2016-05-16T15:25:30-05:00 2015-06-30 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2014-07-01 420796764 Sioux Center Health SIOU 7127221271 1101 9th St SE Sioux Center IA 51250 Jackson Schuiteman CFO 7127221271 2016-05-16 1 Laurie Hanson P00851848 6053391999 2016-05-16 2014 2016-08-17 19:52:53Z Kayleen Lee 1101 9th St SE Sioux Center IA 51250 36356330 0 X www.siouxcenterhealth.org X 1951 IA To provide medical care for all ages. 42 41 570 115 8040 5931 51794 62077 31701115 35960765 100680 -1577803 132283 150647 31985872 34595686 3524 2425 0 0 17303010 18313121 0 0 74137 13033987 18092346 30340521 36407892 1645351 -1812206 85641219 82125464 46334886 44631337 39306333 37494127 X Bring hope, health and healing to life. 1 0 31925086 2425 35952725 Sioux Center Health operates a 19-bed acute-care hospital, a 69-bed nursing care facility, a medical clinic, specialty physician clinics, two independent assisted living facilities, and a daycare center located in Sioux Center, Iowa. During the fiscal year ending June 30, 2015, patient days were 1,238, swing-bed days were 754, and newborn days were 316.The Center also provides a wide variety of medically-related activities at less than, or at no cost to residents of communities throughout northwest Iowa. These activities include general community education programs and sponsorship of support groups for victims of chronic disease and their families. Other activities designed to measure or enhance the general health status of residents of the community include: classes related to CPR, diabetes, cardiac rehabilitation and childbirth; participation in health fairs at industrial and community sites throughout the area; cost free screenings to alert people with high blood pressure; providing use of meeting facilities at no charge to cancer, Alzheimer's, diabetes, weight maintenance, "senior and hospice support groups; programs for children; providing speakers for various events and education groups; and representation in community education programs.The Health Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Since the Health Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue. The estimated cost of providing these services was $211,000 for the year ended June 30, 2015, calculated by multiplying the ratio of cost to gross charges for the Health Center by the gross uncompensated charges associated with providing charity care to its patients. 31925086 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 37 0 1 570 1 1 1 0 0 0 0 0 0 0 0 0 X 42 41 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 X Jackson Schuiteman 7127228158 1101 9th St SE Sioux Center IA 51250 Brian VanEngen President 1.00 X X 0 0 0 Tim Byl Vice President 1.00 X X 0 0 0 Marj Wagner Secretary 1.00 X X 0 0 0 Jeffrey Timmer Treasurer 1.00 X X 0 0 0 Vernon Beernink Director 1.00 X 0 0 0 Mary Beimers Director 1.00 X 0 0 0 Janet Boone Director 1.00 X 0 0 0 Terry Boote Director 1.00 X 0 0 0 Delbert Broek Director 1.00 X 0 0 0 Leslie Brommer Director 1.00 X 0 0 0 Bob Bruxvoort Director 1.00 X 0 0 0 Mayra Castelan Director 1.00 X 0 0 0 Lisa Christians Director 1.00 X 0 0 0 Paul Clousing Director 1.00 X 0 0 0 Brenda Dokter Director 1.00 X 0 0 0 Bruce Dooyema Director 1.00 X 0 0 0 David Eekhoff Director 1.00 X 0 0 0 Roger Fedders Director 1.00 X 0 0 0 Randy Feenstra Director 1.00 X 0 0 0 Dan Hibma Director 1.00 X 0 0 0 Kyle Hiemstra Director 1.00 X 0 0 0 Curt Hohman Director 1.00 X 0 0 0 Jennifer Jansen Director 1.00 X 0 0 0 Lauren Kaemingk Director 1.00 X 0 0 0 John Koerselman Director 1.00 X 0 0 0 Ardith Lein Director 1.00 X 0 0 0 Scott Peterson Director 1.00 X 0 0 0 Rich Rikkers Director 1.00 X 0 0 0 Norman Snieder Director 1.00 X 0 0 0 Stan Speer Director 1.00 X 0 0 0 Sherri Ten Napel Director 1.00 X 0 0 0 Janene Van Gorp Director 1.00 X 0 0 0 Doug Van Meeteren Director 1.00 X 0 0 0 Con Van Roekel Director 1.00 X 0 0 0 Neil Van Schouwen Director 1.00 X 0 0 0 Dale Vander Berg Director 1.00 X 0 0 0 Betty Vermeer Director 1.00 X 0 0 0 Lyle Vermeer Director 1.00 X 0 0 0 Virginia Vermeer Director 1.00 X 0 0 0 Dennis Wright Director 1.00 X 0 0 0 Verdean Wynja Director 1.00 X 0 0 0 Gretchen Zomermaand Director 1.00 X 0 0 0 John A Franken Director (deceased May 2015) 1.00 X 0 0 0 Eric Rankin Director (until Jan 2015) 1.00 X 0 0 0 Ardene Ver Hoef Director (until Jan 2015) 1.00 X 0 0 0 Kayleen Lee CEO 40.00 0.50 X 212785 0 24814 Jackson Schuiteman CFO 40.00 X 91390 0 17610 Dr Julie A McKay MD Diagnostic radiology 24.00 X 302708 0 44113 Dr Jamie J Vitamvas Family Medicine/OB 40.00 X 247331 0 31590 Dr Scott A Rens MD Family Medicine/OB 40.00 X 344861 0 44208 Dr LoriAnne S Andersen MD Family Medicine/OB 40.00 X 243896 0 38149 Dr Jason R Koelewyn MD Family Medicine/OB 40.00 X 227541 0 19721 1670512 0 220205 10 0 1 0 Avera McKennan 1325 S Cliff Avenue Sioux Falls SD 571175045 Management fees & other services 1546214 Jon Clegg 1226 Turnberry Avenue Le Mars IA 51031 Anesthesia 356180 Imaging Solutions Inc 3223 32nd Ave S Ste 201 Fargo ND 58103 MRI Readings 244608 Northwest Iowa Diagnostics 714 Lincoln St Ne Le Mars IA 51031 Ultrasound Readings 142060 Aventure Staffing 509 Douglas St Sioux City IA 51102 Nursing Services 117123 5 62077 62077 Patient service revenue 622110 31671313 31671313 Assisted and Independent Living 623990 1779970 1779970 Daycare revenue 624410 974887 974887 Avera Health Fdtn interest 900099 666004 666004 Investment in affiliates 900099 52676 44636 8040 815915 815915 35960765 73791 73791 127086 0 127086 127086 127086 93864 1745458 -1651594 -1651594 -1651594 38747 15186 23561 23561 34595686 35952725 8040 -1427156 2425 2425 340077 340077 146269 146269 14522148 13381384 1104945 35819 595265 551706 43095 464 1680541 1560932 115391 4218 1028821 926003 100520 2298 1331625 1331625 157636 157636 3371251 3208201 163050 176778 1076 170806 4896 1208413 837663 346298 24452 724179 711265 12914 66467 63071 3396 149527 114921 33191 1415 1414692 1414692 4189584 4189584 497696 87329 410367 Medical Supplies 3259676 3259676 Bad Debt 698987 698987 Food 626709 607609 18525 575 Taxes 113913 113913 105213 48380 56833 36407892 31925086 4408669 74137 10993938 9901274 3659433 2482747 3403820 5417115 165838 332959 366969 369610 420344 72859201 15394338 61081779 57464863 3434789 3528372 2364891 2377942 85641219 82125464 4704094 3157227 205127 132527 39535508 39628597 98115 99140 134722 26635 1657320 1587211 46334886 44631337 X 38715099 36581684 470921 703803 120313 208640 39306333 37494127 85641219 82125464 -1812206 0 X 0 1 X 1 1 1 X 0 0 210511 118265 328776 187178 23333 210511 174398 12780 187178 159714 14684 174398 0.63460 0.36540 1 0 630000 2219111 2849111 55580150 8847497 46732653 13643990 6427454 7216536 785950 119387 666563 57464863 Deferred Compensation 1337211 Estimated third-party payor settlements 250000 1587211 X 33575490 -698987 -698987 34274477 321209 321209 34595686 35708905 0 35708905 698987 698987 36407892 Part V, Line 4: The Health Center's endowment consists of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The Center does not have a formal policy or agreement with the Foundation covering the distribution of endowment fund earnings. The Center expects the Foundation to allow its endowment to grow consistent with the Center's objective to maintain the purchasing power of the endowment assets in order to provide additional real growth through new gifts and investment return. However, there is no current intention of using the permanently endowed funds. Part X, Line 2: The Health Center is an Iowa 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 Health Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Health Center is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Health Center files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Health Center 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 Health Center 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. The Health Center's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2012. Part XI, Line 2d - Other Adjustments: Bad Debt Expense -698,987. Part XI, Line 4b - Other Adjustments: Temp change in net assets 321,209. Part XII, Line 4b - Other Adjustments: Bad Debt Expense 698,987. 1 1 X 1 X 1 X 1 1 0 1 1 120 211000 211000 0.00590 3471608 2726496 745112 0.02090 120 3682608 2726496 956112 0.02680 2035 23463 565 22898 0.00060 17724 7299858 6056087 1243771 0.03480 24399 24399 0.00070 19759 7347720 6056652 1291068 0.03610 19879 11030328 8783148 2247180 0.06290 1 1368 1368 0.00000 999396 974887 24509 0.00070 1 1000764 974887 25877 0.00070 0 698987 179919 7650529 7787889 -137360 X 1 1 1 1 Sioux Center Health 1101 9th St SE Sioux Center IA 51250 www.schospital.org 840080H X X X X 1 provider based clinic - Sioux Ctr Medical Clinic Sioux Center Health 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X www.siouxcenterhealth.org/patient-rights/ X www.avera.org X 1 12 1 www.siouxcenterhealth.org/patient-rights/ 0 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X 1 X http://siouxcenterhealth.org/wp-content/uploads/2014/09/Avera-Financial-Ass X X X 1 X 0 X X X X 1 X 0 0 Sioux Center Health Part V, Section B, Line 5: Sioux Center Health held three focus groups and made surveys available to the general public in order to solicit feedback and identify healthcare disparities. Among the focus groups were healthcare professionals from Sioux Center Health & Health Center Avera, Mothers of Preschool Children (MOPS group), and women from the Latina Health Coalition. Additionally, a meeting was conducted with public health experts from Sioux County Community Health Partners and neighboring hospitals in Sioux County. Sioux Center Health Part V, Section B, Line 11: The health needs identifited in the CHNA are important for overall community health. However, due to limited human and financial resources, the organization will not be able to address the following needs as part of its implementation plan: public and recreational services that address recreational affordability, transportation, housing and environmental waste from farmland chemicals. Expanding services to include dermatology will not be addressed at this time due to limited resources. Programs that have been implementation and now are in the process of improvements include:-Identify Ways to Better Care for the Medically Underserved-Promote Active Living and Healthy Eating-Action: Improve Clinical and Community Preventive Screenings-Action: Continue Partnerships with Sioux County Sheriff and Iowa State PatrolSioux Center Health built a new state-of-the-art facility which opened May 2014. It is expected the new facility will play a significant role in physician recruitment. Sioux Center Health Part V, Section B, Line 13b: Sioux Center Health provides free care based on meeting presumptive eligibility requirements listed in the policy. Sioux Center Health Part V, Section B, Line 16i: Self pay patients are given a self-pay packet that explains financial assistance. A statement is sent out to all patients indicating financial assistance is available upon request. The charity care and other financial assistance options are discussed with inpatients before discharge. The charity care and other financial assistance options are discussed with OB patients during their "mommy and me" visit. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Sioux Center Health Part V, Section B, line 16b website: http://siouxcenterhealth.org/wp-content/uploads/2014/09/Avera-Financial-Ass 6 Hull Medical Clinic 807 Main Hull IA 51239 Physician clinic Chears Home Health & Hospice 1400 7th Ave SE Sioux Center IA 51250 Home health and hospice Royal Meadows 1400 7th Ave SE Sioux Center IA 51250 Nursing facility Franken Manor 527 S Main Ave Sioux Center IA 51250 Assisted living Crown Pointe 1400 7th Ave SE Sioux Center IA 51250 Independent assisted living SCH Occupational Health Center 38 19th St SW Sioux Center IA 51250 Occupational health Part I, Line 3c: Sioux Center Health (SCH) provides free care based on meeting presumptive eligibility requirements listed in the policy. Federal Poverty Guidelines and financial asset-liabilities are used to determine eligibility for discounted care.Additional factors used to determine financial assistance eligibility can be found at Schedule H, Part V, Line 13. Part I, Line 6a: The community benefit report is maintained at Sioux Center Health, but submitted to Avera and is included in their annual community benefit report. Part I, Line 7: Charity care expense on line 7a and Medicaid on line 7b were converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Lines 7e and 7i: Costs are reported based on data from the general ledger accounting system. The general ledger accounting system addresses all patient segments (inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, and self-pay). The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $698,987. Part II, Community Building Activities: The Hospital provides benefits to the community through the Hospital's membership in the local Chamber of Commerce and the recruitment of qualified professional staff. Part III, Line 2: All discounts and payments including contractual allowances, uninsured discounts, and charity care adjustments are applied to a patient's account before the account is written off to bad debt. Bad debt recoveries are applied to bad debt expense in the current year.Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 3: The estimated amount of bad debt expense attributable to patients that could have been eligible for charity care is based on estimated calculations from our collection agency. The agency estimated 25.74% of the total amount in collections could be charity care. Part III, Line 4: The footnote that describes bad debt expense is on pages 8 and 9 of the attached audited financial statements. Part III, Line 8: The current year shortfall was due to an increase in sequestration. A 2% reduction began 4/10/13. The decrease in reimbursement contributed to the shortfall. Sioux Center Health will continue to provide services to Medicare patients as access to healthcare and individual's health is important