2025-04-11T14:14:47-05:00 2024-06-30 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2023-07-01 460225414 ST MICHAEL'S HOSPITAL INC STMI 6055892100 410 WEST 16TH AVENUE TYNDALL SD 570662318 ASHLI DANILKO CEO 6055892100 2025-04-10 1 1 LAURIE HANSON CPA P00851848 6053391999 2025-04-09 2023 2025-03-06 01:10:19Z ASHLI DANILKO 410 WEST 16TH AVENUE TYNDALL SD 570662318 15038562 0 0928 X WWW.AVERA.ORG/ST-MICHAELS X 1966 SD TO PROVIDE HEALTHCARE SERVICES. 6 6 105 10 300984 0 296542 23572 13445160 14472134 46676 535392 2900 4000 13791278 15035098 0 0 0 0 6749583 6794503 0 0 0 5876836 6557037 12626419 13351540 1164859 1683558 23294313 25509450 678694 784836 22615619 24724614 X IT IS THE MISSION OF ST. MICHAEL'S HOSPITAL TO PROVIDE READILY ACCESSIBLE HEALTH CARE TO THE PEOPLE OF BON HOMME COUNTY AND THE SURROUNDING AREAS. IN KEEPING WITH THE HERITAGE OF THE CATHOLIC CHURCH, ST. MICHAEL'S WILL AIM TO PROMOTE THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL HEALTH OF ALL ITS PATIENTS. THE HEALTH CARE CENTERS WILL CONTINUE TO OFFER QUALITY SERVICES BASED ON COMMUNITY NEEDS AND FISCAL SOLVENCY. 0 0 11142574 14175150 ST. MICHAEL'S HOSPITAL, INC. (SMH) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL WITH PROVIDER BASED RURAL HEALTH CLINICS LOCATED IN TYNDALL AND IN AVON. PROVIDER STAFF, NURSING PERSONNEL, LABORATORY AND RADIOLOGY PERSONNEL ARE AVAILABLE AS NEEDED 24-HOURS A DAY, 7-DAYS A WEEK. DURING THE FISCAL YEAR ENDING JUNE 30, 2024, ACUTE PATIENT DAYS WERE 343 AND SWING-BED DAYS WERE 739. 11142574 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 28 0 1 105 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X X LISA RONKE 6055892100 410 W 16TH AVE TYNDALL SD 570662318 CONNIE TJEERDSMA BOARD CHAIR 1.00 X X 0 0 0 AUSTIN KOCH VICE CHAIR 1.00 X X 0 0 0 LAURIE JURRENS SECRETARY/TREASURER 1.00 X X 0 0 0 FATHER JOE FORCELLE MEMBER 1.00 X 0 0 0 DR JAMES TORSNEY MEMBER 1.00 X 0 0 0 SUSAN SHRADER MEMBER UNTIL 04/2024 1.00 X 0 0 0 BEN HELLMANN MEMBER 1.00 X 0 0 0 ASHLI DANILKO CEO 40.00 X 180288 0 41856 LISA RONKE DIRECTOR OF FINANCE 40.00 X 75987 0 9094 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 28.00 X 219678 0 43032 JACLYN DVORACEK PHARMACY DIRECTOR 36.00 X 142682 0 42766 TARA SCHAFERS PHARMACIST 40.00 X 138030 0 32890 DR KARL DEMARCO PHYSICIAN 40.00 X 277617 0 13759 ANGELA SCHNETZER PA-C 32.00 X 136700 0 9556 1170982 0 192953 12 0 1 1 AVERA SACRED HEART HOSPITAL 501 SUMMIT YANKTON SD 57078 MGMT,ST,IT,BIOMED,LAB,DIETARY AND SUPPLI 843878 AMERICAN HEALTHCARE STAFF 3051 WILLOWOOD RD EDMOND OK 73034 LOCUMS STAFFING COVERAGE 330600 AVERA MCKENNAN 1325 S CLIFF AVE SIOUX FALLS SD 57117 MEDICAL SERVICES 289360 AVERA HEALTH 3900 W AVERA DRIVE SIOUX FALLS SD 57108 MEDICAL SERVICES, CODING, OTHER SERVICES 248278 TESSIERS INC 218 E 1ST AVE MITCHELL SD 68512 CHILLER INSTALLED 148098 6 13312 10260 23572 PATIENT SERVICE FEES 621110 10622097 10622097 RETAIL PHARMACY 456110 3777060 3476076 300984 72977 72977 14472134 408642 408642 4000 0 4000 4000 4000 