2017-05-10T07:16:06-05:00 2016-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2015-07-01 460319070 Rapid City Regional Hospital Inc RAPI 6057559130 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 Mark Thompson CFO 6057559130 2017-05-08 1 Kim Hunwardsen CPA P00484560 6122536500 2017-05-08 2015 2021-01-29 14:40:06Z Brent Phillips 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 622349990 0 X www.regionalhealth.com X 1973 SD Helping Patients and Communities Live Well 12 9 4324 413 7883186 320671 1824646 2503829 524969244 594165731 14259712 16754640 2304855 5211301 543358457 618635501 0 0 0 0 222995701 252267378 0 0 606055 270618343 321433762 493614044 573701140 49744413 44934361 918466588 924629930 294609276 294479856 623857312 630150074 X PURPOSE: Helping Patients and Communities Live WellVISION: We aspire to be the best healthcare system in AmericaVALUES: Courage, Integrity, Compassion, Innovation, and Mutual RespectPRIORITIES: Patient & Family EXPERIENCE; Culture of Safety & Quality CARE; Physician & Caregiver ENGAGEMENT; Community & Financial STEWARDSHIP 0 0 339098908 339293147 Rapid City Regional Hospital, Inc. (RCRH) is a tertiary hospital serving Western South Dakota. The nearest larger hospital is in Sioux Falls, SD, more than 350 miles away. As such, the services provided by RCRH are truly a healthcare safety net for Western South Dakota. The Hospital provides comprehensive care, including Level II Trauma Care. 21952594 7848665 Hospitalists - provides care for hospitalized patients who may or may not have a primary care physician. 26383436 140111198 Pharmacy - provide pharmaceuticals in support of acute care hospital patients. 20336583 107008239 Surgical Services - provide in and out patient surgical services to acute care patients. 20336583 107008239 407771521 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 0 1 476 0 1 4324 1 1 1 0 0 0 0 1 1 0 0 0 0 X 12 9 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 NC CA X Mark Thompson 6057559127 PO Box 6000 Rapid City SD 57701 Dennis Popp Chairman 1.50 0.00 X X 696 0 0 Jack Lynass Vice Chairman 1.35 0.00 X X 0 0 0 Stephen Kovarik MD Secretary 1.12 0.00 X X 0 0 0 Roy Dishman Treasurer 2.14 0.01 X X 0 0 0 Steven Benn MD Director 1.49 0.00 X 18975 0 0 Diedre Budahl Director 1.28 0.00 X 0 0 0 Sandra Burns Director 0.61 0.00 X 811 0 0 Timothy Frost MD Director 0.91 0.00 X 0 0 0 Robert Mudge Director 1.44 0.00 X 0 0 0 Tamara Riddle-Schumacher Director 1.49 0.00 X 0 0 0 Lisa Seaman Director 2.31 0.02 X 0 0 0 Kyle White Director 1.01 0.00 X 0 0 0 Brent Phillips President & CEO 47.17 12.83 X X 724743 0 62004 Mark A Thompson VP CFO 43.24 11.76 X 419639 0 67323 Paul W Clemments VP Professional Services 55.00 0.00 X 194328 0 43135 Michael Gibbs President Rapid City Market 55.00 0.00 X 381659 0 54574 Maureen G Henson VP Human Resources 43.24 11.76 X 242973 0 21876 Richard S Latuchie VP Info Technology CIO 43.24 11.76 X 297230 0 44951 Mary E Masten General Counsel 43.24 11.76 X 330753 0 42033 John Pierce VP Rapid City Market 31.35 23.65 X 159174 138945 50675 Samuel Durr MD Physician - Cardiology 40.00 0.00 X 882097 0 71995 Michael P D'urso MD Physician - Cardiology 40.00 0.00 X 722448 0 38802 John K Heilman III MD Physician - Cardiology 40.00 0.00 X 823643 0 27800 Joseph Tuma MD Physician - Cardiology 40.00 0.00 X 983831 0 85636 Amad Zineldine MD Physician - Cardiology 40.00 0.00 X 746633 0 87287 Charles E Hart MD Former President Emeritus 47.17 12.83 X 210452 0 10516 Timothy Sughrue Former CEO RCRH & RHN; COO RHI 43.37 11.63 X 595718 0 17808 7735803 138945 726415 234 1 1 0 Emergency Services PA 353 Fairmont Blvd Rapid City SD 57701 ER Physician Coverage 4203596 Comphealth Medical Staffing PO Box 972651 Dallas TX 753972651 Temporary Medical Staff Coverage 3306851 MEDEFIS 10826 Old Mill Rd 101 Omaha NE 68105 Temporary Medical Staff Coverage 2087679 Microsoft One Microsoft Way Redmond WA 98052 Software Maintenance 1791687 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Temporary Medical Staff Coverage 1760853 114 5140 257084 2241605 2503829 In Patient Pharmacy 446110 135778901 135778901 Surgical Services 622110 107008239 107008239 Laboratory 621500 104123494 104123494 Cardiac Services 622110 62548761 62548761 MIS CT Scan 621500 55799563 55799563 128906773 125863194 3043579 594165731 12779211 56021 12723190 9428 9428 620468 459219 161249 161249 161249 4213866 2643754 1313355 1578264 2900511 1065490 3966001 3966001 344993 174045 170948 170948 285124 189606 95518 95518 Other UBI 900099 4783586 4783586 4783586 618635501 591217670 7883186 17030816 6391772 3705727 2686045 158367 158367 218933220 170148872 48469672 314676 4056606 3130617 920328 5661 8341074 6437083 1892351 11640 14386339 10770018 3594252 22069 1071637 1071637 263316 263316 32068 32068 51958978 34279295 17559411 120272 711784 5137 666212 40435 1528557 822515 694775 11267 12717275 2712746 10001142 3387 7521700 587597 6933747 356 600168 345095 253232 1841 1849462 853598 985752 10112 3716037 41447 3674590 23085728 9718941 13364134 2653 1835259 1284395 550864 Medical Supplies 98059309 98059309 Interco. Serv. & Suppl. 49565371 7798110 41767261 Bad Debt Expense 47934033 47934033 UBI Tax 150141 150141 18832939 8978619 9792634 61686 573701140 407771521 165323564 606055 27533022 26148140 5871216 3928821 69063000 78213679 11838900 14101774 8287028 10771464 522434226 326115284 190637616 196318942 538098563 532129654 996384 57268789 3580906 3580906 62559953 2167761 918466588 924629930 46303449 52261730 149788896 141481645 98516931 100736481 294609276 294479856 X 607693923 614095839 14500460 14391306 1662929 1662929 623857312 630150074 918466588 924629930 X 44934361 -10863600 -27777999 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 75383 75383 0 Part II-B, Line 1: Schedule C, Part II-B, Line 1i: Annual dues are paid to the South Dakota Association of Healthcare Organizations. A portion of the dues are applicable to lobbying activities. For calendar year 2016 dues, which were paid in fiscal year 2016, in the amount of $326,540, 4.56% was used for lobbying purposes. Annual dues were paid to the American Hospital Association, a portion of which is applicable to lobbying activities. For calendar year 2016 dues, which were paid in fiscal year 2016, in the amount of $60,732, 22.12% was used for lobbying purposes. Annual dues were paid to the American Medical Rehab Providers Association, a portion of which is applicable to lobbying activities. For calendar year 2016 dues, which were paid in fiscal year 2016, in the amount of $10,400, 36.00% was used for lobbying purposes. In fiscal year 2016, $28,315 of employee salary expense and $15,000 of consulting expense were incurred in regard to lobbying. 