MADISON COMMUNITY HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
MADISON COMMUNITY HOSPITAL (EIN 46-0228038)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-16
IRS object ID
202201369349302425
Schema version
2020v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-16T08:39:58-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 E 10TH ST STE 500AddressLine1Txt
CitySIOUX FALLSCityNm
State AbbreviationSDStateAbbreviationCd
ZIP571046375ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN460228038EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MADISON COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMADIBusinessNameControlTxt
Phone6052566551PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1323 SW 10TH STAddressLine1Txt
CityMADISONCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57042ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTAMARA MILLERPersonNm
Person TitleCEOPersonTitleTxt
Phone6052566551PhoneNum
Signature2022-05-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTAMARAPersonFirstNm
Person LastMILLERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURIE HANSON CPAPreparerPersonNm
PTINP00851848PTIN
Phone6053391999PhoneNum
Preparation2022-05-02PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MADISON REGIONAL HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTAMARA MILLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1323 SW 10TH STAddressLine1Txt
CityMADISONCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57042ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$38,454,353GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MADISONREGIONALHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1955FormationYr
Legal Domicile StateSDLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH CARE SERVICES TO AREA RESIDENTS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee322TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$153,276PYContributionsGrantsAmt
CY Contributions Grants$7,248,656CYContributionsGrantsAmt
PY Program Service Revenue$30,168,650PYProgramServiceRevenueAmt
CY Program Service Revenue$30,941,858CYProgramServiceRevenueAmt
PY Investment Income$258,654PYInvestmentIncomeAmt
CY Investment Income$73,811CYInvestmentIncomeAmt
PY Other Revenue$144,755PYOtherRevenueAmt
CY Other Revenue$153,386CYOtherRevenueAmt
PY Total Revenue$30,725,335PYTotalRevenueAmt
CY Total Revenue$38,417,711CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$16,721,319PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,467,158CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$14,263,469PYOtherExpensesAmt
CY Other Expenses$12,916,929CYOtherExpensesAmt
PY Total Expenses$30,984,788PYTotalExpensesAmt
CY Total Expenses$29,384,087CYTotalExpensesAmt
PY Revenues Less Expenses-$259,453PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,033,624CYRevenuesLessExpensesAmt
Total Assets BOY$58,899,676TotalAssetsBOYAmt
Total Assets EOY$56,987,593TotalAssetsEOYAmt
Total Liabilities BOY$42,010,357TotalLiabilitiesBOYAmt
Total Liabilities EOY$31,064,651TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,889,319NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$25,922,942NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMADISON COMMUNITY HOSPITAL, D/B/A MADISON REGIONAL HEALTH SYSTEM SERVES AS A COMMUNITY HEALTH FOCAL POINT THROUGH THE PROVISION AND MAINTENANCE OF A PROGRESSIVE, EFFICIENT, AND WELL MANAGED HEALTHCARE INSTITUTION, COMMITTED TO QUALITY MEDICAL PRACTICE, AND HIGH ETHICAL STANDARDS.MADISON COMMUNITY HEALTH SYSTEM SERVES AS A COMMUNITY AND SERVICE AREA BASED PRIMARY CARE INSTITUTION WITH BASIC SECONDARY CARE SUPPORT SERVICES, AND FACILITIES PROVIDED TO MEET DEMONSTRATED NEEDS WHICH CAN BE MET WITHIN THE FINANCIAL AND RESOURCE CONSTRAINTS OF THE ORGANIZATION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$24,123,996ExpenseAmt
Revenue$30,941,858RevenueAmt
DescMADISON REGIONAL HEALTH SYSTEM (HOSPITAL) IS A 22-BED ACUTE CARE HOSPITAL LOCATED IN MADISON, SOUTH DAKOTA. FOR THE YEAR ENDED JUNE 30, 2021: ACUTE PATIENT DAYS =1,256; NEWBORN DAYS = 96; SKILLED DAYS =2,097; AND INTERMEDIATE DAYS =76.Desc
Total Program Service Expenses$24,123,996TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee322EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TAMARA MILLERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6052566551PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1323 SW 10TH STAddressLine1Txt
CityMADISONCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57042ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
LAURA JOHNSON
PRESIDENT0.50Yes (X)Yes (X)$0$0$0
ROBERT VAN LIERE
VICE PRESIDENT0.50Yes (X)Yes (X)$0$0$0
ABBY OFTEDAL
SECRETARY0.50Yes (X)Yes (X)$0$0$0
BETTY VANDERWERFF
TREASURER0.50Yes (X)Yes (X)$0$0$0
DAN BROWN
TRUSTEE0.50Yes (X)$0$0$0
ROBIN SCHWEBACH
TRUSTEE0.50Yes (X)$0$0$0
LOIS NIEDERT
TRUSTEE0.50Yes (X)$0$0$0
LORI HANSEN
TRUSTEE0.50Yes (X)$0$0$0
DAN TALLEY
TRUSTEE0.50Yes (X)$0$0$0
CHRIS LEMAIR
TRUSTEE0.50Yes (X)$0$0$0
SANDY SCHWADER
TRUSTEE0.50Yes (X)$0$0$0
BRAD WILKENS
TRUSTEE UNTIL 10/20200.50Yes (X)$0$0$0
TAMARA MILLER
CEO40.00Yes (X)$254,928$0$25,962
TERESA MALLETT
CFO40.00Yes (X)$131,115$0$20,001
ROBERT SUMMERER
SURGEON40.00$528,731$0$35,179Yes (X)
LAURA HOEFERT
MD OF FAMILY MEDICINE40.00$415,488$0$28,173Yes (X)
