2024-10-07T08:30:23-05:00 2023-12-31 450310328 BRADY MARTZ & ASSOCIATES PC PO BOX 14296 GRAND FORKS ND 582084296 990 2023-01-01 450358986 WISHEK HOSPITAL CLINIC ASSOCIATION WISH 7014522326 PO BOX 647 WISHEK ND 584950647 LUKAS FISCHER CEO 7014522326 2024-09-30 1 1 NICOLE HELDSTAB P01220683 7017754685 2024-09-30 2023 2024-10-15 13:58:12Z SOUTH CENTRAL HEALTH LUKAS FISCHER 1007 4TH AVE S WISHEK ND 58495 10031692 0 X HTTPS://SCHEALTHND.COM/ X 1949 ND THE MISSION OF WISHEK HOSPITAL CLINIC ASSOCIATION IS TO PROVIDE THE HIGHEST POSSIBLE STANDARD OF HEALTH CARE IN A COMPASSIONATE AND PROFESSIONAL MANNER FOR THE PEOPLE IN OUR REGION. 9 8 92 9 0 0 438330 390081 8433796 9557290 8759 3879 132012 77564 9012897 10028814 0 0 0 0 5029884 5904552 0 0 795 4298901 4297400 9328785 10201952 -315888 -173138 6908239 7022344 1923275 2197939 4984964 4824405 WISHEK HOSPITAL CLINIC ASSOCIATION IS A PROGRESSIVE AND INNOVATIVE HEALTHCARE LEADER PROVIDING PERSONALIZED SERVICES PROMOTING THE CREATION OF HEALTHIER COMMUNITIES. 0 0 6019021 7833233 ACUTE HEALTHCARE/OUTPATIENT SERVICES/EMERGENCY DEPARTMENT/SKILLED SWINGBED. 2046138 1724057 HEALTHCARE SERVICES PROVIDED TO FOUR COMMUNITIES WITHIN OUR SERVICE AREA OF RURAL ND. FOUR RURAL HEALTH CLINICS. 8065159 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 17 0 1 92 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ORGANIZATION 7014522326 1007 4TH AVE S WISHEK ND 58495 X SHEILA BROSY DIRECTOR 1.00 X 0 0 0 NATHAN WOLF VICE PRESIDENT 1.00 X X 0 0 0 LILA RAILE PRESIDENT 1.00 X X 0 0 0 MARLA BERNTSON DIRECTOR 1.00 X 0 0 0 LISA WEIGEL DIRECTOR 1.00 X 0 0 0 REBECCA SCHNABEL SECRETARY 1.00 X X 0 0 0 TANYA SCHNABEL DIRECTOR 1.00 X 0 0 0 LEE AIPPERSPACH DIRECTOR 1.00 X 0 0 0 DONALD HOCHHALTER DIRECTOR 1.00 X 0 0 0 ERIC FROEHLING DIRECTOR (LEFT DURING THE YEAR) 1.00 X 0 0 0 MEGAN RATH CFO 40.00 X 119817 0 24066 LUKAS FISCHER CEO 20.00 X 73112 0 0 BEV VILHAUER CEO-CONTRACTED (LEFT DURING THE YEAR) 40.00 X 0 0 0 PAULETTE BENSON NURSE PRACTITIONER 40.00 X 188185 0 19264 TRINA SCHILLING NURSE PRACTITIONER 40.00 X 151069 0 30788 DAN BEACH NURSE PRACTITIONER 40.00 X 141001 0 32690 SHAWNA BRADLEY NURSE PRACTITIONER 40.00 X 150947 0 14537 CARLY SANDERS DIRECTOR OF NURSING 40.00 X 124832 0 31678 948963 0 153023 10 0 1 0 WISHEK DRUG 9 CENTENNIAL ST S WISHEK ND 58495 PHARMACY SERV & PRESCRIPTIONS 170023 NORTHERN PLAINS LABORATORY 401 N 9TH ST 2 BISMARCK ND 58501 REFERENCE LABOARATORY 107905 ST ALEXIUS MEDICAL CENTER 900 E BROADWAY AVE BISMARCK ND 58501 MGM'T & PHYS. SERV./HEALT EQUIP. 