2026-07-29T09:45:02-05:00 2025-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2024-10-01 450226729 St Aloisius Hospital STAL 7013244651 325 Brewster Street East Harvey ND 58341 Nicole Anderson CFO 7013244651 2026-07-28 1 1 Kim Hunwardsen CPA P00484560 6122536500 2026-07-27 2024 2025-03-06 01:10:19Z SMP Health - St Aloisius Ryan Mickelson 325 Brewster Street East Harvey ND 58341 27307379 0 0928 X https://smphealth.org/staloisius/ X 1938 ND Provide healthcare and healing services with special concern for the elderly and poor 8 7 302 80 0 0 272291 468000 26151950 26450795 290177 382721 1717 -774 26716135 27300742 0 0 0 0 14502042 14850617 0 0 0 12612035 12356776 27114077 27207393 -397942 93349 26614266 27619399 8410436 8247092 18203830 19372307 X SMP Health - St. Aloisius, inspired by Jesus, in union with the Sisters of Mary of the Presentation, ministers health to all we serve. 0 0 23246677 26450795 CRITICAL ACCESS HOSPITAL DESIGNATIONSMP Health - St. Aloisius is a 25-bed acute care hospital and 65-bed skilled nursing facility located in Harvey, North Dakota. The Hospital was designated as a Critical Access Hospital in 2002. As a critical access hospital, our role is vital to the health and welfare of the community we serve. The patient and resident days for FY 2025 were as follows: 649 acute days and 1,597 swing-bed days.(Continued on Schedule O) RESPONDING TO THE NEEDS OF THE POOR The Medical Center provides healthcare services to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Medical Center does not pursue collection of these amounts they are not reported as patient and resident service revenue. The estimated cost of providing these services was $4,000 for the year ended September 30, 2025, calculated by multiplying the ratio of cost to gross charges for the Medical Center by the gross uncompensated charges associated with providing charity care to its patients and residents.In addition, the Medical Center provides services to other medically indigent patients under certain government-reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Medical 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.SMP Health - St. Aloisius provides a Senior Living Facility. This consists of 16 apartment units. Two of the one-bedroom apartments are handicap accessible. A noon meal is optional but is served 7 days per week. There is also a 24-hour emergency call system.SMP Health - St. Aloisius Long Term Care is a 65-bed skilled nursing facility licensed by the State of North Dakota. The facility provides occupational, physical and speech therapy and other activities offered 7 days per week. St. Aloisius Long Term Care facility had 21,944 patient days for FY25. 23246677 1 1 0 0 0 0 0 0 1 0 1 1 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 1 0 0 0 0 0 0 1 0 0 0 1 38 0 1 302 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X Nicole Anderson 7013244651 325 Brewster Street East Harvey ND 58341 Ryan Mickelsen President & CEO 40.00 0.00 X X 0 289033 51958 Gordon Schmidt-Vice Chair until Jul Chair as of Aug 2025 0.50 0.00 X X 0 0 0 Mary Hager-Director until Jul Vice Chair as of Aug 2025 0.50 0.00 X X 0 0 0 Jason Schneider Chair until Jul 2025 0.50 0.00 X X 0 0 0 Sr Debra Berry Director 0.50 1.30 X 0 0 0 Doug Heil Director as of July 2025 0.50 0.00 X 0 0 0 Dr Steven Kourajian Director 0.50 0.00 X 0 0 0 Kathy Muscha Director 0.50 0.00 X 0 0 0 Sr Anne Germaine Picard Director 0.50 0.80 X 0 0 0 Nicole Anderson CFO 40.00 0.00 X 0 95385 29249 Sr Elaine Lange Secretary non-voting 0.50 1.50 X 0 0 0 Rick Geier MD Physician 40.00 0.00 X 433896 0 10500 Kimberly Thorson NP Nurse Practitioner 40.00 0.00 X 328293 0 9849 Tuan Dean MD Physician 40.00 0.00 X 287062 0 20237 Tracey Harness CNA until Mar 2025 60.00 0.00 X 191885 0 7962 Robert Rotering Jr MD Physician 40.00 0.00 X 171783 0 13048 1412919 384418 142803 15 0 1 0 Homestead Recruiters 821 Senior Ave Dickinson ND 58601 Contract staffing 1554542 SMP Health 1202 Page Dr SW Fargo ND 58106 Administrative services 1023495 DTN Staffing Inc 1200 Collins Ave Mandan ND 58554 Contract staffing 667787 Northland Imaging Services 2223 E Rosser Ave Bismarck ND 58501 Imaging services 360331 Onestaff Medical LLC PO Box 3544 Omaha NE 68103 Contract Staffing 219548 16 10118 85620 372262 468000 Patient Revenue 621110 25491186 25491186 Pharmacy Revenue 621400 508075 508075 Senior Living 623990 119102 119102 Daycare Services 624410 80813 80813 251619 251619 26450795 370268 370268 17721 5268 12453 12453 12453 595 10118 1369 -774 -774 27300742 26450795 0 381947 X 130337 130337 11992085 10999939 992146 297296 272721 24575 1589816 1459608 130208 841083 772224 68859 23824 23824 172049 172049 6493739 4543109 1950630 16732 16732 707616 529005 178611 85997 26326 59671 509229 503462 5767 145190 87942 57248 35059 128 34931 436795 375674 61121 1228071 1056227 171844 182859 182859 Medical Supplies 