2022-04-26T08:21:56-05:00 2021-06-30 450250958 EIDE BAILLY LLP 200 E 10TH ST STE 500 SIOUX FALLS SD 571046375 990 2020-07-01 466015787 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION LAND 6055832226 600 BILLARS ST SCOTLAND SD 570592026 MELISSA GALE CEO 6055832226 2022-04-20 1 MELISSA GALE 999009999 LAURIE HANSON CPA P00851848 6053391999 2022-04-20 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MELISSA GALE 600 BILLARS ST SCOTLAND SD 570592026 8879318 0 X WWW.AVERA.ORG/SCOTLAND X 1969 SD OPERATION OF A COMMUNITY CRITICAL ACCESS HOSPITAL. 9 9 70 10 0 0 90859 2786598 5444234 6073606 8699 -1385 0 0 5543792 8858819 0 0 0 0 2428924 2811514 0 0 0 3295011 3862261 5723935 6673775 -180143 2185044 6558466 5817155 5296304 2320113 1262162 3497042 LANDMANN-JUNGMAN MEMORIAL HOSPITAL IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTHCARE WITH COMPASSION AND RESPECT. OUR COMMITMENT SHALL BE TO THE ETHICAL TREATMENT OF ALL PEOPLE THROUGHOUT THE CONTINUUM OF LIFE. 0 0 5386638 6073606 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION (LJMH) IS A LICENSED CRITICAL ACCESS HOSPITAL WITH 20 ACUTE CARE BEDS, OF WHICH 10 MAY BE USED AS SWING BEDS. THE FACILITY OFFERS INPATIENT, OUTPATIENT (THERAPIES, LABORATORY, IMAGING), AND PHYSICIAN CLINIC SERVICES TO RESIDENTS IN AND AROUND THE CITY OF SCOTLAND, SD. SPECIALTY SERVICES SUCH AS MOBILE IMAGING, SLEEP STUDIES, CARDIOVASCULAR AND ULTRASOUND SERVICES PROVIDED TO PATIENTS THROUGH CONTRACTED SERVICES. LJMH IS PROUD OF THE EXCELLENT CARE IT PROVIDES FOR PATIENTS OF THE SERVICE AREA. THE FACILITY IS ALSO NOTED FOR ITS COMMUNITY SERVICE WHICH INCLUDES COMMUNITY HEALTH EDUCATION AND HEALTH CARE SUPPORT. 5386638 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 23 0 1 70 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X ERIN ODENS 6055832226 600 BILLARS STREET SCOTLAND SD 57059 MELISSA GALE CEO 40.00 X 140455 0 24224 CODY CARSTENSEN PHARMACIST 40.00 X 101759 0 23069 JULIE DAVIS CFO 40.00 X 75485 0 13841 GREG GEMAR PRESIDENT 1.00 X X 0 0 0 JARED SCHORTZMAN VICE PRESIDENT 0.50 X X 0 0 0 RHONDA BOUZA SECRETARY 0.50 X X 0 0 0 DEVIN LUBINUS TREASURER 0.50 X X 0 0 0 REBECCA PEDERSEN DIRECTOR 0.50 X 0 0 0 TANYA BULT DIRECTOR 0.50 X 0 0 0 CRAIG WINCKLER DIRECTOR 0.50 X 0 0 0 GARY PEPPER DIRECTOR 0.50 X 0 0 0 ANDREW ROKUSEK DIRECTOR FROM 08/2020 0.50 X 0 0 0 317699 0 61134 1 0 1 1 AVERA MCKENNAN 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS SD 571175045 MANAGEMENT/OTHER HEALTH SERVICES 1521983 AVERA HEALTH 3900 W AVERA DR STE 301 SIOUX FALLS SD 57108 HEALTH SERVICES 342957 HEALTH CAROUSEL LLC PO BOX 714216 CINCINNATI OH 452714216 CONTRACT NURSING 241256 ROVE STAFFING PO BOX 31001-2434 PASADENA CA 911102434 CONTRACT NURSING 155330 4 2758805 27793 2786598 NET PATIENT SERVICE RE 621110 5089771 5089771 PHARMACY REVENUE 446110 801413 801413 WEST WINDS REVENUE 623990 118330 118330 64092 64092 6073606 19114 19114 20499 -20499 -20499 -20499 8858819 6073606 0 -1385 X 273388 80727 192661 2314551 2166301 148250 14412 14412 69927 47105 22822 139236 118923 20313 