BENJAMIN LISCANO
MD OF FAMILY MEDICINE40.00$406,363$0$35,760Yes (X)
JUSTIN CLEM
MD OF FAMILY MEDICINE40.00$388,863$0$36,692Yes (X)
MITCHELL POPPENS
PHYSICIAN ASSISTANT40.00$305,536$0$35,516Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,431,024TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$217,283TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K22IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AVERA RADIOLOGY GROUP
PO BOX 86370SIOUX FALLSSD57118RADIOLOGIST PROFESSIONAL FEES$404,085
SANFORD LABORATORIES
PO BOX 5056SIOUX FALLSSD57117LABORATORIES SERVICES$389,044
MEDICAL SOLUTIONS
PO BOX 310737DES MOINESIA50331TRAVELING STAFF$342,744
AGILITI HEALTHINC
PO BOX 851313MINNEAPOLISMN55485BIO-MED SERVICES$324,686
NATIONAL MEDICAL RESOURCES
2792 E BROADWAY AVEBISMARKND58501LOCUMS PHYSICIANS$307,983
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Government Grants$7,206,707GovernmentGrantsAmt
All Other Contributions$41,949AllOtherContributionsAmt
Total Contributions$7,248,656TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE624210$29,427,460$29,427,460
PHARMACY REVENUE621110$1,251,055$1,251,055
MEALS621110$151,456$151,456

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$111,887TotalRevenueColumnAmt
Related Or Exempt Func Income$111,887RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$30,941,858TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$110,453TotalRevenueColumnAmt
Exclusion$110,453ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$153,386RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$153,386RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$153,386TotalRevenueColumnAmt
Exclusion$153,386ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$36,642OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$36,642OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$36,642TotalRevenueColumnAmt
Exclusion-$36,642ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,417,711TotalRevenueColumnAmt
Related Or Exempt Func Income$30,941,858RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$227,197ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$432,101TotalAmt
Management And General$432,101ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,713,541TotalAmt
Program Services$11,770,345ProgramServicesAmt
Management And General$1,943,196ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$610,626TotalAmt
Program Services$521,190ProgramServicesAmt
Management And General$89,436ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$631,360TotalAmt
Program Services$482,192ProgramServicesAmt
Management And General$149,168ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,079,530TotalAmt
Program Services$900,431ProgramServicesAmt
Management And General$179,099ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,599,797TotalAmt
Program Services$540,661ProgramServicesAmt
Management And General$1,059,136ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$74,352TotalAmt
Management And General$74,352ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,259,511TotalAmt
Program Services$936,076ProgramServicesAmt
Management And General$323,435ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$416,143TotalAmt
Program Services$416,143ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$38,212TotalAmt
Program Services$38,212ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$48,346TotalAmt
Program Services$44,838ProgramServicesAmt
Management And General$3,508ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$910,428TotalAmt
Program Services$787,692ProgramServicesAmt
Management And General$122,736ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,806,562TotalAmt
Program Services$2,359,438ProgramServicesAmt
Management And General$447,124ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$242,914TotalAmt
Management And General$242,914ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$4,809,242$4,809,242
OUTREACH$493,938$493,938
MAINTENANCE AND REPAIRS$23,598$23,598

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$193,886TotalAmt
Management And General$193,886ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$29,384,087TotalAmt
Program Services$24,123,996ProgramServicesAmt
Management And General$5,260,091ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$21,578,146BOYAmt
EOY$23,410,605EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,696,385BOYAmt
EOY$3,938,812EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$523,174BOYAmt
EOY$538,989EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$254,078BOYAmt
EOY$359,291EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$43,262,888LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$18,041,906LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$26,450,712BOYAmt
EOY$25,220,982EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,280,672BOYAmt
EOY$3,416,400EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$116,509BOYAmt
EOY$102,514EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$58,899,676BOYAmt
EOY$56,987,593EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,663,537BOYAmt
EOY$2,685,792EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,291,471BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$28,386,140BOYAmt
