Gibson General Hospital Inc.

“Executive committee delegated authority: the executive committee will exercise all authority of the board of trustees between regular board meetings during all emergency situations (immediate action that could result in a serious negative impact upon the organization) and/or when the non-emergency action(s) result in commitment to a capital investment or lease less than $50,000.”

“Management duties: the ceo, cno and cfo of the organization are employeed and provided, subject to approval of the board of trustees, by deaconess hospital, inc., an indiana not for profit corporation as of december 2016.”

“Power to elect or appoint: the organization governing documents allows for the county commissioners of gibson county, indiana to select one (1) member of the board of trustees; deaconess hospital, inc to select three (3) members of the board of trustees; and, the mayor of princeton, indiana, the president of gibson general hospital foundation, and the chief of staff of gibson general hospital serve as ex-officio members.”

“Form 990 review process: the process of review the form 990 includes a detailed review of the form and required schedules by the chief financial officer. Each voting member of the governing body receives a copy of the form 990 including required schedules, as ultimately filed with the irs, prior to filing.”

“Conflict of interest policy: the conflict of interest policy is included within the bylaw of the organization and covers all board of trustees. The policy provides procedures to prevent those with duality of interest or possible conflicts of interest from participating in any action that could personally benefit the individual trustee. The ceo and/or board compliance officer review annual written and signed conflict of interest statements that provide any duality of interest or possible conflicts of interest disclosed by all board of trustees. The individual trustee will again disclose to the board when the interest becomes a matter of board action and recues himself or herself from voting on the related issue. The board meeting minutes document the disclosure made, who abstained from voting, and the quorum situation.”

“Compensation process: ceo: the ceo evaluation committee, consisting of four independent and board chair appointment trustee members, evalutates the performance of the ceo on an annual basis and makes compensation-related recommendations to the board prior to the ceo's annual review date for approval. The evaluation committee uses a compensation consultant, compensation survey, and comparative data from simliar organization to determine the ceo's compensation package. All deliberation and decisions are documented in the evaluation committee's minutes. Officers and/or key employees: annual reviews for top management officials are conducted by the ceo. The compensation is annually reviewed and approved by the board of trustees.”

“The hospital's governing documents, conflict of interest policy, and financial statements are available to the public upon written request and board of trustees approval. Written requests should be sent to attn: james childers, at the address listed on page 1 of the form 990.”

“The organization does not have a formal written policy on evaluating participation in a joint venture, however, the organization performs due diligence and involves legal counsel to review any partnerships ensuring that the joint venture would be organized and operated in a manner consistent with the hospital's exempt purpose and status.”

“Purchased services: program service expenses 1,530,547. Management and general expenses 826,551. Fundraising expenses 0. Total expenses 2,357,098. Professional fees - medical: program service expenses 2,124,287. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,124,287. Other fees: program service expenses 3,577. Management and general expenses 162,036. Fundraising expenses 0. Total expenses 165,613.”

“The board of trustees assumes responsibility for oversight of the audit of the financial statements and selection of the independent accountant; and no processes have changed from prior year.”