2018-11-07T15:30:00-06:00 2017-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2017-01-01 460232450 FREEMAN REGIONAL HEALTH SERVICES FREE 6059254000 PO BOX 370 FREEMAN SD 57029 NICHOLAS BRANDNER CEO 6059254000 2018-11-07 1 LAURIE HANSON P00851848 6053391999 2018-11-07 8.39.233.11 2018-11-07 11:48:41 CS P 0EF6C9B349DEB06A6B4E5671A1DAE43878736DC9 63CC26E97BB1FED79B38F32C11916C42E1B9DC98 2017 2018-06-14 16:35:46Z NICHOLAS BRANDNER PO BOX 370 FREEMAN SD 57029 11736121 0 X WWW.FREEMANREGIONAL.COM X 1944 SD PROVIDE ACCESSIBLE, COMMUNITY BASED QUALITY CARE THAT IS COMPETENT, CREATIVE AND COMPASSIONATE. 9 9 202 85 0 0 128757 149298 11097213 11293666 62492 58548 75035 74638 11363497 11576150 0 0 0 0 5656300 5949014 0 0 23559 5090991 5498486 10747291 11447500 616206 128650 13121800 13324845 2994602 2988048 10127198 10336797 THE MISSION OF FREEMAN REGIONAL HEALTH SERVICES IS TO PROVIDE ACCESSIBLE, COMMUNITY-BASED QUALITY CARE THAT IS COMPETENT, CREATIVE AND COMPASSIONATE. 0 0 10315471 11293666 TO OPERATE ON A NON-PROFIT AND PURELY CHARITABLE BASIS, A HOSPITAL AND NURSING HOME FOR THE CARE AND TREATMENT OF THOSE IN NEED. FRHS IS COMPRISED OF A 56 BED NURSING HOME AND A 25 BED CRITICAL ACCESS HOSPITAL WITH A 24/7 EMERGENCY ROOM. THE EMERGENCY ROOM HAS LOCAL PROVIDERS ON CALL AND TELEMEDICINE CAPABILITIES WITH A REGIONAL TRAUMA CENTER. HOSPITAL ACUTE PATIENT DAYS= 476, SWING BED DAYS= 269, NURSING HOME RESIDENT DAYS= 18,780. 10315471 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 31 0 1 202 1 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X X PHIL HUSHER 6059254000 510 EAST 8TH STREET FREEMAN SD 57029 LORI UECKER PRESIDENT 2.00 X X 0 0 0 STEVE FUHRMANN VICE PRESIDENT 2.00 X X 0 0 0 JASON AANENSON TREASURER 2.00 X X 0 0 0 CYNTHIA MUTCHELKNAUS SECRETARY 2.00 X X 0 0 0 DELMER HOFER TRUSTEE 2.00 X 0 0 0 CAMERON BECKER TRUSTEE 2.00 X 0 0 0 JAMES JULSON TRUSTEE 2.00 X 0 0 0 DAN CRICK TRUSTEE 2.00 X 0 0 0 GLENN ROTH TRUSTEE 2.00 X 0 0 0 NICHOLAS BRANDNER CEO 40.00 X 148421 0 10708 PHILLIP HUSHER BEG OCT 2017 CFO 40.00 X 14786 0 701 MARK MILLER END AUG 2017 CFO 40.00 X 74251 0 8778 ANTHONY MILLER THERAPY MANAGER 40.00 X 116732 0 3347 SARAH FODNESS CERTIFIED NURSE PRACTITIONER 40.00 X 102095 0 9311 456285 0 32845 3 0 1 0 AVERA MCKENNAN 800 E 21ST ST SIOUX FALLS SD 57105 E-SERVICES 1117645 ENGINEERS-ARCHITECHS PC 3100 DEMERS AVE GRAND FORKS ND 58201 ENGINEERING/ARCHITECTURE 550206 AVERA SACRED HEART HOSPITAL 501 SUMMIT ST YANKTON SD 57078 IT SUPPORT 362801 DAKOTA TRAVEL NURSE 1200 COLLINS AVE MANDAN ND 58554 STAFFING 351239 CARDINAL HEALTH 7000 CARDINAL PLACE DUBLIN OH 43017 SUPPLIES 176465 10 48337 43094 57867 149298 PATIENT SERVICE REVENUE 622110 11137346 11137346 COLLABORATIVE ARRANGEMENT 900099 135552 135552 MEALS ON WHEELS 624210 10503 10503 10265 10265 11293666 57472 57472 222687 150010 72677 72677 72677 1500 424 1076 1076 1076 11498 48337 9537 1961 1961 11576150 11293666 0 133186 X 285277 285277 4649657 4261641 388016 99880 90882 8998 556851 510943 45908 357349 310812 46537 5123 5123 39490 39490 2843721 2700123 