2022-09-13T17:27:57-05:00 2021-10-31 381357951 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2020-11-01 381455020 STRAITH HOSPITAL FOR SPECIAL SURGERY STRA 2483573360 23901 LAHSER ROAD SOUTHFIELD MI 480336035 BRAD BESCOE CEO 2483573360 2022-09-12 1 BRAD BESCOE 999009999 DAVID LOWENTHAL P00378651 2483522500 2022-09-12 3 AAL1 IAL1 2020 2023-04-26 12:10:37Z BRAD BESCOE 23901 LAHSER ROAD SOUTHFIELD MI 480336035 16598366 0 X WWW.STRAITHHOSPITAL.ORG X 1952 MI TO IMPROVE THE HEALTH STATUS OF OUR PATIENTS AND PROVIDE HIGH LEVELS OF SATISFACTION TO OUR PHYSICIANS. 9 9 194 9 0 0 1340461 3227304 11041220 11979824 156988 394820 35248 270490 12573917 15872438 0 0 0 0 7404299 7903247 0 0 0 7157731 8699752 14562030 16602999 -1988113 -730561 22252376 21266065 14455080 12981287 7797296 8284778 X TO IMPROVE THE HEALTH STATUS OF OUR PATIENTS AND PROVIDE HIGH LEVELS OF SATISFACTION TO OUR PHYSICIANS. 1 0 12208794 11979824 THE ORGANIZATION OPERATES A SHORT-TERM, ACUTE-CARE FACILITY OFFERING BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. TOTAL PATIENTS FOR THE YEAR WERE 168 HOSPITALIZED INPATIENTS (1,182 DAYS OF CARE) AND 3,500 SURGICAL OUTPATIENTS.STRAITH HOSPITAL ASSISTED THE COMMUNITY BY HELPING OUT THE LARGER LOCAL HOSPITALS WITH THE TRANSFER OF PATIENTS WITH COVID-19 TO PERFORM ACUTE REHABILITATION ON THESE PATIENTS DURING THE PANDEMIC. THE HOSPITAL ALSO INITIATED COVID-19 TESTING AND COVID-19 VACCINATION SERVICES FOR THE COMMUNITY. THE HOSPITAL CONTINUES TO EVALUATE HOW IT CAN CONTINUE TO CONTRIBUTE TO ITS COMMUNITY DURING COVID-19. 12208794 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 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 0 0 0 0 1 23 0 1 194 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X BRAD BESCOE 2483573360 23901 LAHSER ROAD SOUTHFIELD MI 480336035 RAY HUSBAND TRUSTEE 1.00 X 350 0 0 ENRIQUE SABBAGH MD TRUSTEE 1.00 X 300 0 0 WILLIAM M STRAITH TRUSTEE 1.00 X 50 0 0 JUSTIN HORNBURG FSA TRUSTEE 1.00 X 250 0 0 SUNNY SQUINDO TRUSTEE 1.00 X 250 0 0 JAMES C STRAITH CHAIRMAN 1.00 X X 350 0 0 THOMAS W STRAITH PE VICE CHAIRMAN 1.00 X X 350 0 0 EDWARD S JEFFRIES MD TREASURER 1.00 X X 350 0 0 ALEXANDER LEBEDINSKI TRUSTEE 1.00 X 350 0 0 JANET RYS CEO 40.00 X 248183 0 7390 BRADLEY BESCOE CFO 40.00 X 193022 0 5861 MICHAEL DRELLES PHYSICIAN 40.00 X 696449 0 8700 RONALD BRANT PHYSICIAN 40.00 X 312669 0 8700 RAJEEV SEHGAL PHYSICIAN 40.00 X 301152 0 0 1754075 0 30651 5 0 1 0 AMBULATORY ANESTHESIA ASSOCIATION PO BOX 1904 MONROE MI 48161 ANESTHESIA 925925 HI-TECH REHABILITATION 24450 EVERGREEN ROAD SUITE 205 SOUTHFIELD MI 48075 THERAPY 186864 2 3227304 3227304 MEDICARE/MEDICAID PAY 622110 10267296 10267296 OTHER PATIENT SERVICE REVENUE 