2024-05-06T08:59:44-05:00 2023-06-30 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2022-07-01 460225414 ST MICHAEL'S HOSPITAL INC STMI 6055892100 410 WEST 16TH AVENUE TYNDALL SD 570662318 ASHLI DANILKO CEO 6055892100 2024-04-26 1 ASHLI DANILKO 999009999 1 LAURIE HANSON CPA P00851848 6053391999 2024-04-25 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ASHLI DANILKO 410 WEST 16TH AVENUE TYNDALL SD 570662318 13792150 0 0928 X WWW.AVERA.ORG/ST-MICHAELS X 1966 SD TO PROVIDE HEALTHCARE SERVICES. 7 7 113 10 230953 0 237502 296542 12577297 13445160 205980 46676 3650 2900 13024429 13791278 168 0 0 0 5960501 6749583 0 0 0 5312361 5876836 11273030 12626419 1751399 1164859 21985702 23294313 843293 678694 21142409 22615619 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 10593515 13217107 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, 2023, ACUTE PATIENT DAYS WERE 318 AND SWING-BED DAYS WERE 789. 10593515 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 34 0 1 113 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 7 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 1.00 X X 0 0 0 FATHER JOE FORCELLE MEMBER 1.00 X 0 0 0 RICHARD R PIER MEMBER UNTIL DEC 2022 1.00 X 0 0 0 DR JAMES TORSNEY MEMBER 1.00 X 0 0 0 SUSAN SHRADER MEMBER BEG JAN 2023 1.00 X 0 0 0 BEN HELLMANN MEMBER BEG JAN 2023 1.00 X 0 0 0 ASHLI DANILKO CEO 40.00 X 168717 0 42336 LISA RONKE DIRECTOR OF FINANCE 40.00 X 78245 0 5552 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 28.00 X 215905 0 36431 JACLYN DVORACEK PHARMACY MANAGER 36.00 X 147469 0 16309 TARA SCHAFERS PHARMACIST 40.00 X 135897 0 14847 JEREMIAH BERTSCHINGER PHARMACIST 40.00 X 135889 0 16191 ANGELA SCHNETZER PA-C 32.00 X 127787 0 5104 1009909 0 136770 8 0 1 1 AVERA SACRED HEART HOSPITAL 501 SUMMIT YANKTON SD 57078 ADMIN, IT, OTHER SERVICES 734746 HAUSMANN & SONS CONSTRUCTION 8885 EXECUTIVE WOODS DR LINCOLN NE 68512 CONSTRUCTION SERVICES 604761 AMERICAN HEALTHCARE STAFF 3051 WILLOWOOD RD EDMOND OK 73034 STAFFING COVERAGE 293018 AVERA MCKENNAN 1325 S CLIFF AVE SIOUX FALLS SD 57117 MEDICAL SERVICES 223312 AVERA HEALTH 3900 W AVERA DRIVE SIOUX FALLS SD 57108 MEDICAL SERVICES, CODING, OTHER SERVICES 200260 8 296442 100 296542 PATIENT SERVICE FEES 621110 10148808 10148808 RETAIL PHARMACY 456110 3249833 3018880 230953 46519 46519 13445160 3045 3045 2900 0 2900 2900 2900 44503 0 872 44503 -872 43631 43631 13791278 13217107 230953 46676 X 322389 322389 76053 76053 5135879 4697691 438188 232848 212079 20769 595706 539747 55959 386708 344909 41799 69760 69760 1343210 1042509 300701 13201 3161 10040 40223 17726 22497 193434 3366 190068 166432 119455 46977 25849 22324 3525 3456 2201 1255 732767 490615 242152 94573 63320 31253 SUPPLIES 2780783 2718560 62223 REPAIRS AND MAINTENANCE 245146 164026 81120 EQUIPMENT 66971 62150 4821 DUES AND SUBSCRIPTIONS 39698 29775 9923 61333 59901 1432 12626419 10593515 2032904 0 10901794 11723875 1616130 1586757 77777 392559 396947 50479 35253 11944798 7708224 3976867 4236574 4722066 4270760 325807 966370 21985702 23294313 769575 678694 73718 0 843293 678694 X 21121223 22594433 21186 21186 21142409 22615619 21985702 23294313 X 1164859 232989 75362 X 0 1 X 1 0 X 20893 0 20893 20893 20893 20893 20893 20893 20893 20763 130 20893 0.00000 1.00000 0.00000 0 0 5000 34375 39375 7052405 4283851 2768554 4705740 3311626 1394114 147278 112747 34531 4236574 INVESTMENT IN AVERA POOLED FUND 3191952 F INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 1078808 F 4270760 X 14099629 232989 232989 13866640 -75362 -75362 13791278 12626419 0 12626419 0 12626419 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 -75,362. 1 1 X 1 X 1 X 1 1 0 0 20000 20000 0.00160 20000 20000 0.00160 259669 11793 247876 0.01960 23479 2250 21229 0.00170 2480927 1294125 1186802 0.09400 13047 13047 0.00100 2777122 1308168 1468954 0.11630 2797122 1308168 1488954 0.11790 787 787 0.00010 200 200 0.00000 143 143 0.00000 1130 1130 0.00010 1 189519 27480 4380247 4405480 -25233 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 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: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 PLANS HAVE BEEN DETAILED TO SOLVE THE NEEDS IDENTIFIED IN THE CHNA.1. HEALTHCARE ACCESS FOR BON HOMME COUNTY, RECRUITMENT OF ADDITIONAL FAMILY PRACTICE PHYSICIAN. A. WITH THE BOARD DIRECTION, SUPPORT, AND ENGAGEMENT, WORK WITH AVERA'S PHYSICIAN RECRUITER TO IDENTIFY WORKLOAD TO SUPPORT OUR RECRUITMENT EFFORTS.B. EXPLORE THE USE OF A RECRUITMENT COMPANY TO IMPROVE OUR EFFORTS.C. ENGAGE MEDICAL STAFF IN THE RECRUITMENT PROCESS.D. REQUEST COMMUNITY ENGAGEMENT IN HIRING AND ONBOARDING PROCESS.E. ADDITIONAL