101843 3 30 377442 12609 390081 HOSPITAL PATIENT REVENUE 624100 6977687 6977687 CLINIC PATIENT REVENUE 621400 1724057 1724057 340B INCOME 623990 855546 855546 9557290 3879 3879 6770 0 6770 6770 6770 9649 2878 6771 6771 ACTIVITIES/MISC 624200 64023 64023 64023 10028814 9557290 0 81443 187750 187750 4253743 3666241 587502 130440 109865 20575 1041305 876327 164978 291314 241776 49538 704 704 20710 20710 14941 5720 9221 19944 516 19428 208306 65369 142937 464609 464609 353331 344130 9201 36749 31912 4837 26930 26930 445141 439640 5501 80798 80798 CONTRACT SERVICES 1336253 971361 364892 DRUGS 468548 468548 340 B PROGRAM 418500 418500 SUPPLIES 321889 320728 366 795 80047 77596 2451 10201952 8065159 2135998 795 760717 788232 2271796 1854172 1318045 1673875 65626 69789 84747 111948 8333593 6134926 2336036 2198667 71272 325661 6908239 7022344 684857 1204873 499584 53510 738834 680237 0 259319 1923275 2197939 X 4860939 4702404 124025 122001 4984964 4824405 6908239 7022344 -173138 12579 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12708 12708 2809873 2262783 547090 5422305 3809955 1612350 88707 62188 26519 2198667 OPERATING LEASE LIABILITY 240848 FINANCE LEASE LIABILITY 18471 259319 X 10031692 2878 2878 10028814 0 10028814 10204830 2878 2878 10201952 0 10201952 PART X, LINE 2: INCOME TAXES THE ASSOCIATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, THE ASSOCIATION IS NOT SUBJECT TO INCOME TAX. THE ASSOCIATION'S POLICY IS TO EVALUATE THE LIKELIHOOD THAT ITS UNCERTAIN TAX POSITIONS WILL PREVAIL UPON EXAMINATION BASED ON THE EXTENT TO WHICH THOSE POSITIONS HAVE SUBSTANTIAL SUPPORT WITHIN THE INTERNAL REVENUE CODE AND REGULATIONS, REVENUE RULINGS, COURT DECISIONS, AND OTHER EVIDENCE. ACCOUNTING FOR UNCERTAINTIES IN INCOME TAXES IT IS THE OPINION OF MANAGEMENT THAT THE ASSOCIATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION. THE FEDERAL INCOME TAX RETURNS OF THE ASSOCIATION ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED; ALL FILINGS ARE CURRENT. 1 1 1 X 1 X 1 1 0 1 1 15999 15999 0.00160 227043 146445 80598 0.00790 243042 146445 96597 0.00950 243042 146445 96597 0.00950 1 4171744 4210703 -38959 X 1 1 1 1 WISHEK COMMUNITY HOSPITAL 1007 4TH AVE S WISHEK ND 58495 HTTPS://SCHEALTHND.COM/ DBA SOUTH CENTRAL HEALTH X X X WISHEK COMMUNITY HOSPITAL 0 0 1 X X X X X X X X X 23 1 0 1 1 X WWW.SCHEALTHND.COM 1 23 1 WWW.SCHEALTHND.COM 0 1 X 100.000000000000 200.000000000000 X 1 1 X X X X 1 X WWW.SCHEALTHND.COM X WWW.SCHEALTHND.COM X X X X X X 1 X 0 X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A WISHEK COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: THROUGH A JOINT EFFORT, PROFESSIONALS FROM WISHEK HOSPITAL AND CLINICS, WITH THE ASSISTANCE OF THE CENTER FOR RURAL HEALTH AT THE UNIVERSITY OF ND SCHOOL OF MEDICINE AND HEALTH SCIENCES CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2023. A COMMUNITY