2026-08-14T15:07:23-05:00 2025-09-30 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 55802 990 2024-10-01 410808719 ELY-BLOOMENSON COMMUNITY HOSPITAL ELY- 2183653271 328 WEST CONAN STREET ELY MN 55731 TIMOTHY BALTHAZOR CFO 2183653271 2026-08-13 1 1 JULIE BOYER P01278549 2187275025 2026-08-13 2024 2025-03-06 01:10:19Z PATTI BANKS 328 WEST CONAN STREET ELY MN 55731 32436770 0 X WWW.EBCH.ORG X 1956 MN ELY-BLOOMENSON COMMUNITY HOSPITAL IS COMMITTED TO CARING FOR AND ENHANCING THE HEALTH AND WELL-BEING OF THE COMMUNITY IT SERVES. 9 9 159 15 3951998 0 565000 195745 32569536 31502669 392472 553940 77466 117763 33604474 32370117 110579 0 0 0 13828592 13978548 0 0 0 19225515 19006294 33164686 32984842 439788 -614725 29624244 27570197 10984652 9361047 18639592 18209150 X ELY-BLOOMENSON COMMUNITY HOSPITAL IS COMMITTED TO CARING FOR AND ENHANCING THE HEALTH AND WELL-BEING OF THE COMMUNITY IT SERVES. 0 0 27752091 31544907 HOSPITAL SERVICES PROVIDED FOR THE ELY COMMUNITY AND SURROUNDING AREA. ELY-BLOOMENSON COMMUNITY HOSPITAL (EBCH), RECOGNIZED BY THE FEDERAL & STATE OF MINNESOTA GOVERNMENTS AS A CRITICAL ACCESS HOSPITAL, IS THE ONLY LOCAL HEALTHCARE CENTER SERVING ELY AND SURROUNDING COMMUNITIES BORDERING THE VAST ACREAGE OF BOUNDARY WATERS CANOE AREA WILDERNESS. UNDER ORIGINAL FEDERAL RULES EBCH WOULD HAVE BEEN ONLY ONE OUT OF SEVEN HOSPITALS IN MINNESOTA THAT WOULD HAVE QUALIFIED FOR CRITICAL ACCESS HOSPITAL STATUS. THE HOSPITAL BOASTS: IN AND OUTPATIENT HOSPITAL NURSING SERVICE, IN-HOUSE LABORATORY, AN ON-SITE RETAIL PHARMACY, PHYSICAL AND OCCUPATIONAL THERAPY, CHEMOTHERAPY, A FULLY-STAFFED 24-7 RADIOLOGY DEPARTMENT, A PROFESSIONAL ANESTHESIA TEAM, SWING BED CARE FOR PATIENTS WHO NO LONGER REQUIRE ACUTE CARE HOSPITALIZATION, AND A 24-7 EMERGENCY ROOM. DURING THE FY2025 EBCH PERFORMED 571 SURGICAL PROCEDURES, 19,159 LABORATORY TESTS, 8,864 RADIOLOGICAL EXAMS, AND 3,746 EMERGENCY ROOM VISITS. IN ADDITION, 277 PEOPLE WERE ADMITTED FOR INPATIENT CARE. 467 DAYS OF CARE WERE PROVIDED FOR INPATIENTS AND 476 DAYS OF CARE WERE PROVIDED TO SWING BED PATIENTS, 2,146 OUTPATIENTS WERE SEEN, 22,223 MODALITIES WERE PERFORMED IN OT AND PT, AND 1,773 MODALITIES WERE PERFORMED IN CARDIAC REHAB. 27752091 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 47 0 1 159 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 MN X PATTI BANKS 2183653271 328 WEST CONAN STREET ELY MN 55731 MARY ANN SMITH DIRECTOR 1.00 0.50 X 0 0 0 CRYSTAL CHOPP DIRECTOR 1.00 0.50 X 0 0 0 RIANA HEGMAN DIRECTOR 1.00 0.50 X 0 0 0 TIMOTHY RILEY DIRECTOR 1.00 0.50 X 0 0 0 JOHN SAW DIRECTOR 1.00 0.50 X 0 0 0 DEVON LUTHENS PRESIDENT 1.00 0.50 X X 0 0 0 ROBERT WILMUNEN VICE PRESIDENT 1.00 0.50 X X 0 0 0 BARBARA SODERBERG SECRETARY 1.00 0.50 X X 0 0 0 STEPHEN PETERSON SR TREASURER 1.00 0.50 X X 0 0 0 TODD HEIMAN TREASURER (THRU 12/31/2024) 0.25 2.50 X X 0 0 0 PATTI BANKS CEO 39.50 0.50 X 267454 0 58519 BROCK URIE MD CMO 40.00 0.00 X 536192 0 18950 JOHN SCHINDELE EPIC DIRECTOR 40.00 0.00 X 165090 0 49277 SAM RICE PHYSICIAN (THRU 11/4/2024) 40.00 0.00 X 161879 0 42606 KARLA GRIZZARD RN 40.00 0.00 X 153203 0 44443 BETH HARTSHORN PHARMACIST 40.00 0.00 X 169670 0 9090 ABIGAIL SIREK PHARMACIST 40.00 0.00 X 152499 0 21482 1605987 0 244367 26 0 1 0 CENTRAL MINNESOTA DIAGNOSTIC INC PO BOX 158 MILACA MN 56353 DIAGNOSTIC EQUIP SERVICE 991743 LAKE COUNTRY ANESTHESIA LLC 2760 BEAR ISLAND RIVER RD ELY MN 55731 ANESTHESIA SERVICES 887836 ACUTE CARE INC 1609 N ANKENY BLVD STE 200 ANKENY IA 50023 EMERGENCY ROOM PHYSICIAN COVERAGE 631888 ESSENTIA HEALTH HOSPITALISTS 502 EAST 2ND ST DULUTH MN 55805 HOSPITALIST