2025-09-15T13:09:46-05:00 2024-10-31 331498605 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2023-11-01 381455020 STRAITH HOSPITAL FOR SPECIAL SURGERY STRA 2483573360 23901 LAHSER ROAD SOUTHFIELD MI 480336035 BRAD BESCOE CEO 2483573360 2025-09-15 1 0 DAVID LOWENTHAL P00378651 2483522500 2025-09-11 2023 2025-03-06 01:10:19Z BRAD BESCOE 23901 LAHSER ROAD SOUTHFIELD MI 480336035 22854166 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. 10 9 185 9 0 0 621442 3315885 14747963 14888173 303782 251407 0 0 15673187 18455465 0 0 0 0 8873498 6324864 0 0 0 9964920 8553093 18838418 14877957 -3165231 3577508 14404304 18885087 9565601 9850361 4838703 9034726 TO IMPROVE THE HEALTH STATUS OF OUR PATIENTS AND PROVIDE HIGH LEVELS OF SATISFACTION TO OUR PHYSICIANS. 0 0 10560226 14888173 THE ORGANIZATION OPERATES A SHORT-TERM, ACUTE-CARE FACILITY OFFERING BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. TOTAL PATIENTS FOR THE YEAR WERE 486 HOSPITALIZED INPATIENTS (3,398 DAYS OF CARE) AND 2,788 SURGICAL OUTPATIENTS ALONG WITH 5,101 CLINIC VISITS. 10560226 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 14 0 1 185 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 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 200 0 0 ENRIQUE SABBAGH MD TRUSTEE 1.00 X 1100 0 0 WILLIAM M STRAITH TRUSTEE 1.00 X 0 0 0 EDWARD S JEFFRIES MD TREASURER 1.00 X X 1200 0 0 SUNNY SQUINDO TRUSTEE 1.00 X 1150 0 0 JAMES C STRAITH CHAIRMAN 1.00 X X 1200 0 0 THOMAS W STRAITH PE VICE CHAIRMAN 1.00 X X 1200 0 0 JUSTIN HORNBURG FSA TRUSTEE 1.00 X 1200 0 0 ALEXANDER LEBEDINSKI TRUSTEE 1.00 X 1200 0 0 BRIAN HUSBAND TRUSTEE 1.00 X 600 0 0 BRADLEY BESCOE PRESIDENT & CEO 40.00 X 250000 0 11240 LAMIA ALFATLAWI COO 40.00 X 200000 0 6538 MICHAEL DRELLES PHYSICIAN 40.00 X 823629 0 0 MICHAEL PEER PHYSICIAN ASSISTANT 40.00 X 114217 0 5346 MICHAEL FLEISCHMAN PHYSICIAN 40.00 X 719645 0 0 MINA SEDAROUS PHARMACIST 40.00 X 162397 0 0 STEPHANIE HALEY QUALITY AND UTILIZATION COORDINATOR 40.00 X 121407 0 575 2400345 0 23699 7 0 1 0 AMBULATORY ANESTHESIA ASSOCIATION PO BOX 1904 MONROE MI 48161 ANESTHESIA 1170210 1 3315885 3315885 MEDICARE/MEDICAID PAY 621110 10236960 10236960 OTHER PATIENT SERVICE REVENUE 621110 4649990 4649990 MEANINGFUL USE PAYMENTS 621110 1223 1223 14888173 155062 155062 4495046 4398701 96345 96345 96345 18455465 14888173 0 251407 476828 476828 5101133 3811009 1290124 214163 63960 150203 63646 39532 24114 469094 291369 177725 66472 66472 121800 121800 3124 3124 14084 14084 78990 51277 27713 101152 101152 57377 37247 20130 373041 373041 408857 265413 143444 48235 48235 319695 319695 948535 641140 307395 235522 235522 SUPPLIES 3387075 3387075 CONTRACTED LABOR 1505870 977549 528321 EQUIP REPAIRS & MAINT 712655 462627 250028 170609 110752 59857 14877957 10560226 4317731 0 149949 1272871 246538 98339 1875849 4844307 723967 696112 107948 120762 21653397 15327010 6997699 6326387 4144379 1887285 157975 3639024 14404304 18885087 1797648 3252531 6872331 6325817 895622 272013 9565601 9850361 X 4838703 9034726 4838703 9034726 14404304 18885087 X 3577508 169900 448615 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 0 1 3124 3124 0 PART II-B, LINE 1: DUES WERE PAID TO A NATIONAL AND STATE HOSPITAL ASSOCATION IN FY 2024. PART OF THE DUES PAID WERE USED BY THESE ASSOCIATIONS FOR PURPOSES OF LOBBYING. 