1662929 1662929 1662929 1662929 1662929 1662929 1747979 10000 95050 1662929 1747979 1747979 0.00000 1.00000 0.00000 0 0 4054096 4054096 265476371 142918243 122558128 225357938 175302360 50055578 27545821 7894681 19651140 196318942 Mortgage-Backed Securities 157298 F Investment in WDHC/RHN 38690676 F Investment in Privately Held Companies 18420815 F 57268789 Payable Under Interest Rate Swap 11275091 Other Long Term Liabilities 16947583 Accrued Pension Liability 27574772 Intercompany Payable 44939035 100736481 X Part V, Line 4: Endowed funds are held in an interest bearing account subject to the terms as specified by the donor and Board of Directors. The earnings on the endowment funds become temporariliy restricted funds and therefore are not part of the endowment balance. Of the $1,662,929 endowment funds, $692,332 are restricted to be used for grants/scholarships to students in a healthcare program, $512,197 is restricted for use in the pediatrics unit, $100,000 for promotion of a healthy community, $197,400 for cardiac services, $100,000 for hospice patients, $36,000 for plants in public areas and $25,000 for cancer care. Part X, Line 2: References to "Regional Health" apply to all entities controlled or leased by Regional Health, Inc. and its subsidiaries. This includes the reporting entity. Regional Health and subsidiaries are organized as nonprofit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Regional Health and subsidiaries are annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). In addition, Regional Health and subsidiaries may be subject to income tax on income that is derived from business activities that are unrelated to its tax exempt purpose. Regional Health 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 consolidated financial statements. Regional Health 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. Regional Health's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2012. Duck Race 100905 100905 54687 Tough Enough to Wear Pink 107801 107801 56689 6 136287 136287 62669 344993 344993 174045 174045 170948 1 1 X 1 X 1 X 1 1 0 0 10117474 10117474 0.01920 53990435 36261888 17728547 0.03370 64107909 36261888 27846021 0.05290 5 2740 59614 59614 0.00010 1 177 6031021 3805680 2225341 0.00420 7053051 6902607 150444 0.00030 1808405 1550633 257772 0.00050 4 342256 342256 0.00070 10 2917 15294347 12258920 3035427 0.00580 10 2917 79402256 48520808 30881448 0.05870 2 6113 6113 0.00000 1 1497 1497 0.00000 1 20 1395 1395 0.00000 4 20 9005 9005 1 47934033 413606 154637881 159254733 -4616852 X 1 1 1 Black Hills Medical Office BD LLC Office Building 0.67930 0.32070 2 Medical & Dental Building Office Building 0.71450 0.28550 3 The Imaging Center LLC Medical Imaging 0.50000 0.50000 4 The MRI Center LLC Medical Imaging 0.33330 0.66670 5 Same Day Surgery Center Specialty and Ambulatory Srvcs 0.40000 0.60000 6 Western Providers Inc PHO 0.50000 0.50000 2 1 Rapid City Regional Hospital 353 Fairmont Blvd Rapid City SD 57701 www.regionalhealth.com 10558 X X X X 7 Provider-based clinics; 1 behavioral health facility 2 Same Day Surgery Center 651 Cathedral Drive Rapid City SD 57701 www.samedaysurgerycenter.org 10581 X Rapid City Regional Hospital Inc 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X http://www.regionalhealth.com/about-us/community-needs-assessment X 1 15 1 http://www.regionalhealth.com/about-us/community-needs-assessment 0 0 1 X 200.000000000000 250.000000000000 X X X 1 1 X X X X 1 X http://www.regionalhealth.com/patients-and-families X http://www.regionalhealth.com/patients-and-families X http://www.regionalhealth.com/patients-and-families X X X X X X 1 X 0 X X X 1 X 0 1 Same Day Surgery Center 2 0 0 1 X X X X X X X X X 15 1 1 0 1 http://www.samedaysurgerycenter.org/community-health-needs-assessment/ X http://www.regionalhealth.com/about-us/community-needs-assessment X 1 15 1 http://www.samedaysurgerycenter.org/community-health-needs-assessment/ 0 0 1 X 200.000000000000 250.000000000000 X X X 1 1 X X X X 1 X http://www.samedaysurgerycenter.org/financial-assistance/ X http://www.samedaysurgerycenter.org/financial-assistance/ X http://www.samedaysurgerycenter.org/financial-assistance/ X X X X X 1 X 0 X X X 0 X X 0 1 Rapid City Regional Hospital, Inc. Part V, Section B, Line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. A total of 294 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Regional Health service area. Same Day Surgery Center Part V, Section B, Line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. A total of 294 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Regional Health service area. Rapid City Regional Hospital, Inc. Part V, Section B, Line 6a: The Community Health Needs Assessment was undertaken by Regional Health, including: Rapid City Regional Hospital, Same Day Surgery Center, Spearfish Regional Hospital, Sturgis Regional Hospital, Lead-Deadwood Regional Hospital, and Custer Regional Hospital. Under a management contract with Regional Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Same Day Surgery Center Part V, Section B, Line 6a: The Community Health Needs Assessment was undertaken by Regional Health, including: Rapid City Regional Hospital, Same Day Surgery Center, Spearfish Regional Hospital, Sturgis Regional Hospital, Lead-Deadwood Regional Hospital, and Custer Regional Hospital. Under a management contract with Regional Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Rapid City Regional Hospital, Inc. Part V, Section B, Line 11: In review of the needs identified in the CHNA, Rapid City Regional Hospital has identified the areas below that will not be addressed due to prioritization of health needs:1) Cancer: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. Awareness activities through the American Cancer Society also currently exist in the community and surrounding area. 2) Dementia, Including Alzheimer's Disease: This issue will not be addressed as a primary need, but will be impacted through the mental health priority. In addition, there are local licensed skilled nursing facilities providing services to the elderly of the community. 