1343789 1335753 8036 Repairs and maintenance 499246 495850 3396 Dietary food 450471 450381 90 26110 25132 978 27207393 23246677 3960716 0 995676 915878 3974727 4204144 227195 217573 100334 75539 26871244 20198520 7094792 6672724 287400 335703 13503994 15189064 430148 8774 26614266 27619399 2369508 2472954 10373 10199 9148 8774 5156686 4871339 864721 883826 8410436 8247092 X 18136984 19305461 66846 66846 18203830 19372307 26614266 27619399 93349 1075128 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 102501 102501 19053653 15084567 3969086 7197978 4817542 2380436 517112 296411 220701 6672724 SMPHS pooled investment funds 15189064 F 15189064 Lease Liability 650826 Third Party Settlements 233000 883826 X 28377239 1075128 1369 1076497 27300742 0 27300742 27208762 1369 1369 27207393 0 27207393 Part IV, Line 2b: The Medical Center holds funds under an agency relationship for the residents of the nursing facility. Resident trust funds held as of September 30, 2025 totaled $5,354. Security deposits held as of September 30, 2025 totaled $3,420. Part X, Line 2: The Medical Center believes that it has appropriate support for any tax position taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Medical 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. Part XI, Line 2d - Other Adjustments: Fundraising expenses included in revenue 1,369. Part XII, Line 2d - Other Adjustments: Fundraising expenses included in revenue 1,369. 1 1 X 1 X 1 X 1 1 0 1 1 4000 4000 0.00010 446437 355326 91111 0.00330 450437 355326 95111 0.00340 212922 21441 191481 0.00700 27914 27914 0.00100 12769 4833 7936 0.00030 1590 1590 0.00010 255195 26274 228921 0.00840 705632 381600 324032 0.01180 7044 5283 1761 0.00010 7044 5283 1761 0.00010 1 424233 50908 7962790 7921628 41162 X 1 1 1 1 St Aloisius Hospital 325 Brewster Street East Harvey ND 58341 www.staloisius.com 5023a X X X X 1 provider based rural health clinic St Aloisius Hospital 1 0 0 1 X X X X X X X X X 24 1 0 1 1 X smphealth.org/staloisius/resources/ X 1 24 1 smphealth.org/staloisius/resources/ 0 1 X 100.000000000000 200.000000000000 X X X 1 1 X X X X 1 X smphealth.org/staloisius/resources/ X See line 16a. X See line 16a. X X X X X X 1 X 0 X X X X 1 X 0 0 St. Aloisius Hospital Part V, Section B, Line 5: The CHNA addressed the broad interest of the community by identifying a committee that then identified individuals that met recommended criteria and 8 interviews were conducted by UND Rural Health Team. The committee working with the UND Rural Health team consisted of members from the local economic development office, City of Harvey, Wells County District Health as well as business and community members. The time period that the CHNA was completed was March 3, 2025 to March 17, 2025. There was a community meeting with invitations for additional input provided by community members identified to expand the population diversity. Electronic surveys cards were distributed, and 84 surveys were completed in addition to community meetings and individual interviews.The focus group included members from the City of Harvey, the Economic Development Board in Harvey, Public Health, Wells County Social Services and many business and community members. St. Aloisius Hospital Part V, Section B, Line 6b: A Community Health Needs Assessment was performed in collaboration with Wells County District Health to determine the most pressing health needs of Harvey area. St. Aloisius Hospital Part V, Section B, Line 11: The Board of SMP Health - St. Aloisius identified the following health needs in the 2024 CHNA. Due to the timing of the completion of the CHNA no needs were addressed during FY2025 but will be addressed over the next 3 years.1. Depression/Anxiety (All Ages)2. Having enough Child Daycare Services3. Availability of SpecialistsOther Needs Identified in the CHNA but Not Addressed in This Plan:Each of the health needs listed below is important and is being addressed by numerous programs and initiatives operated by the Hospital, other organizations within the Hospital system, and other community partners of the Hospital. However, the Hospital will not address the need of not enough affordable housing identified in the CHNA as part of this Implementation Plan due to limited resources and the need to allocate significant resources to the three priority health needs identified above.GOAL: DEPRESSION/ANXIETY (ALL AGES)Specific Needs Identified in CHNA: High rates of depression/anxiety across all age groups Limited awareness of available mental health resources Need for strengthened community partnerships and stigma-reduction effortsKey Objectives: Increase community-wide mental health awareness through targeted education and outreach. Expand visibility and accessibility of behavioral health services for all age groups.Implementation Strategies/Activities and Timeline:Short-Term Develop and adopt a