Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
RAMSEY INTEGRATED HEALTH SERVICES
Employer identification number
41-1503090
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
6,856,696
7,344,517
7,127,903
7,891,371
7,822,613
37,043,100
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
6,856,696
7,344,517
7,127,903
7,891,371
7,822,613
37,043,100
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
0
c
Add lines 7a and 7b..
0
8
Public support (Subtract line 7c from line 6.)
37,043,100
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
6,856,696
7,344,517
7,127,903
7,891,371
7,822,613
37,043,100
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
4,201
2,940
1,350
1,065
609
10,165
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
4,201
2,940
1,350
1,065
609
10,165
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
6,860,897
7,347,457
7,129,253
7,892,436
7,823,222
37,053,265
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
99.970 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
99.940 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.030 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0.060 %
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
RAMSEY INTEGRATED HEALTH SERVICES
Employer identification number
41-1503090
Return Reference
Explanation
FORM 990, PART III, LINE 4A - EXEMPT PURPOSE AND ACHIEVEMENTS
I. ORGANIZATION AND GOVERNANCE RAMSEY INTEGRATED HEALTH SERVICES (RIHS) IS A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS 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 RIHS AND ITS SISTER ORGANIZATIONS, REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, RH-WISCONSIN, INC., STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), AND CAPITOL VIEW TRANSITIONAL CARE CENTER, ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RIHS IS A MEDICARE-CERTIFIED AND MINNESOTA-LICENSED HOME CARE AGENCY THAT PROVIDES SERVICES OF SKILLED NURSES; PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS; SOCIAL WORKERS; HOME HEALTH AIDES; AND OTHER PROFESSIONALS. THE GOAL OF RIHS IS TO HELP INDIVIDUALS REMAIN IN THEIR OWN HOMES AND PREVENT UNNECESSARY HOSPITALIZATIONS AND NURSING HOME STAYS. HOME DELIVERED PATIENT CARE IS PREFERRED BY PATIENTS AND IS MORE COST EFFECTIVE THAN SIMILAR SERVICES IN AN INSTITUTIONAL SETTING. II. PROVISION OF CARE HOME HEALTH CARE SERVICES IN 2013, RIHS SERVED OVER 4,000 CLIENTS AND PROVIDED APPROXIMATELY 66,000 VISITS. FORTY-FIVE PERCENT OF REVENUE WAS RECEIVED FROM MEDICARE; 19 PERCENT FROM MEDICAID MANAGED CARE AND THE STATE ELDERLY WAIVER PROGRAM; 27 PERCENT FROM HEALTHPARTNERS FOR CUSTOMERS WITH HEALTHPARTNERS MEDICAL COVERAGE (EXCLUDING HEALTHPARTNERS PREPAID MEDICAL ASSISTANCE PLAN), AND THE REMAINDER FROM OTHER SOURCES. IN 2013, RIHS PROVIDED SERVICES IN RAMSEY, HENNEPIN, WASHINGTON, DAKOTA, ANOKA AND SEVERAL OTHER COUNTIES. AS A PART OF HEALTHPARTNERS, RIHS WORKS COLLABORATIVELY WITH REGIONS HOSPITAL, THE HEALTHPARTNERS MEDICAL GROUP CLINICS (HPMG), STILLWATER MEDICAL GROUP, PARK NICOLLET CLINIC, PARK NICOLLET METHODIST HOSPITAL, AND HEALTHPARTNERS HOSPICE AND PALLIATIVE CARE TO PROVIDE EXCELLENT HOME CARE INCLUDING END OF LIFE CARE AND CARE TO