to the Organization. Therefore, the Medicare shortfall is considered a community benefit.Total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicaid and Medicare Services. Part III, Line 9b: Sioux Center Health provides free care based on meeting presumptive eligibility requirements listed in the financial assistance policy. The Hospital does not pursue collection efforts to patients in the process of applying for assistance or persons meeting the presumptive eligibility requirements. Any personal portion due follows normal collection procedures. Sioux Center Health 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: Sioux Center Health has a broad based Board of Directors providing community feedback on a quarterly basis. An open public meeting is conducted annually to listen to issues of the community and share information regarding services and programs. The Hospital analyzes statistical data through IHA and Iowa Public Health to determine disease related needs, services and market share. The Hospital works closely with Community Health Partners to identify and address community health related needs. Additionally, the Hospital conducted a community health needs assessment during the year ended 6/30/13 in compliance with 501(r). Part VI, Line 3: Patients are made aware of financial assistance programs in a variety of ways:1.Self pay patients are given a self-pay packet that explains financial assistance, payment plans, and the Hospital's 10% lump sum payment options. The self-pay packet includes a Medicaid application. 2.A statement is sent out to all patients indicating financial assistance is available upon request.3.The charity care and other financial assistance options are discussed with inpatients before discharge.4.The charity care and other financial assistance options are discussed with OB patients during their "mommy and me" visit.5. The financial assistance application is available on the Hospital website.Additionally, the financial assistance policy is available upon request and on the Sioux Center Health website. Part VI, Line 4: Sioux Center Health serves the local Sioux Center community and the surrounding area of Sioux County, IA. Sioux County is primarily rural located in northwest Iowa. As of 2010, the county's population was just over 33,700. The county is also home to three other critical access hospitals. Over 80% of the inpatient discharges come from a 15 mile radius. This 15 mile radius includes 8 communities in addition to Sioux Center. According to 2010 census data, Sioux Center had a population of just over 7,000 with median family income of $55,885. 7.3% of the families in Sioux Center were below the poverty level. The 2010 census shows a Hispanic population record of 13.1% in Sioux Center, and this number does not take into account undocumented aliens. Part VI, Line 5: Sioux Center Health has a strong community focused perspective. The governing board is comprised of 42 volunteer members that reside in the community and primary service area. The Hospital is focused on its mission and serving people regardless of their ability to pay. The Hospital participates in mission projects throughout the year yielding support for various causes from cancer research via Relay for Life activities, to local missions that provide after school activities, counseling, or domestic abuse services. This support comes in the form of paid staff volunteering their time, Hospital sponsored fundraisers, and direct financial support from the Hospital and its employees. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are used to make improvements in patient care, medical education, and research. Part VI, Line 6: The Hospital 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, the Hospital is able to participate in Avera eCARE services. These services include Avera eICU, eEmergency, ePharmacy and eConsult. 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.The Hospital 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 the Hospital at a cost below that which the Hospital could otherwise achieve. In turn, local caregivers are able to devote more resources to patient and resident care. Avera Health and the Hospital 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 0 0 0 0 0 0 0 0 0 Kayleen Lee CEO 209685 0 0 0 3100 0 4338 0 21236 0 238359 0 0 0 Dr Julie A McKay MD Diagnostic radiology 193732 0 108161 0 815 0 27572 0 17019 0 347299 0 0 0 Dr Jamie J Vitamvas Family Medicine/OB 178559 0 10657 0 58115 0 14455 0 17613 0 279399 0 0 0 Dr Scott A Rens MD Family Medicine/OB 333468 0 10858 0 535 0 26553 0 18133 0 389547 0 0 0 Dr LoriAnne S Andersen MD Family Medicine/OB 167388 0 57858 0 18650 0 19055 0 19572 0 282523 0 0 