622110 1699489 1699489 MEANINGFUL USE PAYMENTS 622110 13039 13039 11979824 147359 147359 973389 725928 247461 247461 247461 MISC NON-PATIENT REVENUE 900009 246790 246790 CADAVER LAB REVENUE 900009 23700 23700 270490 15872438 11979824 0 665310 394559 394559 6392814 5329641 1063173 378644 206596 172048 276370 203895 72475 460860 340005 120855 59685 59685 76200 76200 7100 7100 29026 29026 27400 12666 14734 223275 223275 101744 47034 54710 285972 285972 393498 181904 211594 4402 4402 195740 195740 1019809 712417 307392 266496 266496 SUPPLIES 3903010 3903010 CONTRACTED LABOR 1363387 630259 733128 EQUIP REPAIRS & MAINT 617976 285674 332302 125032 65319 59713 16602999 12208794 4394205 0 2893889 206627 3647839 3828827 1242806 1238798 598728 665815 125962 105293 20657927 12509879 9078230 8148048 4606292 4962278 58630 2110379 22252376 21266065 1237769 1278877 209724 0 6076962 5997321 933767 660709 5996858 5044380 14455080 12981287 X 7797296 8284778 7797296 8284778 22252376 21266065 X -730561 412996 805047 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 0 1 7100 7100 0 PART II-B, LINE 1: DUES WERE PAID TO A NATIONAL AND STATE HOSPITAL ASSOCATION IN FY 2021. PART OF THE DUES PAID WERE USED BY THESE ASSOCIATIONS FOR PURPOSES OF LOBBYING. 1175669 1175669 15331979 10356126 4975853 4047134 2057368 1989766 103145 96385 6760 8148048 COST REPORT SETTLEMENT RECEIVABLE 172842 LONG TERM EMPLOYEE RETENTION CREDIT 645845 GROUP INSURANCE PAYABLE 1291692 2110379 RESERVE FOR PROFESSIONAL LIABILITY 100000 PENSION LIABILITY 948374 MEDICARE ADVANCE PAYMENTS 3600373 SHORT TERM MEDICARE ACCELERATED PAYMENT 395633 5044380 16349863 412996 64429 477425 15872438 0 15872438 16396403 -206596 -206596 16602999 0 16602999 PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN FAIR VALUE OF INTEREST SWAP AGREEMENT 64,429. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN PENSION VALUE -206,596. 1 1 X 1 X 1 X 0 0 0 1796802 991648 805154 0.04850 1796802 991648 805154 0.04850 1796802 991648 805154 0.04850 1 3289113 4540377 -1251264 X 1 1 1 1 STRAITH HOSPITAL FOR SPECIAL SURGERY 23901 LAHSER ROAD SOUTHFIELD MI 48033 HTTPS://.STRAITHHOSPITAL.ORG 1060000035 X X STRAITH HOSPITAL FOR SPECIAL SURGERY 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTPS://STRAITHHOSPITAL.ORG X 1 18 1 HTTPS://STRAITHHOSPITAL.ORG 0 1 X 200.000000000000 300.000000000000 X 1 1 X X X 1 X HTTPS://STRAITHHOSPITAL.ORG/FOR-PATIENTS/ X HTTPS://STRAITHHOSPITAL.ORG/FOR-PATIENTS/ X HTTPS://STRAITHHOSPITAL.ORG/FOR-PATIENTS/ X X X X X X X 1 X 0 X X X X 0 X X 0 0 STRAITH HOSPITAL FOR SPECIAL SURGERY PART V, SECTION B, LINE 5: STRAITH HOSPITAL FORMULATED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE TO REVIEW THE