Northland Pace Program

“The organization has an Executive Committee that consists of the Board President, Vice President, Secretary/Treasurer and one Board Director. The Executive Committee has the following roles and responsibilities: -Represent and act on behalf of the corporation and to make recommendations to the board of directors for its approval; -Coordinate, receive and act upon the activities and general policies of the various functions of the corporation and to make appropriate recommendations to the board of directors; -To receive and act upon reports and make recommendations from other committees of the corporation; -To implement the policies adopted by the board of directors of the corporation; -To make recommendations on the corporation management matters to the board of directors; -To act as a nominating committee for the corporation if so directed by the board of directors; -Conduct such other functions delegated by the board of directors;”

“Gary Miller and Susan Sisk have a business relationship. Gary is an officer of the organization that employs Susan. Lynn Grimm and Tim Cox have a business relationship with Darrold Bertsch, Kevin Greff, Gary Miller, Jeffrey Drop, Jon Frantsvog, Susan Sisk. Lynn and Tim are employed by a related organization that these individuals are associated as a Director or Board Officer.”

“The sole member of the Northland PACE Program is Northland Healthcare Alliance.”

“The sole member, Northland Healthcare Alliance, is responsible for selecting the governing body of the organization.”

“The Member, Northland Healthcare Alliance, reserves consent to the following: -The purchase or sale of assets over $20,000; -The entry into any business line not expressly stated in the PACE application; -Any contract for services or contract to provide service exceeding $25,000 in consideration; -The admission of any additional Members; -The merger or combination of the Corporation; -The dissolution of the Corporation.”

“Northland PACE Program has determined that its Finance Committee shall review and approve a draft of the Form 990. Subsequently, the Form 990 will be presented to the full board at a board meeting prior to filing with the IRS.”

“Director conflict of interests: Director conflicts of interest shall be governed by North Dakota Century Code (NDCC) 10-33-46 or its successor statute and 42 cfr 460.68 or its successor regulation. The board shall adopt policies and procedures necessary for handling any direct or indirect conflict of interest as required under 42 cfr 460.68 the organization.”

“Compensation is paid by the sole member of the organization, Northland Healthcare Alliance, and the member is reimbursed by the organization monthly. The sole member oversees the process for determining compensation. The CEO is reviewed annually by the executive committee based on his annual evaluation instrument provided to the committee. The CEO's compensation is compared to other health facilities and organizations. The CFO undergoes an annual performance evaluation. Compensation amounts determined for the CFO are compared to other PACE organizations as well as experience and evaluation on an annual basis. The process described above last took place in November 2012 for the CEO and April 2013 for the CFO.”

“Governing documents, financials, and conflict of interest policy are not made available to the public.”

“Ancillary Services : Program service expenses 739,474. Management and general expenses 0. Fundraising expenses 0. Total expenses 739,474. Hospital & Clinic Services : Program service expenses 854,476. Management and general expenses 0. Fundraising expenses 0. Total expenses 854,476. Institutional : Program service expenses 1,408,750. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,408,750. Consulting : Program service expenses 95,497. Management and general expenses 0. Fundraising expenses 0. Total expenses 95,497. Other Professional Fees : Program service expenses 236,809. Management and general expenses 0. Fundraising expenses 0. Total expenses 236,809. Other fees-Mngmnt-990 : Program service expenses 0. Management and general expenses 82,769. Fundraising expenses 0. Total expenses 82,769.”