2021-04-15T16:35:09-05:00 2020-05-31 460434947 ELO PROF LLC PO BOX 249 MITCHELL SD 57301 990 2019-06-01 460400557 DOUGLAS COUNTY MEMORIAL HOSPITAL DOUG 6057242159 708 8TH ST ARMOUR SD 57313 HEATH BROUWER CEO 6057242159 2021-04-15 true JAY TOLSMA CPA P00736087 6059967717 2021-04-15 2019 2022-09-23 18:48:47Z HEATH BROUWER 11720428 false X WWW.DCMHSD.ORG X PROMOTION OF GENERAL HEALTH CARE AND REHABILITATION SERVICES 7 7 110 7 0 197622 1270133 10135135 10301261 16496 62488 50215 86546 10399468 11720428 0 0 5621319 5698114 0 0 4338411 4880350 9959730 10578464 439738 1141964 13441108 16894081 3977286 6288295 9463822 10605786 PROMOTION OF GENERAL HEALTH CARE AND REHABILITATION SERVICES false false 9167885 DOUGLAS COUNTY MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO PERSONS IN THE ARMOUR, CORSICA, AND STICKNEY COMMUNITIES. DURING THE FISCAL YEAR ENDED MAY 31, 2019, THE HOSPITAL PROVIDED 492 INPATIENT DAYS, 314 SUBACUTE DAYS, 509 EMERGENCY ROOM VISITS, 9,129 OUTPATIENT VISITS AND 6,186 ASSISTED LIVING DAYS. THE FACILITY PROVIDED 886 HOME DELIVERED MEALS TO HOME-BOUND COMMUNITY MEMBERS ALONG WITH 2,251 MEALS TO SENIOR MEALS PROGRAM. EACH RURAL HEALTH CLINIC LOCATION CONDUCTS AN ANNUAL HEALTH FAIR. FOR THE FISCAL YEAR ENDED MAY 31, 2019, THE HOSPITAL PROVIDED 149 LIPID LAB TESTS, 149 GLUCOSE TESTS, 149 HEMOGLOBIN TESTS, AND 149 VITAL CHECKS (BLOOD PRESSURE, PULSE, AND OXYGEN SATURATION LEVEL) AT NO CHARGE. 9167885 true false false false false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 23 0 true 110 true false false false false false false false false false false false false false false X 7 7 false false false false false false false true true false false false true true true true true true true false X JOSHUA CHRISTENSEN CFO 6057242159 708 8TH STREET ARMOUR SD 57313 GEORGE NICHOLAS PHYSICIAN 40.00 X 218927 0 8944 MARLYS LUEBKE PHYSICIAN 24.00 X 183566 0 18866 JENNIFER BIETZ PHYSICIAN AS 40.00 X 159712 0 36991 NICOLE BAMBERG RN - CLINIC 40.00 X 155778 0 36955 VANESSA MIILLER PHYSICIAN AS 40.00 X 166670 0 25804 HEATH BROUWER CEO 40.00 X 135045 0 22130 JOSHUA CHRISTENSEN CFO 40.00 X 90810 0 16030 JOEL BAIER PRESIDENT X 0 0 0 BRAD VANDEN BERG VICE-PRESIDE X 0 0 0 SCOTT HOLBECK MEMBER X 0 0 0 DEAN MEYERINK MEMBER X 0 0 0 JODI SCHRANK SECRETARY X 0 0 0 MARK VAN DER WERFF TREASURER X 0 0 0 1110508 165720 6 false true false SANFORD OCC MEDICINE PO BOX 5064 SIOUX FALLS SD 57117 MEDICAL SERVICE 518509 ZOSS ANESTHESIA PC 42668 263RD ST EMERY SD 57332 MEDICAL SERVICE 110000 PHILIPS HEALTHCARE 42668 263RD ST EMERY SD 57332 MEDICAL SERVICE 106812 AVERA 3900 W AVERA DR SIOUX FALLS SD 57117 MEDICAL SERVICE 102716 SANFORD LABORATORIES PO BOX 5056 SIOUX FALLS SD 57117 MEDICAL SERVICE 