clear community definition of "mental health" to improve awareness. Expand education about EAP services for schools, healthcare, EMS, and local workplaces. Promote the Senior Life Solutions program annually at the November Health Fair. Partner with FCCLA to host an additional STAR mental health event. Create and implement a robust Mental Health Awareness Month plan, including "flags on Main Street." Develop digital mental health messaging to display in school cafeterias, outdoor signs, and local businesses (Dakota Heritage Bank, St. Aloisius, Leevers). Strengthen community connection with local behavioral health providers. Launch a Senior Life Solutions awareness campaign for 2026 (walk, proclamations, toolkit, suicide awareness event). Incorporate a mental health rotation into Scrubs Camp for local youth. Increase outreach using local media, including Midco Channel 19, sports broadcasts, and local radio.Long-Term Encourage health providers to include mental health screening questions in routine visits. Develop and unveil a community mural that promotes mental health awareness.The goals:1. Enhance community mental health literacy. Increase education on recognizing early signs of depression/anxiety, available supports, and how to seek help.2. Expand access and reduce stigma surrounding behavioral health services. Strengthen partnerships, improve outreach, and promote new and existing services such as Senior Life Solutions and tele-behavioral health.GOAL: HAVING ENOUGH CHILD DAYCARE SERVICESSpecific Needs Identified in CHNA: Insufficient daycare capacity. The city operates one daycare facility with a maximum capacity of 30 children, and there are four home-based providers. Staffing shortages and limited operating hours High regulatory burden and cost barriers Difficulty maintaining adequate provider-to-child ratiosKey Objectives: Increase the number of licensed daycare providers in the community. Strengthen workforce sustainability and retention among daycare staff. Improve access to extended or flexible childcare options.Implementation Strategies/Activities and Timeline:Short-Term Encourage prospective providers to contact a social worker or follow ND licensing steps to begin home daycare licensing. Develop informational pamphlets to simplify the licensing process. Host "How to Become a Daycare Provider" educational sessions with a social worker and JDA representative. Streamline the fingerprinting process for applicants. Create a daycare workgroup to expand community partnerships and coordinate solutions.Long-Term Collaborate with local schools to explore Pre-K curriculum implementation. Support daycare staff retention strategies. Evaluate opportunities to expand daycare hours (earlier drop-off, later pick-up). Explore development of after-school childcare options.The goals:1. Increase the availability of licensed daycare services. Support licensing, workforce development, and community awareness.2. Improve sustainability and flexibility of childcare options. Enhance staff retention and expand operating hours and after-school programs.GOAL: AVAILABILITY OF SPECIALISTSSpecific Needs Identified in CHNA: Limited access to specialists (neurology, mental health, pain management, sleep studies) Long wait times (neurology up to 6 months) Barriers due to provider travel and availability Need to keep patients within Harvey for care Opportunity to expand telehealth servicesKey Objectives: Increase availability of specialty and subspecialty services. Strengthen awareness of available healthcare services. Utilize telemedicine to reduce wait times and expand access.Implementation Strategies/Activities and Timeline:Short-Term Evaluate telemedicine options for expanding specialty services. (Currently partnered with Avel eCare.) Increase public awareness of existing and upcoming services through social media, hospital billboards, and Minot newspaper. Develop a "How to Access Substance Abuse Resources" guide, including insurance information. (Aligned with the 3-yr BHP Strategy Planning Workshop partnership.) Publish informational updates across social media, hospital website, billboards, Minot newspaper, and local radio. Use 3RNET and CRH workforce specialist toolkits to support recruitment and ensure all positions are listed.Long-Term Partner with high school HOSA groups to promote healthcare career pathways.There is currently no active HOSA chapter in Harvey. Contact Minot HOSA to gather guidance on starting a chapter.The goals:1. Increase local access to specialty healthcare services. Expand telehealth, develop new specialty clinics, and reduce out-of-town travel.2. Improve long-term workforce development and recruitment. Strengthen pipelines (e.g., HOSA), marketing efforts, and telehealth partnerships.A Community Health Needs Assessment (CHNA) was completed in FY2022 in collaboration with Wells County District Health to determine the most pressing health needs of Harvey area. The actions the Hospital took to address the needs in FY2025 are as follows.1. Depression and Anxiety-all ages2. Smoking and tobacco use3. Attracting and retaining young familiesDepression and Anxiety - all agesDepression and anxiety, emotional abuse, bullying and cyberbullying, and alcohol and drug use and abuse are all related to mental health and having access to these services. As a result of the specific needs identified, stakeholders discussed increasing the access of mental health and addiction providers within the service area and how to develop a resilient prevention approach for the community at large. In FY2025 the Hospital started Senior Life Solutions mental health program.Rural mental health services continue to be provided at SMP Health - St. Aloisius. A mental health counselor is provided once a week at the Hospital. A counselor from The Village in Minot provides counseling for children and adults and continues to serve the Harvey area at the Harvey Public School. The Harvey Area Community Cares Coalition has existed for the past several years and has developed a strong collaboration with Harvey Public school, City of Harvey, faith communities, St. Aloisius Medical Center, Wells County District Health Unit (WCDHU), Village Family Services, Harvey business, community members, Harvey Police and WC sheriff office. This group continues to lead the mental health concerns of the communities.The Community Care's Coalition continues to sponsor educational events where mental health services are shared with participants.Smoking and Tobacco UseClinicians in the clinic continue to provide literature on tobacco cessation including NDQuits.Attracting and Retaining Young FamiliesCommunity and environmental health concerns identified were attracting and retaining young families, creating community Health programs, and strengthening the relationship between school, health services and community leaders. In FY2025 the Hospital recruited international employees with families.The Hospital will not address Assisted Living Options as part of this Implementation Plan due to limited resources and the need to allocate significant resources to the priority health needs identified above. St. Aloisius Hospital Part V, Section B, Line 13h: In addition to income, assets and liabilities may also be used to determine eligibility. St. Aloisius Hospital Part V, Section B, Line 16j: A note is printed on monthly statements providing information regarding financial assistance. The financial assistance policy is provided to self-pay patients upon registration at the Hospital. It is not provided to all patients. The Uncompensated Care & Service Application and information regarding the financial assistance policy is available on our website and available upon request. 2 1 - St Aloisius Long Term Care 325 Brewster Street East Harvey ND 58341 Skilled nursing facility 2 - St Aloisius Senior Housing 325 Brewster Street East Harvey ND 58341 Senior housing units Part I, Line 3c: In addition to income, assets and liabilities may also be used to determine eligibility. Part I, Line 6a: The Hospital's community benefit report is available upon request. Part I, Line 7: Charity care expense was converted to cost on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, health professions education, line 7f, and cash and in-kind contributions, line 7i, are reported based on actual expenses recorded in the Organization's general ledger. The cost for subsidized health services was determined using the Medicare cost report. Part II, Community Building Activities: Community building activities include language education service. This service improves public health and access to services. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: The Hospital reasonably estimates the portion of implicit price considerations that could have qualified for charity care. An estimated 12% of implicit price concessions in 2024 are attributable to patients living below the federal poverty level in Wells 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: SMP Health - St. Aloisius had a Medicare gain during the fiscal year. The Hospital provides services to patients under the Medicare program. Providing these services is essential to these patients and the community and increases their access to healthcare services. 