GROUP ALONG WITH AFOREMENTIONED PROFESSIONALS SERVED AS A FOCUS GROUP THAT IDENTIFIED THE GENERAL HEALTH NEEDS OF THE COMMUNITIES OF THE THREE COUNTIES THEY SERVE. A SURVEY WAS DISTRIBUTED TO RESIDENTS IN LAMOURE, LOGAN, AND MCINTOSH COUNTY AND THE RESULTS OF THIS SURVEY WERE SHARED WITH THE FOCUS GROUP AND PRIORITY HEALTH NEEDS WERE DETERMINED. WISHEK COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: THE OTHER FACILITIES INCLUDED IN WISHEK'S 2023 CHNA WERE CENTRAL VALLEY HEALTH DISTRICT AND MCINTOSH DISTRICT HEALTH UNIT. WISHEK COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: IN ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED BY OUR 2023 CHNA, WISHEK HOSPITAL CLINIC ASSOCIATION WILL CONTINUE TO PARTNER WITH RURAL PSYCHIATRY ASSOCIATES TO PROVIDE TELEHEALTH PSYCHIATRY SERVICES. ALSO, WHCA WILL WORK WITH AVEL TO TRY TO GET TELEHEALTH SERVICES IN THE LOCAL SCHOOLS. 4 2 - WISHEK CLINIC 1015 4TH AVE S WISHEK ND 58495 RURAL HEALTH CLINIC 3 - NAPOLEON CLINIC 420 MAIN STREET NAPOLEON ND 58561 RURAL HEALTH CLINIC 4 - KULM CLINIC 4TH 1ST AVE SE KULM ND 58456 RURAL HEALTH CLINIC 5 - GACKLE CLINIC 321 MAIN STREET GACKLE ND 58442 RURAL HEALTH CLINIC PART I, LINE 3C: WISHEK HOSPITAL CLINIC ASSOCIATION (WHCA) USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING FREE OR DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. WHCA USES 200% AS THE FAMILY INCOME LIMIT. PART I, LINE 7: A COST TO CHARGE RATIO WAS USED FOR THE FIGURES REPORTED IN THE TABLE USING WORKSHEET 2. PART III, LINE 2: NO BAD DEBT EXPENSE WAS REPORTED IN OPERATING EXPENSE AS NOTED IN THE NET PATIENT SERVICE REVENUE NOTE IN THE FINANICAL STATEMENTS. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE. PART III, LINE 3: IT IS POLICY TO MAKE FINANICAL ASSISTANCE AVAILABLE TO PATIENTS WHO FIT THE FINANICAL ASSISTANCE CRITERIA. IT IS THE ORGANIZATION'S GOAL TO MAKE CERTAIN THAT THEY ARE PROACTIVE IN THE DETERMINATION OF FINANCIAL ASSISTANCE. ALL EFFORTS ARE MADE TO ENSURE THAT FINANCIAL ASSISTANCE ELIGIGLE PATIENTS DO NOT PROGRESS TO BAD DEBTS AND THEREFORE NO DOLLAR AMOUNT FOR BAD DEBT IS INCLUDED. PART III, LINE 4: THE AUDITED FINANICAL STATEMENTS DO NOT INCLUDE A BAD DEBT FOOTNOTE. THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GAAP. PART III, LINE 8: THE AMOUNTS WERE DETERMINED BASED UPON THE COST TO CHARGE RATIO FROM THE COST REPORT THAT WAS FILED FOR THE YEAR. PART III, LINE 9B: ALL PATIENTS ARE NOTIFIED ON THEIR MONTHLY STATEMENT THAT THE ORGANIZATION OFFERS AN UNCOMPENSATED CARE PROGRAM FOR ANYONE UNABLE TO MEET THEIR PRIVATE PAY POLICY AND THAT THEY ARE TO CONTACT THE ACCOUNTS RECEIVABLE DEPARTMENT. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING WITH THE ORGANIZATION IN GOOD FAITH TO RESOLVE THEIR BILLS, THE ORGANIZATION WILL OFFER EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS, REDUCE THE BILL BY THE APPROPRIATE AMOUNTS, WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS. PART VI, LINE 2: THE MEDICAL STAFF TEAM MEETS MONTHLY TO DISCUSS CURRENT OR MOST RECENT CASES THAT THEY HAVE ENCOUNTERED. UNIQUE CASES, AS WELL AS THE ROUTINE CASES ARE DISCUSSED. EVERY OTHER MONTH, SUPPORT STAFF, WHICH INCLUDE THE DIRECTORS OF NURSING, HEALTH INFORMATION MANAGEMENT, LABORATORY/RADIOLOGY, PHARMACY, DISCHARGE PLANNING AND ADMINISTRATION, ARE INVITED TO THESE MEETINGS FOR SIMILAR DISCUSSIONS, IN ADDITION TO UNIFYING THE APPROACH IN VARIOUS MATTERS SUCH AS STANDARDS OF CARE, QUALITY ASSURANCE STUDY REVIEW, MEDICARE/MEDICAID OR 3RD PARTY GUIDELINES ON STANDARDS OF CARE AND/OR REIMBURSEMENT. THE ORGANIZATION HAS ALSO ESTABLISHED A "CALL-BACK" SYSTEM. ALL PATIENTS DISCHARGED FROM THE HOSPITAL ARE FOLLOWED UP WITH A CALL AND/QUESTIONNAIRES ASKING ABOUT HOW THEY ARE DOING, IF THERE ARE ANY QUESTIONS, ADDITIONAL AREAS OF NEED OR SERVICES THAT WE MAY NEED TO GET IN PLACE FOR THEM. WE HAVE A SYSTEM IN OUR ORGANIZATION THAT ALSO ALLOWS FOR OUR STAFF TO REVIEW THE PATIENT'S CHART PRIOR TO A CLINIC VISIT TO IDENTIFY ANY NEEDS SUCH AS MAMMOGRAMS, BONE DENSITY, PSA, CHOLESTEROL, PAP, COLONOSCOPE OR ANY OTHER IDENTIFIED FOLLOW-UP SCREENING OR TEST. A SHEET IS PLACED ON THE FRONT OF THE CHART TO ASSIST THE MEDICAL STAFF IN CUEING INTO THESE NEEDS. ONCE THE VISIT IS COMPLETE THE CHART IS THEN RE-ROUTED BACK INTO THE CALL-BACK OFFICE FOR PLACING INTO THE SYSTEM THE NEXT DATE OF SCREENING SERVICES OR TO SCHEDULE FOLLOW-UP OR REFERRAL APPOINTMENTS FOR THAT PATIENT NEEDS. MESSAGES ARE ALSO SENT TO PATIENTS IN RELATION TO THE ROUTINE FOLLOW-UPS FOR MEDICATION REFILLS OR MONITORING OF CHRONIC MEDICAL CONDITIONS SUCH AS DIABETES, HEART DISEASE, KIDNEY OR LIVER DISEASE PROCESS, OSTEOPOROSIS OR ANY OTHER IDENTIFIED DISEASE PROCESS/ABNORMALITY.THE MANAGEMENT TEAM AND THE BOARD OF DIRECTORS ALSO MEETS MONTHLY TO BRING TO THE TABLE THE CURRENT OPERATIONS AND DISCUSSION OF CURRENT HAPPENINGS AND FEEDBACK. DUE TO THE FACT WE REPRESENT DIFFERENT AREAS THAT COME TOGETHER AS A TEAM TO ENSURE ACCESS TO HEALTHCARE AT A LOW COST HIGH QUALITY MANNER IS IN PLACE - THIS OPPORTUNITY ALLOWS VARIABLE DISCUSSION TO COMMUNITY NEEDS AND HOW WE CAN ADDRESS THEM IN AN INTERDISCIPLINARY TEAM APPROACH.UTILIZATION IS MONITORED IN RELATION TO THE CURRENT PROGRAMS IN PLACE. SUCH PROGRAMS INCLUDE THE CARDIAC REHAB PROGRAM, WOMEN'S WAY PROGRAM, CHARITY CARE OR UNCOMPENSATED CARE PROGRAM, HOME HEALTH AND EXTENDED CARE PROGRAMS.TO EXPAND A BIT ON HOW FAR OUR