Lakeview Memorial Hospital Association Inc.

“THE SOLE MEMBER IS SHS.”

“The sole member ratifies the persons elected to the hospital board, at least 75% of whom must be community leaders. The chief executive officer of the sole member serves as an ex officio non-voting hospital board member. Additionally, healthpartners as the sole member of stillwater health system appoints one person to the hospital board.”

“The sole member has customary powers including approval of highly significant actions of the hospital's board of directors. These include amendment of the governing documents; approval of strategic plans and annual budgets; merger, consolidation or substantial affiliation with another entity; appointment of the president of the hospital; and incurrence of debt.”

“The hospital's 990 return has a comprehensive review process that is followed before it is presented to the governing body of the hospital. The review process includes a layered review by the tax department of group health plan, inc. (ghi), the management team of the hospital, ghi's internal legal department and the hospital's outside independent accountants. Each one of those areas has an opportunity to review, ask questions and make comments back to the tax department of ghi before the form 990 is completed and presented to the governing body of the hospital. The hospital makes available to the governing body (board of directors) a copy of the 990 for review and comment prior to the filing of the 990 return. This copy will be provided in a mailing to the board members prior to the filing of the 990. Each board member will have an opportunity to comment or ask questions about the 990 before it is filed. This process will be noted and documented in a written memo in the files of the board of directors.”

“The hospital board of directors monitors potential conflicts of interest of its board members, officers and key employees, by maintaining a conflict of interest policy. Annually, under the policy, all board members, principal officers, members of a committee with board delegated powers and key employees are provided with a copy of the policy and requested to complete a questionnaire identifying any potential conflicts of interests. A report of these potential conflicts is shared with the governance committee, the chair and the ceo. Board agendas and executive decisions are documented in relation to this policy.”

“The process for determining officers' compensation included a review and approval by independent persons, comparability data, and contemporaneous substantiation in 2012. Each year, under the direction of the lakeview health system's compensation committee, an annual total compensation market review is completed to provide a comprehensive market review for the following executive positions within lakeview health system ceo, system cfo, clinic president, clinic administrator, and hospital president. In 2011, the compensation committee retained an independent executive consulting firm to provide a review of all components of compensation including base salary, annual incentives, benefits and perquisites. In 2012, under the committee's direction, the ghi human resources department used the same recognized third party salary surveys to determine median salary structure changes. Based on this updated data, the committee learned the compensation rates that are considered p50 to p60 of the market for comparable lakeview positions. Other considerations of the committee include: achievement of organizational objectives, individual performance, experience, subjective evaluation by board members, general economic conditions, costs of replacement, prevailing community attitudes and beliefs regarding compensation. Total compensation is appropriately documented on the form 990 and w2s.”

“The hospital's financial statements and 990 returns are made available to any person who requests the information from the hospital or healthpartners, inc. The hospital's articles of incorporation are available to any person who requests the information through the minnesota secretary of state's office.”

“Average weekly hours: the compensated board members and officers of the hospital are employed and compensated by the hospital or ghi. The compensated board members and officers devote their time to multiple related organizations. Reported average hours worked are based on their total compensation from all related organizations.”

