2022-04-18T15:22:44-05:00 2021-05-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2020-06-01 460391067 PRAIRIE LAKES HEALTH CARE SYSTEM INC PRAI 6058827000 PO BOX 1210 WATERTOWN SD 57201 ADAM POPP CFO 6058827000 2022-04-18 1 ADAM POPP 999009999 ROBERT E SCHILE P00369682 6123764500 2022-04-18 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PAUL MACEK PO BOX 1210 WATERTOWN SD 57201 210762765 0 X WWW.PRAIRIELAKES.COM X 1986 SD PROVIDE HIGH QUALITY, AFFORDABLE & COMPASSIONATE HEALTHCARE SERVICES FOR THE PEOPLE IN THE REGION. 14 13 693 104 1249585 332703 2446978 3449979 98526177 114864228 13490621 19358709 1516078 1547575 115979854 139220491 166878 182680 0 0 52101747 55269622 0 0 0 49914219 55456213 102182844 110908515 13797010 28311976 318634035 435632850 54911822 53291480 263722213 382341370 X WE MAKE A POSITIVE DIFFERENCE IN THE HEALTH OF THE PATIENTS AND COMMUNITIES WE SERVE. 1 0 95099265 182680 114864228 PRAIRIE LAKES HEALTH CARE SYSTEM SERVES TEN COUNTIES IN NORTHEASTERN SOUTH DAKOTA AND WESTERN MINNESOTA AS A RURAL, REGIONAL MEDICAL CENTER. IT IS COMMITTED TO PROVIDING ACCESSIBLE, HIGH QUALITY, COST-EFFECTIVE HEALTHCARE SERVICES AS IT MANAGES EFFECTIVELY THE TRANSITION TO NEW PAYMENT AND CARE DELIVERY MODELS. 25 SPECIALTY PHYSICIANS HAVE BEEN RECRUITED OVER THE PAST DECADE TO BUILD NEW SERVICES AND BETTER SERVE THE NEEDS OF THE REGION. 95099265 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 101 0 1 693 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X ADAM POPP 6058827000 401 9TH AVENUE NW WATERTOWN SD 57201 ROBB PETERSON CHAIR 1.00 0.00 X X 0 0 0 SHANNON KRUSE VICE CHAIR 1.00 0.00 X X 0 0 0 VINCE FOLEY TREASURER 1.00 0.00 X X 0 0 0 MIKE LUKEN TREASURER 1.00 0.00 X X 0 0 0 JIM REDLINGER PAST CHAIR 1.00 0.00 X 0 0 0 MARK ROBY BOARD MEMBER 1.00 0.00 X 0 0 0 PAUL MACEK BOARD MEMBER 1.00 0.00 X 0 0 0 CHRIS CARTER BOARD MEMBER 1.00 0.00 X 0 0 0 ALAN CHRISTENSEN MD BOARD MEMBER 1.00 0.00 X 0 0 0 KRISTIN HENDERSON BOARD MEMBER 1.00 0.00 X 0 0 0 SCOTT MUNGER BOARD MEMBER 1.00 0.00 X 0 0 0 STACEY LEE BOARD MEMBER 1.00 0.00 X 0 0 0 GERALD RIEBER MD BOARD MEMBER 1.00 0.00 X 0 0 0 KC DEBOER CEO 40.00 0.00 X 469877 0 47309 D ADAM POPP CFO 40.00 0.00 X 256522 0 38434 DR LEIGHTON SINGH CHIEF OF STAFF EX OFFICIO 1.00 0.00 X 598304 0 32216 MICHELE TURBAK CNO 40.00 0.00 X 239990 0 31242 NATE LAKE VICE PRESIDENT 40.00 0.00 X 238664 0 37256 TRACI RABINE VICE PRESIDENT 40.00 0.00 X 233456 0 37243 GRANT TILLETT CHIEF INFORMATION OFFICER 40.00 0.00 X 228262 0 36154 EVELIO GARCIA MD PHYSICIAN 40.00 0.00 X 1382975 0 32216 SALEM MAALIKI MD PHYSICIAN 40.00 0.00 X 1356625 0 32216 JEFFREY SMITH MD PHYSICIAN 40.00 0.00 X 1252438 0 32216 BIPIN AMIN PHYSICIAN 40.00 0.00 X 694955 0 25821 JACOB SCHAEFFER PHYSICIAN 40.00 0.00 X 786700 0 