PATIENTS WITH HEART FAILURE AND HIP AND KNEE REPLACEMENTS. IN ADDITION, RIHS CONTINUES TO SUPPORT AND PROVIDE THE REQUIRED HOMECARE SERVICES TO DUAL ELIGIBLE (MEDICARE AND MEDICAID) ELDERLY PATIENTS TO HELP KEEP THEM OUT OF MORE EXPENSIVE CARE SETTINGS. IN-HOME SERVICES PROVIDED BY RIHS INCLUDE: - MANAGEMENT OF CONDITIONS SUCH AS CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND CANCER - CARE FOR POST SURGICAL WOUNDS, BURNS, AMPUTATIONS AND SKIN ULCERS - ASSISTANCE WITH OVERCOMING LIFE-ALTERING INJURIES SUCH AS STROKES, FRACTURES AND SURGERIES - ASSISTANCE WITH PERSONAL CARE AND ACTIVITIES THAT SUPPORT INDEPENDENT DAILY LIVING - SOCIAL SERVICES - PAIN MANAGEMENT - PALLIATIVE (COMFORT) CARE, INCLUDING SYMPTOM MANAGEMENT; EMOTIONAL SUPPORT; END OF LIFE PLANNING; SPIRITUAL SUPPORT; MUSIC THERAPY; AND BEREAVEMENT SUPPORT FOR FAMILY MEMBERS. III. COMMUNITY BENEFIT ACTIVITIES UNCOMPENSATED CARE IN 2013, RIHS PROVIDED OVER $243,000 OF SERVICES TO PATIENTS THAT WERE NOT REIMBURSED. THESE COSTS INCLUDED PROVIDING $3,000 IN CHARITY CARE TO 13 CLIENTS WITH KNOWN LACK OF INSURANCE PRIOR TO ADMISSION AND $7,300 IN NON-REIMBURSABLE VISITS BY MEDICAL SOCIAL WORKERS TO 42 MEDICAID RECIPIENTS WHO DID NOT HAVE COVERAGE FOR HOME CARE SERVICES BUT WHO REQUIRED THE SPECIFIC SKILLS OF THE MEDICAL SOCIAL WORKER. COSTS ALSO INCLUDED OVER $136,000 BEING WRITTEN OFF FOR PATIENTS WHO WERE UNABLE TO PAY FOR THE NECESSARY SERVICES PROVIDED TO THEM DUE TO: LAPSES IN INSURANCE, NO COVERAGE FOR SERVICES PROVIDED AND SPEND-DOWNS. IN ADDITION, THE COST OF COMPLIMENTARY SERVICES PROVIDED TO CLIENTS RECEIVING PALLIATIVE CARE WAS $35,000. OF THESE CLIENTS RECEIVING COMPLIMENTARY PALLIATIVE CARE SERVICES, THERE WERE 320 CHAPLAIN HOME VISITS AND 148 MUSIC THERAPY HOME VISITS MADE DURING 2013. IN 2013, RIHS PROVIDED UNREIMBURSED INTERPRETER SERVICES TO CLIENTS AT A COST OF $62,000. RIHS OFFERED SEASONAL FLU SHOTS FREE OF CHARGE TO ALL PATIENTS, WHICH COST RIHS APPROXIMATELY $3,000 FOR THE DRUG COSTS ASSOCIATED WITH FLU SHOTS, PLUS THE EXPENSE OF ADMINISTERING THE FLU SHOTS. COLLABORATIVE RELATIONSHIPS WITHIN THE COMMUNITY RIHS HAS BUILT STRONG RELATIONSHIPS WITH OTHER COMMUNITY AGENCIES, WHICH PROVIDE SERVICES AND SUPPORT TO RIHS PATIENTS. THESE COMMUNITY AGENCIES SERVE AS A RESOURCE FOR THE DIVERSE GROUP OF PATIENTS THAT RIHS ASSISTS. A NUMBER OF RIHS EMPLOYEES ARE MEMBERS OF PROFESSIONAL ORGANIZATIONS SUCH AS THE MINNESOTA HOME CARE ASSOCIATION (MHCA), THE MINNESOTA ASSOCIATION OF HOMECARE SOCIAL WORKERS, THE HOME HEALTH AGENCY PROFESSIONAL ADVISORY COMMITTEE, NURSING ASSISTANT PROGRAM AT ST. PAUL COLLEGE, THE MINNESOTA DEPARTMENT OF HEALTH SPEECH LANGUAGE PATHOLOGIST AND AUDIOLOGIST LICENSING ADVISORY COMMITTEE AND THE TWIN CITIES HUMAN RESOURCE ASSOCIATION. WITHIN THESE ORGANIZATIONS, EMPLOYEES SERVE ON THE BOARDS, ATTEND COUNCIL MEETINGS, AND INTERACT WITH OTHER COMMUNITY LEADERS IN THE FIELD OF HOME HEALTH CARE. FOR EXAMPLE, RIHS EMPLOYEES SERVED ON THE MHCA BOARD OF DIRECTORS, THE MHCA MEDICARE TEAM, THE MHCA HUMAN RESOURCES TEAM, THE MHCA METRO REHAB COUNCIL, AND THE MHCA EDUCATION TEAM. RIHS ALSO SUPPORTS VARIOUS CULTURAL EVENTS AND ORGANIZATIONS IN THE COMMUNITY.
FORM 990, PART VI, SECTION A, LINE 6
HPI - RAMSEY IS THE SOLE CORPORATE MEMBER OF RIHS.
FORM 990, PART VI, SECTION A, LINE 7A
HPI - RAMSEY, THE SOLE CORPORATE MEMBER, ELECTS THE FOUR VOTING DIRECTORS OF THE BOARD OF DIRECTORS. ADDITIONALLY, THE PRESIDENT OF RIHS IS AN EX OFFICIO, NONVOTING DIRECTOR.
FORM 990, PART VI, SECTION A, LINE 7B
HPI - RAMSEY, THE SOLE CORPORATE MEMBER, MUST APPROVE THE DECISIONS OF THE RIHS BOARD OF DIRECTORS AS FOLLOWS: - AMENDMENT OF ARTICLES OR BYLAWS - ANNUAL OPERATING AND CAPITAL BUDGETS - ALL MAJOR CAPITAL EXPENDITURES - MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION - DISPOSITION OF SUBSTANTIALLY ALL ASSETS - DISSOLUTION - ACTIVITIES THAT COULD IMPACT THE SOLE CORPORATE MEMBER'S STATUS
FORM 990, PART VI, SECTION B, LINE 11
RIHS'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF RIHS. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF RIHS, GHI'S INTERNAL LEGAL DEPARTMENT AND RIHS'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 RIHS. RIHS 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.
FORM 990, PART VI, SECTION B, LINE 12C
RIHS'S BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE GENERAL COUNSEL SHARES A REPORT OF THESE POTENTIAL CONFLICTS WITH THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15
RIHS'S OFFICERS, DIRECTORS AND HIGHLY COMPENSATED EMPLOYEES ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS) OR BY GROUP HEALTH PLAN, INC. (GHI), BOTH OF WHICH ARE RELATED ORGANIZATIONS, OR BY RIHS. REGIONS, GHI AND RIHS HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF RIHS'S OFFICERS, DIRECTORS AND HIGHLY COMPENSATED EMPLOYEES. EVERY THREE YEARS, UNDER THE DIRECTION OF THE GHI BOARD OF DIRECTORS' COMPENSATION COMMITTEE (COMPENSATION COMMITTEE), A TOTAL COMPENSATION MARKET REVIEW IS COMPLETED. THE REVIEW INCLUDES ALL COMPONENTS OF COMPENSATION; BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE DIRECTION OF THE COMPENSATION COMMITTEE, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION COMMITTEE. FOR THE CHIEF EXECUTIVE OFFICER AND CERTAIN OTHER POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED. IN ALL CASES, COMMITTEE MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMPENSATION COMMITTEE MEMBERS' INDEPENDENCE, STAFF IS NOT IN ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND W2 STATEMENTS. THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE THE ACCOUNTABILITY TO CONDUCT AN ANNUAL PERFORMANCE EVALUATION AND TO DETERMINE THE COMPENSATION OF THE CEO BASED ON THE PERFORMANCE REVIEW AND THE MARKET COMPARABILITY DATA, APPROVED BY THE COMPENSATION COMMITTEE. THE BOARD HAD DELEGATED TO THE CEO (WITH AUTHORITY TO FURTHER DELEGATE) THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL OTHER OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMPENSATION COMMITTEE. ANY EXCEPTIONS NEED TO BE APPROVED BY THE COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19
RIHS'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM RIHS OR HEALTHPARTNERS, INC. RIHS'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. RIHS'S CONFLICT OF INTEREST POLICY THROUGH IT'S RELATED ORGANIZATION, HEALTHPARTNERS, INC. CAN BE VIEWED THROUGH THE HEALTHPARTNERS.COM WEBSITE.
FORM 990, PART VII, SECT. A, COL. (B) - AVERAGE HRS., RELATED ORGANIZATIONS
ALL BOARD MEMBERS AND OFFICERS OF RIHS ARE EMPLOYED AND COMPENSATED BY GHI OR REGIONS HOSPITAL. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.