EOY$27,881,081EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,499,000BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,170,209BOYAmt
EOY$497,778EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,010,357BOYAmt
EOY$31,064,651EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,840,827BOYAmt
EOY$25,840,255EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$48,492BOYAmt
EOY$82,687EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,889,319BOYAmt
EOY$25,922,942EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$58,899,676BOYAmt
EOY$56,987,593EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$9,033,624ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$523,611OtherCostOrOtherBasisAmt
Book Value$523,611BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,554,358OtherCostOrOtherBasisAmt
Depreciation$7,334,673DepreciationAmt
Book Value$18,219,685BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,764,572OtherCostOrOtherBasisAmt
Depreciation$9,147,705DepreciationAmt
Book Value$4,616,867BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,420,347OtherCostOrOtherBasisAmt
Depreciation$1,559,528DepreciationAmt
Book Value$1,860,819BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$25,220,982TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescESTIMATED THIRD PARTY PAYORDesc
Amt$497,778Amt
FieldValueIRS element (for citing)
Total Liability$497,778TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$38,454,353TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$38,454,353RevenueSubtotalAmt
Other Revenues Not Included-$36,642OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$36,642RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$38,417,711TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$29,420,730TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$29,420,730ExpensesSubtotalAmt
Other Expenses Not Included-$36,642OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$36,642ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$29,384,088TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE SYSTEM 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 SYSTEM 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. THE SYSTEM HAS DETERMINED THAT IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT SYSTEM BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RECLASSIFICATION OF GAIN/LOSS ON SALE FOR 990 -36,642.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RECLASSIFICATION OF LOSS ON SALE FOR 990 -36,642.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$131,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$131,000NetCommunityBenefitExpnsAmt
Total Expense0.00450TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$676,002TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$624,821DirectOffsettingRevenueAmt
Net Community Benefit Expns$51,181NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$807,002TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$624,821DirectOffsettingRevenueAmt
Net Community Benefit Expns$182,181NetCommunityBenefitExpnsAmt
Total Expense0.00620TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,152TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,152NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,963,182TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,135,678DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,827,504NetCommunityBenefitExpnsAmt
Total Expense0.06220TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,968,334TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,135,678DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,832,656NetCommunityBenefitExpnsAmt
Total Expense0.06240TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,775,336TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,760,499DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,014,837NetCommunityBenefitExpnsAmt
Total Expense0.06860TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,847,836BadDebtExpenseAmt
Bad Debt Expense Attributable$182,936BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,518,496ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,414,353CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$104,143MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MADISON COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1323 SW 10TH STAddressLine1Txt
CityMADISONCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57042ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.MADISONREGIONALHEALTH.ORGWebsiteAddressTxt
State License49870StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MADISON COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V SECTION CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MADISON COMMUNITY HOSPITALPART V, SECTION B, LINE 5: MADISON REGIONAL HEALTH SYSTEM (MRHS) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH ASSISTANCE FROM EIDE BAILLY, LLP, AN ACCOUNTING AND CONSULTING FIRM SPECIALIZING IN FINANCIAL, OPERATIONAL, AND HEALTH-NEED CONSULTING WITH HEALTHCARE ORGANIZATIONS. QUALITATIVE AND QUANTITATIVE INFORMATION FROM LOCAL, STATE, AND FEDERAL SOURCES, AND INPUT FROM PERSONS THAT REPRESENT A BROAD RANGE OF INTERESTS IN THE COMMUNITY, PERSONS WITH PUBLIC HEALTH KNOWLEDGE AND EXPERTISE, AND PERSONS REPRESENTING MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS WAS USED IN DEVELOPING THE REPORT.
MADISON COMMUNITY HOSPITALPART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED DURING THE 2018 TAX YEAR. THE FOLLOWING COMMUNITY HEALTH AREAS WERE IDENTIFIED AND THE FOLLOWING ACTIONS ARE BEING TAKEN BY THE HOSPITAL.MENTAL AND BEHAVIORAL HEALTH EDUCATION, ACCESS AND AFFORDABILITY-CONTINUING RELATIONSHIP WITH COMMUNITY COUNSELING SERVICES IN MADISON.-EXPLORING SERVICE CAPABILITY TO BETTER MEET CUSTOMER NEEDS-RESEARCHING UNIVERSITY OF SOUTH DAKOTA'S EMERGENCY DEPARTMENT PSYCHIATRY RESIDENCY TELEMEDICINE PROGRAM.-EXPLORING PRESCRIBER OUTREACH SERVICES WHICH WOULD FURTHER INCREASE CAPACITY AND CAPABILITY TO MEET MENTAL AND BEHAVIORAL HEALTH NEEDS IN THE COMMUNITY.-BRINGING MORE AWARENESS TO AVAILABLE MENTAL AND BEHAVIORAL HEALTH RESOURCES IN THE COMMUNITY AND PROVIDING MORE EDUCATION AROUND WHAT PEOPLE CAN DO TO MAINTAIN MENTAL AND BEHAVIORAL HEALTH.-IN ADDITION TO THE ABOVE, THE HOSPITAL ADDED MENTAL/BEHAVIORAL HEALTH SERVICES THROUGH TELEHEALTH IN FY2021.POSTACUTE CARE, LONGTERM CARE, AND THE SENIOR LIVING CONTINUUM-CONTINUING TO OFFER HOME HEALTH SERVICES ALONG WITH SWING BED PROGRAMMING THAT INCLUDES SKILLED AND INTERMEDIATE CARE.-CONTINUING TO COLLABORATE WITH BETHEL LUTHERAN HOME, A NURSING HOME IN MADISON, SD THAT OFFERS A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING.-ENHANCING MARKETING EFFORTS AROUND WHAT SERVICES ARE OFFERED AND AVAILABLE IN THE COMMUNITY TO EXPAND THE COMMUNITY'S KNOWLEDGE OF AVAILABLE RESOURCES AND THE PRESENCE OF A FULL CONTINUUM OF SENIOR SERVICES.SPECIALTY SERVICES ACCESS, AWARENESS, RECRUITING, AND GAPS-CONTINUING TO PROMOTE SPECIALTY SERVICES THAT ARE OFFERED LOCALLY.-CONTINUING RECRUITMENT EFFORTS FOR REPLACEMENT AND ADDITIONAL SPECIALTY PROVIDERS.-INCREASING AWARENESS AROUND OTOLARYNGOLOGY AND FAMILY MEDICINE.-IN ADDITION TO THE ABOVE, THE HOSPITAL ACTIVELY RECRUITED A FAMILY PRACTICE PHYSICIAN, ADDED ADDITIONAL OUTREACH AND TELEMEDICINE PROGRAMS, AND IMPLEMENTED A TELEHEALTH PLATFORM IN FY2021.DIABETES AND OBESITY RELATED HEALTH ISSUES: AWARENESS, EDUCATION, SERVICES AND NEW PROGRAMMING-FOCUSING ON EDUCATION AND AWARENESS IN THE COMMUNITY, SPECIFICALLY AROUND THE RECENTLY DEVELOPED ROBUST DIABETES PREVENTION PROGRAM (DPP).-DIABETIC EDUCATOR STAFF PARTICIPATE IN MARKETING EFFORTS ALONG WITH MRHS STAFF TO BOOST COMMUNITY AWARENESS AND PARTICIPATION.IN ADDITION TO THE ABOVE, IN FY2021 THE HOSPITAL ADDED CASE MANAGEMENT SERVICES TO SEVERAL POPULATIONS WITH CHRONIC CARE NEEDS.AFFORDABILITY, AN IDENTIFIED NEED, WILL NOT BE ADDRESSED AT THIS TIME. MRHS IS NOT EQUIPPED TO ADDRESS ISSUES RELATED TO INSURANCE PREMIUMS, DEDUCTIBLES, AND COPAYS. MRHS IS A LOW COST PROVIDER AND DOES HAVE AN INCOME BASED FINANCIAL ASSISTANCE PROGRAM WHICH CAN BE ACCESSED IN PERSON OR ON MRHS' WEBSITE.MANY OF THESE ACTIVITIES ARE CONTINUATIONS OF ACTIVITIES THE HOSPITAL HAS BEEN CONDUCTING RELATED TO THE PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT.
