St. Cloud Hospital

“Merryn jolkovsky & richard jolkovsky - family relationship (married)”

“The corporate members of st. Cloud hospital are two representatives of the sisters of the order of saint benedict, two representatives of the diocese of st. Cloud, and four other corporate members appointed by the four representatives. The corporate members serve as representatives of the local catholic church of saint cloud.”

“The centracare health (cch) board appoints the st. Cloud hospital (sch) board based on recommendation of the sch joint nomination committee.”

“In addition to appointing the st. Cloud hospital board, the members approve amendments to the articles of incorporation, approve dissolution of the hospital, and support and assess the hospital's roman catholic identity and missions.”

“The board of directors has delegated the approval authority of the form 990 to the audit committee. Annually, at the audit committee meeting, prior to filing with the irs, the audit committee reviews and approves form 990. A copy of form 990 is then provided for the full board to review prior to filing with the irs.”

“The board members are required to review and sign a conflict of interest questionnaire twice a year. All staff sign conflicts of interest forms on an annual basis. The questionnaires are reviewed by the corporate compliance officer as well as the corporate compliance group (a compliance committee which includes internal members and outside counsel). The responses to the questionnaires are then reviewed with the executive committee of the board. The corporate compliance officer is responsible for monitoring conflicts of interests related to board and staff and to alert affected parties when a conflict arises. When an actual conflict arises, the affected party is asked to recuse him/her self from the decision making process. The corporate compliance officer attends board meetings and specified board committee meetings where conflict issues may arise.”

“The compensation and benefits of the presidents (non-medical providers) are subject to full compensation and benefits comparability studies conducted biennially by a third party independent compensation consultant. However, the compensation portion of the study is reviewed annually by the consultant and updated for compensation committee and board of directors review and approval. The most recent full review was done in june 2019. The third party independent compensation consultant is retained by st. Cloud hospital to perform services. Line 15b: the compensation and benefits of the vice presidents (non-medical providers) are also paid by a related organization and subject to full compensation and benefits comparability studies conducted biennially by a third party independent compensation consultant. However, the compensation portion of the study is reviewed annually by the consultant and updated for compensation committee and board of directors review and approval. The most recent full review was done in june 2019. The third party independent compensation consultant is retained by st. Cloud hospital to perform these services.”

“The hospital/centracare health system does not generally make its governing documents or conflict of interest policy available to the public. The hospital/centracare health system does release an annual report to the community in which financial results are reported to and discussed with the public. This report is available to the public on the organization's website.”

“Adjustments to funded status of pension plan -19,880,316. Net equity transfers to affiliated organizations -90,214,273. Other changes in net assets -81,425.”

“St. Cloud hospital has performed the calculation to determine that it is subject to an excise tax under irc section 4960 for remuneration paid in excess of $1,000,000. The form 4720 will be filed with the irs by centracare health on behalf of st. Cloud health to report the excise tax.”