0 Dr Jason R Koelewyn MD Family Medicine/OB 182040 0 29223 0 16278 0 2800 0 17399 0 247740 0 0 0 Form 990, Part VII, Section A, Line 5 & Form 990, Schedule J, Part II: Kayleen Lee, CEO, is compensated by Avera McKennan, 800 E 21st Street, Sioux Falls, SD 57105. A City of Sioux Center 426005218 2005-04-11 4000000 Acquisition, renovation, construction, equipping, & furnishing nursing home 0 0 0 B City of Hull 426004780 444784AR3 2012-10-18 10000000 Hospital Replacement 0 0 0 C City of Sioux Center 426005218 2012-10-18 5500000 Hospital Replacement 0 0 0 A 2350000 4000000 4000000 2005 0 0 1 1 B 285000 10000000 689062 623609 200000 8487329 2013 0 0 1 1 C 1000000 3669606 3669606 1830394 2013 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 A 0 0 0 1 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 Schedule K Part II Columns B and C The 2005 revenue note matures in 2026. The amount on line 1 represents the amount of principal reduction of the underlying note payable to the financial institutions rather than actual retirement of bonds in the issue. Schedule K Part II Line 11 Column A The amount on line 11 represents the amount of bond proceeds spent to refund prior issues. Schedule K Part II, Line 3, Column C The bond was issued as an interim loan to cover costs incurred on a capital project while waiting for donation pledges to be redeemed. The total proceeds of the issue were less than the issue price because enough donations were on hand to complete the project without using the entire amount of the issue price. Dr Jamie Vitamvas Physician - key employee Recruitment Loan X 250000 165838 0 1 1 165838 Irene Schuiteman Family member of Jackson Schuiteman, CFO 44367 Compensation as an employee 0 Jerry Zomermaand Family member of Gretchen Zomermaand, Director 101902 Compensation as an employee 0 Form 990, Part III, line 2 During fiscal year ended June 30, 2015, wound care services and pain clinics were added to services offered. Form 990, Part VI, Section A, line 1 The Executive Committee is composed of four officers: President, Vice President, Secretary, Treasurer, and six board members. The Executive Committee shall have power to transact all regular business of the facility during the interim between the meetings of the Board of Directors, provided any action taken shall not conflict with the policies and expressed wishes of the Board of Directors and that it shall refer all matters of major importance to the Board of Directors. Form 990, Part VI, Section A, line 2 Betty Vermeer, Director, and Eric Rankin, Director, have a family relationship. Form 990, Part VI, Section A, line 4 Significant changes to the organizational documents for FY2015 include term limits once a director reaches age 65 and frequency of meetings. Form 990, Part VI, Section B, line 11 The CFO reviews the 990 in detail. After his review and prior to filing the return with the IRS, the 990 is emailed to board members of the organization. Form 990, Part VI, Section B, line 12c Officers, Directors and Trustees are required to complete conflict of interest questionnaires which are monitored and tracked. The questionnaires are reviewed by the Board for any possible conflicts with any noted conflicts being brought to management's attention. Conflicts are also reviewed at the Board level. After a conflict is deemed to exist, the individual(s) involved must abstain from the discussion and vote related to the issue. Form 990, Part VI, Section B, line 15a The CEO is employed through a management agreement with Avera McKennan but is considered a common law employee of Sioux Center Health. Avera McKennan annually reviews the compensation of the CEO, using comparability data and a performance rating system and meets with the Board of Directors of Sioux Center Health. Avera McKennan recommends a salary adjustment for the CEO. The Board of Directors is responsible for approval of the salary adjustment. The deliberation and decision is documented at Avera McKennan and in the board minutes. Compensation for the CFO is reviewed and approved annually by the CEO and Human Resources. Market data is used to determine an appropriate salary range. The review process and salary adjustment is documented in the personnel file. Form 990, Part VI, Section C, line 19 The documents are made available upon request. Northwest Iowa Diagnostics 714 Lincoln St NE Le Mars IA 51031 820559254 Diagnostic radiology IA Sioux Center Community Hospital & Health Related 14400 48426 0 1 0.36990 Avera Home Medical Equipment of Sioux Center LLC 38 19th Street SW Sioux Center IA 51250 753203100 Home medical supplies SD N/A Related 32383 153039 0 8040 0 0.50000 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0