REQUIREMENTS OF, STRATEGIZE ON AND ENSURE THE COMPLETION OF THE 2019 CHNA. THE COMMITTEE WAS LED BY STRAITH HOSPITAL'S MARKETING MANAGER, WITH SUPPORT FROM THE UPPER LEVELS OF ADMINISTRATION INCLUDING THE CEO, CFO AND CHIEF OF STAFF (SEE APPENDIX A). THE COMMITTEE WORKED TOGETHER TO GATHER APPROPRIATE INFORMATION, PROVIDE AVAILABLE SOURCES OF SECONDARY DATA, IDENTIFY AND INTERVIEW COMMUNITY LEADERS AND ANALYZE ALL PREVIOUSLY MENTIONED INFORMATION TO PREPARE THE WRITTEN 2019 CHNA AND IMPLEMENTATION STRATEGY. THE STRAITH HOSPITAL CHNA COMMITTEE'S GOAL WAS TO COLLECTIVELY GATHER INTERVIEWS FROM COMMUNITY LEADERS AND OUR CURRENT SERVING POPULATION, ACCUMULATE EXISTING PUBLIC DATA ABOUT THE HEALTH STATUS OF OUR COMMUNITY AND PRIORITIZE THE LOCAL HEALTH NEEDS IN WHICH WE WOULD HELP MEET. THE ASSESSMENT, INCLUDING KEY INTERVIEWS OF COMMUNITY LEADERS (SEE APPENDIX A) AND ANONYMOUS COMMUNITY SURVEYS THAT REFLECT STRAITH HOSPITAL'S TARGET AUDIENCE, WERE CONDUCTED AS PRIMARY QUALITATIVE RESEARCH. THIS WAS DONE BY ADMINISTERING A SHORT SURVEY, WHICH WAS GIVEN TO THE TARGET AUDIENCE IN ORDER TO GATHER APPROPRIATE INFORMATION TO ASSESS THE NEEDS OF THE COMMUNITY. THE SURVEY TO REPRESENT THE COMMUNITY WE SERVE WAS GIVEN TO PATIENTS AND FAMILY MEMBERS OF STRAITH HOSPITAL BETWEEN THE FULL MONTHS OF MAY, JUNE AND JULY 2019. SURVEYS WERE FILLED OUT AND RETURNED TO THE MARKETING MANAGER TO COLLECT ALL DATA AND ANALYZE THE FINDINGS. ADDITIONALLY, THE SURVEY FOR PERSONS REPRESENTING KEY LEADERS OF THE COMMUNITY WAS A SURVEY LINK THAT WAS EMAILED TO INDIVIDUALS WHO WOULD REPRESENT THIS POPULATION. A COLLECTION OF ACADEMIC RESEARCH AND PUBLIC HEALTH RESOURCES WERE GATHERED TO SUPPORT OUR FINDINGS AS SECONDARY QUALITATIVE AND QUANTITATIVE DATA. THE ASSESSMENT WAS CONDUCTED IN A TIMELINE TO MEET THE REQUIREMENTS OF THE PPACA, AS WELL AS REVISIT STRAITH HOSPITAL'S COMMITMENT TO IMPROVING THE HEALTH OF OUR LOCAL COMMUNITY AND PROVIDING THE QUALITY CARE TO MEET THOSE NEEDS. THE PURPOSE OF KEY INTERVIEWS AND DATA COLLECTION (SEE APPENDIX B) WAS TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE LOCAL COMMUNITY AND WHAT IMPROVEMENTS NEEDED TO BE MADE FOR THE APPROPRIATE POPULATION. THIS INCLUDED GATHERING A VARIETY OF INFORMATION SUCH AS COMMUNITY DEMOGRAPHICS, HOUSEHOLD INCOME AND COMMUNITY HEALTH STATISTICS. AFTER ANALYZING THE KEY FINDINGS AND MEASURING THE PRIMARY AND SECONDARY DATA AGAINST A SET OF CRITERIA, THE NEEDS OF STRAITH HOSPITAL'S KEY AUDIENCE WERE PRIORITIZED BY THE CHNA COMMITTEE. THE CHNA COMMITTEE REVIEWED ALL MENTIONED HEALTH NEEDS, THEN DISCUSSED THE RELATIONSHIP BETWEEN THE MOST PREVALENT NEEDS AND RESEARCH OVERVIEW. BY RUNNING THE SURVEY FINDINGS AGAINST