2017-04-18T15:12:48+00:00 2016-05-31 460434947 ELO PROF LLC PO BOX 249 MITCHELL SD 57301 990 2015-06-01 460400557 DOUGLAS COUNTY MEMORIAL HOSPITAL DOUG 6057242159 708 8TH STREET ARMOUR SD 573132102 HEATH BROUWER ADMINISTRATOR/CEO 6057242159 2016-04-15 true JAY TOLSMA CPA P00736087 6059967717 2017-04-13 2015 2021-01-29 14:40:06Z HEATH BROUWER 9362588 false X WWW.DCMHSD.ORG X PROMOTION OF GENERAL HEALTH CARE AND REHABILITATION SERVICES 6 6 123 0 36376 70738 9206178 9150551 267857 27321 157224 113978 9667635 9362588 0 0 4809120 4775383 0 0 4286131 4189258 9095251 8964641 572384 397947 10972151 11409270 4028617 4067789 6943534 7341481 PROMOTION OF GENERAL HEALTH CARE AND REHABILITATION SERVICES false false 7921413 DOUGLAS COUNTY MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO PERSONS IN THE ARMOUR, CORSICA AND STICKNEY COMMUNITIES. DURING THE FISCAL YEAR ENDED MAY 31, 2016, THE HOSPITAL PROVIDED 618 INPATIENT DAYS, 566 EMERGENCY ROOM VISITS, 9,458 OUTPATIENT VISITS AND 5,748 ASSISTED LIVING (PRAIRIE VILLA) DAYS. THE FACILITY PROVIDED 1,939 HOME DELIVERED MEALS TO HOME-BOUND COMMUNITY MEMBERS ALONG WITH 2,478 MEALS TO SENIOR MEALS PROGRAM. EACH RURAL HEALTH CLINIC LOCATION CONDUCTS AN ANNUAL HEALTH FAIR. FOR THE FISCAL YEAR ENDED MAY, 31, 2015, THE HOSPITAL PROVIDED 68 PSA AND 253 LIPID LAB TESTS AT NO CHARGE. 7921413 true true false false false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 18 0 true 123 true false false false false false false false false false false false false X 6 6 false false false false false false false true true false false false true true true true true true true false X JOSHUA CHRISTENSEN CFO 6057242159 708 8TH STREET ARMOUR SD 57313 JOEL BAIER PRESIDENT 1.00 X 0 0 0 BRAD VANDEN BERG VICE-PRESIDE 1.00 X 0 0 0 JODI SCHRANK SECRETARY 1.00 X 0 0 0 MARK VAN DER WERFF TREASURER 1.00 X 0 0 0 SCOTT HOLBECK MEMBER 1.00 X 0 0 0 DEAN MEYERINK MEMBER 1.00 X 0 0 0 HEATH BROUWER ADMINISTRATO 40.00 X 126873 0 10462 JOSHUA CHRISTENSEN CHIEF FINANC 40.00 X 76408 0 10493 DAVID DAVID PHYSICIAN X 183060 0 29489 MARLYS LUEBKE PHYSICIAN X 161658 0 29005 VANESSA MIILLER PHYSICIAN AS X 145860 0 19963 JENNIFER BIETZ PHYSICIAN AS X 142104 0 28107 835963 127519 6 false true false SANFORD HEALTH PO BOX 5039 SIOUX FALLS SD 57117 MEDICAL SERVICE 337677 ZOSS ANESTHESIA PC 42668 263RD ST EMERY SD 57332 MEDICAL SERVICE 224500 SANFORD LABORATORIES PO BOX 5056 SIOUX FALLS SD 57117 MEDICAL SERVICE 144536 3 67309 3429 70738 9150551 9150551 9150551 17321 17321 10000 10000 10000 10000 113978 113978 113978 9362588 9291850 X 3894677 3351719 542958 166656 143629 23027 463842 416220 47622 250208 214101 36107 114 114 46596 46596 904742 785946 118796 29367 8869 20498 117665 99078 18587 14704 13364 1340 120295 120295 300577 300577 111633 111633 SUPPLIES 2438140 2375170 62970 REPAIRS AND MAINTENANCE 50915 50915 OTHER TAXES 42611 36000 6611 RENT AND LEASES 33405 33405 -21506 -27875 6369 8964641 7921413 1043228 0 500 400 2444916 2450478 1432053 1443644 15954 10746 449705 454845 29800 48312 8720363 2410586 6511358 6309777 513322 87865 177746 10972151 11409270 564639 649539 3460353 3414000 3625 4250 4028617 4067789 X 6943534 7341481 6943534 7341481 10972151 11409270 397947 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 71625 71625 6965624 1186254 5779370 1683114 1224332 458782 6309777 DEPOSITS - PRAIRIE VILLA 4250 4250 8991144 8991144 371444 371444 9362588 8593197 8593197 371444 371444 8964641 SCHEDULE D, PAGE 4, PART XI, LINE 4B ASSISTED LIVING REVENUES - NETTED ON FINANCIAL STATEMENTS 371,444 SCHEDULE D, PAGE 4, PART XII, LINE 4B ASSISTED LIVING EXPENSES - NETTED ON FINANCIAL STATEMENTS 371,444 true true true X 1.250000000000 true X true true true false true true 29918 29918 0.00330 29918 29918 0.00330 193261 81978 111283 0.01240 193261 81978 111283 0.01240 223179 81978 141201 0.01580 true 217151 23751 6168484 6135937 32547 X false 1 1 DOUGLAS COUNTY MEMORIAL HOSPITAL 708 8TH STREET ARMOUR SD 57313 WWW.DCMHSD.ORG LICENSE 10526 X DOUGLAS COUNTY MEMORIAL HOSPITAL 1 false false true X X X X X X X X X X 15 true false false true X WWW.DCMHSD.ORG X true 15 true WWW.DCMHSD.ORG false true X 125.000000000000 200.000000000000 X X X X true true X X X true X X X X true X true X X X true X false false FACILITY 1, DOUGLAS COUNTY MEMORIAL HOSPITAL - PART V, LINE 5 IN CONDUCTING THE CHNA THE HOSPITAL FACILITY RELIED HEAVILY UPON THE KNOWLEDGE OF THE ARMOUR MAYOR, DOUGLAS COUNTY COMMUNITY HEALTH NURSE, DIRECTOR OF EMERGENCY MEDICAL TECHNICIANS, ARMOUR HIGH SCHOOL PRINCIPAL, A PHYSICIAN ASSISTANT, THE CEO, AND CFO OF THE DOUGLAS COUNTY MEMORIAL HOSPITAL. THE HOSPITAL RELIED ON THEIR INPUT AS TO WHAT THE NEEDS OF THE COMMUNITY ARE BASED ON THEIR WORKING KNOWLEDGE OF THE ILLNESSES THAT ARE OCCURRING IN THE DOUGLAS COUNTY AREA. FACILITY 1, DOUGLAS COUNTY MEMORIAL HOSPITAL - PART V, LINE 11 MENTAL HEALTH ISSUES ARE BEING ADDRESSED IN AN ATTEMPT TO PROVIDE MENTAL HEALTH SERVICES THROUGH THE FACILITIES' TELEHEALTH SERVICES. INCREASED ACCESS TO SPECIALTY SERVICES ARE ALSO TRYING TO BE ADDRESSED THROUGH THIS SAME MEANS WHICH COSTS THE FACILITY ROUGHLY 33,000 PER YEAR. WELLNESS ISSUES ARE BEING ADDRESSED BY THE FACILITY OFFERING USE OF THEIR EQUIPMENT TO THE PUBLIC AT A RATE OF 10 PER MONTH. THE HOSPITAL ADMINISTRATOR ALSO WROTE A LETTER OF SUPPORT FOR THE ARMOUR HIGH SCHOOL IN THEIR ATTEMPT TO SECURE GRANT FUNDS FOR THE TRACK TO BE RESURFACED. THE HOSPITAL ADMINISTRATOR ALSO IS PART OF THE DEVELOPMENT CORPORATION ATTEMPTING TO BRING IN DENTAL SERVICES. RECRUITMENT OF PHYSICIANS IS A CONTINUAL AREA OF FOCUS FOR THE HOSPITAL. FACILITY 1, DOUGLAS COUNTY MEMORIAL HOSPITAL - PART V, LINE 18D THE HOSPITALS FACILITY'S