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 increased by $(88,561).Medicare fee schedule revenue $133,686Medicare estimated costs of care relating to payments (222,247)Net (Shortage) $ (88,561)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 the Centers for Medicaid and Medicare Services. Part III, Line 9b: Patients that are in the process of applying for charity care or have been approved for charity care will not have collection procedures brought on them. If a patient does not complete the Caring Program application within 120 days the account will follow the same collection procedure as other accounts. Accounts turned over to collections may be eligible for the Caring Program if the patient completes an application and is approved within an additional 120 days. After a determination of charity care, any personal portion due would follow the same collection procedures as other patients. Persons that have been granted bankruptcy by the courts are transferred to the Caring Program and written off as charity care. No collection procedures are pursued. Part VI, Line 2: SMP Health - St. Aloisius addresses needs throughout the community in addition to completing the CHNA. The Hospital employs a marketing/public relations individual and provides feedback on needs in the community. A community care program, named "Community Cares Coalition" was formed to address and assist with suicide prevention and is still active in 2025. The Hospital has other activities to assist families in need throughout the community. Part VI, Line 3: SMP Health - St. Aloisius has a Revenue Cycle Manager, RCM, who works in conjunction with the business office staff on reviewing patient accounts both with insurance and those who are self-pay. Our monthly billing statements include information regarding financial assistance. The financial assistance policy is provided to self-pay patients upon registration at the Hospital and Clinic. It is not provided to all patients. The application for Uncompensated Care and Services and information regarding the financial assistance policy is available on our website and available upon request.The hospital nurses ask the patient if they have any financial concerns about their hospital stay and if they do, the nurse calls the RCM or CFO to notify them that the patient has financial questions. The RCM or CFO will then follow up with the patient about their concerns. Part VI, Line 4: SMP Health - St. Aloisius is a non-profit Critical Access Hospital located in central North Dakota. We serve more than 15 rural communities including Harvey where we are located. Our area of service is approximately 90 miles in diameter. Local doctors have clinics in Harvey. Some of the same community demographic issues still exist, however, the community needs are still being addressed in the current year. Obesity continues to be an issue in all areas as is excessive drinking, drug use, diabetes etc. In 2024, 38% of adults in Wells County were considered obese compared to 36% in North Dakota and 34% nationally. Adult smokers by percent of population in Wells County is 16% compared to 16% in North Dakota and 15% in the US. Excessive drinking was 24% in Wells County, 23% in North Dakota and 18% in the US. Injury Deaths were more prevalent in Wells County (98 deaths per 100,000 residents) than in the state overall (75 per 100,000 residents) and the top 10% of US Counties (80 per 100,000 residents). In Wells County, 50% of households have one or more seniors (60 and older). Unemployment in Wells County in 2024 was 2.8% and in North Dakota 2024 was 2.1%.The estimated median household income in Wells County for 2024 was $42,368. The estimated median household income for North Dakota was $76,525. Also, 12% of residents had income below the poverty level.The closest critical access hospitals are Heart of America Medical Center located in Rugby, ND approximately 42 miles away and Carrington Health Center located in Carrington, ND approximately 54 miles away. Part VI, Line 5: The Organization's governing body is composed of representatives from Harvey and surrounding local communities in addition to representatives from the Sisters of Mary of the Presentation. The group is diverse, as it includes lay people, religious representatives and businessmen and women. This diversity represents the rural population we serve. This facility extends medical staff privileges to those qualified practitioners based on an established credentialing process. We are not a research facility. Any excess funds are reinvested into funded depreciation for future capital projects for the facility. As a critical access facility, there have not been many years with excess funds, but when there is, the facility has made improvements in building infrastructure to increase quality and efficiency for our patients and residents we serve. In FY 2023, we added wound care services, pelvic floor therapy, respiratory therapy services, general surgery services, and podiatry services. In FY 2024, we added Orthopedic and ENT services.SMP Health - St. Aloisius is very supportive of community organizations. The following are examples of services St. Aloisius has provided to the community at large for a total of $350,209.1. The facility has a 24/7 emergency room available to patients regardless of ability to pay.2. 