32216 7738768 0 414539 52 0 1 0 MEDICAL SOLUTIONS PO BOX 310737 DES MOINES IA 50331 LOCUM COVERAGE 465612 GHAITH ABOUD MD 920 3RD ST NW APT C WATERTOWN SD 57201 LOCUM PHYSICIAN 426360 COMPHEALTH PO BOX 972651 DALLAS TX 75397 LOCUM COVERAGE 398839 DMS HEALTH TECHNOLOGIES PO BOX 670747 DALLAS TX 75267 PET SCAN 243910 WAPITI MEDICAL GROUP 107 FLYNN DRIVE STE 600 MILBANK SD 57252 LOCUM COVERAGE 241536 19 16800 3427003 6176 3449979 NET PATIENT SERVICE REVENUE 621400 113614643 113614643 RETAIL PHARMACY 446110 901505 901505 LAB SERVICE 621500 348080 348080 114864228 1461598 1461598 1154949 0 1154949 1154949 1154949 89439385 71531907 10367 17907478 -10367 17897111 17897111 CAFETERIA REVENUE 722210 232267 232267 OTHER INCOME 900099 158791 158791 VENDING MACHINES 722210 1514 1514 54 54 392626 139220491 113614643 1249585 20906284 182680 182680 1802237 1802237 726625 633795 92830 45505663 41129120 4376543 883358 851621 31737 3388480 3073861 314619 2963259 2640680 322579 77079 77079 145283 145283 1292040 1292040 8253287 6773886 1479401 469847 469847 1646187 1182893 463294 955430 222401 733029 948391 20350 928041 404702 404702 196899 152705 44194 889984 889984 6901801 4525220 2376581 452004 452004 MEDICAL SUPPLIES 12523772 12523772 DRUGS 11754630 11754630 PROVISION FOR BAD DEBT 5025331 5025331 EQUIP RENT/MAINTENANCE 2145526 2135291 10235 1374020 524339 849681 110908515 95099265 15809250 0 1573 2086 14289538 21791241 8119474 11540954 566789 346220 3361151 3290632 1155840 1320167 164546224 88242177 80053118 76304047 185098262 291213271 4137187 5700030 3458036 3409614 18393067 20714588 318634035 435632850 13575123 14916467 5218055 2905618 29737808 27665874 443973 0 5936863 7803521 54911822 53291480 X 259890520 376951526 3831693 5389844 263722213 382341370 318634035 435632850 X 28311976 85699327 4607854 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 15020 0 0 0 15020 0 PART II-B, LINE 1: THE LOBBYING EXPEDITURES ARE THE PORTION OF DUES TO VARIOUS HOSPITAL ASSOCATIONS THAT ARE USED FOR LOBBYING. 4207780 4207780 85141480 32603979 52537501 2932961 2251935 681026 71829752 53386263 18443489 434251 434251 76304047 457(B) PAYABLE 6947773 LONG-TERM PTO 763848 ASSET RETIREMENT OBLIGATION 91900 7803521 X PART X, LINE 2: THE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT PRAIRIE LAKES IS A TAX-EXEMPT, NOT-FOR-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE HEALTH SYSTEM FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE HEALTH SYSTEM'S FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 1 0 1 1 3702531 3702531 0.03500 8844758 2452566 6392192 0.06040 12547289 2452566 10094723 0.09540 34908 34908 0.00030 15416757 8721211 6695546 0.06320 15451665 8721211 6730454 0.06350 27998954 11173777 16825177 0.15890 1 5025331 0 38471737 35773368 2698369 X 1 1 1 1 PRAIRIE LAKES HOSPITAL 401 9TH AVE NW WATERTOWN SD 57201 WWW.PRAIRIELAKES.COM 10572 460391067 X X X PRAIRIE LAKES HEALTH CARE SYSTEM 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE LINE 7D X 1 18 1 SEE LINE 7D 0 1 X 150.