143598 54736 40205 13160 1371 407519 322348 63613 21558 165113 165113 25066 24061 1005 16909 13293 3616 40377 40377 548099 548099 66584 66584 MEDICAL SUPPLIES 843110 843110 PROVISION FOR BAD DEBTS 225213 225213 EQUIPMENT RENTAL AND MA 103081 102989 92 RECRUITMENT 37750 37750 76595 11928 64037 630 11447500 10315471 1108470 23559 3545873 3288703 1506778 1942592 35417 22917 150117 130949 90600 108232 14768187 9068813 5602895 5699374 1885072 2053471 3239 3242 11124 2781 290685 72584 13121800 13324845 695691 844710 26774 5700 457957 420516 2498 3967 925228 641655 886454 1071500 2994602 2988048 X 10127198 10336797 10127198 10336797 13121800 13324845 128650 80949 0 X X 0 1 X 1 0 X 0 1 X 299251 299251 8630805 5073626 3557179 4924980 3732429 1192551 913151 262758 650393 5699374 APARTMENT DEPOSITS 961500 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 110000 1071500 X 11591433 80949 -225213 -144264 11735697 -159547 -159547 11576150 11381834 159547 159547 11222287 225213 225213 11447500 PART IV, LINE 2B: THE ORGANIZATION MAINTAINS SEPARATE ACCOUNTS FOR ITS PATIENTS AND USES THE FUNDS FOR PURCHASES AS DIRECTED BY PATIENTS. PART X, LINE 2: THE FACILITY 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 FACILITY IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE FACILITY IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE FACILITY HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE FACILITY 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 FACILITY 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 -225,213. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES RECLASSIFIED -150,010. DIRECT FUNDRAISING EXPENSES -9,537. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES RECLASSIFIED 150,010. DIRECT FUNDRAISING EXPENSES 9,537. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 225,213. GALA 46124 38410 7714 605 4737 1050 840 GOLF TOURNAMENT 13711 9927 3784 484 991 666 164 59835 48337 11498 484 1596 5403 1050 1004 9537 1961 1 1 X 1 X 1 X 1 1 1 0 1 1 9000 9000 0.00080 1275611 982246 293365 0.02610 1284611 982246 302365 0.02690 3496306 2821501 674805 0.06010 3496306 2821501 674805 0.06010 4780917 3803747 977170 0.08700 209860 215307 0 0.00000 15204 6268 8936 0.00080 225064 221575 8936 0.00080 0 225213 30291 3183684 3202429 -18745 X 1 1 1 1 FREEMAN REGIONAL HEALTH SERVICES PO BOX 370 FREEMAN SD 57029 WWW.FREEMANREGIONAL.COM 10541 X X X X 1 PROVIDER BASED CLINIC FREEMAN REGIONAL HEALTH SERVICES 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X WWW.FREEMANREGIONAL.COM/COMMUNITY-NEEDS X 1 16 1 WWW.FREEMANREGIONAL.COM/COMMUNITY-NEEDS 0 1 X 150.