SERVICES 440050 LUTZ 13616 CALIFORNIA ST OMOHA NE 68154 ACCOUNTING AND FINANCE SERVICES 359556 9 195745 195745 PATIENT SERVICE 621400 27147507 27147507 RETAIL PHARMACY 456110 3951998 3951998 EQUITY IN EARNINGS OF AFFILIATES 900099 403164 403164 31502669 526848 526848 25245 2011 23234 23234 23234 91734 64642 27092 27092 27092 DAYCARE INCOME 900099 52291 52291 OTHER OPERATING 621400 42238 42238 94529 32370117 27592909 3951998 629465 X 1225298 725296 500002 9707775 8535933 1171842 340786 297891 42895 1944038 1947971 -3933 760651 647406 113245 48173 48173 468268 468268 2224 2224 39000 39000 4859865 4167434 692431 191370 73016 118354 447195 292831 154364 1070160 570608 499552 251732 242516 9216 91952 33993 57959 194581 194581 934982 862841 72141 156848 156848 DRUGS 5551396 5551396 LEASE EXPENSE 1332558 1332558 MEDICAL SUPPLIES 933404 926247 7157 IMPLICIT PRICE CONCESSI 706281 706281 1726305 837873 888432 32984842 27752091 5232751 0 1968818 1677621 5933997 3678683 3912851 62500 0 1000945 897908 362145 383963 28132000 22907010 5864092 5224990 11246064 5390323 5440997 4148544 29624244 27570197 1979898 2046198 68221 0 5486575 4960962 3449958 2353887 10984652 9361047 X 18639592 18209150 18639592 18209150 29624244 27570197 -614725 184283 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2224 2224 0 PART II-B, LINE 1: THE HOSPITAL PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 77500 200 200 77500 77500 56 56 77500 77500 9 9 77500 77500 2 2 77500 77500 462 462 77500 0.00000 1.00000 0.00000 0 1 1 76827 76827 16955242 14448399 2506843 9483916 7037531 2446385 1616015 1421080 194935 5224990 DIRECT FINANCING LEASE 838952 INVESTMENT IN AFFILIATES 1190805 OPERATING RIGHT-OF-USE LEASE ASSETS 1416786 FINANCE RIGHT-OF-USE LEASE ASSETS 602001 RELATED-PARTY RECEIVABLE 100000 4148544 OPERATING RIGHT-OF-USE LEASE LIABILITIES 1416786 THIRD-PARTY PAYOR SETTLEMENTS 281000 FINANCE RIGHT-OF-USE LEASE LIABILITIES 656101 2353887 X 31850130 184283 -704270 -519987 32370117 0 32370117 32280572 0 32280572 704270 704270 32984842 PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY ELY HEALTH AND HOSPITAL FOUNDATION. THE INCOME FROM THE ENDOWMENT FUNDS WILL BE USED FOR GRANTS AND CONTRIBUTIONS. PART X, LINE 2: THE HOSPITAL IS A NONPROFIT HOSPITAL AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. MANAGEMENT EVALUATED THE HOSPITAL'S TAX POSITIONS AND CONCLUDED THE HOSPITAL HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THE GUIDANCE. GENERALLY, THE HOSPITAL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: IMPLICIT PRICE CONCESSIONS -706,281. RENTAL EXPENSES 2,011. PART XII, LINE 4B - OTHER ADJUSTMENTS: IMPLICIT PRICE CONCESSIONS 706,281. RENTAL EXPENSES -2,011. 1 1 X 1 X 200.000000000000 1 X 275.000000000000 1 1 1 0 0 282782 282782 0.00880 2643781 1565242 1078539 0.03340 2926563 1565242 1361321 0.04220 157702 157702 0.00490 156184 156184 0.00480 131126 131126 0.00410 445012 445012 0.01380 3371575 1565242 1806333 0.05600 15255 15255 0.00050 15255 15255 0.00050 1 706281 0 10485572 10327460 158112 X 1 1 1 1 ELY-BLOOMENSON COMMUNITY HOSPITAL 328 WEST CONAN STREET ELY MN 55731 414711 X X X X N/A ELY-BLOOMENSON COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE PART V, PAGE 8 X 1 24 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 275.000000000000 X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ELY-BLOOMENSON COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: ELY-BLOOMENSON COMMUNITY HOSPITAL (EBCH) CONTRACTED WITH RURAL HEALTH INNOVATIONS (RHI), A SUBSIDIARY OF THE NATIONAL RURAL HEALTH RESOURCE CENTER, TO CONDUCT ITS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT INCLUDED MULTIPLE METHODS TO OBTAIN COMMUNITY INPUT.FOR THE FIRST TIME, AN ELECTRONIC COMMUNITY SURVEY WAS MADE AVAILABLE TO ALL RESIDENTS WITHIN THE HOSPITAL'S SERVICE AREA FROM MARCH 13 THROUGH APRIL 8, 2025. THE SURVEY WAS PROMOTED THROUGH THE LOCAL NEWSPAPER, EBCH WEBSITE, SOCIAL MEDIA, AND FLIERS POSTED THROUGHOUT SEVERAL COMMUNITY LOCATIONS, INCLUDING GROCERY STORES, LIBRARIES, FAITH-BASED ORGANIZATIONS, AND COMMUNITY CENTERS. A TOTAL OF 279 VALID SURVEY RESPONSES WERE INCLUDED IN THE FINAL ANALYSIS.IN ADDITION, FOUR IN-PERSON FOCUS GROUPS WERE CONDUCTED ON MARCH 25-26, 2025, WITH PARTICIPATION FROM SENIORS, PARENTS, HEALTHCARE CONSUMERS, HEALTHCARE PROVIDERS, BUSINESS REPRESENTATIVES, SCHOOL REPRESENTATIVES, AND OTHER COMMUNITY MEMBERS. EIGHT KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN MARCH 17 AND 31, 2025, WITH TARGETED INVITATIONS TO COMMUNITY LEADERS REPRESENTING HEALTHCARE, SERVICE AGENCIES, SCHOOLS, AND COMMUNITY ORGANIZATIONS.THE ASSESSMENT ALSO INCLUDED ANALYSIS OF SECONDARY DATA OBTAINED FROM PUBLICLY AVAILABLE SOURCES, INCLUDING THE U.S. CENSUS BUREAU, COUNTY HEALTH RANKINGS, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. INFORMATION FROM THE SURVEY, FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND SECONDARY DATA ANALYSIS WAS USED TO IDENTIFY AND PRIORITIZE SIGNIFICANT COMMUNITY HEALTH NEEDS. ELY-BLOOMENSON COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: ELY-BLOOMENSON COMMUNITY HOSPITAL (EBCH) IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTHCARE NEEDS IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), WHICH WAS PUBLISHED IN MAY 2025:1. ACCESS TO MENTAL HEALTH SERVICES2. ACCESS TO DENTAL SERVICES3. ACCESS TO SPECIALISTS4. AVAILABILITY OF SERVICES/PROVIDERS5. TRANSPORTATION AND PATIENT TRANSFER SERVICES6. ACCESS TO CHILDCARE7. COMMUNITY AWARENESS, EDUCATION, AND CARE COORDINATIONFOLLOWING REVIEW OF THE CHNA FINDINGS, FOCUS GROUP RESULTS, KEY INFORMANT INTERVIEWS, SECONDARY DATA, AND A PRIORITY-SETTING PROCESS CONDUCTED IN MAY 2025, EBCH AND ITS LEADERSHIP IDENTIFIED THE FOLLOWING THREE PRIORITY AREAS AND HOW THEY WILL BE ADDRESSED:1. CONTINUE TO DEVELOP AND COMMUNICATE EBCH'S ROLE IN LOCAL HEALTHCARE THROUGH BRANDING, AWARENESS, EDUCATION, AND CONNECTING COMMUNITY MEMBERS TO AVAILABLE SERVICES.1.1. EBCH CONTINUES TO EXPAND COMMUNITY OUTREACH AND EDUCATION EFFORTS THROUGH PRINT, RADIO, DIGITAL MEDIA, SOCIAL MEDIA, COMMUNITY PRESENTATIONS, AND PARTNERSHIPS WITH LOCAL ORGANIZATIONS. CHNA FINDINGS IDENTIFIED A NEED FOR INCREASED AWARENESS OF AVAILABLE HEALTHCARE SERVICES AND IMPROVED CARE COORDINATION. EBCH WORKS COLLABORATIVELY WITH COMMUNITY PARTNERS TO EDUCATE RESIDENTS ABOUT AVAILABLE SERVICES, IMPROVE NAVIGATION OF THE HEALTHCARE SYSTEM, AND CONNECT INDIVIDUALS WITH RESOURCES THAT SUPPORT THEIR HEALTH AND WELL-BEING.2. COLLABORATE TO INCREASE ACCESS TO CHILDCARE.2.1. THE CHNA IDENTIFIED CHILDCARE AVAILABILITY AS A SIGNIFICANT CONCERN, PARTICULARLY FOR YOUNG FAMILIES AND WORKFORCE RECRUITMENT AND RETENTION. EBCH OPENED A DAYCARE FOR EMPLOYEES' CHILDREN AND CONTINUES TO EXPLORE WAYS TO ENSURE IT IS SUSTAINABLE IN THE LONG TERM. EBCH ALSO CONTINUES ITS COLLABORATION WITH COMMUNITY ORGANIZATIONS, INCLUDING THE ELY AREA COMMUNITY FOUNDATION AND OTHER LOCAL PARTNERS, TO EXPLORE AND SUPPORT SOLUTIONS TO INCREASE ACCESS TO AFFORDABLE CHILDCARE SERVICES IN THE REGION.3. CREATE A SUSTAINABLE SOLUTION THAT MEETS PATIENT TRANSFER NEEDS, INCLUDING EMS AND NON-EMERGENCY TRANSPORTATION SERVICES.3.1. THE CHNA IDENTIFIED TRANSPORTATION BARRIERS, EMERGENCY MEDICAL TRANSPORTATION CONCERNS, AND PATIENT TRANSFER CHALLENGES AS SIGNIFICANT ISSUES AFFECTING ACCESS TO CARE. EBCH CONTINUES TO EVALUATE AND PURSUE SUSTAINABLE SOLUTIONS THAT IMPROVE EMERGENCY AND NON-EMERGENCY TRANSPORTATION, PATIENT TRANSFERS, AND ACCESS TO HEALTHCARE SERVICES IN COLLABORATION WITH EMS PROVIDERS, TRANSPORTATION ORGANIZATIONS, AND COMMUNITY PARTNERS.IN ADDITION TO OUR THREE MAIN PRIORITIES, EBCH IS ADDRESSING ALL IDENTIFIED PRIORITY NEEDS TO SOME EXTENT.MENTAL HEALTH SERVICESMENTAL HEALTH SERVICES WERE IDENTIFIED AS THE HIGHEST-RANKED COMMUNITY HEALTH CONCERN IN THE CHNA. EBCH, ALONG WITH OUR FULL-TIME SOCIAL WORKER, CONTINUES TO COLLABORATE WITH LOCAL AND REGIONAL ORGANIZATIONS TO INCREASE AWARENESS OF MENTAL HEALTH RESOURCES, REDUCE STIGMA, IMPROVE CARE COORDINATION, AND EVALUATE OPPORTUNITIES TO EXPAND ACCESS TO MENTAL HEALTH SERVICES. SUMMER INTERNS AT EBCH HAVE HOSTED A MENTAL HEALTH EVENT EACH SUMMER FOR LOCAL YOUTH. DENTAL SERVICESACCESS TO DENTAL CARE REMAINS A SIGNIFICANT COMMUNITY NEED. EBCH CONTINUES TO PARTNER WITH LOCAL ORGANIZATIONS AND COMMUNITY RESOURCES THAT SUPPORT DENTAL SERVICES AND ORAL HEALTH NEEDS WHILE EXPLORING OPPORTUNITIES TO IMPROVE ACCESS WITHIN AVAILABLE RESOURCES.ACCESS TO SPECIALISTS AND AVAILABILITY OF SERVICES/PROVIDERSTHE COMMUNITY IDENTIFIED ADDITIONAL SPECIALTY SERVICES AND PROVIDER AVAILABILITY AS IMPORTANT HEALTHCARE NEEDS. EBCH CONTINUES TO EVALUATE OPPORTUNITIES TO RECRUIT PROVIDERS, EXPAND SPECIALTY SERVICE OFFERINGS, MAINTAIN EXISTING SPECIALTY CLINICS, AND COLLABORATE WITH REGIONAL HEALTHCARE PARTNERS TO IMPROVE LOCAL ACCESS TO CARE. PART V, LINE 7A, CHNA - HOSPITAL'S WEBSITE: HTTPS://WWW.EBCH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 10, IMPLEMENTATION PLAN WEBSITE: HTTPS://WWW.EBCH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.EBCH.ORG/WP-CONTENT/UPLOADS/2026/04/EBCH-FINANCIAL-ASSISTANCE-POLICY-2026.PDF PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.EBCH.ORG/WP-CONTENT/UPLOADS/2026/04/EBCH-CHARITY-CARE-APPLICATION-2026.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY: HTTPS://WWW.EBCH.ORG/WP-CONTENT/UPLOADS/2026/04/EBCH-FAP-PLAIN-LANGUAGE-SUMMARY-2026.PDF PART I, LINE 7: COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED 9/30/2024 MEDICARE COST REPORT. PART I, LN 7 COL(F): IMPLICIT PRICE CONCESSIONS FROM THE FINANCIAL STATEMENTS IS $706,281. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY SUPPORT: COMMUNITY BUILDING ACTIVITIES PROMOTED HEALTH IN THE COMMUNITY BY ALLOWING THE COMMUNITY TO USE CONFERENCE ROOM SPACE FREE OF CHARGE TO DISCUSS AND PREPARE FOR HEALTH ISSUES OR EMERGENCIES. MOST OF THESE MEETINGS ARE TIED TO EMERGENCY PREPAREDNESS AND EMERGENCY MANAGEMENT. THERE WAS ALSO IP SPECIFIC EDUCATION, UNDER ONE ROOF CONFERENCE, MASS CASUALTY DRILL & DECONTAMINATION EQUIPMENT REVIEW. PART III, LINE 2: THE HOSPITAL DETERMINES THIS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH CERTAIN CLASSES OF PATIENTS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACT AS COLLECTIVE GROUPS RATHER THAN INDIVIDUALLY. PART III, LINE 4: FROM FOOTNOTE 1 OF THE AUDITED FINANCIAL STATEMENTS: WHEN THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THE HOSPITAL HAS THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS ARE RECEIVABLES IF THE HOSPITALS RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE RATHER THAN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE HOSPITAL DETERMINES THIS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH CERTAIN CLASSES OF PATIENTS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS AS COLLECTIVE GROUPS RATHER THAN INDIVIDUALLY. THE FINANCIAL STATEMENT EFFECTS OF USING THIS PRACTICAL EXPEDIENT ARE NOT MATERIALLY DIFFERENT FROM AN INDIVIDUAL CONTRACT APPROACH.THE PRIMARY COLLECTIONS RISKS RELATE TO UNINSURED PATIENT ACCOUNTS, INCLUDING PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE CARRIER HAS PAID THE AMOUNTS COVERED BY THE APPLICABLE AGREEMENT, BUT THE PATIENT RESPONSIBILITY AMOUNT (DEDUCTIBLES AND COPAYMENTS) REMAIN OUTSTANDING. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO AMOUNTS DUE DIRECTLY FROM PATIENTS. ESTIMATED IMPLICIT PRICE CONCESSIONS ARE RECORDED FOR ALL UNINSURED ACCOUNTS, REGARDLESS OF THE AGING OF THOSE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED.FROM FOOTNOTE 3 OF THE AUDITED FINANCIAL STATEMENTS: GENERALLY, PATIENTS WHO ARE COVERD BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJSUTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMNETS TO PATIENT SERVICES REVENUE IN THE PRIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD-DEBT EXPENSE. PART III, LINE 8: THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6. PART III, LINE 9B: AT LEAST 30 DAYS PRIOR TO TAKING ANY EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL TO OBTAIN PAYMENT FOR AN EPISODE OF CARE, EBCH OR ITS AGENT SHALL PROVIDE THE INDIVIDUAL WITH A WRITTEN NOTICE THAT INCLUDES THE FOLLOWING INFORMATION:I. CHARITY CARE - FINANCIAL ASSISTANCE PROGRAM (FAP) IS AVAILABLE FOR ELIGIBLE INDIVIDUALS.II. THE EXTRAORDINARY COLLECTION ACTIONS THAT EBCH INTENDS TO INITIATE FOR PAYMENT OF CARE.III. A DEADLINE AFTER WHICH EXTRAORDINARY COLLECTION ACTIONS MAY BE INITIATED.BEFORE SENDING AN ACCOUNT TO A COLLECTION AGENCY, EBCH MAY USE INFORMATION PROVIDED BY AN OUTSIDE AGENCY OR VENDOR TO DETERMINE ELIGIBILITY AND POTENTIAL FINANCIAL ASSISTANCE. THESE AGENCIES MAY USE PUBLICLY AVAILABLE AND PURCHASED TRANSACTION DATA TO ESTIMATE A GUARANTOR'S FINANCIAL PROFILE AND HOUSEHOLD SIZE. EXAMPLES OF SUCH DATA ARE CENSUS DATA, BIRTH CERTIFICATES, MARRIAGE LICENSES, LEGAL NOTICES, BANKRUPTCY FILINGS, AUTOMOBILE REGISTRATIONS, PROPERTY TAX RECORDS, AS WELL AS POINT-OF-SALES TRANSACTIONS DATA THAT RETAILERS AND CREDIT CARD COMPANIES MAKE AVAILABLE FOR PURCHASE TO PRESUMPTIVELY DETERMINE WHETHER THAT INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER EBCH'S FINANCIAL ASSISTANCE POLICY.IF THE INDIVIDUAL IS PRESUMPTIVELY DETERMINED TO BE ELIGIBLE FOR A 100% DISCOUNT (COMPLETE WRITE-OFF) UNDER EBCH'S FINANCIAL ASSISTANCE POLICY, EBCH SHALL INFORM THE INDIVIDUAL OF THAT DECISION AND NO FURTHER ACTIONS WILL BE TAKEN IN RELATION TO MEDICAL SERVICES TO WHICH THIS FINANCIAL ASSISTANCE APPLIES. PART VI, LINE 2: NEEDS ASSESSMENT:DURING THE PROCESS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WE HELD FOUR FOCUS GROUPS OVER MARCH 25-26, 2025. THESE SESSIONS WERE HELD IN BABBITT AND TOWER AND TWO SESSIONS IN ELY. WE HAD 127 PARTICIPANTS SHARE INFORMATION DURING A TWO-HOUR Q & A SESSION ABOUT LOCAL HEALTHCARE. THE CHNA ALSO CONSISTED OF AN ELECTRONIC SURVEY THAT WAS SHARED THROUGH THE WEBSITE, SOCIAL MEDIA AND A QR CODE PRESENTED AT LOCAL COMMUNITY EVENTS. THE SURVEY INCLUDED 23 STANDARD QUESTIONS AND 8 CUSTOMIZED QUESTIONS. WE RECEIVED NEARLY 300 RESPONSES DURING THE MARCH 13-APRIL 8, 2025 COLLECTION PERIOD. THE FINAL PIECES OF THE CHNA INCLUDE A SECONDARY DATA PULL FOR REGIONAL, STATE AND NATIONAL COMPARATIVES AND KEY INFORMANT INTERVIEWS HELD WITH 8 LOCAL LEADERS. EBCH PARTICIPATED IN COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) SERVICES ADMINISTRATED BY RURAL HEALTH INNOVATIONS (RHI), A SUBSIDIARY OF THE NATIONAL RURAL HEALTH RESOURCE CENTER. RHI CONFERRED WITH LEADERS FROM EBCH TO DISCUSS THE OBJECTIVES OF A REGIONAL CHNA. THE HOSPITAL ALSO RECEIVES QUESTIONS AND SUGGESTIONS FROM THE COMMUNITY THROUGH THE "CONTACT US" PAGE OF THEIR WEBSITE, THE EBCH FACEBOOK PAGE, AND AT VARIOUS SPEAKING ENGAGEMENTS FOR THEIR LOCAL SERVICE CLUBS AND ORGANIZATIONS, SUCH AS THE ROTARY, LIONS, AND KIWANIS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ELY BLOOMENSON HOSPITAL STAFF ENCOURAGES ANY PATIENT WITH NO INSURANCE TO TALK TO ST. LOUIS COUNTY SOCIAL SERVICES TO FIND OUT ABOUT MEDICAL ASSISTANCE OR MN CARE ELIGIBILITY. ON ALL PATIENT STATEMENTS, THERE ARE DIRECTIONS ON HOW TO ACCESS THE CREDIT AND COLLECTION POLICY AS WELL AS THE FINANCIAL ASSISTANCE POLICY. THE FINANCIAL ASSISTANCE POLICY INFORMS PATIENTS THAT WE HAVE AN INCOME BASED CHARITY CARE POLICY AND THEY CAN CONTACT THE EBCH FINANCIAL COUNCILOR OR BUSINESS OFFICE FOR AN APPLICATION. APPLICATIONS AND POLICIES ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT EBCH.ORG. WHEN AN ACCOUNT IS PAST DUE A SERIES OF COLLECTION LETTERS GO OUT WITH THE MESSAGE THAT THE ELY BLOOMENSON HOSPITAL HAS AN INCOME BASED CHARITY CARE POLICY AND IF ANYONE WOULD LIKE AN APPLICATION OR IF ANYONE HAS A QUESTION ABOUT IT THEY SHOULD CONTACT THE EBCH FINANCIAL COUNCILOR OR THE BUSINESS OFFICE. ALL PATIENTS SHOULD BE AWARE OF THE CHARITY CARE OPTION BEFORE THE ACCOUNT TURNS INTO BAD DEBT STATUS. PART VI, LINE 4: COMMUNITY INFORMATION: ELY, A CITY OF 2.7 SQUARE MILES, AND THE SURROUNDING COMMUNITIES OF WINTON, BABBITT, TOWER AND ISABELLA CONSTITUTES A LARGE RURAL DEMOGRAPHIC REGION IN NORTHEASTERN MINNESOTA BORDERING THE 1.5 MILLION ACRES OF THE BOUNDARY WATERS CANOE AREA WILDERNESS (BWCAW). THE CITY OF DULUTH, 120 MILES SOUTHWEST AND VIRGINIA, 50 MILES WEST, SERVE AS THE NEAREST HEALTH CARE CENTERS. THE HOSPITAL SERVES A YEAR ROUND POPULATION OF APPROXIMATELY 8,600.THE 5 LARGEST ETHNIC GROUPS IN ELY, MN ARE ETHNIC RESPONSES FROM THE CHNA SURVEY DATA OF 279 RESPONSES WHITE (NON-HISPANIC) (92.8%), NO HISPANIC RESPONSES, BLACK OR AFRICAN AMERICAN (NON-HISPANIC) (0.4%), AMERICAN INDIAN & ALASKA NATIVE (NON-HISPANIC) (2.9%), AND OTHER (HISPANIC) (1.1% WITH PEOPLE SITING SLOVENIAN, EUROPEAN AND CAUCASIAN AS RESPONSES ). NONE OF THE HOUSEHOLDS IN ELY, MN REPORTED SPEAKING A NON-ENGLISH LANGUAGE AT HOME AS THEIR PRIMARY SHARED LANGUAGE. ACCORDING TO OUR 2025 CHNA 99.3% OF HOUSEHOLDS SPOKE ENGLISH WITH 1.4% ALSO SPEAKING SPANISH AND 1.1% REPORTING "OTHER AND LISTING TURKISH AND GERMAN AS A RESPONSE. THIS DOES NOT CONSIDER THE POTENTIAL MULTI-LINGUAL NATURE OF HOUSEHOLDS, BUT ONLY THE PRIMARY SELF-REPORTED LANGUAGE SPOKEN BY ALL MEMBERS OF THE HOUSEHOLD. 99.6% OF THE RESIDENTS IN ELY, MN ARE U.S. CITIZENS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:ELY BLOOMENSON DOES HAVE AN OPEN MEDICAL STAFF ALLOWING A VARIETY OF PHYSICIANS TO PRACTICE BENEFITING THE COMMUNITY AND CITIZENS OF THE SURROUNDING AREA. THE COMMUNITY HEALTH COUNCIL, BRINGING HEALTH AND WELLNESS TO THE FOREFRONT IN ELY AND SURROUNDING COMMUNITIES THROUGH VARIOUS INITIATIVE AND SERVICES, MEETS AND IS PARTIALLY FUNDED THROUGH THE HOSPITAL. PROVIDES FUNDING FOR ELY, BABBITT, AND TOWER SOUDAN HIGH SCHOOL GRADUATION ACTIVITIES. FUNDING PROVIDED FOR CHILDREN'S PROGRAMS SPONSORED BY THE ELY POLICE, ELY FIRE DEPARTMENTS, AND LOCAL SCHOOL DISTRICT ISD# 696. THE HOSPITAL RECORDS DAILY RADIO SPOTS PROMOTING HEALTH AND WELLNESS. CONSULTATION SERVICES FOR THE MANY NON PROFIT ORGANIZATIONS SPECIFICALLY HOSPICE/RESPITE AND MENTAL ILLNESS PROGRAMS. TWO BLOOD DRIVES ARE ADMINISTERED ANNUALLY THROUGH ELY BLOOMENSON. ELY BLOOMENSON COMMUNITY HOSPITAL IS THE HEART OF THE CITY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:N/A PART VI, LINE 7, REPORTS FILED WITH STATES MN X X X X 0 0 0 0 0 0 0 0 0 BROCK URIE MD CMO 536181 0 0 0 11 0 0 0 18950 0 555142 0 0 0 PATTI BANKS CEO 252336 0 15000 0 118 0 10549 0 47970 0 325973 0 0 0 JOHN SCHINDELE EPIC DIRECTOR 164908 0 0 0 182 0 6903 0 42374 0 214367 0 0 0 SAM RICE PHYSICIAN (THRU 11/4/2024) 161879 0 0 0 0 0 7132 0 35474 0 204485 0 0 0 KARLA GRIZZARD RN 153021 0 0 0 182 0 6247 0 38196 0 197646 0 0 0 BETH HARTSHORN PHARMACIST 169645 0 0 0 25 0 6744 0 2346 0 178760 0 0 0 ABIGAIL SIREK PHARMACIST 152482 0 0 0 17 0 6185 0 15297 0 173981 0 0 0 A CITY OF ELY MINNESOTA 416005133 2015-03-23 7680415 SRS 2015A - REFUNDING OF 10/28/2008 NOTES 0 0 0 A 7680415 153605 7526810 2009 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 PART IV, LINE 3: THE SERIES 2015A NOTE WAS ISSUED WITH A 2.91% INITIAL INTEREST RATE WITH PRINCIPAL AND INTEREST DUE MONTHLY THROUGH NOVEMBER 2031. THERE WAS AN INTEREST RATE ADJUSTMENT ON DECEMBER 2, 2025, AT WHICH TIME THE INTEREST RATE ADJUSTED ON A PREDETERMINED FORMULA BASED ON THE FIVE-YEAR SECURED OVERNIGHT FINANCING RATE (SOFR)/SWAP RATE PLUS 2.65%. THE INTEREST RATE ADJUSTED WAS 4.16% AS OF DECEMBER 2, 2025. FORM 990, PART VI, SECTION A, LINE 6 THE ELY HEATH AND HOSPITAL FOUNDATION IS THE SOLE MEMBER OF THE ELY-BLOOMENSON COMMUNITY HOSPITAL. THE ELY HEALTH AND HOSPITAL FOUNDATION HAS OVER 670 MEMBERS; ANY RESIDENT OF THE AREA SERVED BY THE HOSPITAL MAY BECOME A MEMBER WITH A PAYMENT OF $100. FORM 990, PART VI, SECTION A, LINE 7A THE ELY HEALTH AND HOSPITAL FOUNDATION (SOLE MEMBER OF EBCH) ELECTS ALL BOARD MEMBERS OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B THERE ARE CERTAIN ISSUES THAT MUST BE APPROVED BY ALL MEMBERS, SUCH AS BY-LAW CHANGES AND TRANSFER OF SUBSTANTIAL AMOUNTS OF ASSETS. ALL MEMBERS HAVE VOTING RIGHTS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CFO AND PRESENTED TO THE BOARD MEMBERS AT A BOARD MEETING PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C DEFINITION OF CONFLICT: A CONFLICT OF INTEREST SHALL EXIST AT ANY TIME THAT A CONTRACT OR OTHER TRANSACTION EXISTS OR IS PROPOSED BETWEEN ELY-BLOOMENSON COMMUNITY HOSPITAL AND ONE OF ITS DIRECTORS OR BETWEEN ONE OF ITS DIRECTORS AND A RELATED ORGANIZATION, OR BETWEEN ELY-BLOOMENSON COMMUNITY AND AN ORGANIZATION IN OR OF WHICH A DIRECTOR OF ELY-BLOOMENSON COMMUNITY HOSPITAL IS ALSO A DIRECTOR, OFFICER OR LEGAL REPRESENTATIVE OR HAS MATERIAL FINANCIAL INTERESTS. A DIRECTOR OF ELY-BLOOMENSON COMMUNITY HOSPITAL HAS A MATERIAL FINANCIAL INTEREST IN AN ORGANIZATION WHICH THE DIRECTOR OR THE SPOUSE, PARENTS, CHILDREN AND SPOUSES OF CHILDREN, BROTHER AND SISTER AND SPOUSES OF BROTHERS AND SISTERS OF THE DIRECTOR, HAVE A MATERIAL FINANCIAL INTEREST. DECLARATION OF CONFLICT OF INTEREST: EACH DIRECTOR OF ELY-BLOOMENSON COMMUNITY HOSPITAL IS EXPECTED TO DECLARE A CONFLICT OF INTEREST AS SOON AS THE DIRECTOR IS AWARE OF SUCH CONFLICT. ONCE A CONFLICT OF INTEREST HAS BEEN DECLARED THE BOARD OF DIRECTORS SHALL FOLLOW THE PROCEDURE OUTLINED IN THE PROCEDURE PARAGRAPH OF THIS POLICY. DETERMINATION OF CONFLICT OF INTEREST: ANY OFFICER OR MEMBER OF THE BOARD OF DIRECTORS OF ELY-BLOOMENSON COMMUNITY HOSPITAL WHO BELIEVES THAT A BOARD MEMBER HAS A CONFLICT OF INTEREST SHALL STATE TO THE BOARD OF DIRECTORS THE BASIS FOR SUCH BELIEF. IF THE PERSON BELIEVED TO HAVE THE CONFLICT OF INTEREST DOES NOT AGREE THAT SUCH A CONFLICT EXISTS, SUCH