130214 0 3464 130214 -3464 126750 126750 15035098 14175150 300984 535392 X 327520 327520 89113 12293 76820 5310051 4832818 477233 62577 60012 2565 617683 558457 59226 387559 345181 42378 57480 57480 1695085 1107451 587634 12268 3084 9184 31020 11940 19080 2727 2727 200042 197665 2377 24684 22157 2527 6244 4815 1429 770031 514306 255725 97996 65452 32544 SUPPLIES 3244907 3092492 152415 REPAIRS AND MAINTENANCE 287059 205562 81497 EQUIPMENT 47208 38284 8924 DUES AND SUBSCRIPTIONS 38525 29256 9269 41761 41349 412 13351540 11142574 2208966 0 11723875 13583347 1586757 1670898 396947 431790 35253 134755 12138576 8315148 4236574 3823428 4270760 4730437 77777 44444 966370 1090351 23294313 25509450 678694 784836 678694 784836 X 22594433 24703428 21186 21186 22615619 24724614 23294313 25509450 X 1683558 297912 127525 X 0 1 X 1 0 X 20893 70 20963 20893 20893 20893 20893 20893 20893 20893 20893 0.00000 1.00000 0.00000 0 0 5000 34375 39375 7044138 4617310 2426828 4907785 3576680 1331105 147278 121158 26120 3823428 INVESTMENT IN AVERA POOLED FUND 3525272 F INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 1205165 F 4730437 X 15460535 297912 297912 15162623 -127525 -127525 15035098 13351540 0 13351540 0 13351540 PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO PROVIDE FOR CAPITAL NEEDS THAT MAY ARISE. PART X, LINE 2: THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -127,525. 1 1 X 1 X 1 X 1 1 1 0 0 231000 231000 0.01730 486283 426988 59295 0.00440 717283 426988 290295 0.02170 226190 9584 216606 0.01620 13534 250 13284 0.00100 2579421 1296590 1282831 0.09610 12871 12871 0.00100 2832016 1306424 1525592 0.11430 3549299 1733412 1815887 0.13600 824 824 0.00010 1139 1139 0.00010 700 700 0.00010 2663 2663 0.00030 1 464205 62203 4363705 4389004 -25299 X 1 1 1 1 ST MICHAEL'S HOSPITAL INC 410 WEST 16TH AVENUE TYNDALL SD 570660027 WWW.AVERA.ORG/ST-MICHAELS 48584 X X X X 2 PROVIDER BASED RURAL HEALTH CLINIC ST MICHAEL'S HOSPITAL INC 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V SECTION B X SEE PART V SECTION B X 1 21 1 SEE PART V SECTION B 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X WWW.AVERA.ORG/LOCATIONS/PROFILE/ST-MICHAELS-HOSPITAL-AVERA/ X WWW.AVERA.ORG/LOCATIONS/PROFILE/ST-MICHAELS-HOSPITAL-AVERA/ X WWW.AVERA.ORG/LOCATIONS/PROFILE/ST-MICHAELS-HOSPITAL-AVERA/ X X X X X X 1 X 0 X X X X 1 X 0 0 ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 5: SMH HELD FOCUS GROUPS IN THE FALL OF 2021, CONDUCTED IN-PERSON ONE ON ONE CONVERSATIONS AND FACILITATED AN ELECTRONIC SURVEY FEBRUARY & MARCH 2022. GROUPS AND INDIVIDUALS WERE CHOSEN TO PARTICIPATE BASED ON BEING A MEMBER OF THE COMMUNITY THE HOSPITAL SERVES AND/OR BEING A PROVIDER OF SERVICES TO THE COMMUNITY IN SOME CAPACITY. VARIOUS INDIVIDUALS, AS WELL AS REPRESENTATIVES FROM BON HOMME AND AVON SCHOOLS, MINISTERIAL ASSOCIATION, FOOD PANTRY, BON HOMME COUNTY HEALTH NURSE, BARGAIN SHOPPE, CHAMBER OF COMMERCE, MIKE DURFEE STATE PRISON, EMS, FIRE DEPARTMENTS, NURSING HOME, SENIOR CITIZENS, BOARD MEMBERS, MEDICAL STAFF AND EMPLOYEES WERE ENGAGED AND PROVIDED INPUT. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 11: AS PART OF THE CHNA COMPLETED IN 2021, THE COMMITTEE DISCUSSED THE DATA GATHERED AND CAME TO A CONSENSUS, RANKING THE HEALTH NEEDS AND FOCUS AREAS FOR THE COMMUNITY AS FOLLOWS:OUR TWO IDENTIFIED ACTION PLANS FROM THE 2022 CHNA ARE AS FOLLOWS:1. HEALTHCARE ACCESS FOR BON HOMME COUNTY, INCLUDING RECRUITMENT OF AN ADDITIONAL FAMILY PRACTICE PHYSICIAN. 2. CONTINUE EFFORTS FROM THE PREVIOUS CHNA BY ADDRESSING PHYSICAL INACTIVITY IN OUR SERVICE AREA. ACTION RELATED UPDATES TO #1. A FAMILY PRACTICE PHYSICIAN WAS HIRED NOVEMBER 2022, GROWING OUR FAMILY PRACTICE PROVIDERS IN THE COUNTY. FOCUSED ON INCREASING COMMUNITY ACCESS TO HEALTHCARE IN FY24 IN THE AREAS OF MEDICARE D REVIEW, SPACE PROVIDED FOR COUNSELING SERVICES, WOUND CARE AND FOOT CARE CLINICS, PLANET HEART SERVICES, AND OUTREACH FOR VARIOUS SERVICE LINES. ACTION RELATED UPDATES TO #2. IN FY2024, WE FOCUSED EFFORTS WITH THE LOCAL SCHOOL DISTRICT AND PROVIDED STRENGTH AND CONDITIONING SUPPORT TO ALL STUDENT ATHLETES, SPORTS SCREENINGS, WEIGHTLIFTING EDUCATION, BIKE HELMETS FOR SAFETY AND ENCOURAGED PHYSICAL ACTIVITY. OTHER EFFORTS IN FY2024 INCLUDED WORKING WITH THE LOCAL FOOD PANTRY FARMERS MARKET TO PROVIDE FOOD VOUCHERS TO COMMUNITY MEMBERS TO ENCOURAGE EATING FRESH, HEALTHY FOODS. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY IS UTILIZED AS A LAST RESORT. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 16J: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE EMERGENCY ROOM, RECEPTION AREA AND WAITING AREAS. STAFF DISCUSS THE AVAILABILITY OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY WITH PATIENTS DURING THEIR STAY. NOTICE IS ALSO INCLUDED IN PAYMENT REMINDER LETTERS AND IN STATEMENTS. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 24: THE HOSPITAL FINANCIAL ASSISTANCE POLICY DOES NOT COVER ELECTIVE PROCEDURES. THE HOSPITAL MAY HAVE CHARGED FAP ELIGIBLE PATIENTS GROSS CHARGES FOR SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY. PART V. SECTION B, LINE 7A THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT HTTPS://WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/#MICHAEL PART V. SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST AND ATHTTPS://WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/#MICHAEL PART I, LINE 3C: IN ADDITION TO THE USE OF FPG TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE, SMH ALSO LOOKS AT THE PATIENT'S MEDICAL INDIGENCY, INSURANCE STATUS AND ELIGIBILITY FOR MEDICARE/MEDICAID. BEING IN A RURAL COMMUNITY WITH A SMALL POPULATION, SMH MAY ALSO USE KNOWN INFORMATION OF A PATIENT'S HARDSHIPS IN MAKING THE FINAL DETERMINATION. PRESUMPTIVE ELIGIBILITY IS UTILIZED AS A LAST RESORT. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINE 7B WAS OBTAINED UTILIZING THE MEDICAID COST REPORT. LINES 7E, 7F, AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINE 7G WAS OBTAINED FROM THE MEDICARE COST REPORT. PART II, COMMUNITY BUILDING ACTIVITIES: SMH IS INVOLVED WITH THE AREA CHAMBER OF COMMERCE AND ROTARY CLUB. SMH WORKS TO ENHANCE THE QUALITY OF LIFE AND EMPOWER ITS PATIENTS, CARE-GIVERS AND COMMUNITY WITH THE RESOURCES THEY NEED WHEN THEY NEED THEM. SMH ALSO PROVIDES HEALTHCARE CAREER EDUCATION TO PROMOTE HEALTHCARE CAREERS AND RURAL HEALTH. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN 2023. THEREFORE, 13.4% OF IMPLICIT PRICE CONCESSIONS CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENT. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 6/30/24. MANY PATIENTS IN OUR SERVICE AREA QUALIFY FOR MEDICARE. THE FACILITY PROVIDES SERVICES TO THESE PATIENTS EVEN THOUGH MEDICARE REIMBURSEMENT IS NOT SUFFICIENT TO COVER THE COST OF PROVIDING THIS CARE. PROVIDING SERVICES TO THIS POPULATION PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE NEEDED IN OUR COMMUNITY, THEREBY PROVIDING A BENEFIT TO OUR COMMUNITY. PART III, LINE 9B: SMH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE HOSPITAL DOES NOT PURSUE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. PART VI, LINE 2: IN ORDER TO DETERMINE NEEDS OF THE COMMUNITY WE SERVE, ST. MICHAEL'S HOSPITAL CONDUCTS PATIENT SURVEYS VIA TELEPHONE THROUGH HEALTHSTREAMS, AND OUR PROVIDERS HAVE MONTHLY MEETINGS FOR CLINIC AND MEDICAL STAFF AT WHICH TIME THEY DISCUSS NEEDS THAT ARE IDENTIFIED THROUGH THE SURVEYS AND THROUGH OFFICE VISITS. INPUT IS ALSO RECEIVED FROM OUR BOARD OF DIRECTORS MEETINGS AND STAFF ROUNDING MEETINGS. PART VI, LINE 3: THE SMH STAFF ASSISTS PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BY DISCUSSING THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTING THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS WHERE APPLICABLE. THE PROGRAMS ARE DISCUSSED DURING THEIR STAY AND AT PATIENT REQUEST. POSTERS HIGHLIGHTING VARIOUS ASSISTANCE OPTIONS ARE POSTED IN THE ADMISSION AREA. SMH STAFF ALSO DISCUSS THE AVAILABILITY OF ITS CHARITY CARE POLICY WITH PATIENTS DURING THEIR STAY. PART VI, LINE 4: ST. MICHAEL'S HOSPITAL SERVES A RURAL POPULATION IN BON HOMME COUNTY WHICH INCLUDES THE CITIES OF TYNDALL, AVON, TABOR, AND SPRINGFIELD. THERE IS ONE OTHER HOSPITAL IN BON HOMME COUNTY LOCATED IN SCOTLAND, SD. THE POPULATION ESTIMATES AS OF 7-1-23 REPORT 7,065 PEOPLE WITH 13.4% OF THE POPULATION AT POVERTY LEVELS IN BON HOMME COUNTY. 21.6% OF BON HOMME POPULATION IS AGE 65 OR OLDER, COMPARED TO 18.4% IN THE STATE OF SOUTH DAKOTA. PART VI, LINE 5: SMH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN BON HOMME COUNTY WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SMH APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE AND PROVIDES READILY ACCESSIBLE HEALTH CARE TO THE PEOPLE OF BON HOMME COUNTY AND THE SURROUNDING AREA. SMH PROVIDES A VARIETY OF COMMUNITY BENEFIT HEALTH ACTIVITIES AT NO COST OR LESS THAN COST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, NUTRITION EDUCATION, FOOT CLINICS, CPR CLASSES, AND BLOOD PRESSURE SCREENINGS. A VARIETY OF