24/7 Pastoral Care services.3. Provided lab services to patients (including free wellness for employees) during our spring and fall Wellness Days.4. We provided sports physicals to area athletes. The minimal payment charged for the physical was donated to Wells County Booster Club.5. Diabetes education is provided by hospital staff who is certified in Diabetes Education.6. Provided donations to local school projects and other community groups, memorial services, child protection referrals.7. Presented bi-weekly "Did You Know" health information in the local newspaper. 9. Provided office space (in kind) for Hearing Aid Services and Mental Health Counselor staff/clients in our hospital building. There were many patients served weekly by the Rural Mental Health staff.10. Provided cable television, internet and phone to our patients and residents which is non-reimbursable on our cost report. Part VI, Line 6: We are an affiliate of SMP Health. SMP Health - St. Aloisius operates in accordance with the mission, vision, and values of the Sisters of Mary of the Presentation Health Corporation. 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. Aloisius 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. Aloisius 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 Rick Geier MD Physician 433896 0 0 0 0 0 10500 0 893 0 445289 0 0 0 Ryan Mickelsen President & CEO 0 257900 0 25000 0 6133 0 20625 0 33909 0 343567 0 133 Kimberly Thorson NP Nurse Practitioner 328293 0 0 0 0 0 9849 0 442 0 338584 0 0 0 Tuan Dean MD Physician 287062 0 0 0 0 0 6338 0 14905 0 308305 0 0 0 Tracey Harness CNA until Mar 2025 191885 0 0 0 0 0 5862 0 2203 0 199950 0 0 0 Robert Rotering Jr MD Physician 171783 0 0 0 0 0 4650 0 9290 0 185723 0 0 0 Part I, Line 3 SMP Health - St. Aloisius does not pay compensation to the President & CEO. This individual is compensated by Sisters of Mary of the Presentation Health System, a related organization, for services at the Hospital. Sisters of Mary of the Presentation Health System uses one or more of the methods on Part I, question 3 to determine compensation. Part I, Line 4b SMP Health, related organization, 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 Ryan Mickelsen 133 3,125 Marissa Mickelsen Family to President/CEO 80989 Compensation and benefits 0 Lori Olson Family to President/CEO 49348 Compensation and benefits 0 Form 990, Part VI, Section A, line 2 Ryan Mickelsen, Nicole Anderson, and Sr. Elaine Lange have a business relationship. Form 990, Part VI, Section A, line 6 The sole member of the Organization is the Sisters of Mary of the Presentation Health System. 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 Sisters of Mary of the Presentation Health System. Form 990, Part VI, Section A, line 7b The authority to act on the following matters is 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 provided to the governing Board before it is filed. The Organization's President & CEO and CFO review the 990. Form 990, Part VI, Section B, line 12c Each Director must submit in writing to the Chairperson of the Board and the Chief Executive Officer 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 Chairperson of the Board reviews the statements of the Directors and the Vice Chairperson of the Board reviews the statement filed by the Chairperson. 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 Chairperson 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 Chairperson, the Vice Chairperson has authority to require the Chairperson remove himself in the same matter. 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 CEO and CFO are compensated by Sisters of Mary of the Presentation Health System, a related organization, on an annual basis. The compensation process is determined by the related organization. The Sisters of Mary of the Presentation Health System 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 Sisters of Mary of the Presentation Health System 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 1,345,731. Management and general expenses 543,874. Fundraising expenses 0. Total expenses 1,889,605. Professional Fees: Program service expenses 3,197,378. Management and general expenses 1,406,756. Fundraising expenses 0. Total expenses 4,604,134. 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. Aloisius Hospital. Sisters of Mary of the Presentation Health Ministry 1202 Page Drive SW Fargo ND 58106 320617468 Supports SMP Health and the related entities ND 501(c)(3) 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 Andrew's Health Center dba SMP Health - St Andrew's 316 Ohmer St Bottineau ND 58318 450226426 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 SMP Long Term Care dba SMP Health - Long Term Care 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 Inc 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 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0