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE X WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE X WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE X X X X X X 1 X 0 X X X X 1 X 0 0 FREEMAN REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 5: THE FOCUS GROUPS UTILIZED FOR THE CHNA WERE COMPRISED OF INVITED COMMUNITY/SERVICE AREA RESIDENTS WHO WERE SELECTED BASED ON OBTAINING AN ADEQUATE CROSS SECTION OF GENDER AND OCCUPATION. OTHER CRITERIA CONSIDERED DURING THE PROCESS WERE FINDING INDIVIDUALS THAT REPRESENTED TWO MAIN GROUPS: RETIRED SENIORS AND WORKING ADULTS, AND THE BROAD INTEREST OF OUR SERVICE AREA. THESE GROUPS WERE ALSO KEPT TO A REASONABLE NUMBER TO FACILITATE DISCUSSION. THIS PROCESS WAS FACILITATED WITH THE ASSISTANCE OF ERIC AMBROSON, COMMUNITY DEVELOPMENT SPECIALIST WITH THE SOUTH DAKOTA PLANNING AND DEVELOPMENT DISTRICT III. FREEMAN REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 11: PURSUANT TO THE 2016 IMPLEMENTATION STRATEGY ADOPTED BY FRHS, THE FOLLOWING NEEDS WERE ADDRESSED AS OF THE END OF THE YEAR FOR THIS 990:- FREEMAN REGIONAL HEALTH SERVICES CONTINUES TO PROMOTE HEALTH AND WELLNESS THROUGHOUT THE COMMUNITY. THE COMMUNITY HAS A LARGE ELDERLY POPULATION, EDUCATIONAL MEETINGS ON DEMENTIA WERE HELD AND WELL ATTENDED. WEIGHT MANAGEMENT CLASSES WERE OFFERED AND 20 PEOPLE WERE IN ATTENDANCE. COMMUNITY CPR EDUCATION CLASSES WERE OFFERED IN CONJUNCTION WITH THE CITY AMBULANCE STAFF. 23 PEOPLE ATTENDED. A BABYSITTING CLINIC WAS HELD AND 10 MEMBERS OF THE COMMUNITY ATTENDED. HYGIENE, NUTRITION, AND FARM SAFETY EDUCATION WAS GIVEN TO SURROUNDING SCHOOLS. DRUG AND TOBACCO PREVENTION EDUCATION WAS ALSO OFFERED TO SCHOOLS IN THE AREA. STAFF PROVIDED INFORMATION ON CAR SEAT SAFETY. - FRHS CONTINUES TO FOSTER AND PROMOTE COMMUNITY OUTREACH AND VOLUNTEERISM. FRHS ADDRESSES THIS NEED BY GETTING STAFF INVOLVED IN COMMUNITY EVENTS SUCH AS OLD FASHION SATURDAY NIGHT, THE WINTER FAIR, HIGH SCHOOL HOMECOMING PARADES AND OTHER COMMUNITY PARADES. THE FACILITY'S CEO AND OTHER EMPLOYEES ARE MEMBERS OF THE LOCAL LIONS CLUB PROVIDING VOLUNTEER SERVICES TO THE LOCAL COMMUNITY. STAFF VOLUNTEER FOR FEEDING SOUTH DAKOTA PROJECT WHICH DISTRIBUTES FOOD TO COMMUNITY MEMBERS. - FRHS WILL POSITION ITSELF TO MEET THE CHANGING NEEDS OF THE SURROUNDING POPULATION. THIS IS BEING DEMONSTRATED BY FRHS'S CONTINUED PLANNING TO UPDATE THE CURRENT FACILITY. FRHS IS CONSIDERING ENLARGING THE LONG-TERM CARE FACILITY'S RESIDENT ROOMS AND BATHROOMS. ALSO THE FRHS IS LOOKING TO IMPROVE THE PATIENT FLOW INTO THE FACILITY BY HAVING ONE COMMUNITY/PATIENT ENTRANCE TO THE FACILITY TO IMPROVE THE PATIENT EXPERIENCE AND MANAGE PATIENT/VISITOR FLOW.- FRHS WILL WORK TO ENSURE THE CONTINUED AVAILABILITY OF MENTAL HEALTH SERVICES IN THE AREA. THIS CONTINUES TO BE A CHALLENGE, BUT IS ADDRESSED BY ITS SUPPORT OF EXISTING MENTAL HEALTH PROVIDERS SUCH AS WELL SPRING AND THE USE OF TELEHEALTH. OTHER OPTIONS CONTINUE TO BE PURSUED. -FRHS RECOGNIZES THE INCREASING DIFFICULTY AND THE NEED FOR WORKFORCE DEVELOPMENT. THIS IS BEING ADDRESSED BY WORKING WITH THE SCHOOLS TO PROMOTE THE HEALTH OCCUPATIONS STUDENTS OF AMERICA PROGRAM AND PUTTING ON A "SCRUBS CAMP" TO GET HIGH SCHOOL KIDS INTERESTED IN HEALTHCARE CAREERS. 40 STUDENTS FROM 4 TO 5 DIFFERENT SCHOOLS ATTENDED. THE STUDENTS HAD A WIDE VARIETY OF HEALTH CAREERS TO CONSIDER AS 8 DIFFERENT HEALTH SPECIALTIES WERE AVAILABLE AT THE CAMP. FREEMAN REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 13H: THE FACILITY MAY USE PRESUMPTIVE ELIGIBILITY AS A LAST RESORT. FREEMAN REGIONAL HEALTH SERVICES 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. 