“I. Organization and governance lakeview memorial hospital association, inc. (hospital), a state licensed 97-bed, acute care, is a minnesota non-profit organization exempt from federal income tax under internal revenue code (irc) section 501(c)(3) and is part of the family of healthpartners organizations (healthpartners), an integrated system of health financing, care delivery, and support services providing health plan services to over 1,165,000 members and delivering care to over 4,500,000 patient encounters, primarily in minnesota and western wisconsin. Healthpartners' mission is to improve health and well-being in partnership with our members, patients and community. Healthpartners seeks to transform healthcare through a relentless focus on the triple aim - providing exceptional experience for the individual, improving the health of the population, and improving affordability - all at the same time. Healthpartners includes an array of tax-exempt and taxable entities - including five hospitals and their related foundations, two health maintenance organizations, four non-profit physician groups, home care, transitional care, medical equipment, a third party administrator that serves self insured employers, and many more. A complete listing of all healthpartners organizations, for which hpi is the parent organization and the reporting relationship between each of those organizations, can be found on schedule r within this 990 return. Healthpartners, inc. (hpi) is the parent entity of healthpartners and is a minnesota non-profit corporation and licensed health maintenance organization (hmo) recognized as exempt from federal income tax under irc section 501(c)(4). Hpi is the sole corporate member of hpi-ramsey, a minnesota non-profit corporation recognized as exempt from federal income tax under irc section 501(c)(3). In turn, hpi-ramsey is the sole corporate member of regions along with regions hospital foundation, capitol view transitional care center, stillwater health system (lakeview health), ramsey integrated health services and rh-wisconsin, inc., all of which are non-profit corporations exempt from federal income tax under irc section 501(c)(3). Stillwater health system (shs) is the sole corporate member of the hospital. Shs is a minnesota 501(c) (3) tax exempt organization. The hospital and shs are part of the lakeview health system along with the lakeview memorial hospital foundation, a minnesota 501(c) (3) tax exempt organization (the foundation) and stillwater medical group (smg), a minnesota 501(c) (3) tax exempt organization. Healthpartners and the hospital also partner with other plans, care providers and non-profit organizations in the region and throughout the nation; to increase access, create and disseminate quality measures and initiatives, participate in development of public policy and collaborate on system improvements. The hospital continues to be an integral part of the stillwater community and surrounding area - a vital and necessary community resource since 1880, the fifth oldest hospital, and second oldest continually operating hospital in minnesota. The hospital is designated a level 3 trauma hospital and has 117 active medical staff in a variety of specialties, including family medicine, internal medicine, pediatrics, ob/gyn, general surgery, orthopedics, otolaryngology, occupational health, emergency medicine, podiatry, hospitalists, neurology, geriatrics, oncology, urology, cardiology, sports medicine, allergy/immunology, ophthalmology, gastroenterology, dermatology, radiology, pathology and anesthesiology. Courtesy and consulting staff provide additional services, including plastic surgery, pain management, and infectious disease, pulmonary/sleep medicine and oral surgery. Hospitalists provide the majority of care for the hospital inpatients. Approximately 49% of surgical procedures performed at the hospital are same-day surgeries. The hospital employs 808 individuals, totaling 497 full time equi”

“Care for medicaid patients the hospital provides inpatient and outpatient care, including emergency department services, to medicaid patients. Payments received for these services are below the cost of care provided. The hospital's expense to cover unreimbursed medicaid costs for patients totaled $2,880,448. Subsidized health services the hospital is committed to providing needed services even at a financial loss. In 2013, loss on services for inpatient and outpatient health services including emergency and trauma (including emergency department and ambulance/ems services), hospital outpatient services (clinical nutrition, cardiac rehabilitation), ob/gyn services, and homecare and hospice services, totaled $1,401,880. Community health improvement services in 2012, in partnership with other members of the healthpartners hospital division, the hospital engaged the resources of community hospital consulting (chc consulting) to conduct a comprehensive, six-step community health needs assessment (chna). The chna started by utilizing relevant health data, findings from the washington county community health improvement plan (2010) and the healthier together - st. Croix county, health improvement process (chip) steering committee. Building on the assessments available from washington and st croix counties, chc coordinated a process to further identify and address specific needs in its market area, to complete the comprehensive community needs assessment for our market area serving a population of more than 250,000 residents in the eastern twin cities' metro area and western wisconsin in 2012. The hospital's 2012 chna worked with stakeholders by way of in-depth interviews, electronic survey results, a focus group, and a town hall meeting to identify the main community health priorities that lakeview will address in its chna implementation plan. From the research, findings and the top five priorities were identified to address these community health needs: priority 1: increase access to mental health priority 2: promote positive behaviors to reduce obesity (nutrition / physical activity) priority 3: increase access to primary and preventive care priority 4: improve service integration priority 5: promote change in unhealthy lifestyles (tobacco / alcohol / substance abuse) these top five priorities correlate very well with the five priorities identified in the healthier together - st. Croix plan that included: 1. Access to primary and preventive health services. 2. Overweight, obesity, and lack of physical activity. 3. Adequate and appropriate nutrition. 4. Alcohol and other substance use and addiction. 5. Tobacco use and exposure. As well as similar priorities identified by washington county public health and environment. 2013 implementation activities towards these priorities included existing and new programs and activities are moving forward to address the needs of the community. - continue support with healthpartners overall efforts to implement the mental health anti- stigma campaign. Some of these efforts include collaborating with local service agencies with a vested interest in mental health, supporting the annual nami walk, and utilizing healthpartners' resources and toolkits to raise public awareness of mental illness. - continue support for the st. Croix valley parish nurse program, which is a healthcare ministry providing physical, emotional and spiritual care for individuals, families and communities served by local congregations. The parish nurse promotes a greater understanding of health related issues and addresses these concerns through information and education. There are presently nine churches in the st. Croix valley parish nurse program. In 2013, the st. Croix valley parish nurses connected with over 3,800 individuals in our community and made over 620 referrals to church and community resources bridging people to the whole person care, services and support that they need for healing and greater well-being. The par”