COMMUNITY REACHES AND ITS REPRESENTATION - WE HAVE ESTABLISHED FOUR RURAL HEALTH CLINICS IN SURROUNDING COMMUNITIES WHICH REACH AS FAR OUT AS 45 MILES FOR THE CLINIC LOCATION, HOWEVER COMMUNITY CITIZEN EXPANSION REACHES BEYOND THE 45 MILE RADIUS. REPRESENTATION ON THE MEDICAL STAFF AND BOARD OF DIRECTORS REACHES INTO THESE AREAS, AS WE HAVE BOTH DESIGNATED PROFESSIONALS FROM THOSE AREAS ON OUR TEAMS FOR ENSURING ACCESS TO HEALTHCARE AND ADDRESSING THOSE NEEDS OF THE POPULATION IN THE AREA. PART VI, LINE 3: AS PATIENTS ENTER INTO THE HOSPITAL THE BUSINESS OFFICE DIRECTOR AND SOCIAL WORKER PAY CLOSE ATTENTION TO THE PATIENT'S FINANCIAL CLASS (TYPE OF PAYOR). IF PATIENTS ARE PRIVATE PAY, WE GO EDUCATE AND SPEAK TO THAT PATIENT ABOUT PROGRAMS THEY WOULD BE ELIGIBLE FOR. IF PATIENTS HAVE LOW ASSETS/LOW INCOME, THEY COULD BE ELIGIBLE FOR MEDICAID THROUGH THE COUNTY SOCIAL SERVICES OR THEY ARE ELIGIBLE FOR THE HOSPITAL'S UNCOMPENSATED CARE. THE UNCOMPENSATED CARE (CHARITY CARE) FOLLOWS THE FEDERAL GUIDELINES REGARDING INCOME ASSET LEVELS. IF PATIENTS NEED ASSISTANCE WITH THE APPLICATION, WE WOULD ASSIST THEM. THE CHARITY CARE GUIDELINES ARE PRINTED ON THE BACK OF EVERY PATIENT'S MONTHLY STATEMENT. THE BUSINESS OFFICE DIRECTOR AND SOCIAL WORKER AT OUR FACILITY ARE THE RESPONSIBLE PARTIES FOR INFORMING PATIENTS WITH EDUCATION ABOUT PROGRAMS THEY MAY BE ELIGIBLE FOR WHETHER IT IS THE HOSPITAL'S CHARITY CARE OR OTHER STATE/FEDERAL FUNDED PROGRAMS. PART VI, LINE 4: WISHEK HOSPITAL CLINIC ASSOCIATION (WHCA) IS A 24-BED NON-PROFIT CRITICAL ACCESS HOSPITAL (CAH) LOCATED IN SOUTH CENTRAL NORTH DAKOTA. OUR ORGANIZATION PROVIDES SUCH SERVICES AS 24-HOUR EMERGENCY CARE, CLINIC, AMBULANCE, OUTPATIENT HOSPITAL AND ANCILLARY SERVICES, INPATIENT AND SWINGBED, AND OUTPATIENT SURGERY. WHCA HAS FOUR RURAL HEALTH CLINICS LOCATED IN WISHEK, KULM, NAPOLEON, AND GACKLE AND OF THE FOUR; THREE ARE LOCATED MORE THAN 30 MILES AWAY. OUR AMBULANCE PROVIDES CPR TRAINING TO THOSE INTERESTED AND IS ON STANDBY CALL AT LOCAL FOOTBALL GAMES AS A COURTESY TO THE COMMUNITY. WHCA SERVES THE COUNTIES OF MCINTOSH, LOGAN, AND WESTERN LAMOURE, WHICH INCLUDES A GEOGRAPHIC AREA OF OVER 2,000 SQUARE MILES AND APPROXIMATELY 8,400 RESIDENTS ACCORDING TO THE U.S. CENSUS BUREAU, CENSUS 2020 REPORT. STATISTICS IN RELATION TO THIS POPULATION INCLUDE A MAJORITY OF THE POPULATION OF AGE 65 OR OLDER WITH MCINTOSH AT 29.7%, LOGAN 27%, AND LAMOURE 27.4%. THE CASE MIX FOR THE HOSPITAL AND CLINICS IS 69% MEDICARE, 20% BCBS, 2% MEDICAID AND 9% OTHER. THE MEDIAN AGE OF RESIDENTS OF MCINTOSH COUNTY IS 54 YEARS OF AGE. WITH THIS STATISTIC, THE MAIN AREA WHICH WHCA SERVES INDICATES MCINTOSH COUNTY IS THE SECOND OLDEST COUNTY