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X SEE LINE 16J X SEE LINE 16J X SEE LINE 16J X X X X X X X 1 X 0 X X X 1 X 0 0 PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 5: TO ENSURE INPUT FROM PERSONS WITH BROAD KNOWLEDGE OF THE COMMUNITY, TWO FOCUS GROUP MEETINGS WERE CONDUCTED (NOVEMBER 7TH AND 8TH 2018) WITH INDIVIDUALS IN THE COMMUNITY. INVITATIONS WERE SENT TO INDIVIDUALS REPRESENTING VARIOUS COMMUNITY, BUSINESS, AND EDUCATIONAL ORGANIZATIONS. REPRESENTATIVES FROM LOCAL HEALTH CARE PROVIDERS AND THE COMMUNITY HEALTH DEPARTMENTS WERE INCLUDED TO BRING IN ADDITIONAL PROFESSIONAL PERSPECTIVE. FOR INVITEES UNABLE TO ATTEND THE FOCUS GROUP SESSIONS, INPUT WAS GATHERED VIA EMAIL OR PHONE INTERVIEW. THE INDIVIDUALS IDENTIFIED TO PARTICIPATE IN THE PROCESS HAVE DIRECT ACCESS TO INDIVIDUALS ACROSS ALL SUBSECTIONS OF THE COMMUNITY AND THEREFORE CAN ADDRESS NEEDS THAT MAY IMPACT THOSE POPULATIONS THAT ARE MEDICALLY UNDERSERVED OR MOST IN NEED. SEE PAGE 17 OF THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT, WHICH IS AVAILABLE ON OUR WEBSITE, FOR A FULL LIST OF PARTICIPATING ORGANIZATIONS. PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 7D: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT HTTPS://WWW.PRAIRIELAKES.COM/COMMUNITY/COMMUNITY-BENEFIT-513.HTML. PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 11: DURING THE FISCAL YEAR ENDED MAY 31, 2020, PRAIRIE LAKES HEALTHCARE SYSTEM TOOK THE FOLLOWING STEPS TO ADDRESS SIGNIFICANT COMMUNITY HEALTH NEEDS AS IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. 1. ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES- PLHS PROVIDES RECRUITING RESOURCES AND FINANCIAL ASSISTANCE FOR THE RECRUITMENT OF PHYSICIANS TO THE COMMUNITY. PLHS WILL CONTINUE TO EXPLORE THE NEED FOR ADDITIONAL SPECIALTIES AND PURSUE RECRUITMENT AS NECESSARY. TELEHEALTH SERVICES WERE ADDED TO ASSIST IN PROVIDING SPECIALTY CARE AS A RESULT OF COVID-19.- PLHS PAYS WATERTOWN AREA COMMUNITY TRANSIT FOR TRANSPORTATION OF INDIVIDUALS TO AND FROM HEALTH APPOINTMENTS IN WATERTOWN.- PLHS FINANCIALLY SUPPORTED THE INITIATION OF THE HELPLINE IN CODINGTON COUNTY.2. SUBSTANCE ABUSE- THE LIFESTYLE HEALTH ISSUES RELATED TO TOBACCO USE AND EXCESSIVE ALCOHOL CONSUMPTION ARE ADDRESSED THROUGH A NUMBER OF COMMUNITY INITIATIVES. PLHS WILL CONTINUE TO SUPPORT THESE INITIATIVES THROUGH CASH DONATIONS.