47125 47125 1819937 1403474 416463 8948 8948 359868 161437 198431 12800 12800 77085 77085 2620 2395 225 83367 59425 23942 273819 200992 72827 33871 24144 9727 MEDICAL SUPPLIES 1086249 1010082 76167 CONTINUING EDUCATION 26579 22153 4426 LICENSE AND PERMITS 9023 8187 836 COMMUNITY & EMPLOYEE RE 5834 5834 15136 4208 10928 6673775 5386638 1287137 0 2954555 1203677 1036619 798579 191404 239369 15475 18397 8569465 5805816 1906855 2763649 453558 503484 0 290000 6558466 5817155 462883 745813 2384427 250000 1364075 1258976 313920 770999 65324 5296304 2320113 X 1262162 3497042 1262162 3497042 6558466 5817155 X 2185044 31293 18543 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 36163 36163 4824856 3875233 949623 2879545 1837289 1042256 828901 93294 735607 2763649 INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 88581 F ASSETS LIMITED AS TO USE 414903 F 503484 CONDITIONAL ASSET RETIREMENT OBLIGATION 54224 DAMAGE DEPOSITS PAYABLE 11100 65324 X 8908655 31293 18543 49836 8858819 0 8858819 6673775 0 6673775 0 6673775 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 2D - OTHER ADJUSTMENTS: CHANGE IN AVERA FOUNDATION 18,543. 1 1 X 1 X 1 X 1 1 0 1 1 37000 37000 0.00550 143573 153290 0 0.00000 180573 153290 37000 0.00550 18 2248 20886 2250 18636 0.00280 1550591 1099016 451575 0.06770 2 150 150 0.00000 20 2248 1571627 1101266 470361 0.07050 20 2248 1752200 1254556 507361 0.07600 1 140007 21001 2021011 2001001 20010 X 1 1 1 1 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION 600 BILLARS STREET SCOTLAND SD 57059 WWW.AVERA.ORG/SCOTLAND 10561 X X X X LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPO 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE PART V, LINE 7D X X 1 18 1 SEE PART V, LINE 7D 0 1 X 150.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X SEE 16J NARRATIVE X SEE 16J NARRATIVE X SEE 16J NARRATIVE X X X X X X X 1 X 0 X X X X 1 X 0 0 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 5: A VARIETY OF INDIVIDUALS AND GROUPS OF PEOPLE WERE INVOLVED IN THE CHNA PROCESS FROM NOVEMBER 2018 THROUGH MARCH 2019. QUALITATIVE DATA WAS OBTAINED FROM FOCUS GROUPS WITH THE SCOTLAND ROTARY CLUB (A LOCAL CHAPTER OF ROTARY INTERNATIONAL/ROTARY FOUNDATION), SCOTLAND CHAPTER AE PEO, AND THE SCOTLAND YOUTH CENTER. FORMAL INDIVIDUAL INTERVIEWS WERE CONDUCTED WITH THE BON HOMME COUNTY HEALTH NURSE, THE PRESIDENT OF THE LOCAL PARENT TEACHER ASSOCIATION (PTA), THE SUPERINTENDENT AND PRINCIPAL OF THE SCOTLAND SCHOOL DISTRICT, AND A SMALL BUSINESS OWNER OF A LOCAL DAYCARE FACILITY. AN ELECTRONIC SURVEY WAS ALSO COMPLETED BY 97 COMMUNITY MEMBERS, APPROXIMATELY 5 PERCENT OF WHOM EITHER WORK WITH UNDERSERVED, LOW INCOME INDIVIDUALS THROUGH THE SCOTLAND FOOD PANTRY OR DIRECTLY RECEIVE FEDERAL WOMEN, INFANT, CHILD (WIC) SUBSIDIES FOR FOOD. LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 7D: CHNA: HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/74760/2019-CHNA-LANDMANN.PDFIMPLEMENTATION STRATEGY: HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/75770/2019-CHNA-LANDMANN-IMPLEMENTATION-PLAN.PDF LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 11: LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION CONDUCTED A CHNA IN 2018-2019. THE PRIORITIES FROM THE NEEDS ASSESSMENT WERE BEHAVIORAL HEALTH CONCERNS, HEALTH EDUCATION, ACCESS TO HEALTH CARE FROM PEDIATRIC TO GERIATRIC, AND ADDRESSING OBESITY AND SOCIAL DETERMINANTS OF HEALTH. TO ADDRESS THESE NEEDS, AN IMPLEMENTATION PLAN WAS APPROVED WITH MANY GOALS IN EACH AREA AND CORRESPONDING ACTION PLANS. BEHAVIORAL HEALTH CONCERNS: TO ADDRESS BEHAVIORAL HEALTH EDUCATION, OUR FACILITY IMPLEMENTED BEHAVIORAL HEALTH CARE VIA TELEMEDICINE. WE ALSO DISTRIBUTED EDUCATIONAL MATERIALS TO LOCAL BUSINESSES ON THE FARMER STRESS HOTLINE. EDUCATION ON BEHAVIORAL HEALTH AND SUBSTANCE ABUSE TOPICS ARE GIVEN TO PATIENTS AND SENT TO THE LOCAL SCHOOL DISTRICTS, AND IN PERSON EDUCATION SESSIONS WILL BE UPCOMING. HEALTH EDUCATION SESSIONS: WE PROVIDE DIGITAL MEDIA EDUCATION ON A VARIETY OF HEALTH ISSUES. WE UTILIZE THE LOCAL NEWSPAPER TO SUBMIT HEALTH EDUCATION ARTICLES. WE ASSIST OUR LOCAL SCHOOL DISTRICT ON EDUCATING STAFF AND STUDENTS ON HEALTH TOPICS, SUCH AS HANDS ONLY CPR AND STOP THE BLEED. WE TRAIN THE LOCAL VOLUNTEER EMS WITH TEACHING CERTAIN EDUCATIONAL TOPICS TO EMS STAFF. ADDITIONAL HEALTH EDUCATION HAS BEEN PROVIDED IN PUBLIC ACTIVITIES FOR PREVENTATIVE HEALTH CARE INCLUDING: BREAST CANCER SCREENING EDUCATION, WOMEN'S PREVENTATIVE HEALTH EDUCATION, FALLS AND BALANCE COMMUNITY EXERCISE CLASSES, AND MONTHLY HEALTH TOPICS AT THE LOCAL ROTARY CLUB MEETINGS.ACCESS TO HEALTH CARE FROM PEDIATRIC TO GERIATRIC: WE HAVE STARTED TO ASSESS GAPS IN COMMUNITY TRANSPORTATION THAT PREVENT INDIVIDUALS FROM BEING ABLE TO ACCESS HEALTH CARE. WE STARTED A PHARMACY DELIVERY SERVICE AND PROVIDE CHRONIC CARE RN SERVICES. WE HAVE INCREASED PROVIDER COVERAGE IN THE CLINIC, WHICH HELPS WITH ADDITIONAL HOURS OF ACCESS. OBESITY AND SOCIAL DETERMINANTS OF HEALTH: THE HOSPITAL HAS REPRESENTATION FOR LOCAL PROGRAMS AND PROJECTS THAT WORK TOGETHER TO ADDRESS ENVIRONMENT ISSUES RELATED TO EXERCISE AND HEALTHY EATING. A WALK WITH EASE CLASS WAS LAUNCHED. THE CHNA IMPLEMENTATION PLAN LAYS OUT GOALS AND AN ACTION PLAN TO ADDRESS EACH OF THESE AREAS. ALTHOUGH MANY SOCIAL DETERMINANTS OF HEALTH FACTORS AND BUILT ENVIRONMENT NEEDS WERE CONSIDERED A NEED IN THE COMMUNITY, THE COMMITTEE DID NOT FEEL THAT THIS WAS REALISTIC FOR THE HOSPITAL TO ADDRESS ALONE NOR BY DIRECT FUNDING. WALKING AND BIKE PATHS, SIDEWALK REPAIR, AND HOME DILAPIDATION ARE SIGNIFICANT COST ITEMS AND NEED ONGOING MAINTENANCE, WHICH THE COMMITTEE FELT WAS A RESOURCE CONSTRAINT FOR THE HOSPITAL AT THIS TIME FROM A FINANCIAL PERSPECTIVE. LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE USED AS A LAST RESORT. LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 16J: A NOTICE IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS OR WAITING ROOMS AND IN THE FACILITY'S ADMISSIONS OFFICE ALERTING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INSTRUCTIONS FOR OBTAINING A COPY OF THE FULL POLICY. A NOTICE IS ALSO PROVIDED ON ALL BILLING STATEMENTS SENT TO PATIENTS.PART V, SECTION B, LINES 16A: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/66924/FINANCIAL-ASSISTANCE-POLICY-LANDMANN-JUNGMAN-MEMORIAL-HOSPITAL.PDFPART V, SECTION B, LINES 16B: THE FINANCIAL ASSISTANCE APPLICATION IS AVAILABLE AT:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/4732/PDF-AVERA-CORP-AVERA-FINANCIAL-ASSISTANCE-APPLICATION.PDFPART V, SECTION B, LINES 16C: THE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/66929/SUMMARY-OF-FINANCIAL-ASSISTANCE-LANDMANN-JUNGMAN-MEMORIAL-HOSPITAL.PDF LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION 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. 2 1 - WEST WINDS APARTMENTS 1140 WASHINGTON STREET SCOTLAND SD 57059 INDEPENDENT SENIOR LIVING CENTER 2 - SCOTLAND PHARMACY 620 BILLARS STREET SCOTLAND SD 57059 RETAIL PHARMACY PART I, LINE 3C: IN ADDITION TO USING FPG TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE FACILITY ALSO CONSIDERS ASSET LEVEL AND INSURANCE STATUS, AND MAY PROVIDE PRESUMPTIVE CARE IF WARRANTED. PART I, LINE 6A: LJMH PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY. THE REPORT IS AVAILABLE TO THE PUBLIC UPON REQUEST. 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 7G WAS OBTAINED UTILIZING THE COST REPORTS. LINES 7E AND 7I WERE OBTAINED USING GENERAL LEDGER DETAIL. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION 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. BASED ON THE POVERTY LEVEL, APPROXIMATELY 15% 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 CONCESSION IS ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 6/30/21. 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. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED PATIENTS AND IS COOPERATING WITH THE ORGANIZATION WITH REGARD TO EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN CURRENT SELF-PAY COLLECTION POLICY GUIDELINES AND TIMEFRAMES, THE ORGANIZATION OR ITS AGENT SHALL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE COLLECTION AGENCY. LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION (LJMH) ALLOWS INDIVIDUALS 120 DAYS FROM THE FIRST POST DISCHARGE STATEMENT TO APPLY FOR FINANCIAL ASSISTANCE BEFORE SENDING THE UNCOLLECTED ACCOUNT TO AN OUTSIDE COLLECTION AGENCY. LJMH WILL PROVIDE THE PATIENT WITH A STATEMENT OR FINAL NOTICE THAT CONTAINS A LISTING OF THE SPECIFIC COLLECTION ACTION(S) IT INTENDS TO INITIATE, AND A DEADLINE AFTER WHICH THEY MAY BE INITIATED NO EARLIER THAN 30 DAYS BEFORE ACTION IS INITIATED. IF THE PATIENT QUALIFIES FOR 100% CHARITY CARE, NO FURTHER BILLS WILL BE SENT. A LETTER WILL BE SENT INSTEAD INDICATING THAT THE PATIENT'S BILL HAS BEEN COMPLETELY FORGIVEN. PART VI, LINE 2: LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION (LJMH) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE FISCAL YEAR ENDED JUNE 30, 2019.LJMH REGULARLY CONDUCTS PATIENT SATISFACTION SURVEYS WHICH CAN LEAD TO INFORMATION REGARDING NEEDED SERVICES. ADDITIONALLY, INTERACTIVE QUESTIONS ARE ASKED ABOUT SERVICES DURING HEALTH SCREENINGS. RESULTS OF THE QUESTIONNAIRE ARE REPORTED BACK TO THE OFFICERS AND BOARD. PART VI, LINE 3: PATIENTS ARE INFORMED OF THE FINANCIAL ASSISTANCE/CHARITY CARE POLICY WITH A DOCUMENT EXPLAINING THE PROCEDURE. THE DOCUMENT IS AT THE REGISTRATION DESK AND IS GIVEN TO PATIENTS AT TIME OF REGISTRATION. THE STAFF REGISTERING THE PATIENT CAN IDENTIFY ON THE FRONT END THAT THE PATIENT IS ABLE TO PAY THROUGH INSURANCE OR OTHERWISE. IF THEY IDENTIFY ON THE FRONT END THAT THE PATIENT NEEDS ASSISTANCE, THE PATIENT IS GIVEN A FINANCIAL PACKET TO COMPLETE TO SEE IF THEY QUALIFY FOR BENEFITS. IF THERE IS NO OPTION FOR AN OUTSIDE ASSISTANCE PROGRAM, THE PATIENT IS INFORMED OF AND ENCOURAGED TO COMPLETE THE APPLICATION THAT UTILIZES A COMBINATION OF INCOME, ASSETS, AND EXPENSES TO DETERMINE WHAT PERCENTAGE OF CHARITY CARE THEY WOULD QUALIFY FOR. PART VI, LINE 4: LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION IS LOCATED IN SCOTLAND, S.D IN BON HOMME COUNTY, S.D., IN THE SOUTH-CENTRAL PART OF THE STATE. AGRICULTURE IS THE PRIMARY ECONOMIC DRIVER IN THE COUNTY. LANDMANN JUNGMAN'S PRIMARY SERVICE AREA IS BON HOMME COUNTY. 70 PERCENT OF INPATIENT DISCHARGES WERE FROM BON HOMME COUNTY IN FY21. ACCORDING TO THE U.S. CENSUS BUREAU'S APRIL 2020 ESTIMATED DATA, THE POPULATION OF BON HOMME COUNTY WAS ABOUT 7,003 PEOPLE AND IS PREDOMINATELY WHITE/CAUCASIAN (88 PERCENT). ABOUT 21 PERCENT OF THE POPULATION IS OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME OF BON HOMME COUNTY IS $54,737, COMPARED WITH THE STATE OF SOUTH DAKOTA'S $58,275 MEDIAN HOUSEHOLD INCOME. THE PERCENTAGE OF PERSONS BELOW THE FEDERAL POVERTY LEVEL WAS 15 PERCENT, WHILE THE STATE OF SD HAS A RATE OF 14.6 PERCENT. US CENSUS DATA SHOWS HIGH SCHOOL GRADUATION IN THE COUNTY AT 87 PERCENT, WHILE THE STATE RATE IS 82 PERCENT, AND REPORTS ADULTS OVER 25 YEARS OF AGE WITH A BACHELOR'S DEGREE OR HIGHER AT 18 PERCENT, WHICH IS SIGNIFICANTLY BELOW THE STATE RATE OF 29 PERCENT. COUNTY HEALTH RANKINGS DATA ASSESSES THE UNEMPLOYMENT RATE OF BON HOMME COUNTY AT 3.2 PERCENT, COMPARED WITH THE STATE OF SOUTH DAKOTA'S 3.3 PERCENT UNEMPLOYMENT. THE SECONDARY SERVICE AREA INCLUDES PORTIONS OF HUTCHINSON AND YANKTON COUNTIES. HUTCHINSON AND YANKTON COUNTIES ARE DEMOGRAPHICALLY SIMILAR TO BON HOMME COUNTY WITH RURAL, AGRICULTURAL LIFESTYLES. IN CALENDAR YEAR 2020, THESE TWO COUNTIES MADE UP 16 PERCENT OF INPATIENT DISCHARGES. LANDMANN JUNGMAN HAS ABOUT 4,900 CLINIC VISITS IN FY2021. PART VI, LINE 5: LJMH IS FOCUSED ON SERVING THE NEEDS OF THE COMMUNITY. THE GOVERNING BODY OF THE HOSPITAL IS MADE UP ENTIRELY OF VOLUNTEERS FOR THE COMMUNITY. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN ITS COMMUNITY. EXCESS FUNDS ARE USED FOR THE IMPROVEMENT OF PATIENT CARE AND FACILITIES. THE HOSPITAL IS CONTRACTED WITH SEVERAL HIGHER LEARNING HEALTH CARE RELATED INSTITUTIONS TO BE A CLINICAL SITE FOR VARIOUS HEALTH CARE FIELDS. THE FACILITY IS OPEN TO ANYONE WHO WANTS TO LEARN ABOUT CAREERS IN THE HEALTH CARE INDUSTRY THROUGH THE CLINICAL PROGRAM AND THROUGH A HIGH SCHOOL SHADOWING PROGRAM.THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL ADMINISTRATION IS VERY RECEPTIVE TO INPUT FROM THE COMMUNITY.AVERA HEALTH AND LJMH 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. WE ALSO HAVE A FITNESS CENTER SO PATIENTS AND THE COMMUNITY CAN MAINTAIN A HEALTHY LIFESTYLE. PART VI, LINE 6: LJMH IS A MANAGED FACILITY OF AVERA HEALTH. AVERA HEALTH AND THE HOSPITAL WORK COOPERATIVELY TO ENHANCE HEALTHCARE THROUGHOUT THE COMMUNITY SERVED BY LJMH. LJMH ALSO HAS ACCESS TO "BACK OFFICE" SUPPORT SERVICES, SUCH AS LEGAL CONSULTATION, QUALITY BENCHMARKING, CODING, COMPUTER SERVICES, CONTRACT NEGOTIATIONS, ADMINISTRATIVE CONSULTATION, GROUP PURCHASING, HUMAN RESOURCE ASSISTANCE AND MANY OTHER SERVICES. AVERA HEALTH IS ABLE TO PROVIDE THESE SERVICES TO LJMH AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT AND RESIDENT CARE. X X 0 0 0 0 0 0 0 0 0 MELISSA GALE CEO 139459 0 0 0 996 0 2933 0 22413 0 165801 0 0 0 FORM 990 PART VII, LINE 5 MELISSA GALE, CEO, WAS COMPENSATED THROUGH AN ARRANGEMENT WITH AVERA MCKENNAN, 1325 S CLIFF AVE, SIOUX FALLS, SD 57108. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPOSED OF THE PRESIDENT, VICE-PRESIDENT, SECRETARY, AND ONE ADDITIONAL BOARD MEMBER OF THE BOARD OF TRUSTEES ELECTED BY THE BOARD. 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 DIRECTORS AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE CEO WILL REVIEW THE 990 IN DETAIL. A COPY OF THE 990 IS GIVEN TO THE BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS AND MANAGEMENT. BOARD MEMBERS ARE RESPONSIBLE FOR DETERMINING WHETHER A POTENTIAL CONFLICT EXISTS WITH THE ADMINISTRATOR AND BOARD MEMBERS. THE ADMINISTRATOR IS RESPONSIBLE FOR DETERMINING IF THERE ARE POTENTIAL CONFLICTS OF INTEREST AMONGST MANAGEMENT. THE BOARD IS ULTIMATELY RESPONSIBLE FOR DETERMINING WHETHER AN ACTUAL CONFLICT EXISTS. ANY BOARD MEMBER WITH A CONFLICT IS REQUIRED TO ABSTAIN FROM VOTING ON THE MATTER OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AVERA MCKENNAN AND LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION USE COMPARABILITY DATA TO DETERMINE APPROPRIATE COMPENSATION OF THE ADMINISTRATOR BASED ON EXPERIENCE AND PERFORMANCE. THE COMPENSATION AMOUNT IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS. FOR OTHER KEY EMPLOYEES AVERA MCKENNAN DOES A SALARY SURVEY THAT IS THEN APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC DURING ITS ANNUAL BOARD MEETING AND UPON REQUEST. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G TEMPORARY AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 744,732. MANAGEMENT AND GENERAL EXPENSES 270,237. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,014,969. PHYISICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 411,612. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 411,612. OTHER FEES: PROGRAM SERVICE EXPENSES 247,130. MANAGEMENT AND GENERAL EXPENSES 146,226. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 393,356. FORM 990, PART XI, LINE 9: CHANGE IN AVERA FOUNDATION 18,543.