PROGRAMS ARE PROVIDED AT NO CHARGE FOR THE CHILDREN IN OUR COMMUNITIES SUCH AS THE IMPACT CONCUSSION PROGRAM, FLU SHOT CLINICS, AND ATHLETIC SCREENINGS. SMH ALSO PROVIDES ATHLETIC PHYSICALS FOR STUDENTS AT A DISCOUNTED RATE. SMH PROVIDES A NURSE ON AN AS NEEDED BASIS FOR AMBULANCE TRANSFERS AT NO COST TO THE LOCAL AMBULANCE SERVICE. APPROXIMATELY 13 CLIENTS WERE SERVED DURING THE FISCAL YEAR ENDED 6/30/24 FOR AMBULANCE TRIPS. SMH PROVIDED FINANCIAL AND IN KIND DONATIONS FOR VARIOUS COMMUNITY NEEDS SUCH AS MEETING ROOM AVAILABILITY, MEDICAL STAFF COVERAGE AT LOCAL SPORTING EVENTS, AND HEALTH EDUCATION, INCLUDING HEALTH PROFESSION EDUCATION FOR STUDENTS GOING INTO THE HEALTHCARE FIELD. SMH PROVIDES EMERGENCY SERVICES 24-HOURS A DAY, 7-DAYS A WEEK. IN ADDITION TO NURSING STAFF, A MIDLEVEL PROVIDER AND/OR PHYSICIAN ARE IN HOUSE OR ON CALL AT ALL TIMES TO PROVIDE CARE TO ANYONE PRESENTING WITH AN EMERGENT CONDITION REGARDLESS OF THEIR ABILITY TO PAY. FOR FISCAL YEAR ENDED 6/30/24, THERE WERE 985 PATIENTS WHO RECEIVED EMERGENCY CARE AT SMH. SMH ALSO MAKES AVAILABLE E-EMERGENCY SERVICES THROUGH AN ARRANGEMENT WITH AVEL, LLC WHEREBY EMERGENCY PHYSICIANS AND OTHER SPECIALISTS ARE AVAILABLE VIA VIDEO CONFERENCING TO ASSIST THE MEDICAL STAFF AND NURSES WITH PATIENTS PRESENTING TO THE SMH EMERGENCY ROOM. THE E-EMERGENCY SERVICES ARE PROVIDED AT NO COST TO THE PATIENT. 27 PATIENTS BENEFITED FROM THE E-EMERGENCY SERVICES DURING THE FISCAL YEAR ENDED 6/30/24. PART VI, LINE 6: SMH IS A MANAGED FACILITY OF AVERA HEALTH. AVERA HEALTH AND THE HOSPITAL WORK COOPERATIVELY TO ENHANCE HEALTHCARE THROUGHOUT THE COMMUNITY SERVED BY SMH. SMH ALSO HAS ACCESS TO "BACK OFFICE" SUPPORT SERVICES, SUCH AS LEGAL CONSULTATION, QUALITY BENCHMARKING, CODING, COMPUTER SERVICES, CONTRACT NEGOTIATIONS, ADMINISTRATIVE CONSULTATION, GROUP PURCHASING, HUMAN RESOURCES ASSISTANCE AND MANY OTHER SERVICES. AVERA HEALTH IS ABLE TO PROVIDE THESE SERVICES TO SMH AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT CARE. AVERA HEALTH AND SMH DEDICATE RESOURCES TO ENDEAVORS THAT MAKE A POSITIVE DIFFERENCE TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. THESE ACTIVITIES INCLUDE LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENTS IN THE COMMUNITY, CONTRIBUTIONS TO NON-PROFIT COMMUNITY ORGANIZATIONS, NON-PROFIT EVENT SPONSORSHIPS, DONATED MEDICAL SUPPLIES, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH SCREENINGS, FLU-SHOT CLINICS, AND VARIOUS OTHER ACTIVITIES. X X X 0 0 0 0 0 0 0 0 0 DR KARL DEMARCO PHYSICIAN 277617 0 0 0 0 0 2581 0 11177 0 291375 0 0 0 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 217392 0 0 0 2286 0 13647 0 29384 0 262709 0 0 0 ASHLI DANILKO CEO 180123 0 0 0 165 0 7203 0 36280 0 223771 0 0 0 JACLYN DVORACEK PHARMACY DIRECTOR 142493 0 0 0 189 0 12292 0 30475 0 185449 0 0 0 TARA SCHAFERS PHARMACIST 137569 0 0 0 461 0 10478 0 22412 0 170920 0 0 0 SCHEDULE J LINE 3 ASHLI DANILKO, CEO, IS COMPENSATED THROUGH AN ARRANGEMENT WITH AVERA SACRED HEART HOSPITAL, 501 