- PLHS COLLABORATED WITH HUMAN SERVICE AGENCY AND WATERTOWN BOYS AND GIRLS CLUB TO ORGANIZE A COMMUNITY EDUCATION TO PROMOTE THE PREVENTION OF DRUG, OPIOID, ALCOHOL USE, AND SMOKING.3. NURTRITION HEALTH/OBESITY- OBESITY IS CURRENTLY BEING ADDRESSED THROUGH COMMUNITY NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT LOSS INITIATIVES. PRIMARY CARE CLINICS, THE HOSPITAL, AND THE COMMUNITY RECREATION CENTER PROVIDE A NUMBER OF PROGRAMS. - PLHS PROVIDED CASH DONATIONS TO SUPPORT COMMUNITY INITIATIVES SUCH AS: PEOPLE AGAINST CHILD HUNGER AND BOYS AND GIRLS CLUB.4. PREVENTATIVE CARE- PLHS PROVIDED FREE COMMUNITY EDUCATION, INCLUDING TOPICS ON ACID REFLUX, LUNG CANCER, BREATHING ISSUES, STRETCHING, AND COLON CANCER.- PLHS COMPENSATED A SOCIAL WORKER TO PROVIDE DIABETES EDUCATION VIA FREE WORKSHOPS AND SUPPORT GROUPS.5. HEALTHCARE COSTS- PLHS HAS A FINANCIAL ASSISTANCE POLICY TO PROVIDE CHARITY CARE TO LOW-INCOME AND MEDICALLY UNDERSERVED INDIVIDUALS THAT QUALIFY.6. NEEDS NOT ADDRESSED- DENTAL CARE/ORAL HEATLH, SEXUALLY TRANSMITTED INFECTIONS, TEEN PREGNANCY- THESE NEEDS ARE BEYOND PLHS' SCOPE AND ARE BEING ADDRESSED BY OTHER ORGANIZATIONS. PLHS DOES MAKE CASH CONTRIBUTIONS TO ASSIST THOSE ORGANIZATIONS WITH THEIR EFFORTS. PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 16J: HTTPS://WWW.PRAIRIELAKES.COM/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM-510.HTML 3 1 - SISSETON SATELLITE DIALYSIS 5 EAST CHESTNUT SISSETON SD 57262 DIALYSIS UNIT 2 - MALLARD POINTE SURGICAL CENTER 1425 MICKELSON DRIVE WATERTOWN SD 57201 OUTPATIENT SURGERY CENTER 3 - ORTONVILLE SATELLITE DIALYSIS 450 EASTVOLD AVENUE ORTONVILLE MN 56278 DIALYSIS UNIT PART I, LINE 3C: IN ADDITION TO INCOME BASED CRITERIA FOR DETERMINING THE AMOUNT OF FINANCIAL ASSISTANCE SERVICES FOR WHICH A PATIENT IS ELIGIBLE AT THE TIME OF SERVICE OR DURING THE BILLING-AND-COLLECTION PROCESS, PLHS USES AN ASSET TEST. ASSET EXCLUSIONS THAT ARE CONSIDERED IN QUALIFYING FOR FINANCIAL ASSISTANCE ARE: (A) EQUITY IN PRIMARY RESIDENCE UP TO $15,000(B) EQUITY IN AUTOMOBILE UP TO $5,000(C) 70% OF VALUE OF ASSETS IN RETIRMENT ACCOUNTS(D) ASSETS IN CHECKING/SAVINGS/ETC. UP TO $15,000(E) OTHER ASSETS USED FOR INCOME PRODUCING PURPOSES. PART I, LINE 7: THE COSTS OF THE SUBSIDIZED SERVICES ARE BASED ON DIRECT COST PROVIDED BY THE DEPARTMENTS FOR THE SERVICES. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES INCLUDED IN SCHEDULE H, PART I, LINE 7G RELATE TO THE EMERGENCY ROOM, CARDIOLOGY CLINIC, ONCOLOGY CLINIC, NEPHROLOGY CLINIC, UROLOGY CLINIC, PULMONOLOGY CLINIC, AND ENT CLINIC. PART I, LN 7 COL(F): $5,025,331 OF BAD DEBT EXPENSE WAS ELIMINATED WHEN CALCULATING PART I, LINE 7, COLUMN F. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION SUPPORTS COMMUNITY BUILDING ACTIVITIES THROUGH DONATIONS TO COMMUNITY PROJECTS SUCH AS THE WATERTOWN COMMUNITY FOUNDATION WHICH WORKS TO BRING NEW BUSINESSES TO WATERTOWN, JOY RANCH WHICH PROVIDES CAMP EXPERIENCE TO DISABLED CHILDREN, LAKE AREA TECHNICAL COLLEGE WHICH PROVIDES EDUCATION AND TRAINING FOR HEALTH PROFESSIONALS, THE BOYS AND GIRLS CLUB WHICH PROVIDES RESOURCES FOR COMMUNITY YOUTH. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 3: THE ORGANIZATION DOES NOT HAVE A WAY TO IDENTIFY THE NUMBER OF PEOPLE WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE SO WE HAVE REPORTED $0 IN PART III, LINE 3. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE" PARAGRAPH ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THERE WAS NO SHORTFALL CALCULATED IN PART III, LINE 7.THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WAS DERIVED USING THE 2021 FILED MEDICARE COST REPORT. PART III, LINE 9B: BILLING STATEMENTS AND COLLECTION LETTERS WILL CONTAIN INFORMATION DIRECTING PATIENTS TO CONTACT THE HOSPITAL FOR INFORMATION ABOUT FINANCIAL ASSISTANCE OR PAYMENT PLANS IF THE PATIENTS ARE UNABLE TO PAY THE FULL OUTSTANDING ACCOUNT BALANCE BY THE DUE DATE. IF A COMPLETE ASSISTANCE APPLICATION IS RECEIVED, A DETERMINATION OF THE PATIENT'S ELIGIBILITY WILL BE DOCUMENTED APPROPRIATELY AND COMMUNICATED TO THE PATIENT IN WRITING. IF ELIGIBLE, THE HOSPITAL WILL ISSUE A BILLING STATEMENT WITH THE AMOUNT NOW OWED (ALONG WITH THE AMOUNT GENERALLY BILLED AND HOW IT WAS CALCULATED), REFUND ANY CREDIT BALANCES, AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS. IF AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION (FAA) IS RECEIVED BY THE HOSPITAL, THE HOSPITAL WILL CEASE COLLECTION ACTIONS AND ALLOW 30 DAYS FOR THE FAA TO BE FULLY COMPLETED. PART VI, LINE 2: THE FACILITY CONDUCTS NEEDS ASSESSMENT SURVEYS IN THE COMMUNITY AND SURROUNDING AREA TO DETERMINE WHAT HEALTH CARE SERVICES NEED TO BE ADDRESSED. PART VI, LINE 3: PLHS INFORMS AND EDUCATES PATIENTS ABOUT FINANCIAL ASSISTANCE THROUGH INFORMATION PROVIDED ON THE PLHS WEBSITE. FURTHERMORE, HOSPITAL STAFF PROVIDE INFORMATION REGARDING FINANCIAL ASSISTANCE ELIGIBILITY. PART VI, LINE 4: PRAIRIE LAKES HEALTH CARE SYSTEM'S PRIMARY SERVICE AREA COVERS 3 COUNTIES IN SOUTH DAKOTA WITH A POPULATION OF APPROXIMATELY 38,000. IT'S SECONDARY SERVICE AREA COVERS 4 COUNTIES IN SOUTH DAKOTA AND 3 COUNTIES IN MINNESOTA WITH A POPULATION OF 49,000. PART VI, LINE 5: THE ORGANIZATION OFFERS HEALTH SEMINARS FREE TO COMMUNITY MEMBERS COVERING A VARIETY OF HEALTH TOPICS IN AN EFFORT TO EDUCATE PEOPLE ABOUT LEADING HEALTHY LIVES. COMMUNITY FORUMS ARE HELD TO UPDATE ATTENDEES ABOUT NEW EVENTS AND TECHNOLOGY AT THE FACILITY. THE ORGANIZATION WORKS WITH THE TECHNICAL COLLEGE AND TWO STATE UNIVERSITIES TO HELP TRAIN MEDICAL STUDENTS. THE ORGANIZATION IS DEDICATED TO IMPLEMENTING AND MAINTAINING THE MOST CURRENT TECHNOLOGY IN PROVIDING CARE. PART VI, LINE 7, REPORTS FILED WITH STATES SD 1 WATERTOWN AREA UNITED WAY PO BOX 283 WATERTOWN SD 57201 460359557 501(C)(3) 43750 SUPPORT OF UNITED WAY AGENCIES LAKE AREA TECHNICAL INSTITUTE FOUNDATION PO BOX 730 WATERTOWN SD 57201 363860861 501(C)(3) 8575 SCHOLARSHIPS HUMAN SERVICE AGENCY PO BOX 1030 WATERTOWN SD 57201 460275247 501(C)(3) 30000 DETOX UNIT SUPPORT WATERTOWN DEVELOPMENT CORP PO BOX 1267 WATERTOWN SD 57201 466012194 501(C)(6) 40000 SUPPORT NEW BUSINESS DEVELOPMENT SANFORD CLINIC 901 4TH STREET NW WATERTOWN SD 57201 460447693 501(C)(3) 15000 SUPPORT OF FAMILY PLANNING CLINIC. BOYS & GIRLS CLUB OF WATERTOWN PO BOX 833 WATERTOWN SD 57201 460311845 501(C)(3) 10000 SUPPORT 5 1 PART I, LINE 2: FUNDS ARE GRANTED BASED ON ORGANIZATIONS AND INTERNAL REQUESTS. GRANT REQUESTS ARE REVIEWED AND APPROVED BY ADMINISTRATIVE LEADERSHIP TO BE USED FOR THE PURPOSES REQUESTED BY THE ORGANIZATION. FURTHER MONITORING IS NOT DONE ON A REGULAR BASIS. X X X X 0 0 0 0 0 0 0 0 0 EVELIO GARCIA MD PHYSICIAN 1382975 0 0 0 0 0 8550 0 23666 0 1415191 0 0 0 SALEM MAALIKI MD PHYSICIAN 1356625 0 0 0 0 0 8550 0 23666 0 1388841 0 0 0 JEFFREY SMITH MD PHYSICIAN 726262 0 526176 0 0 0 8550 0 23666 0 1284654 0 0 0 JACOB SCHAEFFER PHYSICIAN 427607 0 359093 0 0 0 8550 0 23666 0 818916 0 0 0 BIPIN AMIN PHYSICIAN 664955 0 30000 0 0 0 8550 0 17271 0 720776 0 0 0 DR LEIGHTON SINGH CHIEF OF STAFF EX OFFICIO 598304 0 0 0 0 0 8550 0 23666 0 630520 0 0 0 KC DEBOER CEO 392677 0 70000 0 7200 0 23643 0 23666 0 517186 0 0 0 D ADAM POPP CFO 220522 0 36000 0 0 0 14768 0 23666 0 294956 0 0 0 NATE LAKE VICE PRESIDENT 202664 0 36000 0 0 0 13590 0 23666 0 275920 0 0 0 MICHELE TURBAK CNO 203990 0 36000 0 0 0 13971 0 17271 0 271232 0 0 0 TRACI RABINE VICE PRESIDENT 197456 0 36000 0 0 0 13577 0 23666 0 270699 0 0 0 GRANT TILLETT CHIEF INFORMATION OFFICER 192262 0 36000 0 0 0 12488 0 23666 0 264416 0 0 0 A SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 460315509 2017-01-27 36000000 FUNDING OF THE NEW SPECIALTY CLINIC BUILDING 0 0 0 A 6030000 36000000 397999 35602001 2017 0 0 1 1 A 0 1 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART III, LINE 2 PRAIRIE LAKES HEALTHCARE SYSTEM (PLHS) EXPANDED PROGRAM SERVICES DUE TO COVID-19. PLHS CONTRIBUTED TOWARD A POSITIVE OUTCOME IN THE COMMUNITY DURING THE PANDEMIC BY DOING THE FOLLOWING ITEMS: -PLHS PARTICIPATED IN THE CODINGTON COUNTY INCIDENT COMMAND THAT WAS INITIATED IN RESPONSE TO COVID-19 -PLHS CROSS-TRAINED CLINICAL STAFF ACROSS DEPARTMENTS FOR POTENTIAL RE-DEPLOYMENT -PLHS WAS AN ACTIVE PARTICIPANT AS A POINT OF DISTRIBUTION WORKING WITH THE COUNTY AND THE STATE IN PERFORMING MASS VACCINATION EVENTS AT LOCATIONS SUCH AS THE LOCAL COLLEGE AND THE COUNTY EXTENSION BUILDING -BUILT A COVID-19 SPECIFIC WING WITH NEGATIVE AIR PRESSURE RETURN -KEPT PATIENTS AND STAFF