STEPS TO BE DETERMINED AS THE PROCESS IS UNDERWAY.2. CONTINUE EFFORTS FROM THE PREVIOUS CHNA BY ADDRESSING THE PHYSICAL INACTIVITY IN OUR SERVICE AREA. A. EDUCATE COMMUNITY ON INCIDENCE OF DISEASE IN THE COUNTY AND ITS RELATION TO PHYSICAL INACTIVITY. POTENTIAL EDUCATIONAL OFFERINGS: SMH WOMEN'S NIGHT, DIABETIC EDUCATION, WELLNESS CENTER CLASSES, DISCHARGE PLANNING, EMPLOYEE WELLNESS CHALLENGES, ETC.B. ENGAGE COMMUNITY GROUPS AND EMPLOYEES IN EDUCATION AND PROGRAMMING EFFORTS. GROUPS TO COLLABORATE WITH: OTHER COMMUNITY FITNESS CENTERS, CIVIC GROUPS, LOCAL BUSINESSES, SCHOOL DISTRICT EVENTS AND SPORTS, ETC. C. UTILIZE EXISTING PROGRAMS AND SERVICES TO BUILD IN PREVENTATIVE EDUCATION AND PHYSICAL ACTIVITY. THESE PROGRAMS AND SERVICES INCLUDE PLANET HEART, OSTEOPOROSIS STRENGTH CLASS, PHARMACY CONSULTS, FOOT CLINIC, ETC. D. PREVENTATIVE PROGRAM FOCUS WOULD INCLUDE OBESITY, CARDIOVASCULAR DISEASE, AND DIABETES. IN THE CURRENT YEAR ST. MICHAEL'S HOSPITAL HAS HIRED A FAMILY PRACTICE PHYSICIAN, WHICH SATISFIES ONE OF THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA. SMH HAS ALSO CONTINUED WITH EFFORTS TO INCREASE EDUCATION AND PROMOTE PROGRAMS AND SERVICES TO ADDRESS PHYSICAL INACTIVITY IN OUR SERVICE AREA.DUE TO RESOURCE CONSTRAINTS, THE OTHER PRIORITY AREAS OF BEHAVIORAL HEALTH, DIABETES PREVALENCE AND OBESITY ARE NOT THE MAIN FOCUS AND WOULD NATURALLY BE CONDUITS OF IMPROVED OUTCOMES BASED ON THE TWO PRIORITY TOPICS CHOSEN. 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 1 1 - BON HOMME FAMILY PRACTICE CLINIC 130 MAIN STREET AVON SD 57315 FAMILY PRACTICE CLINIC 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. LINES 7E, 7F, AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINE 7G WAS OBTAINED FROM THE MEDICARE COST REPORT. PART I, LINE 7G: PHYSICIAN CLINIC COSTS ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES. REVENUES OF $704,372 AND COSTS OF $1,863,284 WERE INCLUDED FOR A NET COMMUNITY BENEFIT OF $1,158,912. 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 2022. THEREFORE, 14.5% 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 PAGES 9-10 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 6/30/23. 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 MAY 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 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: SMH 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. THE POPULATION ESTIMATES AS OF JULY 2023 REPORT 7,062 PEOPLE WITH 14.5% OF THE POPULATION AT POVERTY LEVEL IN BON HOMME COUNTY. 21% OF BON HOMME COUNTY'S POPULATION IS AGE 65 OR OLDER, COMPARED TO THE 18% 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 16 CLIENTS WERE SERVED DURING THE FISCAL YEAR ENDED 6/30/23 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 6/30/23, THERE WERE 946 PATIENTS WHO RECEIVED EMERGENCY CARE AT SMH. SMH ALSO MAKES AVAILABLE E-EMERGENCY SERVICES THROUGH AN ARRANGEMENT WITH AVEL ECARE 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 AND E-HOSPITALIST SERVICES ARE PROVIDED AT NO COST TO THE PATIENT. 34 PATIENTS BENEFITED FROM THESE SERVICES DURING THE FISCAL YEAR ENDED 6/30/2023. 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 NONPROFIT COMMUNITY ORGANIZATIONS, NONPROFIT EVENT SPONSORSHIPS, DONATED MEDICAL SUPPLIES, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH SCREENINGS, FLU-SHOT CLINICS, COMMUNITY HEALTH EDUCATION AND VARIOUS OTHER ACTIVITIES. X X X 0 0 0 0 0 0 0 0 0 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 213619 0 0 0 2286 0 8925 0 27506 0 252336 0 0 0 ASHLI DANILKO CEO 168205 0 0 0 512 0 8784 0 34852 0 212353 0 0 0 JACLYN DVORACEK PHARMACY MANAGER 146749 0 0 0 720 0 6272 0 10037 0 163778 0 0 0 JEREMIAH BERTSCHINGER PHARMACIST 135150 0 0 0 739 0 5821 0 10370 0 152080 0 0 0 TARA SCHAFERS PHARMACIST 135478 0 0 0 419 0 5540 0 9307 0 150744 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 76053 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 27,521. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,521. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 773,407. MANAGEMENT AND GENERAL EXPENSES 123,912. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 897,319. OTHER FEES: PROGRAM SERVICE EXPENSES 3,518. MANAGEMENT AND GENERAL EXPENSES 1,924. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,442. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 238,063. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 238,063. SHARED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 174,865. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 174,865. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF 75,362.