PERSON SHALL BE GIVEN AN OPPORTUNITY TO RESPOND. IF IT IS NOT AGREED THAT A CONFLICT DOES EXIST THEN THE BOARD OF DIRECTORS SHALL VOTE TO DETERMINE WHETHER OR NOT SUCH CONFLICT EXISTS. ANY DIRECTOR WHO IS ENTITLED TO VOTE MAY REQUEST THAT THE VOTE BE BY CLOSED BALLOT AND UPON SUCH REQUEST THE CHAIRPERSON SHALL DECLARE THE VOTE BY CLOSED BALLOT. A SIMPLE MAJORITY OF THE MEMBERS PRESENT AND VOTING SHALL BE SUFFICIENT TO ESTABLISH THAT A CONFLICT OF INTEREST DOES EXIST. PROCEDURE UPON DETERMINATION OF CONFLICT: ONCE A CONFLICT OF INTEREST HAS BEEN DECLARED OR DETERMINED BY THE BOARD, THE INTERESTED PERSON OR PERSONS SHALL BE EXCUSED FROM THE MEETING UNTIL SUCH TIME AS A VOTE HAS BEEN TAKEN BY THE BOARD IN REGARD TO THE ISSUE IN WHICH THE INTERESTED MEMBER HAS A CONFLICT. ONCE A CONFLICT OF INTEREST HAS BEEN DECLARED OR DETERMINED, THE INTERESTED MEMBER SHALL NOT PARTICIPATE IN ANY DISCUSSION IN REGARD TO THE SUBJECT MATTER AND MAY ONLY RESPOND TO QUESTIONS DIRECTED TO HIM/HER BY ANY ONE OR MORE THE DIRECTORS. THE INTERESTED DIRECTOR SHALL NOT BE COUNTED IN THE QUORUM AND SHALL ABSTAIN FROM VOTING. THE STATEMENT REGARDING THE CONFLICT OF INTEREST MUST BE ENTERED INTO THE MINUTES. ONCE A DIRECTOR OR OFFICER HAS DECLARED OR BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, SUCH CONFLICT SHALL BE DEEMED TO CONTINUE UNTIL THE FINAL VOTE HAS BEEN TAKEN BY THE BOARD OF DIRECTORS IN REGARD TO THE SUBJECT MATTER IN WHICH SUCH DIRECTOR HAS A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THERE IS A BOARD LEVEL COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT DIRECTORS, THAT MEETS ANNUALLY AND REVIEWS AND COMPARES THE COMPENSATION OF THE CEO, CFO, COO, CHRO & CNO WITH VARIOUS COMPENSATION STUDIES OF HOSPITALS OUR SIZE, SUCH AS THE MINNESOTA HOSPITAL ASSOCIATION ANNUAL SURVEY. THIS COMMITTEE IS APPRAISED OF 990 DISCLOSURE REQUIREMENTS. THE CEO MAKES RECOMMENDATIONS TO THE COMMITTEE REGARDING THE COMPENSATION OF THE CFO AND CNO BASED ON VARIOUS COMPENSATION STUDIES. THE COMPENSATION COMMITTEE THEN MAKES RECOMMENDATIONS TO THE FULL BOARD IN CLOSED SESSION AND MINUTES ARE KEPT OF SAID MEETING. THE MINUTES AND ALL MATERIALS RELATED TO THE COMPENSATION DECISIONS ARE KEPT ON FILE WITH THE HOSPITAL'S ATTORNEY'S OFFICE. OTHER POSITIONS RELY ON THE HEALTHCARE HUMAN RESOURCES ASSOCIATION OF MINNESOTA (HHRAM) SURVEY AND ANNUAL BUDGET REQUESTS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. ANNUAL FINANCIAL REPORTS ARE PROVIDED TO ALL SHAREHOLDERS WHO ATTEND THE ANNUAL MEETING OR UPON REQUEST. OTHER DOCUMENTS WILL BE PROVIDED TO MEMBERS UPON REQUEST. THE ANNUAL FINANCIAL REPORT WILL BE GIVEN TO THE GENERAL PUBLIC IF REQUESTED DURING THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 606,388. MANAGEMENT AND GENERAL EXPENSES 48,903. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 655,291. OUTSIDE CONTRACTORS: PROGRAM SERVICE EXPENSES 2,441,972. MANAGEMENT AND GENERAL EXPENSES 410. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,442,382. OUTSIDE CONSULTANTS: PROGRAM SERVICE EXPENSES 1,119,074. MANAGEMENT AND GENERAL EXPENSES 643,118. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,762,192. ELY HEALTH & HOSPITAL FOUNDATION 328 W CONAN STREET ELY MN 55731 412001411 TO PROVIDE SUPPORT TO ELY-BLOOMENSON COMMUNITY HOSPITAL FOR HEALTHCARE MN 501(C)(3) LINE 12B, II N/A 0 ELY HEALTH & HOSPITAL FUND 328 W CONAN STREET ELY MN 55731 461836177 TO PROVIDE SUPPORT TO ELY-BLOOMENSON COMMUNITY HOSPITAL FOR HEALTHCARE MN 501(C)(3) LINE 12B, II ELY HEALTH & HOSPITAL FOUNDATION 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0