MADISON COMMUNITY HOSPITALPART V, SECTION B, LINE 13B: HOUSEHOLD SIZE
MADISON COMMUNITY HOSPITALPART 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 7ATHE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ATHTTPS://MADISONREGIONALHEALTH.ORG/ABOUT-US/#COMMUNITY-HEALTH-NEEDS
PART V. SECTION B, LINE 10ATHE IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST AND ATHTTPS://MADISONREGIONALHEALTH.ORG/ABOUT-US/#COMMUNITY-HEALTH-NEEDS
PART V. SECTION B, LINE 16A-16CTHE FAP, FAP APPLICATIOIN AND FAP PLAIN LANGUAGE SUMMARY ARE AVAILABLE ATHTTPS://MADISONREGIONALHEALTH.ORG/PATIENT-VISITOR-GUIDE/#FINANCIAL-ASSISTANCE

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:PRESUMPTIVE ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY MAY BE USED IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED.
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 AND LINE 7G WERE DETERMINED USING THE MEDICAID AND MEDICARE COST REPORTS, RESPECTIVELY. LINE 7E WAS DETERMINED USING THE GENERAL LEDGER.
PART I, LINE 7G:LINE 7G INCLUDES PROVIDER BASED CLINIC REVENUE OF $4,368,646, EXPENSE OF $4,853,487, FOR A NET COMMUNITY BENEFIT OF $484,841.
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 2020. THEREFORE 9.9% 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 FOUND ON PAGE 10 AND 11 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR THE FISCAL YEAR ENDING 06/30/2021.MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY.
PART III, LINE 9B:ACCOUNTS THAT MEET THE CRITERIA FOR THE FINANCIAL ASSISTANCE POLICY WILL BE WRITTEN OFF IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS THAT DO NOT MEET THE CRITERIA FOR FINANCIAL ASSISTANCE WILL PROCEED THROUGH THE COLLECTION PROCESS. IF, DURING THE COLLECTION PROCESS, IT IS DETERMINED THAT AN ACCOUNT IN COLLECTION BELONGS TO A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT WILL BE REMOVED FROM COLLECTION AND RETURNED TO THE HOSPITAL FOR RESOLUTION.
PART VI, LINE 2:MADISON REGIONAL HEALTH SYSTEM CONDUCTS PATIENT SURVEYS OF MANY LEVELS OF CARE. MRHS HAS MANY WORKING COMMITTEES THAT DISCUSS THE NEEDS OF THE COMMUNITY (ANTIBIOTIC STEWARDSHIP, OPIOID EPIDEMIC COMMITTEE, ETC).
PART VI, LINE 3:A SUMMARY OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE, ATTACHED TO BILLING INVOICES, POSTED IN THE EMERGENCY ROOM OR WAITING ROOMS, POSTED IN THE ADMISSIONS OFFICE, GIVEN TO PATIENTS ON ADMISSION, AND UPON REQUEST. DISCHARGE PLANNING PERSONNEL IN THE BUSINESS OFFICE COUNSEL PATIENTS UPON ADMISSION AND THROUGH THE DISCHARGE PLANNING PROCESS ON MEDICAID, COUNTY WELFARE PROGRAMS, CHARITY CARE, ETC. FINANCIAL ASSISTANCE PROGRAMS ARE DETAILED EITHER IN PERSON OR THROUGH A BROCHURE THAT EXPLAINS THE HOSPITAL'S FINANCIAL ASSISTANCE AND PAYMENT REQUIREMENTS. COVERED VS NON-COVERED CHARGES ARE DISCUSSED WITH THE PATIENT. A PATIENT ASSESSMENT, INCLUDING A DISCUSSION ON FINANCIAL RESPONSIBILITIES, CONCERNS, AND GOVERNMENT PROGRAMS, IS COMPLETED ON EACH INPATIENT BY DISCHARGE PLANNING. A FINANCIAL COUNSELOR MEETS ONE-ON-ONE WITH PATIENTS PRIOR TO DISCHARGE TO GO OVER INSURANCE COVERAGE AND WHAT TO EXPECT ONCE INSURANCE IS PROCESSED.