“Mental and chemical health: grants to support mental and chemical health service for youth and adults in the community included: canvas health, community thread, familymeans, hope adoption & family service, place of grace, scv chaplaincy, youth service bureau; somerset schools; treehouse, familymeans and youth service bureau in addition, shs supported youth matters (formerly yadp) to bring courage retreats to stillwater junior high and oakland junior high schools through the youth frontiers program, the courage retreat, a prevention program for issues facing junior high youth. Shs continues as an active committee member and provides sponsorship support. Stillwater area schools wellness program and center: center- which operates at the largest high school in the service area. The wellness center is a physical space in the high school in collaboration with family means, youth service bureau, lakeview health system and independent school district 834 nonprofit organizations. This collaboration provides services to youth at low to no cost regarding mental health, diet and nutrition and chemical and alcohol abuse. The number of students served through the wellness center and program in isd 834 were as follows: - chemical health: 75 students - mental health: 351 students nutrition counseling was expanded to include students considered high risk through the alternative learning center and federal four program in 2013. Services were also expanded in somerset, wi schools reaching more than 500 students in 2013 for healthy lifestyles, plus more than 1500 through health classes, health fairs and presentations. On student surveys, 100% report nutrition counseling has been helpful and 98% report they have changed their eating habits for the better. In addition, the following organization and programs were supported for overall community benefit: - project life - valley outreach-support to provide milk for families who use the food shelf - young life-support young lives program for teenage mothers - youth advantage-providing scholarships for athletic, academic, and musical extracurricular activities for low income children - camp odayin - coalition for st. Croix river crossing - courage center st. Croix valley - good samaritan society (stillwater) - hope house - hudson hospital foundation - maef - northern star council bsa - red cross - st. Croix valley - rotary stillwater - somerset high school - stillwater high school - st. Andrews lutheran - st. Michaels catholic - stillwater lions club - stillwater public library - valley chamber chorale health professions education the hospital coordinates and supports weekly continuing medical education (cme) programs for staff and community education. Total direct costs for stipends, purchased services, supplies, room rentals, and indirect costs for the year were $62,260. Cash donations the hospital's cash donations to other tax-exempt community organizations in the form of sponsorships or contributions totaled $162,736. Community-building activities the hospital participated in community-building activities that supported economic development, emergency preparedness, leadership development, coalition building, health improvement advocacy, and workforce development including the st. Croix valley bridge coalition.”

“Transfer to affiliate - stillwater health system -100,000. Transfer to affiliate - lakeview memorial hospital foundation -289,969. Transfer to affiliate - stillwater medical group -6,100,000.”