SAFE BY LIMITING THE NUMBER OF VISITORS INTO THE FACILITY -REQUIRED SCREENING OF ALL VISITORS AND STAFF AND THE WEARING OF MASKS IN PUBLIC AREAS -DURING PERIODS OF HIGH VOLUMES, PLHS KEPT NURSING HOME PATIENTS FOR LONGER THAN NORMAL BECAUSE NURSING HOMES WERE NOT ACCEPTING THE RETURN OF ADMITTED PATIENTS -PLHS PURCHASED AND INSTALLED A BIOFIRE INSTRUMENT WHICH TESTS A PANEL OF RESPIRATORY VIRUSES INCLUDING COVID-19. THE VALUE OF THIS PIECE OF EQUIPMENT IS THE EXPANDED IN-HOUSE TESTING CAPABILITY COUPLED WITH THE EXPEDIENT TURNAROUND TIME FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL BE COMPRISED OF THE OFFICERS OF THE CORPORATION. EXCEPT AS MAY BE LIMITED BY THE BOARD, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL ACT IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD AND SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL ALSO SERVE AS THE CORPORATION'S COMPENSATION COMMITTEE, UNLESS IT OR THE BOARD DELEGATES THOSE RESPONSIBILITIES TO ANOTHER COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL NOT USURP THE FUNCTIONS OF THE OTHER STANDING COMMITTEES, ALTHOUGH IT WILL COORDINATE PROJECTS, TASKS AND COMMUNICATIONS AMONG SUCH COMMITTEES. A MAJORITY OF THE EXECUTIVE COMMITTEE SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF ANY BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B EXECUTIVE MANAGEMENT REVIEWS THE FORM 990 IN DETAIL. THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE CHAIR FOR FINAL REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST STATEMENT IS SIGNED BY ALL BOARD MEMBERS ANNUALLY. THIS STATEMENT DISCLOSES ANY AREAS THAT MAY POTENTIALLY PRESENT A CONFLICT OF INTEREST WITH THEMSELVES OR FAMILY MEMBERS. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO AND THE BOARD. MEMBERS WILL EXCUSE THEMSELVES DURING BOARD MEETING FROM ANY DISCUSSION OR VOTING ON AN ISSUE WHERE THERE MAY BE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION COMPARABILITY STUDIES ARE REVIEWED EACH YEAR FOR ALL POSITIONS BY THE HUMAN RESOURCES DEPARTMENT. THE HUMAN RESOURCES DEPARTMENT HAS ACCESS TO VARIOUS COMPENSATION SURVEYS, WHICH ARE REVIEWED TO DETERMINE IF THE HOSPITAL'S COMPENSATION IS REASONABLE COMPARED TO OTHER FACILITIES. THE BOARD DELEGATES VICE PRESIDENT EXECUTIVE COMPENSATION APPROVAL TO THE CEO BASED ON THE ORGANIZATION'S COMPENSATION PHILOSOPHY IN CONJUCTION WITH MARKET BENCHMARKS. THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE SALARIES OF OTHER KEY EMPLOYEES. THIS PROCESS WAS LAST COMPLETED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE THROUGH FILINGS WITH BONDING AUTHORITY. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PRAIRIE LAKES FOUNDATION 1,558,149. CHANGE IN HCI NET ASSETS 3,049,705. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.