PART VI, LINE 4:MADISON REGIONAL HEALTH SYSTEM IS THE ONLY HOSPITAL IN THE SERVICE AREA. EIGHT PHYSICIANS AND FOUR PHYSICIAN EXTENDERS PRACTICE IN THE COMMUNITY. THE SERVICE AREA FOR MRHS INCLUDES 14 ZIP CODE COMMUNITIES THAT ARE WITHIN A 2-MILE RADIUS OF THE HOSPITAL. IT INCLUDES ALL OF LAKE COUNTY AND PORTIONS OF BROOKINGS, KINGSBURY, MINER, MOODY, MCCOOK AND MINNEHAHA COUNTIES. TOTAL SERVICE AREA POPULATION IS APPROXIMATELY 32,000. ESTIMATED MEDIAN HOUSEHOLD INCOME IS $62,843 ACCORDING TO THE U.S CENSUS BUREAU.
PART VI, LINE 5:THE GOVERNING BODY OF MRHS IS COMPRISED OF COMMUNITY MEMBERS, NONE OF WHOM ARE EMPLOYEES OR CONTRACTORS OF THE HOSPITAL. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE USED TO IMPROVE PATIENT CARE AND FACILITIES. THE HOSPITAL OPERATES AN EMERGENCY ROOM WHICH IS AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS THROUGH RESIDENCIES AND INTERNSHIPS FOR NURSING STUDENTS, THERAPY STUDENTS, PHYSICIANS AND PHYSICIAN'S EXTENDERS. THE HOSPITAL PARTICIPATES IN SEVERAL GOVERNMENT SPONSORED HEALTH PROGRAMS, INCLUDING BUT NOT LIMITED TO: MEDICARE, MEDICAID, VA, TRI-CARE, AND ALL-WOMEN-COUNT. THE HOSPITAL OFFERS VOLUNTEER OPPORTUNITIES TO MEMBERS OF THE COMMUNITY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (1)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT SUMMERER
SURGEON$528,731$0$0$0$0$0$14,250$0$21,726$0$564,707$0$0$0
LAURA HOEFERT
MD OF FAMILY MEDICINE$389,958$0$0$0$25,530$0$14,250$0$15,085$0$444,823$0$0$0
BENJAMIN LISCANO
MD OF FAMILY MEDICINE$406,363$0$0$0$0$0$14,250$0$22,672$0$443,285$0$0$0
JUSTIN CLEM
MD OF FAMILY MEDICINE$361,915$0$0$0$26,948$0$14,250$0$23,498$0$426,611$0$0$0
MITCHELL POPPENS
PHYSICIAN ASSISTANT$305,536$0$0$0$0$0$14,250$0$22,069$0$341,855$0$0$0
TAMARA MILLER
CEO$225,695$0$29,233$0$0$0$13,002$0$14,144$0$282,074$0$0$0
TERESA MALLETT
CFO$131,115$0$0$0$0$0$6,837$0$13,848$0$151,800$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 5FormAndLineReferenceDesc
ExplanationCEO BONUS IS CALCULATED BASED ON REVENUE GROWTH AND EBITA. HER BONUS FOR 2020 WAS $29,233ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 3THE ORGANIZATION CEASED THE OPERATION OF URGENT CARE.
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL HAVE THE BOARD PRESIDENT AS ITS CHAIRMAN AND FOUR APPOINTED MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE FACILITY DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF TRUSTEES AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11BTHE CEO AND CHIEF FINANCIAL OFFICER REVIEW THE 990 IN DETAIL. AFTER THEIR REVIEW, THE 990 IS PROVIDED TO EACH BOARD MEMBER. THE CEO PRESENTS THE 990 TO THE BOARD OF DIRECTORS AT THE MEETING HELD PRIOR TO ITS FILING IF SO REQUESTED BY ANY BOARD MEMBER. WHETHER PRESENTED IN A BOARD MEETING OR NOT, THE 990 IS NOT FILED UNTIL EACH BOARD MEMBER HAS BEEN GIVEN A COPY OF IT AND GIVEN AMPLE TIME TO REVIEW IT.
FORM 990, PART VI, SECTION B, LINE 12CALL BOARD MEMBERS AND OFFICERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE BOARD WILL REVIEW ACTUAL CONFLICTS AND MAKE DETERMINATIONS WHETHER A CONFLICT EXISTS. THE RESTRICTIONS ARE IMPOSED ON A CASE BY CASE BASIS BASED ON THE BOARD'S DETERMINATION.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO'S COMPENSATION AND BENEFITS ARE REVIEWED ON AN ANNUAL BASIS IN EXECUTIVE SESSION AT THE BOARD OF TRUSTEE MEETING. THE BOARD OF TRUSTEES APPROVES THE SALARY AND BENEFITS COMPENSATION. SDAHO SALARY SURVEY AND OTHER FACILITY 990'S ARE USED TO DETERMINE CEO'S COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.

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