3) Diabetes: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.4) Heart Disease & Stroke: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.5) Infant health and Family Planning: Data from the CHNA revealed that infant mortality and teen births were of greatest concern in this area in the community. However, limited resources excluded this as an area chosen for action. 6) Injury & violence: RCRH has partnered with Kohl's Cares, Safe & Sound South Dakota, Farm Bureau of South Dakota, and Community Organized Resources in Educating Youth in order to address this area of opportunity. With these partnerships, Rapid City Regional Hospital determined that progress is being made in this area and that other areas of opportunity required more immediate and focused attention. 7) Oral Health: RCRH has limited resources, services and expertise available to address oral health and access to oral health insurance. Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action.8) Respiratory Diseases: RCRH believes this priority area falls more within the purview of other community resources, including outpatient clinical settings.9) Sexually Transmitted Diseases: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. 10) Substance Abuse: This issue will not be addressed as a primary need, but will be impacted through the mental health priority.11) Tobacco Use: Rapid City Regional Hospital is a tobacco-free facility. The facility provides smoking cessation screening to patients and provides reference to the South Dakota Quit Line as applicable. Limited resources and lower priority excluded this as an area chosen for action.This most recent assessment identified the following three priority areas that three Regional Health workgroups are addressing:Access to Healthcare Services: Focus on developing strategies to support timely access to primary care, specialty care, diagnostics, and inpatient services. This area has four primary objectives:1. Improve Patient Access for Primary Care, Specialists, and Diagnostic Procedures2. Develop and implement a community-based population health program3. Investigate, Plan, Build and Launch First Phase of a Digital Health Strategy4. Support access to primary and preventive care for vulnerable populations.Strategies to meet these objectives are as follows:-Optimize scheduling rules, templates, and processes-Standardize scheduling practices-Develop specialist referral criteria-Build Population Health Infrastructure-Develop Primary Case Management program-Provide education and promotion concerning use of advanced directives-Determine organizational and community needs and solutions options-Develop business plan for the digital health strategy-Increase support of All Women Count SD programMental Health: Increase access and awareness of culturally appropriate mental health resources and education. This priority has three objectives:1. Reduce stigma of mental health and increase public and provider awareness of available mental health resources available in their community.2. Improve mental health screening process across the Black Hills region (starting with Regional Health system)3. Explore adding mental health access into primary care clinicsStrategies to meet these objectives are as follows:-Partner with 211 Helpline to develop a comprehensive list of mental health resources in the service area -Create a community mental health asset map-Develop publicity campaign in partnership with community to reduce stigma of mental health-Develop education for providers on importance of screening process-Standardize mental health screening tool -Standardize process for referrals of patients who screen positive -Develop case management program for mental health-Build business case -Explore other access solutions (telehealth, mobile)Wellness: Explore, develop, and support opportunities that will positively impact the health of our community in the areas of physical activity, nutrition, and weight management. There are two objectives under this priority area:1. Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices 2. Enhance access to organized well-being programs and activities in the community Strategies to meet these objectives are as follows:-Marketing campaign for existing health promotion programs -Enhance access to the Regional Health Diabetes Prevention Program-Develop pediatric diabetes prevention program (pilot in Rapid City and Spearfish communities)-Enhance access to the Better Choices Better Health (BCBH) Program -Explore partnership with local Native American agency (non-healthcare)-Expand Regional Health Employee Well-being program to offer consulting to organizations in the Rapid City and Spearfish Communities by the end of 2017 and Lead/Deadwood, Custer, and Sturgis communities by end of 2018-Live Well Black Hills resource support-Develop toolkit of disease prevention and disease management resources for providers (including referral process) Same Day Surgery Center Part V, Section B, Line 11: In review of the needs identified in the CHNA, Same Day Surgery Center has identified the areas below that will not be addressed due to prioritization of health needs:1) Cancer: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. Awareness activities through the American Cancer Society also currently exist in the community and surrounding area. 2) Dementia, Including Alzheimer's Disease: This issue will not be addressed as a primary need, but will be impacted through the mental health priority. In addition, there are local licensed skilled nursing facilities providing services to the elderly of the community. 