2021-03-01T15:43:48-06:00 2020-06-30 450250958 EIDE BAILLY LLP 200 E 10TH ST STE 500 SIOUX FALLS SD 571046375 990 2019-07-01 466015787 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION LAND 6055832226 600 BILLARS STREET SCOTLAND SD 570592026 MELISSA GALE CEO 6055832226 2021-02-24 1 LAURIE HANSON CPA P00851848 6053391999 2021-02-24 X 2019 2022-09-23 18:48:47Z MELISSA GALE 600 BILLARS STREET SCOTLAND SD 570592026 5543792 0 X WWW.AVERA.ORG/SCOTLAND X 1969 SD OPERATION OF A COMMUNITY CRITICAL ACCESS HOSPITAL. 9 8 57 11 0 0 347008 90859 4663646 5444234 6975 8699 200 0 5017829 5543792 0 0 0 0 2214753 2428924 0 0 0 2824268 3295011 5039021 5723935 -21192 -180143 3688627 6558466 2250196 5296304 1438431 1262162 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 4899721 5444234 LANDMANN-JUNGMAN MEMORIAL HOSPITAL (LJMH) IS A LICENSED CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS, OF WHICH 10 MAY BE USED AS SWING BEDS. THE FACILITY OFFERS INPATIENT, OUTPATIENT AND PHYSICIAN CLINIC SERVICES TO RESIDENTS IN AND AROUND THE CITY OF SCOTLAND, SD. SEVERAL VISITING SPECIALISTS SPEND TIME AT LJMH CONDUCTING OUTREACH CLINICS ON A REGULAR BASIS WHICH INCLUDE AREAS OF ORTHOPEDICS, GENERAL SURGERY, OB/GYN, MOBILE MRI, NUCLEAR MEDICINE AND MAMMOGRAPHY. WEST WINDS APARTMENTS IS ALSO PART OF LJMH AND SERVES AS A 16 UNIT SENIOR HOUSING APARTMENT BUILDING. 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 BI-MONTHLY BLOOD DRIVES. 4899721 1 0 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 1 0 0 0 0 0 0 0 0 0 0 1 6 0 1 57 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X JULIE DAVIS 6055832226 600 BILLARS STREET SCOTLAND SD 57059 CODY CARSTENSEN PHARMACIST 40.00 X 108504 0 19750 MELISSA GALE CEO 40.00 X 127526 0 21727 DARCY PERMANN CFO (UNTIL MAR 2020) 40.00 X 70409 0 8776 JULIE DAVIS CFO (BEG MAR 2020) 40.00 X 63887 0 14519 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 JAMES DANGEL DIRECTOR 0.50 X 0 0 0 DEVIN LUBINUS DIRECTOR 0.50 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 370326 0 64772 1 0 1 1 AVERA MCKENNAN 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS SD 571175045 ADMIN, IT, AND OTHER SERVICES 1095278 AVERA HEALTH 3900 W AVERA DR STE 301 SIOUX FALLS SD 57108 HEALTH SERVICES 324626 HEALTH CAROUSEL 3805 EDWARDS RD STE 700 CINCINNATI OH 45209 CONTRACT RN 233387 ROVE 220 E 249TH ST CHAMBERLAIN SD 57325 CONTRACT EMPLOYEES 117351 4 71892 18967 90859 NET PATIENT SERVICE RE 621110 4436436 4436436 PHARMACY REVENUE 446110 830696 830696 WEST WINDS REVENUE 623990 105603 105603 71499 71499 5444234 8699 8699 5543792 5444234 0 8699 X 312697 64342 248355 23722 23722 1903846 1829962 73884 12339 12339 64467 49167 15300 111853 100315 11538 67380 67380 1412069 1218169 193900 9392 9392 279244 172031 107213 75463 75463 5144 2821 2323 72021 57218 14803 246615 200085 46530 31538 25056 6482 MEDICAL SUPPLIES 947344 947344 BAD DEBT 115639 115639 CONTINUING EDUCATION 19841 18222 1619 COMMUNITY & EMPLOYEE RE 6413 6413 6908 165 6743 5723935 4899721 824214 0 426039 2954555 517668 1036619 167123 191404 16064 15475 7622611 5715756 2059795 1906855 501938 453558 3688627 6558466 571520 462883 2384427 1480870 1364075 313920 197806 770999 2250196 5296304 X 1438431 1262162 1438431 1262162 3688627 6558466 X -180143 -6242 10116 X 0 1 X 1 0 X 36163 36163 4824856 3751386 1073470 2628995 1873217 755778 132597 91153 41444 1906855 INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 82705 F ASSETS LIMITED AS TO USE 370853 F 453558 CONDITIONAL ASSET RETIREMENT OBLIGATION 64045 DAMAGE DEPOSITS PAYABLE 10500 CAPITAL LEASE 36454 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 660000 770999 X 5432027 -6242 -105523 -111765 5543792 0 5543792 5608296 0 5608296 115639 115639 5723935 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: PROVISION FOR BAD DEBTS -115,639. CHANGE IN AVERA FOUNDATION 10,116. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 115,639. 1 1 X 1 X 1 X 1 1 0 1 1 21000 21000 0.00370 21000 21000 0.00370 23612 2250 21362 0.00370 1231285 710440 520845 0.09100 100 100 0.00000 1254997 712690 542307 0.09470 1275997 712690 563307 0.09840 1005 1005 0.00020 1005 1005 0.00020 0 115639 12605 2198904 2208411 -9507 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 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. HEALTH NEED TO BE ADDRESSED: BEHAVIORAL HEALTH CONCERNS OVERARCHING GOAL: PROVIDE ACCESS TO BEHAVIORAL HEALTH CARE AND EDUCATION IN OUR COMMUNITY. - PROVIDED BEHAVIORAL HEALTH CARE ACCESS THROUGH TELEMEDICINE OPTIONS, INCLUDING ETRIAGE AND AVERA ADDICTION RECOVERY SERVICES. - MET WITH ROTARY CLUB TO DISCUSS THE BEHAVIORAL HEALTH SERVICES AVAILABLE. - PROVIDED EDUCATION MATERIALS ON THE FARMER STRESS HOTLINE TO LOCAL BUSINESSES. - PROVIDED EDUCATION ABOUT VAPING, BULLYING, AND OTHER POTENTIAL BEHAVIORAL HEALTH RELATED EMERGING TOPICS THROUGH OUR SOCIAL MEDIA PLATFORM AND SENT INFORMATION TO THE SCHOOL TO HAVE AVAILABLE FOR STUDENTS.HEALTH NEED TO BE ADDRESSED: HEALTH EDUCATION OVERARCHING GOAL: PROVIDE HEALTH EDUCATION IN A VARIETY OF DIFFERENT LEARNING PLATFORMS TO LANDMANN JUNGMAN'S SERVICE AREA. - UTILIZED OUR SOCIAL MEDIA PLATFORM AND LOCAL NEWSPAPER ON A VARIETY OF HEALTH ISSUES INCLUDING WOMEN'S HEALTH, COVID-19, IMMUNIZATIONS, BONE DENSITY, INSURANCE 101, AND PALLIATIVE CARE. - CONDUCTED SEVERAL PUBLIC SERVICE ANNOUNCEMENTS AT COMMUNITY SPORTING EVENTS TO RAISE AWARENESS FOR CARDIAC CARE AND BREAST CANCER. - PROVIDED RESOURCE GUIDES AND EDUCATION SHEETS FOR DISEASES THAT ARE PREVALENT IN OUR SERVICE AREA AND HAD THEM AVAILABLE VIA PRINT/DIGITAL ON THE FOLLOWING HEALTH TOPICS: DIABETES, HYPERTENSION, AND OTHER CHRONIC ILLNESSES. - HELD FOOT CLINIC DAYS TO EDUCATE PEOPLE, ESPECIALLY THOSE WITH DIABETES, ON THE IMPORTANCE OF PROPER FOOT CARE. - TAUGHT HANDS ONLY CPR AND STOP THE BLEED IN THE SCHOOL AND COMMUNITY - ASSISTED THE LOCAL EMS WITH TEACHING CERTAIN EDUCATION TOPICS TO EMS STAFF INCLUDING CARDIAC CARE, TRAUMA CARE, RESPIRATORY CARE, MEDICAL EMERGENCIES, AND DISASTER PREPAREDNESS.HEALTH NEED TO BE ADDRESSED: ACCESS TO HEALTH CARE FROM PEDIATRIC TO GERIATRIC OVERARCHING GOAL: IMPROVE ACCESS TO HEALTH CARE IN THE SERVICE AREA. - IMPLEMENTED A PHARMACY DELIVERY SERVICE. - CONTINUED CHRONIC CARE RN SERVICES. - PROMOTED TELEHEALTH SERVICES TO IMPROVE ACCESS TO CARE WHILE REDUCING TRANSPORTATION NEEDS AND INCREASED THESE SERVICES DUE TO THE COVID PANDEMIC.HEALTH NEED TO BE ADDRESSED: OBESITY AND SOCIAL DETERMINANTS OF HEALTH OVERARCHING GOAL: PROMOTE HEALTHY LIFESTYLE THROUGH NUTRITIONAL AND EXERCISE EDUCATION AND ACTIVITIES. - THE HOSPITAL WILL COMMIT TO HAVING A REPRESENTATIVE AT THE TABLE WITH LOCAL PROGRAMS AND PROJECTS THAT WORK TOGETHER TO ADDRESS BUILT ENVIRONMENT ISSUES RELATED TO EXERCISE AND HEALTHY EATING. THIS WORK IS IN CONJUNCTION WITH WELLMARK HEALTHY HOME TOWN. - LAUNCHED "WALK WITH EASE" CLASS. - LAUNCHED "FIT AND STRONG" CLASS. 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/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/FINANCIAL-ASSISTANCE-FORMS/PART 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 I, LN 7 COL(F): BAD DEBT EXPENSE OF $115,639 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: LJMH HOSTED SEVERAL HEALTHY HOME TOWN MEETINGS TO IMPROVE SCOTLAND WALKABILITY, BIKE ABILITY, AND PERSONAL SAFETY. PART III, LINE 2: THE AMOUNT REPORTED ON LINE 2 REPRESENTS THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS.LJMH BAD DEBT SYSTEM TAKES INTO ACCOUNT CONTRACTUAL ALLOWANCES AND/OR DISCOUNTS. IF AN ACCOUNT IS WRITTEN OFF TO BAD DEBTS, PAYMENTS RECEIVED AFTER THE WRITE OFF FOR THAT ACCOUNT ARE POSTED TO THE BAD DEBT RECOVERY ACCOUNT. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE 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 2019. BASED ON THE POVERTY LEVEL, APPROXIMATELY 10.9% OF BAD DEBT EXPENSE 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 BAD DEBT IS ON PAGE 7 AND 8 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 6/30/20. 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: BILLING STATEMENTS ARE SENT OUT EVERY 30 DAYS FOR 6 MONTHS (180 DAYS). THE LAST STATEMENT INCLUDES AN ITEMIZED BILL AND A STICKER THAT STATES IF THE BALANCE IS NOT PAID WITHIN 30 DAYS THE ACCOUNT WILL BE TURNED OVER TO COLLECTIONS. PART VI, LINE 2: LANDMANN-JUNGMAN MEMORIAL HOSPITAL (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 IS LOCATED IN SCOTLAND, S.D. SCOTLAND IS LOCATED 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. IN FISCAL YEAR 2019, 83 PERCENT OF INPATIENT DISCHARGES AND 65 PERCENT OF EMERGENCY ROOM VISITS WERE FROM BON HOMME COUNTY. ACCORDING TO THE U.S. CENSUS BUREAU'S 2019 ESTIMATED DATA, THE POPULATION OF BON HOMME COUNTY WAS ABOUT 6,901 PEOPLE AND IS PREDOMINATELY WHITE/CAUCASIAN (89%). ABOUT 21 PERCENT OF THE POPULATION IS OVER THE AGE OF 65. COUNTY HEALTH RANKINGS ASSESSES THE UNEMPLOYMENT RATE OF BON HOMME COUNTY AT 3.7 PERCENT, COMPARED WITH THE STATE OF SOUTH DAKOTA'S 3.5 PERCENT UNEMPLOYMENT (2020). COUNTY HEALTH RANKINGS STATES THAT THE MEDIAN HOUSEHOLD INCOME OF BON HOMME COUNTY IS $54,737, WHICH IS ABOUT $4,000 LESS THAN THE STATE'S AVERAGE OF $58,275 (2020). THE PERCENTAGE OF PERSONS BELOW 100 PERCENT OF THE FEDERAL POVERTY LEVEL IN 2020 WAS 14.1 PERCENT, WHILE THE STATE OF SD HAS A RATE OF 11.9 PERCENT. US CENSUS DATA SHOWS HIGH SCHOOL GRADUATION IN THE COUNTY AT 87.4 PERCENT, WHILE THE STATE RATE IS 91.7 PERCENT AND REPORTS ADULTS OVER 25 YEARS OF AGE WITH A BACHELOR'S DEGREE OR HIGHER AT 18.3 PERCENT, WHICH IS SIGNIFICANTLY BELOW THE STATE RATE 28.8 PERCENT (2020). 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 FISCAL YEAR 2019, THESE TWO COUNTIES MADE UP 13 PERCENT OF INPATIENT DISCHARGES AND 22 PERCENT OF EMERGENCY ROOM VISITS. LANDMANN JUNGMAN HAS ABOUT 4,200 CLINICAL ENCOUNTERS EACH YEAR. THE NEXT CLOSEST HOSPITAL IS LOCATED IN TYNDALL, S.D., WHICH IS ABOUT 22 MILES FROM SCOTLAND. 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. AS A MANAGED FACILITY, LJMH IS ABLE TO PARTICIPATE IN AVERA E-CARE SERVICES. THESE SERVICES INCLUDE AVERA E-EMERGENCY, E-PHARMACY AND E-CONSULT. THESE SERVICES ALLOW RURAL PATIENTS TO BE CARED FOR AT THEIR LOCAL HOSPITALS, PROVIDE RURAL HOSPITALS ACCESS TO IMMEDIATE SPECIALTY CARE AND SUPPORT, AND HELP REDUCE HEALTH CARE COSTS AND TRAVEL.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 127292 0 0 0 234 0 2681 0 20138 0 150345 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. JONATHAN DANGEL SIBLING OF BOARD MEMBER JAMES DANGEL 23722 COMPENSATION 0 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 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 593,192. MANAGEMENT AND GENERAL EXPENSES 27,244. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 620,436. PHYISICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 397,032. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 397,032. OTHER FEES: PROGRAM SERVICE EXPENSES 227,945. MANAGEMENT AND GENERAL EXPENSES 166,656. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 394,601. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 10,116.