CHI St. Alexius Health Garrison

What it reported doing in 2024

Garrison memorial hospital delivers primary health care to a population of approximately 6,000 in mclean, ward, mchenry, and mountrail counties. We operate a 22-bed critical access hospital and a 26-bed skilled nursing facility. We also operate a rural health clinic in garrison, North Dakota. Our facility employs approximately 100 staff and providers.garrison memorial hospital makes medical care accessible to the entire community it serves. It operates a 24-hour, level 5 state certified emergency room. In fiscal year 2025 we had 1,770 emergency room visits. We also had 431 acute days of care, 650 swing bed days, 6,486 days of skilled nursing care, and 8,368 provider visits. Garrison memorial hospital's charity care policy provides discounted and free services to patients who lack the resources to be fully responsible for the healthcare they receive. The charity care policy is designed to ensure the population served by garrison memorial hospital has access to needed healthcare services. In fiscal year 2025, garrison memorial hospital and its clinic had $179,825 in charity care and $98,477 in bad debt write offs. Our rural health clinic offers a sliding fee schedule to uninsured and underinsured patients, which is mandated by the national health service corps program. One hundred percent of qualified uninsured or underinsured sliding fee schedule patients are written off as charity care. In fiscal year 2025, the garrison memorial hospital (excluding ltc) payer mix was approximately 56% medicare, 8% medicaid, 3% other (including indian health services), 4% self-pay and 29% commercial insurance. All payers are charged the same regardless of insurance.

Financial Efficiency

• Mission deployment rate: 100%; rating input score 100
• Program expense ratio: 94.5%; rating input score 95
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 62nd percentile among comparable filings
• Pay-setting controls: 0 of 6 controls in place; rating input score 0
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Missing
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Limited
• Related-party transparency: Limited

Accountability

• Independent voting board: 56.2%; rating input score 56; 9th percentile among comparable filings
• Governance controls: 7 of 9 controls in place; rating input score 78
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Fail
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -5.8%; rating input score 15; 15th percentile among comparable filings
• Total-asset coverage ratio: 2.76; rating input score 72; 72nd percentile among comparable filings
• Liabilities to assets ratio: 0.79; rating input score 14; 14th percentile among comparable filings
• Officer compensation ratio: 17.4%; rating input score 6; 6th percentile among comparable filings

Growth

• Program expense growth: 3.3% per year; rating input score 100; 28th percentile among comparable filings
• Revenue growth: 2.7% per year; rating input score 100; 23rd percentile among comparable filings
• Asset growth: 15.7% per year; rating input score 100; 82nd percentile among comparable filings