4 1 - OAKVIEW TERRACE 510 E 8TH STREET FREEMAN SD 57029 LONG TERM CARE FACILITY 2 - MENNO CLINIC 301 SOUTH HIGH STREET MENNO SD 57045 RURAL MEDICAL CLINIC 3 - MARION CLINIC 307 STATE MARION SD 57043 RURAL MEDICAL CLINIC 4 - BRIDGEWATER CLINIC 209 N MAIN BRIDGEWATER SD 57319 RURAL MEDICAL CLINIC PART I, LINE 3C: FREEMAN REGIONAL HEALTH SERVICES (FRHS) REQUIRES THAT THE PATIENT COMPLETE A FINANCIAL ASSISTANCE APPLICATION SHOWING HIS/HER INCOME AND EXPENSES. THE APPLICATION IS REVIEWED TO SEE WHAT FUNDS AND ASSETS THE PATIENT HAS AND WHETHER THE PATIENT HAS THE RESOURCES TO PAY HIS/HER MEDICAL BILLS. FOR SOME PATIENTS, FRHS USES DOCUMENTATION FROM OTHER GOVERNMENT BASED AGENCIES OF THE PATIENT'S FINANCIAL SITUATION AND RESOURCES AS A WAY TO HELP DETERMINE THE PATIENT'S FINANCIAL SITUATION. THE CHIEF FINANCIAL OFFICER REVIEWS ALL APPLICATIONS AND MAKES THE DETERMINATION OF ASSISTANCE OFFERED. PRESUMPTIVE DETERMINATION OF ELIGIBILITY IS USED AS A LAST RESORT. 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 7B AND 7G WERE OBTAINED FROM THE MEDICAID AND MEDICARE COST REPORTS, RESPECTIVELY. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $225,213 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: WE PROVIDED CONGREGATE LIVING SERVICES TO SENIORS IN ORDER TO KEEP THEM IN THEIR HOME COMMUNITY LONGER. SUBSIDIZED THE MEALS ON WHEELS PROGRAM TO PROVIDE AT LEAST ONE GOOD NUTRITIOUS MEAL PER DAY TO SENIORS IN NEED OF THAT SERVICE. PART III, LINE 2: BEFORE AN ACCOUNT IS WRITTEN OFF TO BAD DEBT ALL DISCOUNTS AND PAYMENTS ARE APPLIED, INCLUDING CONTRACTUAL ALLOWANCES. AFTER EVERY ATTEMPT IS MADE TO COLLECT THE UNPAID BALANCE, THE ACCOUNT IS WRITTEN OFF TO BAD DEBT. PAYMENTS ON ACCOUNTS THAT WERE WRITTEN OFF AS BAD DEBT REDUCES BAD DEBT EXPENSE.BAD DEBT EXPENSE IS REPORTED BASED ON CHARGES FOR THE YEAR ENDING 12/31/17 AS STATED IN THE AUDITED FINANCIAL STATEMENT. PART III, LINE 3: THE ESTIMATE 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 2017. 13.45% 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 EXPENSE IS ON PAGE 6 NOTE 1 - ORGANIZATION AND SIGNIFICANT ACCOUNTING POLICIES UNDER PATIENT AND RESIDENT RECEIVABLES FROM THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COSTS OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2017. 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: THE COLLECTION POLICY CONTAINS PROVISIONS FOR PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. IF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS MAKE PAYMENTS AS DETERMINED THROUGH COMPLETION OF THE FINANCIAL ASSISTANCE PROCESS, THEIR ACCOUNT WILL NOT BE SENT TO COLLECTION. HOWEVER, IF PAYMENTS ARE NOT MADE AS PLANNED, THE ACCOUNT OF A FINANCIAL ASSISTANCE ELIGIBLE PATIENT MAY GO TO COLLECTION. FRHS WILL ALLOW 240 DAYS FROM THE FIRST POST DISCHARGE BILLING STATEMENT FOR PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE. FRHS WILL ALLOW ALL PATIENTS 120 DAYS