary care physicians. Access to strong, reliable primary care is the foundation of community health, and St. Andrew's recognizes the importance of ensuring patients can receive preventative, routine, and ongoing care close to home. To address this, St. Andrew's will take a multipronged approach:-Partner with 3RNET and the Center for Rural Health at the University of North Dakota (UND) to expand outreach, leverage statewide networks, and identify candidates interested in rural practice.-Hire a dedicated recruiter to actively pursue and secure a Family Practice Physician who can strengthen local primary care capacity.2. Strengthening Access to Preventative CareSt. Andrew's Hospital recognizes that preventive care, particularly for women's health, is essential to the overall well-being of the community. Early detection of disease and consistent access to routine screenings save lives, reduces long-term healthcare costs, and empowers individuals to take an active role in maintaining their health. To meet these goals, the hospital is implementing a multi-faceted approach to strengthen access to preventive and gynecological care for women and families across the region.The first initiative will be to promote preventive health screenings such as colorectal, prostate/PSA, and diabetes testing among others. By increasing awareness and making these screenings more accessible, St. Andrew's aims to catch chronic and life-threatening conditions earlier, when treatment is most effective. Educational outreach, provider reminders, and community partnerships will help ensure that more residents take advantage of these important preventive services. At the same time, the hospital will expand the availability of women's health screenings, including Pap smears and mammograms. These services are critical to the early detection of cervical and breast cancers, both of which are highly treatable when found early. St. Andrew's will work to improve scheduling options, reduce wait times, and remove barriers such as transportation and cost so that women can receive timely care close to home. Finally, St. Andrew's will explore additional gynecological service options to enhance care access and continuity. The goal is to ensure that every woman, regardless of where she lives, has consistent access to preventive and routine gynecological care. Through these efforts, St. Andrew's Hospital is reinforcing its commitment to proactive, patient-centered care. By focusing on prevention, expanding women's health services, and exploring new partnerships, the hospital will help create a healthier, more informed, and better-served community for generations to come.3. Building a Stronger Value-Based Care ProgramThe third priority identified through the community survey is the need to expand value-based care. This approach focuses on improving health outcomes, preventing disease, and aligning care delivery with models that reward quality rather than volume. By strengthening value-based initiatives, St. Andrew's will be able to improve patient health while also supporting the long-term financial sustainability of the hospital.St. Andrew's will focus on three key areas:-Expand Annual Wellness Visits Increasing participation in annual wellness visits for seniors and younger populations will promote early detection of health issues, provide opportunities for preventative counseling, and support continuity of care.-Increase Screenings Enhanced access to screenings such as Pap smears, PSA tests, STD testing, colorectal cancer screening, and others will ensure patients receive timely preventative care, reducing the risk of late-stage diagnoses.-Strengthen Chronic Care Management By expanding chronic disease management programs and engaging with the Rough Rider High Value Network, St. Andrew's will improve coordination of care for patients with long-term conditions such as diabetes, hypertension, and heart disease, while also meeting quality benchmarks associated with value-based care models.The Hospital took actions in FY2025 to address some of the needs in the 2021 CHNA. Below is a description of the actions taken.1. Increase the number of mental health providers for adultsSMP Health continues to contract with Psychiatry Network for mental health services.2. Increase the number of prescribing mental health providersA physician is providing med management via telehealth.3. Increase or promote opportunities for physical fitness.A physician sits on the Bottineau Park board helping promote physical activity in the community.4. Improve school-based mental health support for children and youthThe hospital continues to try to bring a provider in person instead of virtually.5. Improve drug and other substance abuse early intervention and prevention servicesThe Hospital continues to provide referrals to Essential Family Solutions, a mental health and addiction counseling service in Bottineau, ND. St. Andrew's Hospital Part V, Section B, Line 13h: Individuals with medical expenses in excess of 30% of their gross income who would otherwise not qualify for the Caring Program based on their earnings can qualify for catastrophic charity care and receive a reduction in the cost of their medical services.In addition to using 200% of the federal poverty guidelines to determine eligibility for providing discounted care to low income individuals, St. Andrew's Hospital also uses a sliding fee schedule based on income and family size. Depending on income and family size a patient could have 20%, 40%, 60%, 80% or 100% written off to charity care. 1 1 - St Andrew's Senior Housing 316 Ohmer Street Bottineau ND 58318 Senior housing Part I, Line 3c: In addition to using 200% of the federal poverty guidelines to determine eligibility for providing discounted care to low-income individuals, St. Andrew's Hospital also uses a sliding fee schedule based on income and family size. Depending on income and family size a patient could have 20%, 40%, 60%, 80% or 100% written off to charity care.Individuals with medical expenses in excess of 30% of their gross income who would otherwise not qualify for the Caring Program based on their earnings can qualify for catastrophic charity care and receive a reduction in the cost of their medical services.Part I, Line 6b:St. Andrew's Hospital makes its community benefit report available to the public by posting it on our website and an internal bulletin board. Part I, Line 7: Charity care expense on line 7a was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Subsidized health services line 7g was calculated using the costing methods to prepare the cost reports. Part III, Line 2: The amount on line 2 represents implicit price concessions and bad debts. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Bad debt reflects amounts that will not be paid by patients based on an adverse change in the patient's ability to pay. Part III, Line 3: The Hospital reasonably estimates the portion of implicit price considerations that could have qualified for charity care. An estimated 7.6% of implicit price concessions in 2024 are attributable to patients living below the federal poverty level in Bottineau County. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 11 and 12 of the attached audited financial statements. Part III, Line 8: St. Andrew's Hospital provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Fiscal year 2025 had a Medicare shortfall. Any year there is a Medicare shortfall that would be considered a community benefit.Hospital services reimbursed on a fee schedule are not included in the Medicare calculation per the 990 instructions. Had this been reported the total loss from Medicare services would have been increased by $124,059.Medicare fee schedule revenue $ 123,098Medicare estimated costs of care relating to payments (247,158)Net (Shortage) $ (124,059)Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicaid and Medicare Services. Part III, Line 9b: The Hospital does not pursue extraordinary collection activities for 120 days from the date of service while the patient is applying for financial assistance. A 30-day notice is provided to the patient before any collection activities begin. A patient has a total of 240 days to apply for financial assistance. Individuals provided with charity discounts, financial assistance, or who are on payment plans are not referred to a collection agency. After a determination of charity care, any personal portion due would follow the same collection procedures as other types of patients. Part VI, Line 2: In addition to the CHNA, the Hospital receives regular feedback on community needs from board members, other community organizations such as Economic Development Corporation and Chamber of Commerce, and from interested community members. Part VI, Line 3: Extensive signage is posted throughout the facility in the ER, waiting rooms, and the admissions/registration area. Patient statements include language regarding opportunity for financial assistance. The financial assistance policy and application for charity care/financial assistance are on the website. All collection related notices include encouragement to patients to explore financial assistance. The facility educates our employees, who assist in offering an array of services in searching for medical coverage for those that are underinsured or uninsured. The number of uninsured and underserved is growing in Bottineau County. We are seeing an increase in the individual's out of pocket costs that remain following payments provided by their insurance carriers. With the rise in health care premiums and aging population, families have to make some difficult decisions. The lack of insurance or underinsured has a devastating effect on the people of our community. We are committed to the Catholic Healthcare Initiative on working towards insurance coverage issues for the uninsured and underinsured. Part VI, Line 4: St. Andrew's Hospital is a 25-bed acute care hospital and a senior apartment facility located in Bottineau, North Dakota. St. Andrew's Hospital serves approximately 6,400 individuals, encompassing a large part of Bottineau County. Bottineau County is located in rural, North Central North Dakota, next to the Canadian border. Our main patient base is of senior-citizen age, as the percentage of individuals over the age of 65 in Bottineau County is 25.7%. 7.6% of our population base is living below the poverty level and the estimated median household income was $85,000. Unemployment in 2025 was 2.8% compared to 2.4% in North Dakota. The most common industries are retail trade, health care and social assistance and construction. Part VI, Line 5: SMP Health - St. Andrew's board is comprised of eight members: Christopher Albertson, CEO, two sisters from the Sisters of Mary of the Presentation, and five community members otherwise unaffiliated with the facility or Sisters of Mary of the Presentation. To meet the needs of our community, the Hospital extends privileges to medical staff that are qualified and licensed. In addition to regular planning for systematic replacement/enhancement of patient care equipment like CT scanners and patient beds, the organization periodically assesses additional needs for equipment and utilizes surplus funds as well as community donations to help meet those needs.SMP Health - St. Andrew's and its team of co-workers strive to increase their level of community involvement. Many of the employees of St. Andrew's Hospital serve on multiple local and regional committees working to improve the health and lives of the members of Bottineau County. SMP Health - St. Andrew's operates an emergency room available 24 hours a day and accepts all patients, regardless of ability to pay. We are the sole provider of emergency and inpatient services in our county. The Hospital operates a separate foundation which conducts fundraising activities and solicits funds that are utilized to further the programs of St. Andrew's Hospital. The Foundation makes regular contributions to the Hospital for items that directly improve patient care (minor and capital). We also work with the school system to provide volunteer opportunities for students to work in the Health Care Center.Beyond Charity CareIn addition to our free charity care, the Hospital has provided many other services to meet the needs of those in Bottineau County and service area: we provide access to clinical practice to the Bottineau and Minot region.A number of students job shadow in various departments as part of their education requirements. Over the past year we have had students job shadowing or completing internship hours for Lab technician. We have the school of nursing students from Dakota College Bottineau at the facility completing practicals during the college school year. We are happy to be a clinical site to Dakota College-Bottineau for the ADN/PN nursing program and UND for the NP program; we have a number of students that utilize SMP Health - St. Andrew's for their clinicals on a day-to-day basis. St. Andrew's Health Center allows for time to educate high school students about potential career opportunities in health care and provides job shadowing opportunities for those interested. We work closely with the Health and Sciences Instructor from the local high school to provide health career access to the students. We have provided presentations to members of our community and the surrounding areas/groups to educate them about the health and wellness issues. We have a regular Healthbeat article that is printed in our local newspaper. We also have a weekly radio spot to discuss current healthcare related issues. We expanded our service offers to bring blood pressures and wellness profiles to the community of Bottineau. SMP Health - St. Andrew's participates in a number of community events/activities that pertain to healthcare and our direct relations to our community; including wellness committee, bio terrorism group, disaster preparedness, co-sponsor a blood drive, blood pressures are offered during a variety of community events such as North Central Electric's annual meeting held in June, and our annual Hospital week celebration, just to name a few. We offer a free blood pressure screening day every Tuesday. This helps monitor the vascular health of 20 to 30 patients each week. Annually we impact roughly 1,000 people. Throughout the year we held food pantry drives and collected funds to give to the school system for children in need of money for milk at snack time. We also have an angel tree within the facility that has a range of ages of boys and girls that are in need of receiving some gifts at Christmas. We do this in collaboration with a service group in our community.We continue to maintain employees that carry out duties of the Community Resource Coordinator (CRC); this person offers assistance to those in need. The CRC offers an array of services in searching for medical coverage for those that are underinsured or uninsured. The CRC maintains our blanket hugs program and provided approximately 50 free blankets for pediatric patients in need of comforting. The CRC also helps individuals fill out Caring Program paperwork. In total the CRC provides resources to approximately 100 people in our community and service area; without the resource many of these individuals would have gone with needs unmet. Part VI, Line 6: We are an affiliate of the Sisters of Mary of the Presentation Health System dba SMP Health. SMP Health - St. Andrew's operates in accordance with the mission, vision, and values of the SMP Health. Our annual budgeting process includes an assessment of how our budget demonstrates a commitment to the values of the system and the system works to ensure we are always mindful of our duty to care for the poor and those in need. SMP Health - St. Andrew's has a Strategic Plan developed from themes set forth by the Health System for all affiliates. The strategic plan is an active document which SMP Health - St. Andrew's works on continuously and reports back to the health system on our progress toward established goals which again, align with the mission, vision, and values of the organization. 0 1 0 0 0 0 0 0 0 Christopher Albertson President & CEO 0 292500 0 31805 0 20798 0 24640 0 36389 0 406132 0 14798 Tyrone Berentson MD Family Medicine Physician 281565 0 0 0 0 0 8861 0 23748 0 314174 0 0 0 Robert Hamilton MD Family Medicine Physician 263252 0 0 0 0 0 8298 0 23748 0 295298 0 0 0 Laurie Thompson Pharmacist 177310 0 0 0 0 0 7481 0 18503 0 203294 0 0 0 Courtney Vandal CFO 0 128400 0 7513 0 6739 0 7886 0 34282 0 184820 0 739 Brenda McIntyre RN 136221 0 0 0 0 0 4973 0 22119 0 163313 0 0 0 Karla Spence DON 150436 0 0 0 0 0 4698 0 1001 0 156135 0 0 0 Part I, Line 3 St. Andrew's Hospital does not pay compensation to the President & CEO. The President & CEO position is compensated by Sisters of Mary of the Presentation Health System, a related organization, for services to the Hospital. Sisters of Mary of the Presentation Health System uses one or more of the methods in Part I, question 3 to determine compensation. Part I, Line 4b SMP Health has a nonqualified deferred compensation plan that complies with Section 409A of the IRC. SMP Health begins contributions into the plan after the employee's first year of service. The employee is vested based on a 20 year vesting schedule or becomes fully vested in the event of death, disability or reaching the age of 65. Employee name and amounts included on Schedule J are as follows: Name Part II, column B (iii) Part II, column C Courtney Vandal 739 1,500 Christopher Albertson 14,798 2,500 Form 990, Part VI, Section A, line 6 The sole member of the organization is the Sisters of Mary of the Presentation Health System dba SMP Health. Form 990, Part VI, Section A, line 7a The member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The member is also entitled to one vote on every other matter to be voted on by the member. Votes cast on behalf of the member are cast by the Chief Executive Officer of SMP Health. The member has the exclusive right to elect or remove Directors. Form 990, Part VI, Section A, line 7b The authority to act on the following matters are exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer. Form 990, Part VI, Section A, line 8b The Organization does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is made available to the governing body before it is filed. The Organization's President & CEO and CFO review the Form 990. Form 990, Part VI, Section B, line 12c Each Director and Officer must submit in writing to the Chair of the Board and the President & CEO a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chair of the Board reviews the statements of the Directors and the Vice Chair of the Board reviews the statement filed by the Chair. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chair of the Board has authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chair, the Vice Chair has authority to require the Chair remove himself in the same manner. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he will not participate in the deliberations or vote on it. Form 990, Part VI, Section B, line 15 The Organization's President & CEO and CFO are compensated by SMP Health. The compensation process is determined by SMP Health. The SMP Health's Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. The SMP Health's Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990. Form 990, Part IX, line 11g Purchased services: Program service expenses 2,007,309. Management and general expenses 303,988. Fundraising expenses 0. Total expenses 2,311,297. Management services: Program service expenses 0. Management and general expenses 638,569. Fundraising expenses 0. Total expenses 638,569. Form 990, Part XI, line 9: Change in interest in net assets of St. Andrew's Foundation 107,692. Form 990, Part XII, Line 2c: The governing board of Sisters of Mary of the Presentation Health System assumes responsibility for oversight of the audit for St. Andrew's Hospital. Sisters of Mary of the Health Ministry 1202 Page Drive SW Fargo ND 58106 320617468 Supports SMP Health and the related entities ND 501(c)(3) Canonical Entity N/A 0 Sisters of Mary of the Presentation Health System dba SMP Health 1202 Page Drive SW Fargo ND 58103 450359620 Support related ND Catholic Health Care System ND 501(c)(3) Line 12a, I SMP Health Ministry 0 St Aloisius Medical Center dba SMP Health - St Aloisius 325 E Brewster St Harvey ND 58341 450226729 Provision of health care services ND 501(c)(3) Line 3 SMP Health 0 St Andrew's Hospital Foundation dba SMP Health St Andrew's Foundation Inc 316 Ohmer St Bottineau ND 58318 450413201 Support SMP Health - St. Andrew's ND 501(c)(3) Line 12a, I SMP Health 0 Presentation Medical Center dba SMP Health - St Kateri 213 2nd Ave NE Rolla ND 58367 450227391 Provision of health care services ND 501(c)(3) Line 3 SMP Health 0 Sisters of Mary of the Presentation Long Term Care dba SMP Health - Long Te 1202 Page Drive SW Fargo ND 58106 752999939 Provide extended care and medically related services ND 501(c)(3) Line 10 SMP Health 0 St Margaret's Hospital Foundation 600 E 1st St Spring Valley IL 61362 364042262 Support SMP Health - St. Margaret's IL 501(c)(3) Line 12a, I SMP Health 0 SMP Illinois Region Health System dba St Margaret's Health 600 E 1st St Spring Valley IL 61362 842023121 Support related Illinois health care entities IL 501(c)(3) Line 12a, I SMP Health 0 IV HealthCorp Inc 925 W St Peru IL 61354 371211890 Support SMP affiliated entities IL 501(c)(3) Line 12a, I St Margaret's Health 0 St Margaret's Health - Spring Valley (ceased operations during 2023) 600 E 1st St Spring Valley IL 61362 362167884 Provision of health care services IL 501(c)(3) Line 3 St Margaret's Health 0 Illinois Valley Community Hospital Foundation 925 W St Peru IL 61354 371211780 Support IV HealthCorp, Inc. IL 501(c)(3) Line 12a, I IV HealthCorp Inc 0 St Margaret's Health - Peru (ceased operations during 2023) 925 W St Peru IL 61354 362852553 Provision of health care services IL 501(c)(3) Line 3 IV HealthCorp Inc 0 SMP Enterprises PO Box 10007 Fargo ND 581060007 363486506 Inactive ND N/A C 0 Valley Health Enterprises 925 W St Peru IL 61354 363476877 Home medical equipment IL N/A C 0 Illinois Valley Health Services Inc 925 W St Peru IL 61354 364050682 Inactive IL N/A C 0 Health Care Building Corp 925 W St Peru IL 61354 363306917 Inactive IL N/A C 0 IVCH General Professional Liability Loss Fund 925 West Street Peru IL 61354 366673231 Inactive IL N/A T 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 1 0