1175669 1175669 15453163 11958808 3494355 4920968 3269065 1651903 103597 99137 4460 6326387 COST REPORT SETTLEMENT RECEIVABLE 50000 CONSTRUCTION IN PROGRESS 3589024 3639024 RESERVE FOR PROFESSIONAL LIABILITY 100000 PENSION LIABILITY 172013 272013 15824871 169900 -2800494 -2630594 18455465 0 18455465 14813997 -63960 -63960 14877957 0 14877957 PART XI, LINE 2D - OTHER ADJUSTMENTS: CAPITAL ASSET PURCHASES -2,800,494. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN PENSION VALUE -63,960. 1 1 X 1 X 1 X 0 0 0 791806 406599 385207 0.02590 791806 406599 385207 0.02590 791806 406599 385207 0.02590 1 5201404 5423662 -222258 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 22 1 0 0 1 X HTTPS://STRAITHHOSPITAL.ORG X 1 22 1 HTTPS://STRAITHHOSPITAL.ORG/FOR-PATIENTS/ 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 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, STRATEGIZE, AND ENSURE THE COMPLETION OF THE 2022 CHNA. THE COMMITTEE WAS LED BY STRAITH HOSPITAL'S DIRECTOR OF MARKETING, WITH SUPPORT FROM THE UPPER LEVELS OF ADMINISTRATION INCLUDING THE CEO, COO, AND CHIEF OF STAFF. 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 2022 CHNA AND IMPLEMENTATION STRATEGY. RECOGNIZING THE SHARED COMMUNITIES SERVED ACROSS SOUTHEAST MICHIGAN, STRAITH HOSPITAL UTILIZED AVAILABLE DATA FROM ASCENSION SOUTHEAST MICHIGAN TO CONDUCT THE 2022 CHNA. ASCENSION SOUTHEAST MICHIGAN COMMUNITY HEALTH DEPARTMENT, ASCENSION MICHIGAN COMMUNITY BENEFIT CENTER OF EXPERTISE, ASCENSION SOUTHEAST MICHIGAN HOSPITALS, AND SOUTHEASTERN MICHIGAN HEALTH ASSOCIATION (SEMHA) ANALYZED SECONDARY DATA OF OVER 50 INDICATORS AND GATHERED COMMUNITY INPUT THROUGH COMMUNITY SURVEYS AND KEY STAKEHOLDERS FOCUS GROUPS TO IDENTIFY THE COMMUNITY HEALTH NEEDS. IN COLLABORATION WITH COMMUNITY PARTNERS, ASCENSION SOUTHEAST MICHIGAN HOSPITALS USED A PHASED PRIORITIZATION APPROACH TO DETERMINE THE MOST CRUCIAL NEEDS FOR COMMUNITY STAKEHOLDERS TO ADDRESS. THE SIGNIFICANT NEEDS ARE AS FOLLOWS: -CHRONIC DISEASE, INCLUDING DIABETES AND CANCER -DIET AND EXERCISE, INCLUDING OBESITY -MENTAL AND BEHAVIORAL HEALTH -ACCESS TO CARETO BETTER FOCUS ON THE COMMUNITY THAT STRAITH HOSPITAL SERVES A SURVEY WAS OFFERED TO PATIENTS FROM MAY TO JULY OF 2022. THE SURVEY WAS DEVELOPED WITH KEY INTERVIEWEES (SEE APPENDIX A) TO GATHER FEEDBACK ON MORE SPECIFIC ISSUES THAT STRAITH HOSPITAL SERVES. PATIENTS COMPLETED THE SURVEY ANONYMOUSLY, AND THE SURVEY EXCLUDED QUESTIONS REGARDING INCOME, INSURANCE, GENDER, AND RACE AS A METHOD TO INCLUDE OUR MEDICALLY UNDERSERVED AND MINORITY POPULATION. STRAITH HOSPITAL FOR SPECIAL SURGERY PART V, SECTION B, LINE 11: AFTER ANALYZING THE KEY FINDINGS AND MEASURING THE PRIMARY AND SECONDARY DATA AGAINST A SET OF CRITERIA, THE NEEDS OF THE COMMUNITY 