RESEARCH, IT ALLOWED THE COMMITTEE TO BETTER CONCLUDE WHAT HEALTH NEEDS WERE MOST PREVALENT OR OVERLAPPED. BASED ON OUR FINDINGS, THE MOST PREVALENT HEALTH NEEDS MENTIONED IN OUR SELF-ADMINISTERED SURVEYS WERE A FAIR REPRESENTATION OF THE OVERALL NEEDS OF MICHIGAN RESIDENTS. FOLLOWING THE PRIORITIZATION OF THE HEALTH NEEDS, THE CHNA COMMITTEE WORKED TOGETHER TO ESTABLISH AN IMPLEMENTATION STRATEGY IN RESPONSE TO THE HEALTH NEEDS OF THE COMMUNITY STRAITH HOSPITAL SERVES. STRAITH HOSPITAL FOR SPECIAL SURGERY PART V, SECTION B, LINE 11: BASED ON KEY INFORMANT INTERVIEWS, FREE HEALTH SCREENINGS AND CONSULTATION WERE RECOMMENDED AS THE MOST EFFECTIVE WAY TO REDUCE THE RISK OF IDENTIFIED HEALTH ISSUES IN THE COMMUNITY. STRAITH HOSPITAL WILL PROVIDE ADDITIONAL RESOURCES TO EDUCATE THE COMMUNITY ABOUT COMMON CHRONIC DISEASES, SUCH AS OBESITY, HEART DISEASES AND DIABETES. OF THE RISKS IDENTIFIED, THE HOSPITAL ADDRESSED THE TOP 3 RISKS IDENTIFIED WHICH WERE OBESITY, HEART DISEASE AND DIABETES. THIS PLAN WAS CHOSEN BY THE HOSPITAL TO GET THE MOST IMMEDIATE IMPACT REGARDING THE QUALITY OF LIFE IN THE COMMUNITY. OTHER RISKS WILL BE ADDRESSED AS FINANCIAL RESOURCES BECOME AVAILABLE. STRAITH HOSPITAL FOR SPECIAL SURGERY PART V, SECTION B, LINE 16J: THE POLICY IS PRESENTED TO THE MEDICAL STAFF AND THEIR OFFICE PERSONNEL. SINCE MOST OF THE HOSPITAL'S PATIENTS ARE SURGICAL PATIENTS SCHEDULED BY THE MEDICAL STAFF, THE PATIENTS ARE MADE AWARE OF THE POLICY BEFORE THEY ARE EVEN BOARDED FOR SURGERY. PART I, LINE 7: THE COSTING METHOD USED TO CALCULATE THE AMOUNTS IN LINE 7 OF THE TABLE IS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. PART III, LINE 2: FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES IMPLICIT PRICE CONCESSIONS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE PROVISION. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. PART III, LINE 3: PATIENT, AS ADJUDICATED BY MEDICARE. THESE AMOUNTS HAVE A HIGHER COST TO CHARGE RATIO THAN THE OVERALL RATIO. BASED ON THE HOSPITAL'S HISTORICAL EXPERIENCE, APPROXIMATELY 6% OF IMPLICIT PRICE CONCESSIONS MAY BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. PART III, LINE 4: FROM NOTE 2 TO THE AUDITED FINANCIAL STATEMENTS, "EFFECTIVE NOVEMBER 1, 2019, THE HOSPITAL ADOPTED FASB ACCOUNTING STANDARDS UPDATE (ASU) NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), USING A MODIFIED RETROSPECTICE METHOD OF APPLICATION TO ALL CONTRACTS EXISTING ON NOVEMBER 1, 2019. THE CORE PRINCIPLE OF THE GUIDANCE IS THAT AN ENTITY SHOULD RECOGNIZE REVENUE TO DEPICT THE TRANSFER OF PROMISED GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ENTITY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. THE ADOPTION