OF THE 53 COUNTIES IN NORTH DAKOTA. THE STATE MEDIAN AGE IS 35.2 YEARS AND THE NATIONAL MEDIAN AGE IS 38.2. FIGURES ARE ACCORDING TO THE 2020 CENSUS. THE PERCENT OF NORTH DAKOTA RESIDENTS LIVING IN POVERTY WAS ESTIMATED IN 2020 TO BE 10.5%. MCINTOSH COUNTY WAS ESTIMATED TO BE 10.2%, LOGAN COUNTY 7.1%, AND LAMOURE COUNTY 13.5%.THE COMMUNITY OF WISHEK POSSESSES A 60-BED NURSING HOME (WISHEK LIVING CENTER), WHICH IS INDEPENDENT OF THE HOSPITAL. THE COMMUNITY OF NAPOLEON, WHICH IS LOCATED IN LOGAN COUNTY, HAS A 44-BED NURSING HOME (NAPOLEON CARE CENTER) AND WE PROVIDE THE MAJORITY OF HEALTH CARE IN THESE TWO SKILLED FACILITIES. WE ALSO PROVIDE HEALTH CARE SERVICES TO THE RESIDENTS OF THE GACKLE CARE CENTER'S BASIC CARE RESIDENTS IN GACKLE, ND.WHCA IS LOCATED IN A DESIGNATED MEDICALLY UNDERSERVED AREA AND IN A HEALTH PROFESSIONAL SHORTAGE AREA IN NORTH DAKOTA. PART VI, LINE 5: THE WHCA GOVERNING BOARD IS COMPOSED OF MEMBERS FROM THE COMMUNITIES IT SERVES AND ARE NOT EMPLOYEES, CONTRACTORS, NOR FAMILY MEMBERS. THE SURPLUS OF FUNDS IS USED TO UPDATE THE AGING FACILITY AS WELL AS UPDATED TECHNOLOGICALLY MEDICAL EQUIPMENT AND COMPUTER SYSTEMS TO MEET THE ELECTRONIC MEDICAL RECORDS REQUIREMENTS TO SERVICE OUR PATIENT POPULATION. HAVING UPDATED MEDICAL EQUIPMENT NOT ONLY KEEPS THE SERVICES IN TO OUR RURAL AREA, BUT ALSO ALLOWS US TO PROVIDE FOR OUR PATIENTS. X X 0 0 0 0 0 0 0 0 0 PAULETTE BENSON NURSE PRACTITIONER 188185 0 0 0 0 0 7714 0 11550 0 207449 0 0 0 TRINA SCHILLING NURSE PRACTITIONER 151069 0 0 0 0 0 6707 0 24081 0 181857 0 0 0 DAN BEACH NURSE PRACTITIONER 141001 0 0 0 0 0 6309 0 26381 0 173691 0 0 0 SHAWNA BRADLEY NURSE PRACTITIONER 150947 0 0 0 0 0 2990 0 11547 0 165484 0 0 0 CARLY SANDERS DIRECTOR OF NURSING 124832 0 0 0 0 0 5555 0 26123 0 156510 0 0 0 SCHEDULE J, PART II: LUKAS FISCHER, CEO, WAS AN EMPLOYEE OF LINTON HOSPITAL AND PROVIDED CEO SERVICES TO BOTH LINTON AND WISHEK HOSPITAL CLINIC ASSOCIATION. HOWEVER,AS AN EMPLOYEE OF LINTON, LUKAS RECEIVED HIS W2 FROM LINTON. WISHEK REIMBURSED LINTON FOR PART OF LUKAS' SALARY BASED ON A CONTRACT. THE COMPENSATION REPORTED IN PART VII OF THE CORE FORM AND SCHEDULE J, PART II REFLECTED TOTAL BASE COMPENSATION, BENEFITS AND PAYROLL TAXES ASSOCIATED WITH THIS COMPENSATION ON WHICH WISHEK REIMBURSED LINTON FOR HIS SERVICES SOLELY TO WISHEK, WHICH WAS REPORTED ON HIS 2023 FORM W2 FROM LINTON. CARLA AIPPERSPACH WIFE OF BOARD MEMBER (LEE AIPPERSPACH) 170023 PAYMENTS TO DRUG STORE FOR PHARMACY SERVICES AND MEDICATIONS. 