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. THE STRAITH HOSPITAL CHNA COMMITTEE UNDERSTANDS THE IMPORTANCE OF ALL THE HEALTH NEEDS OF THE COMMUNITY AND IS COMMITTED TO PLAYING AN ACTIVE ROLE IN IMPROVING THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES. CONSIDERATION WAS GIVEN TO SELECT FACTORS IN DETERMINING THE SIGNIFICANT NEEDS THAT WOULD BE SELECTED AS PRIORITIZED NEEDS. THE CHNA COMMITTEE CONSIDERED THE FACTORS BELOW: -IS THE NEED ONE THAT CAN BE MEASURED/TRACKED OVER TIME? -DOES THE NEED ALIGN WITH CURRENT PATIENT POPULATION SERVED BY THE HOSPITAL? -DOES THE NEED ALIGN WITH THE OVERALL AVAILABLE RESOURCES AT THE HOSPITAL? -DOES THE NEED ALIGN WITH A FOCUS AREA FOR COMMUNITY IMPACT?STRAITH HOSPITAL DEFINED PRIORITIZED NEEDS AS THE SIGNIFICANT NEEDS WHICH HAVE BEEN PRIORITIZED BY THE HOSPITAL TO ADDRESS THROUGH THE THREE-YEAR CHNA CYCLE. BASED ON THE RESEARCH ANALYSIS PERFORMED, THE CHNA COMMITTEE DETERMINED TO PRIORITIZE MENTAL AND BEHAVIORAL HEALTH AND MORE SPECIFICALLY SUBSTANCE ABUSE OF OPIOIDS. 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 IS AN UNAFFILIATED, ACUTE CARE, NOT-FOR-PROFIT HOSPITAL THAT IS NOT PART OF A LARGER HEALTH SYSTEM. STRAITH HOSPITAL IS A SPECIALTY HOSPITAL WITHOUT AN EMERGENCY DEPARTMENT, 34 MEDICAL AND SURGICAL ACUTE CARE LICENSED BEDS, AND FIVE OPERATING ROOMS. STRAITH HOSPITAL DOES NOT HAVE THE RESOURCES OR ABILITY TO IMPLEMENT STRATEGIES FOR ALL OF THE COMPLEX HEALTH NEEDS IDENTIFIED DURING THE CHNA PROCESS. STRAITH HOSPITAL HAS ELECTED TO IMPLEMENT A STRATEGY FOR ONE COMPONENT OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED AS PART OF THE CHNA PROCESS. OTHER ORGANIZATIONS IN SOUTHEASTERN MICHIGAN ARE BETTER EQUIPPED TO COMPLETELY HANDLE ALL OF THE COMPLEX COMMUNITY NEEDS IDENTIFIED AS PART OF THE CHNA PROCESS. 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 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 METHODOLOGIES 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/FOR-PATIENTS/ 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/FOR-PATIENTS/ X X X 0 0 0 0 0 0 0 1 0 MICHAEL DRELLES PHYSICIAN 823629 0 0 0 0 0 0 0 0 0 823629 0 0 0 MICHAEL FLEISCHMAN PHYSICIAN 719645 0 0 0 0 0 0 0 0 0 719645 0 0 0 BRADLEY BESCOE PRESIDENT & CEO 250000 0 0 0 0 0 11240 0 0 0 261240 0 0 0 LAMIA ALFATLAWI COO 200000 0 0 0 0 0 6538 0 0 0 206538 0 0 0 MINA SEDAROUS PHARMACIST 162397 0 0 0 0 0 0 0 0 0 162397 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 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 BOTH THE CEO AND COO HAVE EMPLOYMENT AGREEMENTS WITH THE HOSPITAL EFFECTIVE AUGUST 1, 2022. THE AGREEMENTS WERE NEGOTIATED BY AN ATTORNEY REPRESENTING THE HOSPITAL AND THE BOARD OF TRUSTEES, AND THE CEO AND COO INDIVIDUALLY. PAST COMPENSATION HISTORY AND HOSPITAL EXECUTIVE COMPENSATION STUDIES WERE USED TO SUPPORT THE CURRENT COMPENSATION WITHIN THE AGREEMENTS FOR THE 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: CHANGE IN PENSION LIABILITY 448,615. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR.