2018-04-26T15:03:48-05:00 2017-06-30 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2016-07-01 460225414 ST MICHAEL'S HOSPITAL INC STMI 6055893341 410 WEST 16TH AVENUE TYNDALL SD 570662318 CAROL DEURMIER CEO 6055893341 2018-04-18 1 LAURIE HANSON P00851848 6053391999 2018-04-18 198.135.125.43 2018-04-18 09:55:40 CD P 974248CA41D94A414E643A61057C2CD568A63DD6 B16095FA32523CD326D583884BA37C70A3019BC0 2016 2021-01-29 14:40:06Z CAROL DEURMIER 410 WEST 16TH AVENUE TYNDALL SD 570662318 9610543 0 0928 X WWW.AVERA.ORG/ST-MICHAELS X 1966 SD TO PROVIDE HEALTHCARE SERVICES. 6 6 90 49 143756 0 14780 57767 9250092 9386624 38758 162316 4050 3836 9307680 9610543 0 0 0 0 4102847 4284548 0 0 0 4617384 4382554 8720231 8667102 587449 943441 10875684 12369208 799427 1156711 10076257 11212497 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 7600963 9395133 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, 2017, ACUTE PATIENT DAYS WERE 463 AND SWING-BED DAYS WERE 1562. 7600963 1 0 0 0 0 0 0 0 0 1 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 18 0 1 90 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 MARTY KOCH CHAIRPERSON UNTIL 11/2016 1.00 X X 0 0 0 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 152923 0 29842 LISA RONKE DIRECTOR OF FINANCE 40.00 X 49068 0 4097 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 28.00 X 172765 0 19892 JACLYN DVORACEK PHARMACY DIRECTOR 36.00 X 118773 0 11721 JEREMIAH BERTSCHINGER RETAIL PHARMACY COORDINATO 40.00 X 107173 0 15979 TARA SCHAFERS PHARMACIST 40.00 X 103263 0 17152 703965 0 98683 5 0 1 1 AVERA SACRED HEART HOSPITAL 501 SUMMIT YANKTON SD 57078 ADMIN, IT, OTHER SERVICES 642892 AVERA HEALTH 3900 W AVERA DRIVE SIOUX FALLS SD 57108 MEDICAL SERVICES (U/S,ICU,NUC,SLEEP LAB) 143081 2 57187 580 57767 PATIENT SERVICE FEES 621110 7076918 7076918 RETAIL PHARMACY 446110 2231840 2088084 143756 MISCELLANEOUS 900099 55961 55961 MEDICAID EMR INCENTIVE 900009 21905 21905 9386624 8212 8212 3836 0 3836 3836 3836 153354 750 0 0 153354 750 154104 154104 9610543 9242868 143756 166152 250473 250473 3332210 3111328 220882 108134 101333 6801 353282 330999 22283 240449 221000 19449 75100 75100 229545 60460 169085 4193 771 3422 150490 69591 80899 123811 123811 103650 103192 458 15688 10439 5249 3135 3080 55 469065 469065 75966 75966 SUPPLIES 2453135 2453135 EQUIPMENT AND MAINTENAN 369276 315925 53351 BAD DEBT 248774 248774 DUES AND SUBSCRIPTIONS 41342 25395 15947 19384 510 18874 8667102 7600963 1066139 0 2710910 3805950 919875 1376724 372807 353855 35484 27750 9808928 6121784 4065121 3687144 2771487 3117785 10875684 12369208 467236 716426 32191 10285 300000 430000 799427 1156711 X 10044489 11180599 11230 11230 20538 20668 10076257 11212497 10875684 12369208 X 943441 40534 152265 X 0 1 X 1 0 X 20538 130 20668 20403 135 20538 20273 130 20403 20143 130 20273 19898 245 20143 0.00000 1.00000 0.00000 0 0 5000 34375 39375 5688005 2633968 3054037 106452 82273 24179 3975096 3405543 569553 3687144 INVESTMENT IN AVERA POOLED FUND 2334871 F INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 782914 F 3117785 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 430000 430000 X 9554438 40534 -96509 -55975 9610413 130 130 9610543 8418328 0 8418328 248774 248774 8667102 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 -248,774. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 152,265. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION FOR ENDOWMENT FUNDS 130. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 248,774. 1 1 X 1 X 1 X 1 0 1 1 56 36000 36000 0.00430 156417 155868 549 0.00010 56 192417 155868 36549 0.00440 816 155445 3265 152180 0.01810 9 6709 1000 5709 0.00070 640 1496763 696930 799833 0.09500 211 12985 12985 0.00150 1676 1671902 701195 970707 0.11530 1732 1864319 857063 1007256 0.11970 1001 1001 0.00010 1001 1001 0.00010 0 248774 79607 3309548 3329249 -19701 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 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 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, MENTAL HEALTH SERVICES, NUTRITIONAL NEEDS OF CHILDREN, AND ADVANCE DIRECTIVES. ST. MICHAEL'S WILL FOCUS ON TWO MAIN PRIORITIES: PROVIDER RECRUITMENT AND ADVANCE DIRECTIVES.AS PART OF OUR RECRUITMENT INITIATIVE, A COMMITTEE WAS ESTABLISHED CONSISTING OF VARIOUS LOCAL REPRESENTATIVES, THE CHIEF OF STAFF AND CEO OF ST. MICHAEL'S HOSPITAL AVERA, AND THE AVERA RECRUITER. TWO MIDLEVEL PRACTITIONERS WERE HIRED DURING THE PAST FISCAL YEAR, A PHYSICIAN ASSISTANT AND A NURSE PRACTITIONER. THE ADDITION OF THESE TWO PRACTITIONERS HAS EXPANDED THE AVAILABILITY OF LOCAL ACCESS TO PRIMARY MEDICAL CARE.INITIATIVES GEARED TOWARD INCREASING THE NUMBER OF COMMUNITY MEMBERS WHO HAVE ADVANCE DIRECTIVES HAVE INCLUDED A FOCUSED EFFORT ON PROMOTING TO PATIENTS VIA EDUCATIONAL DISPLAYS AND DIRECT CONVERSATIONS WITH PATIENTS.ST. MICHAEL'S HAS INVESTED IN TECHNOLOGY WHICH CAN BE UTILIZED FOR TELEHEALTH VISITS FOR VARIOUS SPECIALTY SERVICES INCLUDING MENTAL HEALTH SERVICES. THIS EXPANDS THE OPPORTUNITY AND FLEXIBILITY TO MOST EFFECTIVELY UTILIZE THE VERY LIMITED AVAILABILITY OF MENTAL HEALTH PROVIDERS. ST. MICHAEL'S WILL CONTINUE TO ADVOCATE FOR AND SUPPORT EXPANSION OF MENTAL HEALTH SERVICES.THE NUTRITIONAL NEEDS OF CHILDREN WERE DISCUSSED AT LENGTH. IT WAS NOTED THAT OTHER ORGANIZATIONS ARE WORKING TO ADDRESS THIS NEED. STAFF MEMBERS OF ST. MICHAEL'S VOLUNTEER THEIR TIME TO ASSIST WITH PROGRAMS THAT PROVIDE FOOD TO CHILDREN. ST. MICHAEL'S WILL CONTINUE TO ENCOURAGE STAFF INVOLVEMENT AND SUPPORT FOR VOLUNTEER EFFORTS THAT MEET THE NEEDS OF LOCAL CHILDREN. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 13B: PRESUMPTIVE ELIGIBILITY IS UTILIZED AS A LAST RESORT. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 13H: ST. MICHAEL'S ALSO LOOKS AT THE PATIENT'S LIABILITIES, OUTSTANDING MEDICAL DEBTS, THE OVERALL DEBT TO ASSET RATIO FOR EACH SITUATION, AND ELIGIBILITY FOR MEDICARE OR MEDICAID. PRESUMPTIVE CARE MAY ALSO BE USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 16J: A SUMMARY OF THE CHARITY CARE POLICY IS POSTED IN THE EMERGENCY ROOM, RECEPTION AREA AND WAITING AREAS. STAFF DISCUSS THE AVAILABILITY OF THE FACILITY'S CHARITY CARE POLICY WITH PATIENTS UPON ADMISSION. NOTICE IS ALSO INCLUDED IN PAYMENT REMINDER LETTERS. ST. MICHAEL'S HOSPITAL, INC. PART V, SECTION B, LINE 24: THE HOSPITAL FACILITY MAY HAVE CHARGED FAP-ELIGIBLE INDIVIDUALS AN AMOUNT EQUAL TO 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 FAMILY SIZE, INCOME AND EXPENSES, INSURANCE STATUS, ELIGIBILITY FOR MEDICARE/MEDICAID AND MEDICAL INDIGENCY. 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 $248,774 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 $79,607 IS 32% 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 32% 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 6/30/17. 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: 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 2016 CENSUS FOR BON HOMME COUNTY REPORTED 6,984 PEOPLE WITH 14.6% OF THE POPULATION AT 100% POVERTY OR BELOW. 20.4% 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 1757 CLIENTS WERE SERVED DURING THE FISCAL YEAR ENDED 6/30/2017.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 6/30/2017, THERE WERE 640 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. 99 PATIENTS BENEFITED FROM THE E-EMERGENCY SERVICES DURING FISCAL YEAR ENDED 6/30/2017. 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 150872 0 0 0 2051 0 7090 0 23885 0 183898 0 0 0 DR MELVIN WALLINGA FAMILY PRACTICE PHYSICIAN 171577 0 0 0 1188 0 7364 0 12528 0 192657 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. 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 152,265.