FROM FIRST POST DISCHARGE BILLING STATEMENT TO APPLY FOR FINANCIAL ASSISTANCE BEFORE INITIATING ANY EXTRAORDINARY COLLECTION ACTIVITIES. IF, DURING THE COLLECTION PROCESS, IT IS DETERMINED THAT A PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, COLLECTION EFFORTS WOULD CEASE UNTIL THE PATIENT HAS AMPLE TIME TO PREPARE AND SUBMIT INFORMATION NEEDED TO DETERMINE ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY. IF THE PATIENT QUALIFIES FOR ASSISTANCE, THE ACCOUNT WILL BE PULLED FROM COLLECTION. PART VI, LINE 2: ANNUALLY, ON THE 4TH MONDAY OF FEBRUARY, FREEMAN REGIONAL HEALTH SERVICES (FRHS) HAS A COMMUNITY MEETING THAT IS ADVERTISED IN THE LOCAL NEWSPAPERS INVITING THE COMMUNITY TO ATTEND AND PROVIDE INPUT REGARDING ITS NEEDS AND IDEAS ON HOW FRHS CAN IMPROVE ITS SERVICES. ON A QUARTERLY BASIS, FRHS MEETS WITH THE MEDICAL STAFF TO DISCUSS OPERATIONS AND ANY SUGGESTIONS THEY MAY HAVE ON SERVICES PROVIDED BY FRHS AND THE NEEDS OF THE COMMUNITY. TWICE A MONTH FRHS HAS DEPARTMENT MANAGER MEETINGS WHERE THE NEEDS OF THE COMMUNITY AND OTHER ISSUES CAN BE DISCUSSED. COMMUNITY MEMBERS ARE ENCOURAGED TO COME TO THE FACILITY AT ANY TIME TO DISCUSS CONCERNS OR ISSUES WITH THE ADMINISTRATION.IN ADDITION, FRHS PREPARED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2016. PLEASE SEE PART V, SECTION B, LINE 3 FOR MORE INFORMATION. PART VI, LINE 3: FRHS HAS POSTED SIGNAGE ABOUT CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. FRHS ADDRESSES THE FINANCIAL ASSISTANCE PROGRAM AND PROVIDES INFORMATION ON HOW TO APPLY FOR ASSISTANCE AT DISCHARGE AND IN PATIENT BILLS. THE BUSINESS OFFICE AND SOCIAL WORKERS ADVISE PATIENTS ON THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. A NOTICE RELATED TO AVAILABLE CHARITY CARE IS PRINTED AT THE BOTTOM OF ALL SERVICE STATEMENTS. PART VI, LINE 4: FRHS IS A HEALTHCARE FACILITY THAT PRIMARILY SERVES RESIDENTS IN RURAL HUTCHINSON, MCCOOK AND TURNER COUNTIES IN SOUTHEASTERN SOUTH DAKOTA. SERVICE AREA DEMOGRAPHICS HUTCHINSON MCCOOK TURNERPOPULATION (2010 CENSUS) 7,343 5,618 8,347HOUSEHOLDS 3,351 2,491 3,939AVERAGE HOUSEHOLD SIZE (PEOPLE) 2.33 2.48 2.40MEDIAN HOUSEHOLD INCOME $42,386 $46,964 $50,143MEDIAN AGE 46.8 42.7 43.7% OF POPULATION UNDER 18 24% 26% 24%% OF POPULATION 19-64 51% 55% 57%% OF POPULATION 65+ 25% 19% 19%% OF POPULATION BELOW POVERTY INCOME LEVEL 11.8% 7.1% 7.3%A MAJORITY OF THE EMPLOYERS IN THESE AREAS ARE SMALL EMPLOYERS WHO OFFER LITTLE TO NO EMPLOYEE BENEFITS. OF THE EMPLOYERS WHO DO OFFER HEALTH INSURANCE TO THEIR EMPLOYEES, DEDUCTIBLES AND CO-PAYS HAVE RISEN FROM 300-500% OVER THE PAST 10 YEARS. MANY EMPLOYERS HAVE PASSED THE INCREASE IN HEALTH INSURANCE PREMIUMS TO THEIR EMPLOYEES MAKING PAYING THE HIGHER DEDUCTIBLES AND CO-PAYS VERY DIFFICULT. PART VI, LINE 5: FRHS'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. FRHS EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN ITS COMMUNITY AND SURROUNDING AREA. FRHS REINVESTS SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, INCLUDING BUT NOT LIMITED TO EXPANSION OF SERVICES OFFERED, PATIENT