3) Diabetes: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.4) Heart Disease & Stroke: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.5) Infant health and Family Planning: Data from the CHNA revealed that infant mortality and teen births were of greatest concern in this area in the community. However, limited resources excluded this as an area chosen for action. 6) Injury & violence: Limited resources and lower priority excluded this as an area chosen for action. 7) Oral Health: SDSC has limited resources, services and expertise available to address oral health and access to oral health insurance. Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action.8) Respiratory Diseases: SDSC believes this priority area falls more within the purview of other community resources, including outpatient clinical settings.9) Sexually Transmitted Diseases: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. 10) Substance Abuse: This issue will not be addressed as a primary need, but will be impacted through the mental health priority.11) Tobacco Use: SDSC is a tobacco-free facility. The facility provides smoking cessation screening to patients and provides reference to the South Dakota Quit Line as applicable. Limited resources and lower priority excluded this as an area chosen for action.This most recent assessment identified the following three priority areas that three Regional Health workgroups are addressing:Access to Healthcare Services: Focus on developing strategies to support timely access to primary care, specialty care, diagnostics, and inpatient services. This area has four primary objectives:1. Improve Patient Access for Primary Care, Specialists, and Diagnostic Procedures2. Develop and implement a community-based population health program3. Investigate, Plan, Build and Launch First Phase of a Digital Health Strategy4. Support access to primary and preventive care for vulnerable populations.Strategies to meet these objectives are as follows:-Optimize scheduling rules, templates, and processes-Standardize scheduling practices-Develop specialist referral criteria-Build Population Health Infrastructure-Develop Primary Case Management program-Provide education and promotion concerning use of advanced directives-Determine organizational and community needs and solutions options-Develop business plan for the digital health strategy-Increase support of All Women Count SD programMental Health: Increase access and awareness of culturally appropriate mental health resources and education. This priority has three objectives:1. Reduce stigma of mental health and increase public and provider awareness of available mental health resources available in their community.2. Improve mental health screening process across the Black Hills region (starting with Regional Health system)3. Explore adding mental health access into primary care clinicsStrategies to meet these objectives are as follows:-Partner with 211 Helpline to develop a comprehensive list of mental health resources in the service area -Create a community mental health asset map-Develop publicity campaign in partnership with community to reduce stigma of mental health-Develop education for providers on importance of screening process-Standardize mental health screening tool -Standardize process for referrals of patients who screen positive -Develop case management program for mental health-Build business case -Explore other access solutions (telehealth, mobile)Wellness: Explore, develop, and support opportunities that will positively impact the health of our community in the areas of physical activity, nutrition, and weight management. There are two objectives under this priority area:1. Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices 2. Enhance access to organized well-being programs and activities in the community Strategies to meet these objectives are as follows:-Marketing campaign for existing health promotion programs -Enhance access to the Regional Health Diabetes Prevention Program-Develop pediatric diabetes prevention program (pilot in Rapid City and Spearfish communities)-Enhance access to the Better Choices Better Health (BCBH) Program -Explore partnership with local Native American agency (non-healthcare)-Expand Regional Health Employee Well-being program to offer consulting to organizations in the Rapid City and Spearfish Communities by the end of 2017 and Lead/Deadwood, Custer, and Sturgis communities by end of 2018-Live Well Black Hills resource support-Develop toolkit of disease prevention and disease management resources for providers (including referral process) Rapid City Regional Hospital, Inc. Part V, Section B, Line 16i: A summary of the hospital's financial assistance policy is posted for all patients at various points of entry, on the facility website, in waiting rooms, and in the admissions office. The policy in its entirety is also available upon request.The hospital is in the process of developing a new public website. Once completed the revised FAP full policy will be available on the Regional Health website. Rapid City Regional Hospital, Inc. Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for medically necessary care. The financial assistance policy does not apply to certain elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on certain elective procedures. Same Day Surgery Center Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for medically necessary care. The financial assistance policy does not apply to certain elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. 4 1 - Rapid City Regional Hospice House 224 Elk St Rapid Ctiy SD 57701 End of Life Care 2 - Regional Dialysis Center - Spearfish 132 Yankee St Spearfish SD 57783 Dialysis Center 3 - Wall Regional Medical Clinic 112 7th Ave Wall SD 57790 Clinic 4 - Pine Ridge Regional Medical Clinic East Highway 18 Pine Ridge SD 57702 Clinic Part I, Line 3c: References to "Regional Health" apply to all entities controlled or leased by Regional Health, Inc. and its subsidiaries. This includes the reporting entity.Part I, Line 3c: Financial assistance debt reduction write-offs for free or discounted care are based on an income matrix utilizing the current Federal Poverty Level (FPL) income guidelines after satisfying applicable co-pay requirements. The income matrix may be updated annually as the FPL guidelines are released. Part I, Line 7: Ratio of patient care cost to charges is used for the calculation of cost of services provided for lines 7a, 7b, and 7g. Actual costs are used for the calculation of costs of services provided for lines 7e, 7f, 7h, and 7i. Part I, Ln 7 Col(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 $47,934,033. Part II, Community Building Activities: Regional Health collaborates with agencies and community-wide coalitions to address prioritized health needs within the communities we serve. Regional Health addresses its community's health needs by: 1) sustaining efforts operating within a targeted health priority area; 2) developing new programs and initiatives to address identified health needs: and 3) promoting an understanding of these health needs among other community organizations and within the public itself. Regional Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Regional Health provides in-kind support and employee volunteers to help support community health events and activities. Part III, Line 2: The bad debt reported on line 2 is at charges as reported on the financial statements. Part III, Line 3: The estimated amount of bad debt attributable to patients eligible under the financial assistance policy is determined through a review of the bad debt records to identify patient accounts that would be eligible for a discount under the financial assistance policy. The organization follows HFMA Statement 15, however the amount reported on Part III, Line 3 reflects amounts not previously determined to be charity care in prior years, however were determined in the current year to be charity care amounts. Part III, Line 4: The footnote to the Organization's financial statements can be found on page nine and ten of the attached audited financial statements. Part III, Line 8: The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. 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. Part III, Line 9b: The collection policy requires invoking of the financial assistance policy at any time a patient expresses financial difficulty in meeting their debt obligation. Upon invoking the FAP, all collection activity is suspended. If the patient is approved for charity, then the account is closed out of the collection process and classified as charity. If a patient expresses financial concern but fails to complete the application process, additional notification is sent to the patient prior to re-instituting collection activity. We are following the 501(r) Final Regulations timelines for notifications and collections. Form 990, Schedule H, Part IV: The MRI Center, LLC was merged into the Imaging Center, LLC effective September 1, 2015. Part VI, Line 2: In Tax Year 2015, Regional Health conducted a Community Health Needs Assessment (CHNA) that included Rapid City Regional Hospital, Same Day Surgery Center, Spearfish Regional Hospital, Sturgis Regional Hospital, Lead-Deadwood Regional Hospital, Custer Regional Hospital, and Hans P. Peterson Memorial Hospital. Regional Health contracted with Professional Research Consultants, Inc. (PRC) to conduct the needs assessment. PRC is a nationally recognized health care consulting firm with extensive experience conducting Community Health Needs Assessments in hundreds of communities across the United States since 1994. PRC conducted Regional Health's previous CHNA in Tax Year 2012. The assessment incorporated data from both quantitative and qualitative sources. Quantitative data input included primary research (the PRC Community Health Survey) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for trending and comparison to benchmark data at the state and national levels. Qualitative data input included primary research gathered through an Online Key informant Survey.A variety of existing (secondary) data sources was consulted to complement the research quality of this Community Health Needs Assessment. Data for the service area was obtained from the following sources:* Center for Applied Research and Environmental Systems (CARES)* Centers for Disease Control & Prevention, Office of Infectious Disease, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention* Centers for Disease Control & Prevention, Office of Public Health Science Services, Center for Surveillance, Epidemiology and Laboratory Services, Division of Health Informatics and Surveillance (DHIS)* Centers for Disease Control & Prevention, Office of Public Health Science Services, National Center for Health Statistics* Community Commons* ESRI ArcGIS Map Gallery* National Cancer Institute, State Cancer Profiles* OpenStreetMap (OSM)* US Census Bureau, American Community Survey* US Census Bureau, County Business Patterns* US Census Bureau, Decennial Census* US Department of Agriculture, Economic Research Service* US Department of Health & Human Services* US Department of Health & Human Services, Health Resources and Services Administration (HRSA)* US Department of Justice, Federal Bureau of Investigation* US Department of Labor, Bureau of Labor StatisticsTo solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of this process. A list of recommended participants was provided by Regional Health; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. In all, 294 community stakeholders from the Regional Health service area participated in the Online Key Informant Survey.The needs assessment report was completed in November 2015 (Tax Year 2015). Rapid City's Healers and Transformers Community group reviewed the areas of opportunity from the 2015 CHNA report, completed in Tax Year 2015. Utilizing input from this group, the Rapid City Regional Hospital Board of Directors approved the following priority areas as the focus of the community-based efforts and resources for FY2017-FY2019: Access to Healthcare Services, Mental Health, and Wellness (Nutrition, Physical Activity, and Weight). Workgroups comprised of caregivers representing each of the communities served by Regional Health developed the goals, objectives, and strategies for each of the selected priority areas from across the system. A proposed Community Health Implementation Strategy was then written to address the community's health needs. In September, 2016, the Rapid City Regional Hospital Board reviewed, discussed and approved the implementation strategies for addressing the community health priorities identified through the Community Health Needs Assessment. Part VI, Line 3: Financial Assistance Program brochures explaining the policy, a copy of the policy and Financial Assistance applications are available at each point of entry. Signs alerting patients to the availability of Financial Assistance are prominently displayed and a plain language summary describing the Financial Assistance program accompanies one billing statement for hospital services sent to the patient. The Financial Assistance policy, plain language summary and Financial Assistance application are provided free upon request and are also available on the hospital website at http://www.regionalhealth.com/patients-and-families. Regional Health contracts with Midland Medical Group (an unrelated entity) to meet with uninsured patients to assist them with finding a funding source or applying for financial assistance; and our self-pay outsource partner also communicates any funding and financial assistance opportunities with our patients. Part VI, Line 4: Regional Health and its affiliates provide health care services to the 380,000 people who live in the Black Hills of South Dakota and the surrounding region, as well as thousands of visitors each year. Regional Health serves a 38-county region comprised of western South Dakota, southeastern Montana, northeastern Wyoming, southwestern North Dakota and northwestern Nebraska. Part VI, Line 5: Rapid City Regional Hospital is governed by a community board that provides leadership to the organization to meet the needs of the communities it serves. Regional Health partners with several educational institutions to provide numerous clinical training programs that would otherwise not exist in our region.Regional Health provides numerous community health education events and screenings throughout the Black Hills Region. Regional Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Regional Health provides in-kind support and employee volunteers to help support community health events and activities and other charitable programs. Part VI, Line 6: Regional Health is committed to partnering with the communities it serves to meet the needs of each respective community. Regional Health, Inc. is the parent organization of Rapid City Regional Hospital, Inc., Regional Health Network, Inc., and Regional Health Physicians, Inc. These corporations work together to meet the health care needs of the region. Financial Assistance Policy As required under the final treasury regulations issued under Section 501(r) of Internal Revenue Code, Regional Health's (parent organization) Board of Directors adopted the current FAP for fiscal year ending June 30, 2016. Its approval is applicable to all of Regional Health's hospital facilities, including RCRH's hospital facility. On May 17, 2016, Regional Health's Finance and Investment Committee recommended that the current FAP be adopted by Regional Health's Board of Directors at its June 16, 2016 meeting. However, due to an inadvertent oversight, it was left off the agenda for that meeting. Once the error was discovered, an electronic vote of the Board was taken to adopt the FAP. Thus, the Board of Directors did not officially adopt the current FAP until August 2, 2016. The delay was slight, RCRH immediately corrected the error once discovered, and RCRH is not aware of any patient being harmed by this slight delay. Thus, because the error was not willful or egregious and RCRH is disclosing such error on its Form 990 in accordance with Treasury Regulation Section 1.501(r)-2(c), the error should not be considered a failure to meet the requirements of Section 501(r) of the Code. X 0 0 1 1 0 0 0 0 0 1 0 Brent Phillips President & CEO 664243 0 54500 0 6000 0 47250 0 14754 0 786747 0 0 0 Mark A Thompson VP CFO 374676 0 37156 0 7807 0 50697 0 16626 0 486962 0 7807 0 Paul W Clemments VP Professional Services 182898 0 11430 0 0 0 20569 0 22566 0 237463 0 0 0 Michael Gibbs President Rapid City Market 356413 0 25246 0 0 0 32267 0 22307 0 436233 0 0 0 Maureen G Henson VP Human Resources 228049 0 14924 0 0 0 20269 0 1607 0 264849 0 0 0 Richard S Latuchie VP Info Technology CIO 278400 0 18830 0 0 0 14588 0 30363 0 342181 0 0 0 Mary E Masten General Counsel 310536 0 20217 0 0 0 24203 0 17830 0 372786 0 0 0 John Pierce VP Rapid City Market 135607 117162 23567 0 0 21783 0 27557 13206 9912 172380 176414 0 17720 Samuel Durr MD Physician - Cardiology 589881 0 79408 0 212808 0 53529 0 18466 0 954092 0 212808 0 Michael P D'urso MD Physician - Cardiology 602282 0 79408 0 40758 0 9173 0 29629 0 761250 0 40758 0 John K Heilman III MD Physician - Cardiology 744235 0 79408 0 0 0 9173 0 18627 0 851443 0 0 0 Joseph Tuma MD Physician - Cardiology 851371 0 79408 0 53052 0 54723 0 35516 0 1074070 0 53052 0 Amad Zineldine MD Physician - Cardiology 626329 0 79408 0 40896 0 52969 0 34318 0 833920 0 40896 0 Charles E Hart MD Former President Emeritus 126523 0 83929 0 0 0 7605 0 2911 0 220968 0 0 0 Timothy Sughrue Former CEO RCRH & RHN; COO RHI 254755 0 0 0 340963 0 9712 0 8096 0 613526 0 0 0 Part I, Line 1a The following individuals received "Tax Indemnification and gross-up payments" for the cost of life insurance in excess of $50,000: Paul W. Clemments 630 Samuel Durr 1,330 Michael D'Urso 434 Michael E. Gibbs 274 Maureen G. Henson 1,778 Richard S. Latuchie 3,186 Mary E. Masten 3,215 Brent Phillips 2,731 John Y. Pierce 411 Mark A. Thompson 2,094 Joseph Tuma 274 Amad Zineldine 531 Part I, Line 3 The Compliance, Audit and Compensation Committee, which is a committee of the Regional Health (parent) Board, reviews and approves base salary and total compensation ranges for all executives within the Regional Health System. Part I, Lines 4a-b Regional Health provides a supplemental nonqualified retirement plan and a flexible benefit plan that can include deferred compensation for its executives. The following individuals had amounts deferred into the account as reported in column c on Schedule J: Maureen G. Henson 12,792 Brent Phillips 39,300 Mark A. Thompson 32,081 Paul W. Clemments 10,857 Michael E. Gibbs 20,238 Samuel Durr, MD 44,356 Joseph Tuma MD 45,550 Amad Zineldine MD 38,479 Severance payments were made to the following individual: Timothy Sughrue 340,963 Part I, Line 7 Executives and Other Employees of System Entities will be eligible to receive annual incentive awards that are competitive with the incentives offered by the organizations in the System's Peer group(s) in accordance with the terms of the Regional Health, Inc. Annual Incentive Plan for Selected Executives and Other Employees (Incentive Plan). In accordance with this plan, the Board's Compliance, Audit and Compensation Committee will review and approve all incentive compensation performance measures and all awards, if any. A SD Health & Educational Facilities Authority 460315509 83755VQJ6 2010-08-17 54390000 Hospital Buildings & Equipment & Refund Series 1998 & 1999 Bonds 0 0 0 B SD Health & Educational Facilities Authority 460315509 83755VSW5 2011-11-22 50460000 Hospital Buildings & Equipment & Refund Series 2001 Bonds 0 0 0 C SD Health & Educational Facilities Authority 460315509 2015-01-27 67210000 Refund series 2008 bonds issued 8/14/08 0 0 0 A 18990000 57312811 785667 24925832 31601312 2013 1 0 1 1 B 11565000 54610462 709782 30161279 23739401 2013 1 0 1 1 C 3200000 67210000 250000 66960000 2015 1 0 1 1 A 0 1 1 0 1 0 0.00690 0.00070 0.00760 0 0 1 B 0 1 1 0 1 0 0.00050 0.00610 0.00660 0 0 1 C 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 0 1 1 US Bank NA 11.200000000000 0 0 0 0 1 A 1 B 1 C 1 Date Rebate Computation Performed Issuer Name: SD Health & Educational Facilities Authority Date the Rebate Computation was Performed: 10/22/2013 Issuer Name: SD Health & Educational Facilities Authority Date the Rebate Computation was Performed: 12/19/2013 Schedule K, Part II, Line 3, Bond A Part I issue price and Part II, line 3 Bond Proceeds differ due to interest earned on the proceeds and a net premium earned. Bond A: Issue Price 54,390,000 Plus Interest Earnings 25,040 Net Premium 2,897,771 Total Part II, Line 3 57,312,811 Bond B: Issue Price 50,460,000 Plus Interest Earnings 161,279 Net Premium 3,989,183 Total Part II, Line 3 54,610,462 Gregg Radtke Family member of Director Sandra Burns 33592 Employed by RCRH 0 Erika L Radtke Family member of Director Sandra Burns 18100 Employed by RCRH 0 Nadine E Radtke Family member of Director Sandra Burns 10523 Employed by RCRH 0 Caleb Hansen Family member of Director Lisa Seaman 50730 Employed by RCRH 0 Lindsey Hansen Family member of Director Lisa Seaman 45422 Employed by RCRH 0 Form 990, Part IV, Line 24a: Bond Issues: The issue price of the bonds includes the filing organization's share of the entire bond issue, which was issued to Rapid City Regional Hospital on behalf of the Obligated Group. The Obligated Group consists of Rapid City Regional Hospital, Regional Health Inc, Regional Health Network Inc, and Regional Health Physicians Inc. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Rapid City Regional Hospital's tax return. Form 990, Part VI, Section A, line 1 The membership of the Executive Committee of the corporation shall consist of the following: Chairman of the Board of Directors, Vice Chairman of the Board of Directors, Secretary, Treasurer, the Chief of the Medical Staff of Rapid City Regional Hospital, the most recent past Chairman of the Board of Directors unless such person is otherwise a member of the Committee (and only if the person continues to be a member of the Board of Directors), and the Corporation's President. The Chairman of the Board of Directors shall serve as Chairman of the Executive Committee. Directors on the Executive Committee shall serve during the term of office they hold which places them on the Executive Committee, or as otherwise provided by the Board of Directors. The Executive Committee, when the Board of Directors is not in session, shall have and may exercise all of the authority of the Board of Directors, except to the extent, if any, that such authority shall be limited by a motion or resolution of the Board of Directors. It is intended that the powers of the Executive Committee to act for the whole Board be confined to such urgent matters as reasonably should not be deferred until the next regularly-scheduled meeting of the full Board. Form 990, Part VI, Section A, line 2 Brent Phillips has a business relationship with the following individuals due to being the CEO of the supporting organization that exercises reserve powers over the supported organizations that employ each of these key employees: Paul