SUMMIT STREET, YANKTON, SD 57078. CHAD JENSEN BROTHER OF CEO 76820 EMPLOYEE WAGES 0 KENDRA KRUEGER DAUGHTER OF BOARD CHAIR 12293 EMPLOYEE WAGES 0 FORM 990, PART VI, SECTION A, LINE 8B THE BOARD OF DIRECTOR COMMITTEES ARE ADVISORY IN NATURE ONLY AND DO NOT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND CFO REVIEW THE 990. THE 990 IS THEN PROVIDED TO EACH BOARD MEMBER FOR THEIR REVIEW PRIOR TO THE ACTUAL FILING OF THE 990. FORM 990, PART VI, SECTION B, LINE 12C ST. MICHAEL'S HOSPITAL CONFLICT OF INTEREST POLICY COVERS ANY DIRECTOR/TRUSTEE, OFFICER, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, MEMBER OF MANAGEMENT WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, CEO AND CFO AS WELL AS THEIR FAMILY MEMBERS. SMH REQUIRES ANY DIRECTOR/TRUSTEE, BOARD COMMITTEE MEMBER, OFFICER AND MEMBER OF MANAGEMENT TO DISCLOSE THE EXISTENCE OF A FINANCIAL INTEREST, OTHER ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND ALL MATERIAL FACTS ANNUALLY BY COMPLETING A DISCLOSURE STATEMENT; AND IF A CONFLICT OF INTEREST ARISES AFTER THE COMPLETION OF THE ANNUAL DISCLOSURE, AT THE TIME THE NEW CONFLICT ARISES. THE BOARD OF DIRECTORS MAKES THE DETERMINATION AS TO WHETHER A CONFLICT OF INTEREST EXISTS. THE BOARD OF DIRECTORS ADDRESSES CONFLICT OF INTERESTS VIA A FORMALIZED PROCEDURE. THIS PROCEDURE MAY INCLUDE A PRESENTATION BY THE INTERESTED PERSON, BUT EXCLUDES THE INTERESTED PERSON FROM FURTHER DISCUSSION OR VOTING ON THE TRANSACTION OR ARRANGEMENT THAT MAY CONSTITUTE A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS ALSO INCLUDE A STANDING AGENDA ITEM AT THE BEGINNING OF EACH MEETING WHICH REQUIRES THE DISCLOSURE OF POTENTIAL CONFLICT OF INTEREST FOR ANY ITEMS INCLUDED ON THE AGENDA. FORM 990, PART VI, SECTION B, LINE 15 AVERA SACRED HEART HEALTH SERVICES AND SMH'S BOARD OF DIRECTORS USE COMPARABILITY DATA TO DETERMINE APPROPRIATE COMPENSATION OF THE CEO BASED ON EXPERIENCE AND PERFORMANCE. THE COMPENSATION AMOUNT IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS. THE CEO DETERMINES THE COMPENSATION FOR OTHER MEMBERS OF MANAGEMENT INCLUDING THE CFO BASED ON AN ANNUAL PERFORMANCE APPRAISAL AND USE OF COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE FACILITY MAKES THE CONFLICT OF INTEREST POLICY AND BYLAWS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 22,758. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,758. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 751,845. MANAGEMENT AND GENERAL EXPENSES 369,709. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,121,554. OTHER FEES: PROGRAM SERVICE EXPENSES 2,953. MANAGEMENT AND GENERAL EXPENSES 22,560. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,513. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 329,895. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 329,895. SHARED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 195,365. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 195,365. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 127,525.