101676 5 1172652 97481 1270133 PROGRAM SERVICE REVENUE 10301261 10301261 10301261 62488 62488 OTHER REVENUE 86546 86546 86546 11720428 10450295 X 4509933 3916187 593746 203736 176083 27653 688229 607137 81092 296216 255922 40294 37497 37497 1193142 921195 271947 116367 4756 111611 146737 124570 22167 15488 14856 632 113325 111842 1483 395328 390553 4775 103450 103450 SUPPLIES 2662902 2587677 75225 REPAIRS AND MAINTENANCE 92758 76277 16481 OTHER TAXES 55636 36000 19636 CONTINUING EDUCATION 33915 31025 2890 -86195 -86195 10578464 9167885 1410579 0 400 400 3769029 7464729 2029008 1399004 23125 115000 407859 489678 62971 51587 9615048 3098223 6523108 6516825 625608 672889 183969 13441108 16894081 708972 3073039 3264814 3211506 3500 3750 3977286 6288295 X 9463822 10605786 9463822 10605786 13441108 16894081 X 1141964 X false true X true false X 186153 186153 7219748 1646510 5573238 2209147 1451713 757434 6516825 DEPOSITS - PRAIRIE VILLA 3750 3750 11720428 11720428 11720428 10578464 10578464 10578464 SCHEDULE D, PAGE 4, PART XI, LINE 4B ASSISTED LIVING REVENUES - NETTED ON FINANCIAL STATEMENTS 0 SCHEDULE D, PAGE 4, PART XII, LINE 4B ASSISTED LIVING EXPENSES - NETTED ON FINANCIAL STATEMENTS 0 true true true X 1.250000000000 true X true true true false false 169236 169236 0.01600 169236 169236 0.01600 166989 73590 93399 0.00880 166989 73590 93399 0.00880 336225 73590 262635 0.02480 true 339878 105962 7037294 7625064 -587770 X false 1 1 DOUGLAS COUNTY MEMORIAL HOSPITAL 708 8TH STREET ARMOUR SD 57313 WWW.DCMHSD.ORG LICENSE 10526 X DOUGLAS COUNTY MEMORIAL HOSPITAL 1 false false true X X X X X X X 18 true false false true X WWW.DCMHSD.ORG X true 18 true WWW.DCMHSD.ORG false false true X 125.000000000000 200.000000000000 X X X X true true X X X true X WWW.DCMHSD.ORG X WWW.DCMHSD.ORG X WWW.DCMHSD.ORG X X X X X true X false X X X X true X false false FACILITY 1, DOUGLAS COUNTY MEMORIAL HOSPITAL - PART V, LINE 5 IN CONDUCTING THE CHNA THE HOSPITAL FACILITY RELIED HEAVILY UPON THE KNOWLEDGE OF THE ARMOUR MAYOR, DOUGLAS COUNTY COMMUNITY HEALTH NURSE, DOUGLAS COUNTY COMMISSIONER, ARMOUR HIGH SCHOOL PRINCIPAL, CORSICA HIGH SCHOOL PRINCIPAL, ARMOUR NURSING HOME ADMINISTRATOR, PHYSICIAN ASSISTANT, CORSICA CLINIC NURSE MANAGER, THE CEO, AND CFO OF THE DOUGLAS COUNTY MEMORIAL HOSPITAL. THE HOSPITAL RELIED ON THEIR INPUT AS TO WHAT THE NEEDS OF THE COMMUNITY ARE BASED ON THEIR WORKING KNOWLEDGE OF THE ILLNESSES THAT ARE OCCURRING IN THE DOUGLAS COUNTY. FACILITY 1, DOUGLAS COUNTY MEMORIAL HOSPITAL - PART V, LINE 11 MENTAL HEALTH ISSUES ARE BEING ADDRESSED IN AN ATTEMPT TO PROVIDE MENTAL HEALTH SERVICES THROUGH THE FACILITIES' TELEHEALTH SERVICES. INCREASED ACCESS TO SPECIALTY SERVICES ARE ALSO TRYING TO BE ADDRESSED THROUGH THIS SAME MEANS WHICH COSTS THE FACILITY ROUGHLY 33,000 PER YEAR. WELLNESS ISSUES ARE BEING ADDRESSED BY THE FACILITY OFFERING USE OF THEIR EQUIPMENT TO THE PUBLIC AT A RATE OF 10 PER MONTH. RECRUITMENT OF PHYSICIANS IS A CONTINUAL AREA OF FOCUS FOR THE HOSPITAL. 