COLLECTION ACTIONS CONSIST OF BILLING STATEMENTS ALONG WITH FOLLOW UP PHONE CALLS IF THERE IS NO RESPONSE THROUGH OUR BILLING ATTEMPTS. ALL OTHER COLLECTIONS ARE SENT TO A THIRD-PARTY COLLECTION AGENCY FOR FUTHER COLLECTION ATTEMPTS. FACILITY 1, DOUGLAS COUNTY MEMORIAL HOSPITAL - PART V, LINE 22D ALL PATIENTS ARE CHARGED THE SAME GROSS CHARGE AMOUNTS FOR ALL SERVICES. FROM THIS POINT, ADJUSTMENTS ARE MADE FOR INSURANCE, PRIVATE PAY, MEDICARE OR MEDICAID BASED ON THE INDIVIDUAL'S METHOD OF COVERAGE. AFTER ADJUSTMENTS, FINANCIAL ASSISTANCE NEEDS ARE MEASURED AND CHARGES ARE ADJUSTED ACCORDINGLY BASED ON THE NEEDS AND FINANCIAL SITUATION OF THE INDIVIDUALS. 6 PRAIRIE PHARMACY-CORSICA 230 E MAIN STREET CORSICA SD 57328 RETAIL/OUTPATIENT PHARMACY PRAIRIE HEALTH CLINIC-ARMOUR 708 8TH STREET ARMOUR SD 57313 RURAL HEALTH CLINIC PRAIRIE PHARMACY-ARMOUR 1311 BRADDOCK STREET ARMOUR SD 57313 RETAIL/OUTPATIENT PHARMACY PRAIRIE VILLA 1309 BRADDOCK STREET ARMOUR SD 57313 ASSISTED LIVING CENTER PRAIRIE HEALTH CLINIC-CORSICA 230 E MAIN STREET CORSICA SD 57328 RURAL HEALTH CLINIC PRAIRIE HEALTH CLINIC-STICKNEY 301 MAIN STREET STICKNEY SD 57375 RURAL HEALTH CLINIC PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE COSTING METHODOLOGY USED FOR LINE 7 IS THE FACILITY'S MEDICARE COST REPORT. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY BAD DEBTS WERE BASED 64% OF HOSPITAL'S AUDITED FINANCIAL STATEMENTS FIGURE. THE 64% CAME FROM THE CALCULATION FIGURED ON WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE BASED ON A SAMPLE OF ACCOUNTS WRITTEN OFF TO COLLECTION AGENCIES THAT WERE NOT INCLUDED IN THE COMMUNITY BENEFIT. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE FOOTNOTE TO THE FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 8. PART III, LINE 6 - FIGURE IS TAKEN DIRECTLY FROM THE MEDICARE COST REPORT FILED FOR FY16. PART III, LINE 8 - MEDICARE EXPLANATION THIS SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT SINCE IF THESE SERVICES WERE NOT PROVIDED, IT WOULD BE A UNDUE BURDEN TO THE COMMUNITY TO TRAVEL TO ANOTHER FACILITY TO RECEIVE SERVICES. PART VI, LINE 2 - NEEDS ASSESSMENT THE DOUGLAS COUNTY MEMORIAL HOSPITAL IS RESPONSIVE TO THE NEEDS OF THE PATIENTS IT SERVES. THE FACILITY IS CONTINUALLY EVALUATING THE SERVICES IT PROVIDES, IN TALKS WITH LOCAL AGENCIES ABOUT THE SERVICES PROVIDED, AND IS ALWAYS OPEN TO INPUT FROM THE COMMUNITY ON EXPANDING OR ADDING SERVICES. OFTEN SERVICES CANNOT BE PROVIDED DIRECTLY BY THE HOSPITAL ITSELF, HOWEVER ARRANGEMENTS ARE MADE TO BRING OUTSIDE PROVIDERS AND/OR EQUIPMENT IN ORDER TO ALLOW THE COMMUNITY THE ABILITY TO RECEIVE THE CARE LOCALLY. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENT FINANCIAL SERVICES EVALUATES EACH ACCOUNT FOR PATIENT ELIGIBILITY UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND PROVIDES ELGIBILE PATIENTS WITH INFORMATION REGARDING THESE PROGRAMS ALONG WITH THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE WRITTEN OFF THROUGH FINANCIAL ASSISTANCE. PART VI, LINE 4 - COMMUNITY INFORMATION DOUGLAS COUNTY MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO PERSONS IN THE ARMOUR, CORSICA, AND STICKNEY COMMUNITIES. DURING THE FISCAL YEAR ENDED MAY 31, 2016, THE HOSPITAL PROVIDED 700 INPATIENT DAYS, 569 EMERGENCY ROOM VISITS, 9,313 OUTPATIENT VISITS AND 5,626 ASSISTED LIVING DAYS. THE FACILITY PROVIDED 1,663 HOME DELIVERED MEALS TO HOME-BOUND COMMUNITY MEMBERS ALONG WITH 2,035 MEALS TO SENIOR MEALS PROGRAM. EACH RURAL HEALTH CLINIC LOCATION CONDUCTS AN ANNUAL HEALTH FAIR. FOR THE FISCAL YEAR ENDED MAY 31, 2016, THE HOSPITAL PROVIDED 93 PSA AND 242 LIPID LAB TESTS AT NO CHARGE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE BOARD OF DIRECTORS IS COMPLETELY MADE UP OF COMMUNITY MEMBERS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE ARE WHO ARE NEITHER EMPLOYED BY NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION. THE HOSPITAL ALSO PROVIDES THE PHYSICAL LOCATION FOR THE DOUGLAS COUNTY COMMUNITY HEALTH OFFICE WHICH ALSO ALLOWS THE HOSPITAL TO WORK CLOSELY WITH OUR LOCAL HEALTH AGENCY. AN OPEN MEDICAL STAFF ALSO ALLOWS PROVIDERS WHO ARE NOT EMPLOYED BY THE ORGANIZATION TO SEE PATIENTS, AND PROVIDE MEDICAL TREATMENT AT THE FACILITY. THE DOUGLAS COUNTY MEMORIAL HOSPITAL IS ALSO EXPANDING ITS TELEMEDICINE CAPABILITIES ALLOWING PATIENTS WHO WOULD OTHERWISE HAVE TO TRAVEL DISTANCES IN EXCESS OF NINETY MILES TO SEE SPECIALIST WHO CAN NOW BE SEEN LOCALLY. GIVEN THE INCLEMENT WEATHER OF SOUTH DAKOTA, THIS PROVIDES PATIENTS THE ABILITY TO SEE THEIR PROVIDERS WITHOUT HAVING TO RUN A RISK OF BEING CAUGHT IN POTENTIALLY DANGEROUS CONDITIONS. THIS IS MOST ESPECIALLY TRUE FOR THE ELDERLY POPULATION AS THEY ARE OFTEN THE ONES IN MOST NEED OF SEEING THESE SPECIALTY PROVIDERS. X X X false false false false false false false false false DAVID DAVID PHYSICIAN 183060 29489 212549 MARLYS LUEBKE PHYSICIAN 161658 29005 190663 VANESSA MIILLER PHYSICIAN ASSISTANT 145860 19963 165823 JENNIFER BIETZ PHYSICIAN ASSISTANT 142104 28107 170211 FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS REVIEWED AND APPROVED BY THE ADMINISTRATOR AND CHIEF FINANCIAL OFFICER BEFORE FILING. FORM 990, PAGE 6, PART VI, LINE 12C AT THE BOARD'S ANNUAL MEETING FORM 990, PAGE 6, PART VI, LINE 15A PROCESS COMPLETED THROUGH BOARD COMPENSATION COMMITTEE FORM 990, PAGE 6, PART VI, LINE 15B PROCESS COMPLETED THROUGH BOARD COMPENSATION COMMITTEE FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATMENTES ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G 785,946 118,796 0 FORM 990, PART XI, LINE 9 ASSISTED LIVING REVENUES - NETTED ON FINANCIAL STATEMENTS -371,444 ASSISTED LIVING EXPENSES - NETTED ON FINANCIAL STATEMENTS 371,444