EDUCATION, EMPLOYEE EDUCATION, AND EQUIPMENT AND FACILITY RENOVATIONS. FRHS IS COMPRISED OF A 56 BED NURSING HOME AND A 25 BED CRITICAL ACCESS HOSPITAL WITH A 24/7 EMERGENCY ROOM. THE EMERGENCY ROOM HAS LOCAL PROVIDERS ON CALL AND TELEMEDICINE CAPABILITIES WITH A REGIONAL TRAUMA CENTER. X X 0 0 0 0 0 0 0 0 0 NICHOLAS BRANDNER CEO 148421 0 0 0 0 0 4610 0 6099 0 159130 0 0 0 A CITY OF FREEMAN 466000164 2006-09-29 750000 TO HELP FINANCE CONGREGATE LIVING UNITS. 0 0 0 A 329484 750000 750000 2006 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 8B FREEMAN REGIONAL HEALTH SERVICES DOES NOT UTILIZE COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND CFO REVIEW THE FORM 990 IN DETAIL, IT IS THEN PRESENTED AND REVIEWED BY THE BOARD AT A BOARD MEETING PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C FRHS REQUIRES ANNUAL COMPLIANCE WITH AND DISCLOSURE OF CONFLICTS IN ACCORDANCE WITH THE WRITTEN POLICY. CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST MUST BE REPORTED TO THE COMPLIANCE OFFICER. IF A CONFLICT IS DEEMED TO EXIST, APPROPRIATE ACTION IS TAKEN SUCH AS A BOARD MEMBER MAY BE REQUIRED TO ABSTAIN FROM DISCUSSION, DELIBERATION, AND VOTING ON THE ISSUE AT HAND. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS INITIALLY SET BY THE BOARD AND/OR ADMINISTRATION FOLLOWING A REVIEW AND ASSESSMENT OF THE SDAHO COMPARABILITY STUDY. THE ANNUAL INCREASES ARE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS. THE COMPENSATION DETERMINATION IS DOCUMENTED IN A WRITTEN CONTRACT. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART IX, LINE 11G COLLECTION FEES : PROGRAM SERVICE EXPENSES 4,652. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,652. PURCHASE OTHER CLINIC : PROGRAM SERVICE EXPENSES 1,312,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,312,126. MEDICAL PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 494,918. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 494,918. PURCHASE COURIER : PROGRAM SERVICE EXPENSES 15,583. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,583. CONSULTING FEES : PROGRAM SERVICE EXPENSES 383. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 383. OTHER PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 713,109. MANAGEMENT AND GENERAL EXPENSES 1,968. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 715,077. MAINTENANCE CONTRACTS : PROGRAM SERVICE EXPENSES 79,698. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,698. ULTRASOUND AND MRI CONTRACTS : PROGRAM SERVICE EXPENSES 79,654. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,654. PT FINANCIAL SVC COLLECTION FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 28,517. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,517. ADMINISTRATION CONSULTING FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 108,176. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 108,176. PURCHASE PRINTING : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,937. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,937. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT.