2016-01-15T10:10:36-06:00 2015-05-31 460434947 ELO PROF LLC PO BOX 249 MITCHELL SD 57301 990 2014-06-01 460400557 DOUGLAS COUNTY MEMORIAL HOSPITAL DOUG 6057242159 708 8TH STREET ARMOUR SD 573132102 HEATH BROUWER ADMINISTRATOR 6057242159 2016-01-14 true MATTHEW S BUENZOW CPA P00721447 6059967717 2016-01-14 2014 2016-04-25 22:37:26Z HEATH BROUWER 708 8TH ST ARMOUR SD 57313 10422533 false X WWW.DCMHSD.ORG X PROMOTION OF GENERAL HEALTH CARE AND REHABILITATION SERVICES 6 6 118 0 41071 36376 8521144 9206178 3989 267857 186974 157224 8753178 9667635 0 0 4463120 4809120 0 0 4119084 4286131 8582204 9095251 170974 572384 11145535 10972151 4774385 4028617 6371150 6943534 PROMOTION OF GENERAL HEALTH CARE AND REHABILITATION SERVICES false false 8094890 DOUGLAS COUNTY MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO PERSONS IN THE ARMOUR, CORSICA, STICKNEY, AND WAGNER COMMUNITIES. DURING THE FISCAL YEAR ENDED MAY 31, 2015, 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. 8094890 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 21 0 true 118 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 118245 0 16598 JOSHUA CHRISTENSEN CHIEF FINANC 40.00 X 68888 0 9815 MORGAN MERRILL PHYSICIAN 40.00 X 231035 0 31596 MARLYS LUEBKE PHYSICIAN 40.00 X 134727 0 26354 VANESSA MIILLER PHYSICIAN AS 40.00 X 132166 0 18603 JENNIFER BIETZ PHYSICIAN AS 40.00 X 118790 0 25967 KRISTIN BITTNER PHARMACIST 40.00 X 107044 0 11672 910895 140605 7 false true false SANFORD HEALTH PO BOX 5039 SIOUX FALLS SD 57117 MEDICAL SERVICE 392304 BROWN'S MEDICAL IMAGING 14315 C CIRCLE OMAHA NE 68144 MEDICAL SERVICE 269482 ZOSS ANESTHESIA PC 42668 263RD ST EMERY SD 57332 MEDICAL SERVICE 230260 SCOTT DOOM CONTRACTING INC 39370 MOON MEADO DRIVE WAGNER SD 57380 CONSTRUCTION 203935 SANFORD LABORATORIES PO BOX 5056 SIOUX FALLS SD 57117 MEDICAL SERVICE 136020 5 32369 4007 36376 PROGRAM SERVICE REVENUE 9206178 9206178 9206178 3755 3755 1019000 754898 264102 264102 264102 157224 157224 157224 9667635 9631259 214231 214231 3739036 3456839 282197 163868 143523 20345 432027 389371 42656 259958 226464 33494 1853 1853 27200 27200 896445 763372 133073 21290 9369 11921 156727 136178 20549 19771 18430 1341 119351 119351 386632 386632 114704 114704 SUPPLIES 2404375 2345902 58473 OTHER TAXES 65421 36000 29421 REPAIRS AND MAINTENANCE 56254 56254 CONTINUING EDUCATION 40628 31725 8903 -24520 -24520 9095251 8094890 1000361 0 500 500 1832530 2444916 1324173 1432053 2640 9926 15954 430942 449705 37835 29800 8720413 2209055 7506989 6511358 87865 11145535 10972151 1047446 564639 3703036 3460353 23903 3625 4774385 4028617 X 6371150 6943534 6371150 6943534 11145535 10972151 572384 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 71625 71625 6950001 1008358 5941643 1698787 1200697 498090 6511358 DEPOSITS - PRAIRIE VILLA 3625 DUE TO THIRD PARTIES 3625 9316316 9316316 351319 351319 9667635 8743932 8743932 351319 351319 9095251 SCHEDULE D, PAGE 4, PART XI, LINE 4B ASSISTED LIVING REVENUES - NETTED ON FINANCIAL STATEMENTS 351,319 SCHEDULE D, PAGE 4, PART XII, LINE 4B ASSISTED LIVING EXPENSES - NETTED ON FINANCIAL STATEMENTS 351,319 true true true X 1.250000000000 true X true true false false 32577 32577 0.00360 32577 32577 0.00360 200064 88946 111118 0.01220 200064 88946 111118 0.01220 232641 88946 143695 0.01580 true 224958 60739 5188832 6330832 -1142000 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 12 true false false true X WWW.DCMHSD.ORG X false 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 LOAL HOME HEALTH PROVIDERS, DOUGLAS COUNTY COMMUNITY HEALTH NURSE, REGIONAL MANAGER OF THE COMMUNITY HEALTH PROGRAMS SERVING BOTH DOUGLAS AND CHARLES MIX COUNTIES, AND THE HOSPITAL'S DIRECTOR OF NURSING. 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 TWO COUNTIES. 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. 7 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-WAGNER 310 W SD HWY 46 WAGNER SD 57380 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 70% OF HOSPITAL'S AUDITED FINANCIAL STATEMENTS FIGURE. THE 70% 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 FY15. 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, STICKNEY, AND WAGNER COMMUNITIES. DURING THE FISCAL YEAR ENDED MAY 31, 2015, THE HOSPITAL PROVIDED 618 INPATIENT DAYS, 566 EMERGENCY ROOM VISITS, 9,548 OUTPATIENT VISITS AND 5,748 ASSISTED LIVING 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. 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 MORGAN MERRILL PHYSICIAN 231035 31596 262631 MARLYS LUEBKE PHYSICIAN 128060 6667 26354 161081 VANESSA MIILLER PHYSICIAN ASSISTANT 132166 18603 150769 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 XI, LINE 9 ASSISTED LIVING REVENUES - NETTED ON FINANCIAL STATEMENTS -351,319 ASSISTED LIVING EXPENSES - NETTED ON FINANCIAL STATEMENTS 351,319