2019-04-04T11:02:15-05:00 2018-06-30 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2017-07-01 460225414 ST MICHAEL'S HOSPITAL INC STMI 6055893341 410 WEST 16TH AVENUE TYNDALL SD 570662318 CAROL DEURMIER CEO 6055893341 2019-03-28 1 LAURIE HANSON P00851848 6053391999 2019-03-28 199.247.46.107 2019-03-28 08:17:16 CD P B602D594AFD2B0B327E07A06F36CA6A7E42546D0 63CC26E97BB1FED79B38F32C11916C42E1B9DC98 2017 2019-02-21 02:37:17Z CAROL DEURMIER 410 WEST 16TH AVENUE TYNDALL SD 570662318 9940759 0 0928 X WWW.AVERA.ORG/ST-MICHAELS X 1966 SD TO PROVIDE HEALTHCARE SERVICES. 6 6 89 59 223906 0 57767 23269 9386624 9796959 162316 116831 3836 3700 9610543 9940759 0 1846 0 0 4284548 4626087 0 0 0 4382554 3796005 8667102 8423938 943441 1516821 12369208 13523678 1156711 613303 11212497 12910375 X IT IS THE MISSION OF ST. MICHAEL'S HOSPITAL TO PROVIDE READILY ACCESSIBLE HEALTH CARE TO THE PEOPLE OF BON HOMME COUNTY AND THE SURROUNDING AREAS. IN KEEPING WITH THE HERITAGE OF THE CATHOLIC CHURCH, ST. MICHAEL'S WILL AIM TO PROMOTE THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL HEALTH OF ALL ITS PATIENTS. THE HEALTH CARE CENTERS WILL CONTINUE TO OFFER QUALITY SERVICES BASED ON COMMUNITY NEEDS AND FISCAL SOLVENCY. 0 0 7434921 1846 9796959 ST. MICHAEL'S HOSPITAL, INC. (SMH) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL WITH PROVIDER BASED RURAL HEALTH CLINICS LOCATED IN TYNDALL AND IN AVON. PROVIDER STAFF, NURSING PERSONNEL, LABORATORY AND RADIOLOGY PERSONNEL ARE AVAILABLE AS NEEDED 24-HOURS A DAY, 7-DAYS A WEEK. DURING THE FISCAL YEAR ENDING JUNE 30, 2018, ACUTE PATIENT DAYS WERE 426 AND SWING-BED DAYS WERE 1359. 7434921 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 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 16 0 1 89 1 1 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X X LISA RONKE 6055892100 410 W 16TH AVE TYNDALL SD 570662318 STEVE JOHNSON CHAIRPERSON 1.00 X X 0 0 0 JOSEPH KOSTAL VICE CHAIRPERSON 1.00 X X 0 0 0 ERNIE BURES SECRETARY 1.00 X X 0 0 0 FATHER JOE FORCELLE MEMBER 1.00 X 0 0 0 RICHARD R PIER MEMBER 1.00 X 0 0 0 LAURIE JURRENS MEMBER 1.00 X 0 0 0 CAROL DEURMIER CEO 50.00 X 176931 0 36103 LISA RONKE DIRECTOR OF FINANCE 40.00 X 53133 0 3856 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 28.00 X 170563 0 29768 JACLYN DVORACEK PHARMACY DIRECTOR 36.00 X 119569 0 17542 JEREMIAH BERTSCHINGER PHARMACIST 40.00 X 115554 0 16559 TARA SCHAFERS RETAIL PHARMACY COORDINATOR 40.00 X 110326 0 17173 STEVE MACH PHYSICAL THERAPIST 40.00 X 106001 0 14011 852077 0 135012 6 0 1 1 AVERA SACRED HEART HOSPITAL 501 SUMMIT YANKTON SD 57078 ADMIN, IT, OTHER SERVICES 435308 AVERA HEALTH 3900 W AVERA DRIVE SIOUX FALLS SD 57108 MEDICAL SERVICES (U/S,ICU,NUC,SLEEP LAB) 268114 2 22858 411 23269 PATIENT SERVICE FEES 621110 7571608 7571608 RETAIL PHARMACY 446110 2170584 1946678 223906 54767 54767 9796959 10710 10710 3700 0 3700 3700 3700 102821 3300 0 0 102821 3300 106121 106121 9940759 9573053 223906 120531 1846 1846 287528 287528 28245 28245 3541468 3317141 224327 119784 112572 7212 395843 371696 24147 253219 233635 19584 35180 35180 199367 80490 118877 2375 808 1567 148566 75120 73446 131110 131110 116371 116357 14 18429 12827 5602 4000 3485 515 391780 391780 76554 76554 SUPPLIES 2141503 2141503 EQUIPMENT AND MAINTENAN 307101 260717 46384 BAD DEBT 173506 173506 DUES AND SUBSCRIPTIONS 36472 23410 13062 13691 13229 462 8423938 7434921 989017 0 3805950 4806862 1376724 774187 353855 361122 27750 29642 10173766 6513564 3687144 3660202 3117785 3401663 0 490000 12369208 13523678 716426 611776 10285 1527 430000 0 1156711 613303 X 11180599 12878382 11230 11230 20668 20763 11212497 12910375 12369208 13523678 X 1516821 52457 128600 X 0 1 X 1 0 X 20668 95 20763 20538 130 20668 20403 135 20538 20273 130 20403 20143 130 20273 0.00000 1.00000 0.00000 0 0 5000 34375 39375 5688005 2882256 2805749 4339934 3545728 794206 106452 85580 20872 3660202 INVESTMENT IN AVERA POOLED FUND 2490149 F INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 911514 F 3401663 X 9948215 52457 -44906 7551 9940664 95 95 9940759 8250432 0 8250432 173506 173506 8423938 PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO PROVIDE FOR CAPITAL NEEDS THAT MAY ARISE. PART X, LINE 2: THE HOSPITAL IS ORGANIZED AS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. 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: BAD DEBT EXPENSE -173,506. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 128,600. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION FOR ENDOWMENT FUNDS 95. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 173,506. 1 1 X 1 X 1 X 1 0 1 1 61000 61000 0.00740 195152 219867 0 0.00000 256152 219867 61000 0.00740 152486 3969 148517 0.01800 8944 8944 0.00110 1496674 1094919 401755 0.04870 14300 14300 0.00170 1672404 1098888 573516 0.06950 1928556 1318755 634516 0.07690 935 935 0.00010 935 935 0.00010 0 173506 53186 3150371 3169693 -19322 X 1 1 1 1 ST MICHAEL'S HOSPITAL INC 410 WEST 16TH AVENUE TYNDALL SD 570660027 WWW.AVERA.ORG/ST-MICHAELS 48584 X X X X ST MICHAEL'S HOSPITAL INC 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X WWW.AVERA.ORG/ST-MICHAELS/ X SEE PART V SECTION C X 1 15 1 SEE PART V SECTION C 0 1 X 150.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X WWW.AVERA.ORG/LOCATIONS/PROFILE/ST-MICHAELS-HOSPITAL-AVERA/ X WWW.AVERA.ORG/LOCATIONS/PROFILE/ST-MICHAELS-HOSPITAL-AVERA/ X WWW.AVERA.ORG/LOCATIONS/PROFILE/ST-MICHAELS-HOSPITAL-AVERA/ X X X X X X 1 X 0 X X X X 1 X 0 0 ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 5: THE HOSPITAL CONSULTED WITH COUNTY COMMUNITY HEALTH SERVICES, NURSES, MEDICAL PROVIDERS, SCHOOL OFFICIALS, BUSINESS LEADERS, RELIGIOUS LEADERS AND COMMUNITY MEMBERS. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 11: OUR COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING NEEDS: ACCESS TO PRIMARY MEDICAL CARE AND PROMOTION OF ADVANCE DIRECTIVES. AS A RESULT OF OUR RECRUITMENT INITIATIVE, A MIDLEVEL PRACTITIONER WAS HIRED DURING THE PAST FISCAL YEAR. THE ADDITION OF THIS PHYSICIAN ASSISTANT HAS HELPED MEET OUR GOAL TO MAINTAIN ACCESS TO CARE LOCALLY THUS SAVING TIME AND DOLLARS WITH TRAVEL.WE HAVE FOCUSED EFFORTS ON PROMOTION OF ADVANCED DIRECTIVES VIA EDUCATION DISPLAYS, DIRECT CONVERSATIONS WITH PATIENTS, AND HOSTING A SPEAKER WHO ADDRESSED THIS TOPIC WITH THE GENERAL PUBLIC. THESE EFFORTS HAVE BEEN BENEFICIAL IN INCREASING THE NUMBER OF COMMUNITY MEMBERS WHO HAVE ADVANCE DIRECTIVES IN PLACE WHICH ENSURES THAT THEIR WISHES ARE KNOWN AND HONORED. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY IS UTILIZED AS A LAST RESORT. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 16J: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE EMERGENCY ROOM, RECEPTION AREA AND WAITING AREAS. STAFF DISCUSS THE AVAILABILITY OF THE FACILITY'S FINANCIAL ASSITANCE POLICY WITH PATIENTS UPON ADMISSION. NOTICE IS ALSO INCLUDED IN PAYMENT REMINDER LETTERS AND IN STATEMENTS. ST. MICHAEL'S HOSPITAL, INC. 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. PART V. SECTION B, LINE 7A THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ATHTTPS://WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/#MICHAEL PART V. SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST AND ATHTTPS://WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/#MICHAEL 1 1 - BON HOMME FAMILY PRACTICE CLINIC 130 MAIN STREET AVON SD 57315 FAMILY PRACTICE CLINIC PART I, LINE 3C: IN ADDITION TO THE USE OF FPG TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE, SMH ALSO LOOKS AT THE PATIENT'S ASSETS, MEDICAL INDIGENCY, INSURANCE STATUS AND ELIGIBILITY FOR MEDICARE/MEDICAID. BEING IN A RURAL COMMUNITY WITH A SMALL POPULATION, SMH MAY ALSO USE KNOWN INFORMATION OF A PATIENT'S HARDSHIPS IN MAKING THE FINAL DETERMINATION. PRESUMPTIVE ELIGIBILITY IS UTILIZED AS A LAST RESORT. PART I, LINE 6A: SMH PREPARES A COMMUNITY BENEFIT REPORT THAT IS SUBMITTED TO AVERA HEALTH. THE INFORMATION IS MADE AVAILABLE TO THE PUBLIC THROUGH AVERA HEALTH'S COMMUNITY BENEFIT REPORT. 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 WAS OBTAINED UTILIZING THE MEDICAID AND MEDICARE COST REPORTS. LINES 7E, 7F, AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINE 7G WAS OBTAINED FROM THE MEDICARE COST REPORT. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $173,506 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: SMH IS INVOLVED WITH THE AREA CHAMBER OF COMMERCE AND ROTARY CLUB. SMH WORKS TO ENHANCE THE QUALITY OF LIFE AND EMPOWER ITS PATIENTS, CARE-GIVERS AND COMMUNITY WITH THE RESOURCES THEY NEED WHEN THEY NEED THEM. SMH ALSO PROVIDES HEALTHCARE CAREER EDUCATION TO PROMOTE HEALTHCARE CAREERS AND RURAL HEALTH. PART III, LINE 2: BAD DEBT EXPENSE IS MADE UP OF THE ACTUAL ACCOUNTS THAT ARE WRITTEN OFF DURING THE YEAR AS WELL AS A CHANGE IN THE ESTIMATE FOR PATIENT ACCOUNTS THAT ARE STILL OUTSTANDING ON THE BOOKS AND RECORDS OF THE FACILITY. BAD DEBT RECOVERIES ARE POSTED AS A REDUCTION TO BAD DEBT EXPENSE. PART III, LINE 3: THE AMOUNT ON LINE 3 OF $53,186 IS 31.5% OF TOTAL BAD DEBT EXPENSE. THE NUMBER IS BASED ON A DETAILED REVIEW OF THE ACCOUNTS THAT ARE CURRENTLY LISTED WITH CREDIT COLLECTION BUREAU (CCB) AND ACCOUNTS MANAGEMENT INC. (AMI). UPON REVIEWING EACH ACCOUNT THAT IS AT CCB AND AMI, IT WAS FOUND THAT ABOUT 31.5% OF THE OUTSTANDING BALANCES MAY HAVE BEEN ELIGIBLE UNDER THE FACILITY'S CHARITY CARE POLICY. SINCE WE ARE A SMALL COMMUNITY, WE WERE ABLE TO IDENTIFY WHICH ACCOUNTS MAY HAVE QUALIFIED FOR CHARITY CARE BECAUSE OF LOW INCOME OR SOME KNOWN HARDSHIP TO THE HOUSEHOLD. ALSO FOR THIS REVIEW PROCESS, ANY FAMILIES WITH PRIOR APPLICATIONS FOR CHARITY CARE WERE GIVEN CONSIDERATION WHEN REVIEWING THE CCB AND AMI ACCOUNTS. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS ON PAGE 6 NOTE 1 OF THE AUDITED FINANCIAL STATEMENT. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 6/30/18. MANY PATIENTS IN OUR SERVICE AREA QUALIFY FOR MEDICARE. THE FACILITY PROVIDES SERVICES TO THESE PATIENTS EVEN THOUGH MEDICARE REIMBURSEMENT IS NOT SUFFICIENT TO COVER THE COST OF PROVIDING THIS CARE. PROVIDING SERVICES TO THIS POPULATION PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE NEEDED IN OUR COMMUNITY, THEREBY PROVIDING A BENEFIT TO OUR COMMUNITY. PART III, LINE 9B: SMH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE HOSPITAL DOES NOT PURSUE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. PART VI, LINE 2: IN ORDER TO DETERMINE NEEDS OF THE COMMUNITY WE SERVE, ST. MICHAEL'S HOSPITAL AVERA CONDUCTS PATIENT SURVEYS VIA TELEPHONE THROUGH HEALTHSTREAMS, AND OUR PROVIDERS HAVE MONTHLY MEETINGS FOR CLINIC AND MEDICAL STAFF AT WHICH TIME MAY DISCUSS NEEDS THAT ARE IDENTIFIED THROUGH THE SURVEYS AND THROUGH OFFICE VISITS. PART VI, LINE 3: THE SMH STAFF ASSISTS PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BY DISCUSSING THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTING THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS WHERE APPLICABLE. THE PROGRAMS ARE DISCUSSED AT THE TIME OF ADMISSION AND PATIENT REQUEST. POSTERS HIGHLIGHTING VARIOUS ASSISTANCE OPTIONS (I.E. ALL WOMEN COUNT) ARE POSTED IN THE ADMISSION AREA. SMH STAFF ALSO DISCUSS THE AVAILABILITY OF ITS CHARITY CARE POLICY WITH PATIENTS UPON ADMISSION. PART VI, LINE 4: SMH SERVES A RURAL POPULATION IN BON HOMME COUNTY WHICH INCLUDES THE CITIES OF TYNDALL, AVON, TABOR, AND SPRINGFIELD. THERE IS ONE OTHER HOSPITAL IN BON HOMME COUNTY LOCATED IN SCOTLAND.THE 2017 CENSUS FOR BON HOMME COUNTY REPORTED 6,984 PEOPLE WITH 13.1% OF THE POPULATION AT 100% POVERTY OR BELOW. 20.5% OF BON HOMME COUNTY'S POPULATION IS AGE 65 OR OLDER (COMPARED TO 16% IN THE STATE OF SOUTH DAKOTA). PART VI, LINE 5: SMH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN BON HOMME WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SMH APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE AND PROVIDES READILY ACCESSIBLE HEALTH CARE TO THE PEOPLE OF BON HOMME COUNTY AND THE SURROUNDING AREA.SMH PROVIDES A VARIETY OF COMMUNITY BENEFIT HEALTH ACTIVITIES AT NO COST OR LESS THAN COST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, NUTRITION EDUCATION, FOOT CLINICS, CPR CLASSES, AND BLOOD PRESSURE SCREENINGS. A VARIETY OF PROGRAMS ARE PROVIDED AT NO CHARGE FOR THE CHILDREN IN OUR COMMUNITIES SUCH AS THE IMPACT CONCUSSION PROGRAM, FLU SHOT CLINICS, AND ATHLETIC SCREENINGS. SMH ALSO PROVIDES ATHLETIC PHYSICALS FOR STUDENTS AT A DISCOUNTED RATE. SMH PROVIDES A NURSE ON AN AS NEEDED BASIS FOR AMBULANCE TRANSFERS AT NO COST TO THE LOCAL AMBULANCE SERVICE. APPROXIMATELY 1783 PATIENTS WERE SERVED DURING THE FISCAL YEAR ENDED 6/30/2018.SMH PROVIDED FINANCIAL AND IN KIND DONATIONS FOR VARIOUS COMMUNITY NEEDS SUCH AS MEETING ROOM AVAILABILITY, MEDICAL STAFF COVERAGE AT LOCAL SPORTING EVENTS, AND HEALTH EDUCATION, INCLUDING HEALTH PROFESSION EDUCATION FOR NURSING, PHYSICAL THERAPY, AND PHARMACY STUDENTS.SMH PROVIDES EMERGENCY SERVICES 24-HOURS A DAY, 7-DAYS A WEEK. IN ADDITION TO NURSING STAFF, A MIDLEVEL PROVIDER AND/OR PHYSICIAN ARE IN HOUSE OR ON CALL AT ALL TIMES TO PROVIDE CARE TO ANYONE PRESENTING WITH AN EMERGENT CONDITION, REGARDLESS OF THEIR ABILITY TO PAY. FOR FISCAL YEAR ENDED 6/30/2018, THERE WERE 722 PATIENTS WHO RECEIVED EMERGENCY CARE AT SMH.SMH ALSO MAKES AVAILABLE E-EMERGENCY SERVICES THROUGH AN ARRANGEMENT WITH AVERA HEALTH WHEREBY EMERGENCY PHYSICIANS AND OTHER SPECIALISTS ARE AVAILABLE VIA VIDEO CONFERENCING TO ASSIST THE MEDICAL STAFF AND NURSES WITH PATIENTS PRESENTING TO THE SMH EMERGENCY ROOM. THE E-EMERGENCY SERVICES ARE PROVIDED AT NO COST TO THE PATIENT. 169 PATIENTS BENEFITED FROM THE E-EMERGENCY SERVICES DURING FISCAL YEAR ENDED 6/30/2018. PART VI, LINE 6: SMH IS A MANAGED FACILITY OF AVERA HEALTH. AVERA HEALTH AND THE HOSPITAL WORK COOPERATIVELY TO ENHANCE HEALTHCARE THROUGHOUT THE COMMUNITY SERVED BY THE HOSPITAL. AS A MANAGED FACILITY, SMH IS ABLE TO PARTICIPATE IN AVERA E-CARE SERVICES. THESE SERVICES INCLUDE AVERA E-ICU, 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.SMH 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 SMH AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT CARE. AVERA HEALTH AND SMH 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. X X X 0 0 0 0 0 0 0 0 0 CAROL DEURMIER CEO 150531 0 1000 0 25400 0 8829 0 27550 0 213310 0 0 0 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 169375 0 0 0 1188 0 7247 0 22521 0 200331 0 0 0 SCHEDULE J LINE 3 CAROL DEURMIER, CEO, IS COMPENSATED THROUGH AN ARRANGEMENT WITH AVERA SACRED HEART HOSPITAL, 501 SUMMIT STREET, YANKTON, SD 57078. DEBORA BURES BOARD DIRECTOR, ERNIE BURES'S WIFE 28245 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 8B THE BOARD OF DIRECTOR COMMITTEES ARE ADVISORY IN NATURE ONLY AND DO NOT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND CFO REVIEW THE 990. THE 990 IS THEN PROVIDED TO EACH BOARD MEMBER FOR THEIR REVIEW PRIOR TO THE ACTUAL FILING OF THE 990. FORM 990, PART VI, SECTION B, LINE 12C ST. MICHAEL'S HOSPITAL CONFLICT OF INTEREST POLICY COVERS ANY DIRECTOR/TRUSTEE, OFFICER, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, MEMBER OF MANAGEMENT WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, CEO AND CFO AS WELL AS THEIR FAMILY MEMBERS. SMH REQUIRES ANY DIRECTOR/TRUSTEE, BOARD COMMITTEE MEMBER, OFFICER AND MEMBER OF MANAGEMENT TO DISCLOSE THE EXISTENCE OF A FINANCIAL INTEREST, OTHER ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND ALL MATERIAL FACTS ANNUALLY BY COMPLETING A DISCLOSURE STATEMENT; AND IF A CONFLICT OF INTEREST ARISES AFTER THE COMPLETION OF THE ANNUAL DISCLOSURE, AT THE TIME THE NEW CONFLICT ARISES. THE BOARD OF DIRECTORS MAKES THE DETERMINATION AS TO WHETHER A CONFLICT OF INTEREST EXISTS. THE BOARD OF DIRECTORS ADDRESSES CONFLICT OF INTERESTS VIA A FORMALIZED PROCEDURE. THIS PROCEDURE MAY INCLUDE A PRESENTATION BY THE INTERESTED PERSON, BUT EXCLUDES THE INTERESTED PERSON FROM FURTHER DISCUSSION OR VOTING ON THE TRANSACTION OR ARRANGEMENT THAT MAY CONSTITUTE A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS ALSO INCLUDE A STANDING AGENDA ITEM AT THE BEGINNING OF EACH MEETING WHICH REQUIRES THE DISCLOSURE OF POTENTIAL CONFLICT OF INTEREST FOR ANY ITEMS INCLUDED ON THE AGENDA. FORM 990, PART VI, SECTION B, LINE 15 AVERA SACRED HEART HEALTH SERVICES AND SMH'S BOARD OF DIRECTORS USE COMPARABILITY DATA TO DETERMINE APPROPRIATE COMPENSATION OF THE CEO BASED ON EXPERIENCE AND PERFORMANCE. THE COMPENSATION AMOUNT IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS. THE CEO DETERMINES THE COMPENSATION FOR OTHER MEMBERS OF MANAGEMENT INCLUDING THE CFO BASED ON AN ANNUAL PERFORMANCE APPRAISAL AND USE OF COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE FACILITY MAKES THE CONFLICT OF INTEREST POLICY AND BYLAWS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 128,600.