Altru Health System

“Form 990 is reviewed and approved by the board of directors prior to filing.”

“Conflict of interest policy is reviewed and signed off annually by all members of the board of directors. These forms are collected and reviewed by the secretary.”

“Determination of the compensation for the president and ceo are determined by the board. Substantiation of these discussions appear in the board minutes. Compensation of key employees are determined by a compensation committee formed of physicians that report to the board of directors.”

“The organizations 990 and 990-t public inspection copies are available upon request. Form 1023 is available upon request.”

“The organization's financial statements are made available to the public through published annual reports and via its web site. Governing documents and conflict of interest policy are available upon request.”

“Exclusion amount biomed services $47,280 site service fees $6,625 subtotal $53,905 cafeteria receipts $3,258 pharmacy sales to employees $11,783 housing/space rentals $499,588 vending machine income $92,101 sale of scrap/other $10,833 gain on disposal $105,613 subtotal $723,176 total exclusion amount $777,081 related or exempt function income cept revenue $68,680 hearing center $871,742 occupational health $427,561 vha supply co - distribution $795,887 purchase discounts $148,211 rebates $76,999 contract services, outreach, education $3,208,586 cpe fund $6,850 medical records transcript fees $193,419 affiliated other revenue $440,813 miscellaneous revenue $9,588,218 total related/exempt income $15,826,966”

“1. Cafeteria receipts: revenue incurred through the provision of meals for employees who have to be in the building during their regular workday. Purpose: provide these employees with a place to acquire and consume their meals; no alternatives are available. 2. Biomed services: revenue earned through the provision of services to area health care facilities needing to keep their equipment in operation in order to provide their patients with their service. The biomed program provides small regional hospitals with a service otherwise unobtainable from anyone in the local area; it is often on a priority basis. 3. Pharmacy sales to employees: revenue incurred in sales strictly for the convenience of employees. 4. Housing/space rentals: income incurred through the rental of space to the area health education center which is required to be on-site to work with our physicians providing health care to patients. 5. Cept revenue: revenue earned from the evaluation and treatment of adolescents through a multi-disciplinary approach including physical therapy, occupational therapy, speech pathology, and psychology. 6. Hearing center: revenue from the provision of audiological services and hearing aids to patients. 7. Occupational health: fees for providing drug screenings for regional employers. 8. Vha supply distribution: rebate received based on volume of supply purchases. 9. Purchase discounts: this figure represents cost savings on purchases from suppliers for goods used in the provision of health care services. 10. Rebates: rebates received based on volume of pharmacy purchases. 11. Site service fees: fees charged for providing grounds and maintenance for the area surrounding the united hospital, including fees for such services as maintenance of hospital parking lot, snow shoveling, and snow removal. 12. Vending machine income: income earned through the operation of vending machines in the buildings. 13. Contract services, outreach, education: revenues earned in the provision of community education/wellness programs, pastoral counseling services, and contracted services with regional healthcare systems to bring outreach services into their communities. 14. Cpe fund: clinical pastoral education income from pastoral residents. Program sponsored by the association of clinical pastoral education. 15. Medical record transcription fees: income earned through the charging of various third party payers for the photocopying of patient records. Insurance companies and payers are charged to offset the cost of copying. 16. Sale of scrap: income earned through the sale of items that are not fixed assets and are of diminished use to the organization. 17.other revenue charged to affiliated corporations: revenue from the provision of patient services, such as psych or laboratory, to the patients of other corporations, which are affiliated to altru health system. 18. Miscellaneous income: includes principally monies from medicare & medicaid for upgrading epic and mandated electronic health records software systems. Includes a return of expenses from an insurance pool. Also includes income earned through the provision of services that are operating in the hospital in nature, but have no specific cost center identifications. An example of this would be if the director of the communications department received a small token amount for filling out a survey from some health care organization.”

“Application of fasb asc topic 715 -10,215,456.”

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