6 PRAIRIE HEALTH CLINIC ARMOUR 708 8TH STREET ARMOUR SD 57313 RURAL HEALTH CLINIC PRAIRIE HEALTH CLINIC CORSICA 230 E MAIN STREET CORSICA SD 57328 RURAL HEALTH CLINIC PRAIRIE PHARMACY ARMOUR 1311 BRADDOCK STREET ARMOUR SD 57313 RETAIL/OUTPATIENT PHARMACY PRAIRIE PHARMACY CORSICA 230 E MAIN STREET CORSICA SD 57328 RETAIL/OUTPATIENT PHARMACY PRAIRIE VILLA 1309 BRADDOCK STREET ARMOUR SD 57313 ASSISTED LIVING CENTER PRAIRIE HEALTH CLINIC STICKNEY 301 MAIN STREET STICKNEY SD 57375 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED FOR LINE 7 IS THE FACILITY'S MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 2 BAD DEBTS WERE BASED 62% OF HOSPITAL'S AUDITED FINANCIAL STATEMENTS FIGURE. THE 62% CAME FROM THE CALCULATION FIGURED ON WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS SCHEDULE H, PART III, LINE 3 BASED ON A SAMPLE OF ACCOUNTS WRITTEN OFF TO COLLECTION AGENCIES THAT WERE NOT INCLUDED IN THE COMMUNITY BENEFIT. SCHEDULE H, PART III, LINE 4 THE FOOTNOTE TO THE FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 10. PART III, LINE 8 - THE FIGURE REPORTED ON LINE 6 COMES DIRECTLY FROM THE FACILITY'S FILED COST REPORT. SCHEDULE H, PART III, LINE 8 THIS SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT SINCE IF THESE SERVICES WERE NOT PROVIDED, IT WOULD BE A UNDUE BURDEN TO THE COMMUNITY TO TRAVEL TO ANOTHER FACILITY TO RECEIVE SERVICES. SCHEDULE H, PART VI, LINE 2 THE DOUGLAS COUNTY MEMORIAL HOSPITAL IS RESPONSIVE TO THE NEEDS OF THE PATIENTS IT SERVES. THE FACILITY IS CONTINUALLY EVALUATING THE SERVICES IT PROVIDES, IN TALKS WITH LOCAL AGENCIES ABOUT THE SERVICES PROVIDED, AND IS ALWAYS OPEN TO INPUT FROM THE COMMUNITY ON EXPANDING OR ADDING SERVICES. OFTEN SERVICES CANNOT BE PROVIDED DIRECTLY BY THE HOSPITAL ITSELF, HOWEVER ARRANGEMENTS ARE MADE TO BRING OUTSIDE PROVIDERS AND/OR EQUIPMENT IN ORDER TO ALLOW THE COMMUNITY THE ABILITY TO RECEIVE THE CARE LOCALLY. SCHEDULE H, PART VI, LINE 3 PATIENT FINANCIAL SERVICES EVALUATES EACH ACCOUNT FOR PATIENT ELIGIBILITY UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND PROVIDES ELGIBILE PATIENTS WITH INFORMATION REGARDING THESE PROGRAMS ALONG WITH THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE WRITTEN OFF THROUGH FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 DOUGLAS COUNTY MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO PERSONS IN THE ARMOUR, CORSICA, AND STICKNEY COMMUNITIES. DURING THE FISCAL YEAR ENDED MAY 31, 2019, THE HOSPITAL PROVIDED 492 INPATIENT DAYS, 314 SUBACUTE DAYS, 509 EMERGENCY ROOM VISITS, 9,129 OUTPATIENT VISITS AND 6,186 ASSISTED LIVING DAYS. THE FACILITY PROVIDED 886 HOME DELIVERED MEALS TO HOME-BOUND COMMUNITY MEMBERS ALONG WITH 2,251 MEALS TO SENIOR MEALS PROGRAM. EACH RURAL HEALTH CLINIC LOCATION CONDUCTS AN ANNUAL HEALTH FAIR. FOR THE FISCAL YEAR ENDED MAY 31, 2019, THE HOSPITAL PROVIDED 149 LIPID LAB TESTS, 149 GLUCOSE TESTS, 149 HEMOGLOBIN TESTS, AND 149 VITAL CHECKS (BLOOD PRESSURE, PULSE, AND OXYGEN SATURATION LEVEL) AT NO CHARGE. SCHEDULE H, PART VI, LINE 5 THE BOARD OF DIRECTORS IS COMPLETELY MADE UP OF COMMUNITY MEMBERS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE ARE WHO ARE NEITHER EMPLOYED BY NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION. THE HOSPITAL ALSO PROVIDES THE PHYSICAL LOCATION FOR THE DOUGLAS COUNTY COMMUNITY HEALTH OFFICE WHICH ALSO ALLOWS THE HOSPITAL TO WORK CLOSELY WITH OUR LOCAL HEALTH AGENCY. AN OPEN MEDICAL STAFF ALSO ALLOWS PROVIDERS WHO ARE NOT EMPLOYED BY THE ORGANIZATION TO SEE PATIENTS, AND PROVIDE MEDICAL TREATMENT AT THE FACILITY. THE DOUGLAS COUNTY MEMORIAL HOSPITAL IS ALSO EXPANDING ITS TELEMEDICINE CAPABILITIES ALLOWING PATIENTS WHO WOULD OTHERWISE HAVE TO TRAVEL DISTANCES IN EXCESS OF NINETY MILES TO SEE SPECIALIST WHO CAN NOW BE SEEN LOCALLY. GIVEN THE INCLEMENT WEATHER OF SOUTH DAKOTA, THIS PROVIDES PATIENTS THE ABILITY TO SEE THEIR PROVIDERS WITHOUT HAVING TO RUN A RISK OF BEING CAUGHT IN POTENTIALLY DANGEROUS CONDITIONS. THIS IS MOST ESPECIALLY TRUE FOR THE ELDERLY POPULATION AS THEY ARE OFTEN THE ONES IN MOST NEED OF SEEING THESE SPECIALTY PROVIDERS. X X X false false false false false false false false false GEORGE NICHOLAS PHYSICIAN 218927 8944 218927 8944 MARLYS LUEBKE PHYSICIAN 183566 18866 183566 18866 JENNIFER BIETZ PHYSICIAN ASSISTANT 159712 36991 159712 36991 NICOLE BAMBERG RN - CLINIC MANAGER 155778 36955 155778 36955 VANESSA MIILLER PHYSICIAN ASSISTANT 166670 25804 166670 25804 HEATH BROUWER CEO 135045 22130 135045 22130 FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS REVIEWED AND APPROVED BY THE ADMINISTRATOR AND CHIEF FINANCIAL OFFICER BEFORE FILING. FORM 990, PAGE 6, PART VI, LINE 12C AT THE BOARD'S ANNUAL MEETING FORM 990, PAGE 6, PART VI, LINE 15A PROCESS COMPLETED THROUGH BOARD COMPENSATION COMMITTEE FORM 990, PAGE 6, PART VI, LINE 15B PROCESS COMPLETED THROUGH BOARD COMPENSATION COMMITTEE FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATMENTES ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G 921,195 271,947 0 FORM 990, PART XI, LINE 9 ASSISTED LIVING REVENUES - NETTED ON FINANCIAL STATEMENTS 0 ASSISTED LIVING EXPENSES - NETTED ON FINANCIAL STATEMENTS 0