OF ASU NO. 2014-09 RESULTED IN CHANGES TO THE HOSPITAL'S PRESENTATION FOR DISCLOSURE OF REVENUE PRIMARILY RELATED TO UNINSURED OR UNDERINSURED PATIENTS. PRIOR TO THE ADOPTION OF ASU NO. 2014-09, A SIGNIFICANT PORTION OF THE HOSPITAL'S PROVISION FOR DOUBTFUL ACCOUNTS RELATED TO SELF-PAY PATIENTS, AS WELL AS COPAYS, COINSURANCE, AND AMOUNTS AND DEDUCTIBLES OWED BY PATIENTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO OPERATING REVENUE, WITH A CORRESPONDING MATERIAL REDUCTION IN THE AMOUNTS PRESENTED SEPERATELY AS PROVISION FOR DOUBTFUL ACCOUNTS. FOR THE YEAR ENDED OCTOBER 31, 2020, THE HOSPITAL RECORDED APPROXIMATELY $400,000 OF IMPLICIT PRICE CONCESSIONS AS A DIRECT REDUCTION OF PATIENT SERVICE REVENUE THAT WOULD HAVE BEEN RECORDED AS PROVISION FOR DOUBTFUL ACCOUNTS PRIOR TO THE ADOPTION OF ASU NO. 2014-09." PART III, LINE 8: THE CONTRACT HOSPITALS HAVE WITH THE FEDERAL AND STATE GOVERNMENTS TO PROVIDE SERVICES FOR REIMBURSEMENT WHICH IS OFTEN LESS THAN COST, IS RATHER UNIQUE, COMPARED TO OTHER GOVERNMENTAL CONTRACTORS. REIMBURSEMENT METHOLOLOGIES APPROPRIATELY INCENTIVIZE HOSPITALS TO REDUCE COSTS, BUT THEY MUST BALANCE THAT AGAINST UNRELENTLESS PRESSURE TO OBTAIN IMPROVED BUT MORE EXPENSIVE EQUIPMENT, SUPPLIES, AND PHARMACEUTICALS. PROVIDING MEDICAL SERVICES AT A LOSS, TO COMMUNITY MEMBERS CERTAINLY BENEFITS THE COMMUNITY, BUT THE LOSS MUST BE OFFSET BY OTHER PAYORS OR ACTIVITIES OF THE HOSPITAL. RECEIVING THE BENEFIT OF A TAX-EXEMPT ORGANIZATION HELPS PROVIDE AN OFFSET TO THAT SHORTFALL, AND ALLOWS THAT HOSPITAL TO PROVIDE SERVICES TO MORE OF THESE PATIENTS THAN THEY OTHERWISE COULD. THE REQUIRED COST REPORT METHODOLOGY WAS USED IN DETERMINING ALLOWABLE COSTS REPORTED IN THE COST REPORT. PART III, LINE 9B: PATIENTS ARE PROVIDED AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY PRIOR TO SURGERY OR UPON ADMISSION FOR NON-SURGICAL ENCOUNTERS. THEY ARE ALLOWED TO PAY THE AMOUNT AT THAT TIME OR RECEIVE A BILL AFTER DISCHARGE. IF NO PAYMENT IS RECEIVED, THE ACCOUNT IS REFERRED TO AN OUTSIDE SERVICE WHICH WILL SEND UP TO SEVEN MORE STATEMENTS. IF PAYMENT IS STILL NOT RECEIVED, ACCOUNTS WITH BALANCES OVER $1,500 ARE FORWARDED TO A COLLECTION AGENCY, OTHERS ARE WRITTEN OFF. IF PAYMENT IS STILL NOT RECEIVED, THE ACCOUNT IS WRITTEN OFF. PART VI, LINE 2: HTTPS://STRAITHHOSPITAL.ORG/WP-CONTENT/UPLOADS/2019/10/STRAITH-HOSPITAL-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-STRATEGY.PDF PART VI, LINE 3: THE HOSPITAL'S ASSISTANCE PROGRAMS ARE COMMUNICATED TO THE MEMBERS OF THE ORGANIZED MEDICAL STAFF WHO SUBMIT THE APPLICATION FOR ELIGIBILITY TO THE HOSPITAL. PATIENTS PRESENTING WITHOUT AN APPLICATION ARE INFORMED OF THE ASSISTANCE PROGRAM PRIOR TO THE CONCLUSION OF THE ADMISSION PROCESS. PART VI, LINE 4: THE HOSPITAL PROVIDES CARE TO PATIENT'S REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL ALSO ACCEPTS PATIENTS COVERED BY GOVERNMENTAL PROGRAMS. THESE PROGRAMS OFTEN REIMBURSE LESS THAN THE COST OF THE CARE PROVIDED. PART VI, LINE 5: HTTPS://STRAITHHOSPITAL.ORG/WP-CONTENT/UPLOADS/2019/10/STRAITH-HOSPITAL-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-STRATEGY.PDF X X X 0 0 0 0 0 0 0 1 0 MICHAEL DRELLES PHYSICIAN 615000 0 81449 0 0 0 8700 0 0 0 705149 0 0 0 RONALD BRANT PHYSICIAN 295361 0 17308 0 0 0 8700 0 0 0 321369 0 0 0 RAJEEV SEHGAL PHYSICIAN 155000 0 146152 0 0 0 0 0 0 0 301152 0 0 0 JANET RYS CEO 248183 0 0 0 0 0 0 0 7390 0 255573 0 0 0 BRADLEY BESCOE CFO 193022 0 0 0 0 0 5861 0 0 0 198883 0 0 0 PART I, LINE 7 STRAITH SPECIALTY HOSPITAL HAS AN INCENTIVE PROGRAM FOR LEADERS AND PHYSICIANS. THE PURPOSE OF THE PLAN IS TO ENHANCE THE ORGANIZATION'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING TOP OFFICIALS AND THE BOARD OF DIRECTORS WITH A TOOL FOR (A) CLEARLY COMMUNICATING PERFORMANCE ON THE PART OF KEY LEADERS & PHYSICIANS, (B) STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE WHICH WILL ULTIMATELY BENEFIT THE COMMUNITY STRAITH SERVES, AND (C) PROTECTING STRAITH'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH-TALENT LEADERS & PHYSICIANS. FORM 990, PART III, LINE 2 STRAITH HOSPITAL LAUNCHED AN ORTHOPEDIC PROGRAM IN MAY OF 2020. THIS INVOLVED SURGICAL OUTPATIENT PROCEDURES, SURGICAL INPATIENT PROCEDURES AND CLINIC VISITS. FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES WILLIAM M STRAITH, THOMAS W STRAITH, JAMES C STRAITH, AND EDWARD S JEFFRIES ALL SHARE A FAMILY RELATIONSHIP. TRUSTEE RAY HUSBAND HAS A FAMILY RELATIONSHIP WITH JAMES C STRAITH. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD IS PROVIDED WITH A FULL COPY OF THE 990 PRIOR TO FILING. THE CEO AND CFO REVIEW THE RETURN BEFORE SIGNING. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. RECORDS OF EACH PROCEEDING ARE KEPT. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, READ AND UNDERSTANDS THE POLICY, AGREED TO COMPLY WITH THE POLICY AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 AT THE JANUARY 29, 2020 BOARD MEETING COMPENSATION FOR THE CEO AND CFO WAS APPROVED BY THE BOARD. THE BOARD OF DIRECTORS USES PAST COMPENSATION HISTORY AND HOSPITAL EXECUTIVE COMPENSATION STUDIES TO SUPPORT CURRENT COMPENSATION FOR OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGES IN FAIR VALUE OF INTEREST SWAP AGREEMENT 64,429. OTHER COMPREHENSIVE INCOME 740,618. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONISIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR.