2018-11-15T14:02:11-06:00 2017-12-31 460403496 CASEY PETERSON LTD 909 ST JOSEPH ST SUITE 101 RAPID CITY SD 57701 990 2017-01-01 432040599 BENNETT COUNTY HOSPITAL AND NURSING HOME BENN 6056856622 PO BOX 70 D MARTIN SD 57551 ANDREW RIGGIN CEO 6056856622 2018-11-15 1 DEIDRE BUDAHL CPA P01273830 6053481930 2018-11-15 65.153.235.186 2018-11-15 14:01:11 MS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 45B7F4684595822E7290ABD736E8533D4E2025B3 2017 2019-02-21 02:37:17Z ANDREW RIGGIN PO BOX 70 D MARTIN SD 57551 10102018 0 X WWW.BENNETTCOUNTYHOSPITAL.COM X 2004 SD PROVIDE HEALTHCARE AND NURSING HOME SERVICES 5 5 167 7 0 0 18570 13033 9542725 9991995 2783 81121 170 12870 9564248 10099019 0 0 0 0 4511394 5160601 0 0 0 5097644 4889609 9609038 10050210 -44790 48809 5277703 5065910 1229422 968820 4048281 4097090 CARING PEOPLE WORKING TOGETHER, AS A TEAM, TO PROVIDE QUALITY HEALTHCARE AND EDUCATION FOR A HEALTHIER COMMUNITY. 0 0 9247701 9997264 BENNETT COUNTY HOSPITAL AND NURSING HOME IS A CRITICAL ACCESS HOSPITAL LOCATED IN MARTIN, SD. THE ORGANIZATION IS THE ONLY HOSPITAL IN THE COUNTY SERVING APPROXIMATELY 3,600 RESIDENTS. BENNETT COUNTY IS LOCATED BETWEEN INDIAN RESERVATIONS IN A VERY RURAL AREA. BENNETT COUNTY HOSPITAL AND NURSING HOME HAS 14 HOSPITAL BEDS, 3 ER BEDS, AND 48 NURSING BEDS. DURING 2017, THE HOSPITAL WING HAD 280 PATIENT BED DAYS AND 934 SWING BED DAYS. THE NURSING HOME HAD 14,801 RESIDENT DAYS. 9247701 1 1 0 0 0 0 0 0 1 0 1 0 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 0 0 0 0 0 0 0 0 0 0 0 1 34 0 1 167 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X X THE ORGANIZATION 6056856622 102 MAJOR ALLEN P O BOX 70D MARTIN SD 57551 DAVID JONES PRESIDENT 0.50 X X 0 0 0 DALE MCDONNELL SECRETARY 0.50 X X 0 0 0 DOUG O'BRYAN VICE PRESIDENT 0.50 X X 0 0 0 BRAD OTTE BOARD MEMBER 0.50 X 0 0 0 JEFF JOHNSON BOARD MEMBER 0.50 X 0 0 0 ANDREW RIGGIN CEO 40.00 X 117683 0 7028 JUDY SODERLIN CFO 40.00 X 50025 0 7003 JASON BUSTIN PHYSICIAN'S ASSISTANT 34.00 X 180711 0 6838 HANNAH BROWN PHYSICIAN'S ASSISTANT 33.00 X 178777 0 27 ROSE HOITEN CERTIFIED NURSE PRACTITION 62.00 X 154253 0 5070 CATHY CHILDRESS PHYSICIAN'S ASSISTANT 75.00 X 282604 0 7028 964053 0 32994 5 0 1 0 MEDPRO HEALTHCARE STAFFING 1580 SAWGRASS CORPORATE PKWY SUITE SUNRISE FL 33323 CONTRACT MEDICAL STAFF 274262 GOLDEN WEST TECHNOLOGY INC 2727 NORTH PLAZA DR RAPID CITY SD 57702 COMPUTER MAINTENANCE SERVICES 164936 CPSI 6600 WALL ST MOBILE AL 36695 COMPUTER SOFTWARE SERVICES 153164 CASEY PETERSON LTD 909 ST JOSEPH ST STE 101 RAPID CITY SD 57701 ACCOUNTING SERVICES 116491 KIRK WILSON 304 MAIN ST MARTIN SD 57551 PHARMACY CONSULTANT 102900 5 13033 13033 PATIENT SERVICE REVENUE 621400 9973893 9973893 OTHER REVENUE 621400 8272 8272 CAFETERIA 621400 5350 5350 HEALTH FAIR REVENUE 621400 4480 4480 9991995 4849 4849 5250 2999 2251 2251 2251 76272 0 76272 76272 76272 MISCELLANEOUS 900099 10619 10619 10619 10099019 9997264 0 88722 181738 181738 4365948 4104445 261503 378473 363318 15155 234442 208840 25602 10975 10975 138537 138537 895087 856182 38905 55105 54974 131 133605 84049 49556 184303 184303 157770 139386 18384 74785 64325 10460 72408 55654 16754 14123 8085 6038 325495 305125 20370 45513 42665 2848 BAD DEBTS 1611838 1611838 MEDICAL SUPPLIES 750721 750721 EQUIPMENT MAINTENANCE 269259 269259 DIETARY SUPPLIES 143695 143695 6390 837 5553 10050210 9247701 802509 0 1043983 714384 1187979 946252 1238359 1494912 188101 203637 61279 60830 4592207 2946312 1558002 1645895 5277703 5065910 556944 634074 230982 0 21161 17266 420335 317480 1229422 968820 X 3697618 3751349 350663 345741 4048281 4097090 5277703 5065910 48809 0 X X 0 1 X 1 0 X 0 1 X 1578372 514126 1064246 2978662 2432186 546476 35173 35173 1645895 X 8490182 -1611836 -1611836 10102018 -2999 -2999 10099019 8441375 2999 2999 8438376 1611834 1611834 10050210 PART IV, LINE 2B: THE LIABILITY ACCOUNT REFLECTS AMOUNTS HELD BY THE HOSPITAL FOR NURSING HOME RESIDENTS TO USE FOR PERSONAL EXPENSES. PART X, LINE 2: AS OF DECEMBER 31, 2017, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL'S INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. THE HOSPITAL IS NO LONGER SUBJECT TO FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2014. MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATION, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE HOSPITAL BELIEVES THEIR ESTIMATES ARE APPROPRIATE BASED ON CURRENT FACTS AND CIRCUMSTANCES. INTEREST AND PENALTIES ASSESSED BY INCOME TAXING AUTHORITIES, IF ANY, ARE INCLUDED IN INTEREST EXPENSE. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -1,611,838. ROUNDING VARIANCE 2. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST REVENUE ON 990 -2,999. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST REVENUE ON 990 2,999. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 1,611,838. ROUNDING VARIANCE -4. 1 1 X 1 X 1 X 180.000000000000 1 1 0 0 1741 1741 0.00020 3231023 3336706 0 0.00000 3232764 3336706 1741 0.00020 3232764 3336706 1741 0.00020 1 1633312 544801 3321337 3342210 -20873 X 1 1 1 1 BENNETT COUNTY HOSPITAL 102 MAJOR ALLEN MARTIN SD 57551 WWW.BENNETTCOUNTYHOSPITAL.COM X X X BENNETT COUNTY HOSPITAL 1 0 0 1 X X X X X X X X 15 1 0 0 1 X WWW.BENNETTCOUNTYHOSPITAL.COM X 1 15 1 WWW.BENNETTCOUNTYHOSPITAL.COM 0 1 X 100.000000000000 180.000000000000 X X X X X 1 1 X X X 1 X WWW.BENNETTCOUNTYHOSPITAL.COM X X X X X 1 X 0 X X X 1 X 0 0 BENNETT COUNTY HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL IS AN ACTIVE PARTICIPANT IN NATIONWIDE QUALITY IMPROVEMENT PROJECTS THROUGH SOUTH DAKOTA FOUNDATION FOR MEDICAL CARE THE QIO FOR MEDICARE AND MEDICAID PROGRAMS IN SOUTH DAKOTA. THE HOSPITAL ALSO USED INFORMATION FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND THE NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION. THESE SOURCES WERE COMPARED TO GOALS ESTABLISHED BY THE SURGEON GENERAL IN "HEALTHY PEOPLE 2010 (HP2010) AND THE TARGET POPULATION OF BENNETT COUNTY HOSPITAL. BENNETT COUNTY HOSPITAL PART V, SECTION B, LINE 11: SUSTAINABILITY OF BENNETT COUNTY HEALTH CARE (HOSPITAL AND NURSING HOME) WILL BE INFLUENCED BY THE FOLLOWING GOALS AND MEASURES IMPLEMENTED:1. TO KEEP THE ORGANIZATION MOVING BY CASH FLOWING TO ENSURE ACCESS TO EMERGENCY, ACUTE, SKILLED SWING BED, HOME HEALTH AND LONG TERM CARE FOR THE COUNTY AND RESERVATION AREAS.2. A CPA FIRM HAS BEEN INVOLVED TO ENSURE COST ACCOUNTING IS MAXIMIZED FOR ORGANIZATIONAL DIRECTION.3. A CONSULTANT TO ASSIST WITH LONG TERM CARE BUDGETING, AND OPERATIONAL ASSISTANCE CONTINUES TO BE ENGAGED TO IMPROVE OPERATIONAL SUCCESS.4. SUCCESSFUL OPENING AND OPERATION OF ON-SITE RURAL HEALTH CLINIC5. THE ORGANIZATION HAS IMPLEMENTED AN ELECTRONIC HEALTH RECORD SYSTEM AND MUST CONTINUE TO MEET THE REQUIREMENTS AND DEADLINES PROPOSED BY THE CENTER FOR MEDICARE SERVICES TO MAXIMIZE QUALITY CARE AND FINANCIAL REIMBURSEMENT.6. THE HOSPITAL IS ASSESSING THE NEED AND SUSTAINABILITY OF EMPLOYING A PHYSICIAN TO FUNCTION SPECIFICALLY ON THE BCHC TEAM.7. THE FACILITY CONTINUES TO FACE WORK FORCE CHALLENGES.8. THE HOSPITAL COMPLETED THE HEN PROJECT WITH THE QIO AND WILL PARTICIPATE IN THE NEW COLLABORATIVE HIIN.THE TRANSPORTATION ISSUE HAS BEEN DISCUSSED WITH PRAIRIE HILLS TRANSIT IN SPEARFISH, SD AND THE PINE RIDGE INDIAN TRIBE WITH NO SUCCESSFUL OUTCOMES FROM COMMUNITY MEETINGS THAT HAVE BEEN HELD. BENNETT COUNTY HOSPITAL PART V, SECTION B, LINE 20E: THE POLICY IS POSTED IN EMERGENCY ROOMS, WAITING ROOMS, AND IN THE ADMISSION OFFICE IN AN EFFORT TO COMMUNICATE WITH POLICY TO PATIENTS AT THE TIME OF SERVICE. 2 1 - BENNETT COUNTY NURSING HOME 102 MAJOR ALLEN MARTIN SD 57551 NURSING HOME 2 - BENNETT COUNTY RURAL HEALTH CLINIC 302 S 1ST AVE MARTIN SD 57551 CLINIC PART I, LINE 7: COSTING METHOD IS RATIO OF PATIENT COST TO CHARGES AS DETERMINED WITH WORKSHEET 2 IN THE INSTRUCTIONS FOR SCHEDULE H. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,611,838. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL CURRENTLY DOES NOT ENGAGE IN ANY COMMUNITY BUILDING ACTIVITIES. PART III, LINE 2: BENNETT COUNTY HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. PART III, LINE 4: PATIENT AND RESIDENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT, RESIDENT, AND THIRD-PARTY PAYOR OBLIGATIONS. PAYMENTS OF PATIENT AND RESIDENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED ON THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM.PATIENT AND RESIDENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE DETERMINED DIRECTLY FROM MEDICARE COST REPORT USING METHODOLOGIES PRESCRIBED BY MEDICARE. PART III, LINE 9B: THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS PRIOR TO COLLECTION PRACTICES BEING PERFORMED. PART VI, LINE 2: AN OUTSIDE CONSULTANT CAME TO THE FACILITY AND PERFORMED AN ENVIRONMENTAL SCAN. THIS CONSISTED OF A MEETING WITH THE BENNETT COUNTY HOSPITAL EXECUTIVE TEAM AND MEMBERS OF OUR COMMUNITY. WE INVITED FIFTEEN BUSINESS OWNERS AND PROMINENT MEMBERS OF THE COMMUNITY TO A STRATEGIC PLANNING MEETING. THIS LISTENING OPPORTUNITY ASSISTED IN MAKING RECOMMENDATIONS TO OUR BOARD OF DIRECTORS IN THE CONTINUED PLANNING AND DIRECTION TO DEVELOP SHORT AND LONG TERM VISION OF HEALTHCARE FOR THE REGION. IN ADDITION SURVEYS WERE SENT OUT TO VARIOUS MEMBERS OF THE COMMUNITY WITH A 50% RETURN RATE. IN THE SUMMER OF 2013, THE HOSPITAL HIRED A CONSULTANT TO HELP WITH STRATEGIC PLANNING. DURING THIS PLANNING SESSION WITH THE BOARD AND KEY MANAGEMENT, CONSIDERATION WAS GIVEN TO COMMUNITY NEEDS. PART VI, LINE 3: WE HAVE POSTED OUR CHARITY CARE POLICY ON OUR WEB SITE, WWW.BENNETTCOUNTYHOSPITAL.COM. OUR BILLING STAFF IN THE FACILITY INFORM PATIENTS OF OUR FINANCIAL ASSISTANCE PROGRAM WHEN PATIENTS ARE HAVING DIFFICULTIES IN PAYING FOR THEIR HEALTHCARE. IN ADDITION, WE HAVE POSTED THE POLICY IN NUMEROUS LOCATIONS WITHIN THE FACILITY. PART VI, LINE 4: MARTIN IS A COMMUNITY WITH A POPULATION OF APPROXIMATELY 1,100, WITHIN BENNETT COUNTY. THE LOCAL ECONOMY IS LARGELY AGRICULTURALLY BASED. OUR FACILITY IS THE SOLE HOSPITAL FOR BENNETT COUNTY, WHICH HAS A POPULATION OF APPROXIMATELY 3,600. BENNETT COUNTY IS SITUATED BETWEEN THE PINE RIDGE AND ROSEBUD INDIAN RESERVATION. BECAUSE OF THIS PROXIMITY, APPROXIMATELY 56% OF THE POPULATION IS NATIVE AMERICAN. ON AVERAGE, APPROXIMATELY 88% OF OUR FACILITY PATIENTS ARE NATIVE AMERICAN. ALTHOUGH PRIMARILY SERVED BY THE INDIAN HEALTH SERVICE (IHS), NATIVE AMERICANS WITHIN MARTIN UTILIZE OUR FACILITY. IN MANY SITUATIONS, OUR FACILITY DOES NOT GET REIMBURSED BY IHS FOR THE CARE PROVIDED TO THEIR BENEFICIARIES. THIS IS A TREMENDOUS FINANCIAL BURDEN IMPOSED UPON US, IN ADDITION TO SERVING OTHER COMMUNITY MEMBERS WHO MAY REQUIRE FINANCIAL ASSISTANCE. IN ADDITION, BENNETT COUNTY AND IT'S NEIGHBORING COUNTY (TODD) ARE THE 25TH AND 5TH, RESPECTIVELY, POOREST COUNTIES IN THE UNITED STATES. 33.8% OF THE BENNETT COUNTY POPULATION HAS AN INCOME LEVEL BELOW 100% OF THE FEDERAL POVERTY LEVEL. PART VI, LINE 5: OUR BOARD OF DIRECTORS CONSISTS OF COMMUNITY MEMBERS WHO ARE ACCESSIBLE TO COMMUNITY MEMBERS FOR INPUT INTO SERVICES PROVIDED. EACH YEAR, WE PROVIDE A HEALTH FAIR FOR COMMUNITY MEMBERS. VARIOUS HEALTH INFORMATION TOPICS ARE PROVIDED TO THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES SD X X X 0 0 0 0 0 0 0 0 0 JASON BUSTIN PHYSICIAN'S ASSISTANT 180711 0 0 0 0 0 0 0 6838 0 187549 0 0 0 HANNAH BROWN PHYSICIAN'S ASSISTANT 178777 0 0 0 0 0 0 0 27 0 178804 0 0 0 ROSE HOITEN CERTIFIED NURSE PRACTITION 154253 0 0 0 0 0 0 0 5070 0 159323 0 0 0 CATHY CHILDRESS PHYSICIAN'S ASSISTANT 282604 0 0 0 0 0 0 0 7028 0 289632 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY MANAGEMENT AS PREPARED BY A CPA. A COPY OF THE FILED 990 IS PROVIDED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES OFFICERS AND BOARD MEMBERS TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST ANNUALLY AND POTENTIAL CONFLICTS ARE MONITORED BY THE BUSINESS OFFICE THROUGHOUT THE YEAR AND BROUGHT TO THE ATTENTION OF THE BOARD AS NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE ADMINISTRATOR IS DETERMINED BY THE BOARD OF DIRECTORS. DATA FROM THE SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS IS USED TO DETERMINE REASONABLE COMPENSATION FOR THE ADMINISTRATOR. ALL OTHER EMPLOYEE COMPENSATION IS DETERMINED BY THE ADMINISTRATOR. COMPARABILITY DATA FROM THE SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS IS USED. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART XI LINE 2C THE ORGANIZATION HAS NOT CHANGED THE PROCESS FOR THE SELECTION OF AN INDEPENDENT AUDITOR OR OVERSIGHT OF THE INDEPENDENT AUDITOR BY THE BOARD OF DIRECTORS.