0 FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT SERVICES ARE PROVIDED BY A MANAGEMENT SERVICES AGREEMENT WITH ST. ALEXIUS MEDICAL CENTER. ST. ALEXIUS PROVIDES CEO SERVICES TO THE ASSOCIATION (DISCONTINUED CEO SERVICES IN 2023). THESE SERVICES INCLUDE HIRING EMPLOYEES, FIRING EMPLOYEES, SUPERVISING PERSONNEL AND SUPERVISING EXEMPT OPERATIONS. ALL DECISIONS OF THE CONTRACTED CEO ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IS OPEN TO ANY INDIVIDUAL IN THE SERVICE AREA WHO CONTRIBUTES $10.00 TO THE ASSOCIATION AND REQUESTS MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A ALL ELIGIBLE MEMBERS MAY VOTE AT THE ANNUAL MEETING FOR THE ELECTION OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B AT THE ANNUAL MEETING THE MEMBERS MAY DISCUSS THE BUSINESS OF THE ASSOCIATION AND MAKE AND APPROVE MOTIONS CONCERNING THAT BUSINESS OR THE ACTIONS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO EACH BOARD MEMBER OF THE GOVERNING BODY PRIOR TO BEING FILED FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE BOARD MEMBERS MUST DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST TO THE BOARD AND MANAGEMENT AND MUST NOT PARTICIPATE IN ANY VOTE THAT INVOLVES A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE ND HOSPITAL ASSOCIATION PERFORMS AN ANNUAL SURVEY, AND THE RESULTS OF THIS SURVEY ARE USED IN THIS PROCESS. IN 2023, WISHEK HOSPITAL CLINIC ASSOCIATION AND LINTON REGIONAL MEDICAL CENTER SIGNED AN AGREEMENT TO SHARE THE SERVICES OF THE CEO EMPLOYED BY LINTON REGIONAL MEDICAL CENTER. IN DETERMINING CEO COMPENSATION IN THE AGREEMENT, HIS CURRENT COMPENSATION AND THE ADDED RESPONSIBILITIES AND DUTIES WERE TAKEN INTO ACCOUNT ALONG WITH THE PERCENTAGE OF HIS COMPENSATION EACH FACILITY WOULD HAVE TO PAY. IN DETERMINING COMPENSATION FOR OTHER EMPLOYEES, THE ND HOSPITAL ASSOCIATION'S ANNUAL SURVEY IS REVIEWED AND COMPARED AND USED AS A REFERENCE WITH THE PERFORMANCE EVALUATIONS. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE PRESENTED TO THE MEMBERS AT THE ANNUAL MEETING AND ARE AVAILABLE UPON REQUEST BY A MEMBER OF THE PUBLIC FOR REVIEW. FORM 990, PART VII: CEO COMPENSATION ARRANGEMENT: LUKAS FISCHER, CEO, WAS AN EMPLOYEE OF LINTON HOSPITAL AND PROVIDED CEO SERVICES TO BOTH LINTON AND WISHEK HOSPITAL CLINIC ASSOCIATION. HOWEVER,AS AN EMPLOYEE OF LINTON, LUKAS RECEIVED HIS W2 FROM LINTON. WISHEK REIMBURSED LINTON FOR PART OF LUKAS' SALARY BASED ON A CONTRACT. THE COMPENSATION REPORTED IN PART VII OF THE CORE FORM AND SCHEDULE J, PART II REFLECTED TOTAL BASE COMPENSATION, BENEFITS AND PAYROLL TAXES ASSOCIATED WITH THIS COMPENSATION ON WHICH WISHEK REIMBURSED LINTON FOR HIS SERVICES SOLELY TO WISHEK, WHICH WAS REPORTED ON HIS 2023 FORM W2 FROM LINTON. FORM 990, PART XI, LINE 2C: THE FULL BOARD OF DIRECTORS APPROVE THE SELECTION OF THE AUDITORS AND MEET WITH THE AUDITORS TO REVIEW AND APPROVE THE AUDITED FINANCIAL STATEMENTS.