Clemments; Michael Gibbs; Maureen Henson; Richard Latuchie; Mary Masten; John Pierce; Timothy Sughrue; Mark Thompson. Directors Sandra Burns and Jack Lynass are Directors of the Black Hills Community Bank Board. Form 990, Part VI, Section A, line 4 The bylaws of the Organization were amended with the following significant changes: -Following changes made to Regional Health, Inc., the President/CEO was changed to a non-voting member of the board, -System Committees were established to further increase responsiveness and gain more direct and efficient input from the supported organization's in Regional Health, Inc.'s decision-making. The amended bylaws require that at least one member of each of RHI's supported entity's governing board be a member of the committee, along with members from the supporting organization's governing body. -Bylaw provisions were modernized to permit notices, meetings, etc. to be sent or attended and action to be taken through electronic means, -Added additional duties to the duties of the governing body related to accomplishment of strategic goals and Medical staff oversight. Form 990, Part VI, Section A, line 6 Regional Health, Inc. is the sole member of Rapid City Regional Hospital, Inc. Form 990, Part VI, Section A, line 7a The organization's sole member and supporting organization, Regional Health, Inc., appoints the members of Rapid City Regional Hospital's governing body. The bylaws require that at least two members of Rapid City Regional Hospital's board also serve as voting members of the sole member's board to better assure the sole member's continued responsiveness to Rapid City Regional Hospital. Form 990, Part VI, Section A, line 7b Regional Health, Inc. provides compliance, governance, financial, and planning support to its Supported Organizations to best assure the functions and services of the Supported Organizations are coordinated and supported in a manner that furthers the shared charitable mission of the Supported Organizations and RHI, as a whole (the System). Regional Health, Inc. has final authority in significant business decisions affecting Supported Organizations. Form 990, Part VI, Section B, line 11 The 990 is prepared and reviewed by an independent accounting firm. It is then reviewed internally by finance and legal management. The Form 990 is further reviewed, prior to filing, by the organization's board of directors through a portal to the organization's internal information system, to which each board member has access. Educational sessions have been provided to each board member on how to access the portal. Form 990, Part VI, Section B, line 12c As a part of the annual disclosure of potential conflicts process, all board members, officers, and management are required to complete a disclosure statement. Annually, a summary list of all conflicts disclosed by board members is prepared and provided to the full board so board members are aware of the conflicts/interests of other board members and are able to point out conflicts if an individual member with a conflict forgets. Additionally, the agenda for each board meeting and each board committee meeting includes an initial agenda item "Conflicts of Interest" where board members are asked if they have any conflicts related to the other items on the agenda. All employees are covered by the conflict of interest policy but completion of the annual disclosure statement is limited to board and board committee members, management, and certain physicians. When a proposed transaction involves a board member, the transaction is reviewed by the compliance and audit committee. At meetings, board members who have a conflict of interest may be invited to speak on the matter by the chairman, but are not permitted to vote on the matter and are required to leave the meeting during discussion, after they have made any comments invited by the chair. Failure to comply with this policy constitutes ground for removal from office or membership and in the case of all employees, termination of employment. Form 990, Part VI, Section C, line 19 The Articles of Incorporation of the organization are filed in the office of the Secretary of State of South Dakota and are available to the public from the Office of the Secretary of State. Other documents (Bylaws, conflict of interest policy and financial statements) are not posted for the public but are available or described in other public documents or sites such as offering statements in bond issues or municipal securities rulemaking board's electronic municipal market access (EMMA) data port. Form 990, Part XI, line 9: Adj to the Funded Status of the Pension Plan -14,678,393. Medical Staff Net Income -93,763. Net Assets Released from Restriction 1,126,039. Gift Shop Net Income -95,518. Auxiliary Net Income -41,747. Amortized Bond Premium 463,224. Change in Interest Swap -3,557,613. Temporarily Restricted Net Asset Changes -2,607,148. Golden Ridge and Fairmont Grand Facility Sale Net Asset Adjustment -8,293,080. Regional Health Inc 353 Fairmont Blvd Rapid City SD 57701 201487506 Healthcare SD 501(c)(3) Line 11c, III-FI N/A 0 Regional Health Network Inc 353 Fairmont Blvd Rapid City SD 57701 460360899 Healthcare SD 501(c)(3) Line 3 Regional Health Inc 0 Regional Health Physicians Inc 353 Fairmont Blvd Rapid City SD 57701 460372454 Healthcare SD 501(c)(3) Line 3 Regional Health Inc 0 Medical & Dental Building 2805 S 5th St Rapid City SD 57701 460339629 Medical Office Bldg SD Rapid City Regional Hospital Inc Investment -29365 921508 0 1 0.71450 Black Hills Medical Office BD LLC 353 Fairmont Blvd Rapid City SD 57701 411992146 Medical Office Bldg SD Rapid City Regional Hospital Inc Investment 797 1578660 0 0 0.67930 Same Day Surgery Center 651 Cathedral Drive Rapid City SD 57701 411889892 Medical Services SD Rapid City Regional Hospital Inc RELATED 3057728 2492427 0 1 0.40000 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 Same Day Surgery Center F 2760000 Accrual