2016-05-16T06:56:49-05:00 2015-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2014-07-01 460319070 Rapid City Regional Hospital Inc RAPI 6057559130 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 Mark Thompson CFO 6057559130 2016-05-06 1 Kim Hunwardsen CPA P00484560 6122536500 2016-05-05 2014 2016-08-17 19:52:53Z Brent Phillips 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 545039812 0 X www.regionalhealth.com X 1973 SD Helping Patients and Communities Live Well 14 9 4033 445 6790252 1328610 1945519 1824646 489517790 524969244 24825565 14259712 1612418 2304855 517901292 543358457 0 0 0 0 217727721 222995701 0 0 348474 243494891 270618343 461222612 493614044 56678680 49744413 1021106059 918466588 246728354 294609276 774377705 623857312 X PURPOSE: Helping Patients and Communities Live WellVISION: We aspire to be the best healthcare system in AmericaVALUES: Courage, Integrity, Compassion, Innovation, and Mutual RespectGOALS: Patient & Family EXPERIENCE; Culture of Safety & Quality CARE; Physician & Caregiver ENGAGEMENT; Community & Financial STEWARDSHIP 0 0 280350954 297355399 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. 25468846 124631773 Pharmacy - provide pharmaceuticals in support of acute care hospital patients. 19979277 7813197 Hospitalists - provides care for hospitalized patients who may or may not have a primary care physician. 18681039 95260270 Surgical services - provide in and out patient surgical services to acute care patients. 18681039 95260270 344480116 1 1 0 1 0 0 0 0 0 1 1 0 0 1 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 1 1 0 0 1 479 0 1 4033 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 NC CA X Mark Thompson 6057559127 PO Box 6000 Rapid City SD 57701 Dennis Popp Chairman 2.40 0.00 X X 0 0 0 Kyle D White Vice Chairman 1.00 0.00 X X 0 0 0 Stephen Kovarik MD Secretary 1.40 0.00 X X 0 0 0 Roy Dishman Treasurer 3.10 0.60 X X 0 0 0 Sandra Burns Directors 1.50 0.00 X 0 0 0 Gene Farrens Directors 1.00 0.00 X 0 0 0 Timothy Frost MD Directors 0.90 0.00 X 2040 0 0 Michael Gibbs Directors 55.00 0.00 X 342721 0 53147 Jack Lynass Directors 1.40 0.00 X 639 0 0 Robert Mudge Directors 1.30 0.00 X 0 0 0 Tamara Riddle-Schumacher Directors 1.30 0.00 X 0 0 0 Lisa Seaman Directors 2.40 0.40 X 0 0 0 Joseph Tuma MD Directors 40.60 0.00 X 940476 0 80655 Charles E Hart MD President & CEO (July-February) 44.30 15.70 X X 0 979329 39070 Brent Phillips Independent Contractor (December) 6.60 2.40 X X 14687 0 0 Brent Phillips President & CEO (January-June) 44.30 15.70 X X 0 0 0 Timothy H Sughrue - CEO RCRH & RHN/COO RHI (July-March) 45.80 9.20 X X 674948 0 47450 Mark A Thompson VP CFO 40.60 14.40 X 425445 0 73711 Joseph C Sluka Jr Executive VP/CAO 40.60 14.40 X 501367 0 34812 Allan Berreth VP Ancillary Serv. 55.00 0.00 X 239623 0 19133 Mark F Brodin VP Decision Support 40.60 14.40 X 201410 0 37229 Sharmila M Chandran VP Corp Responsibility 40.60 14.40 X 204821 0 19062 Paul W Clemments VP Professional Services 55.00 0.00 X 183383 0 41191 Jeanne A Galbraith VP Qual Safety Risk Mgmt 55.00 0.00 X 182315 0 28652 Rita K Haxton VP Patient Care (July-February) 55.00 0.00 X 279153 0 32263 Maureen G Henson VP Human Resources 40.60 14.40 X 171543 0 16891 Jennifer D Horton VP PR Marketing (July-April) 40.60 14.40 X 191144 0 46522 Robert L Houser MD VP Medical Affairs 55.00 0.00 X 328066 0 42910 David L Klocke MD Chief Medical Officer 40.60 14.40 X 424400 0 50564 Suzanne P Koehler VP Operations (July-December) 55.00 0.00 X 201374 0 30204 Richard S Latuchie VP Info Technology CIO 40.60 14.40 X 311312 0 32002 Mary E Masten General Counsel 40.60 14.40 X 343091 0 43130 Michael P D'urso MD Cardiology 40.00 0.00 X 699291 0 77463 Norman Lewis Ferrier MD Cardiology 40.00 0.00 X 857408 0 35677 John K Heilman III MD Cardiac Device Implantation, Cardiology 40.00 0.00 X 1106971 0 26876 Jose M Teixeira MD Cardiology, Electrophysiology 40.00 0.00 X 715851 0 26126 Amad Zineldine MD Cardiology 40.00 0.00 X 824441 0 81532 10367920 979329 1016272 225 0 1 0 Emergency Services PA 353 Fairmont Blvd Rapid City SD 57701 ER Physician Coverage 9976864 Comphealth Medical Staffing PO Box 972651 Dallas TX 753972651 Temporary Medical Staff Coverage 2703769 Simpler North America LP PO Box 643979 Pittsburgh PA 152643979 Management Consulting and Travel 1666534 Athena Health Inc 311 Arsenal St Watertown MA 02472 Computer Software-Pract. Mgmt 1608827 Microsoft One Microsoft Way Redmond WA 98052 Software Maintenance 1597491 89 5000 325029 1494617 1824646 In Patient Pharmacy 446110 120805130 120805130 Laboratory 621500 98920948 94034733 4886215 Surgical Services 622110 95260270 95260270 MIS CT Scan 621500 51431209 51431209 Cardiac Services 622110 44018561 44018561 114533126 114533126 524969244 12823218 22990 12800228 3570 3570 653058 507074 145984 145984 145984 1611223 616863 222271 572891 1388952 43972 1432924 1432924 385290 198861 186429 186429 271653 180258 91395 91395 Other UBI 900099 1881047 1881047 1881047 543358457 520174424 6790252 14569135 10082871 4830320 5252551 756304 756304 183357178 142327273 40822526 207379 4240470 3229847 1006095 4528 12028665 9161896 2853924 12845 12530213 9437137 3078552 14524 801804 801804 252575 252575 37716 37716 41930048 24298316 17628507 3225 375114 11195 318059 45860 1285001 705106 574659 5236 10894684 2146802 8747882 5982520 503956 5478564 413988 264975 147923 1090 927708 559386 366415 1907 4708253 84216 4624037 23118897 9990609 13125617 2671 2105691 500866 1604825 Medical Supplies 86212762 86212762 Interco. Serv. & Suppl. 38135922 5353230 32782692 Bad Debt Expense 35731006 35731006 UBI Tax 332185 332185 17372469 8374914 8948346 49209 493614044 344480116 148785454 348474 17031842 17770867 70780736 69063000 11590971 11838900 7716621 8287028 530418196 339780580 191708455 190637616 512981171 538098563 15622639 16629755 2126511 3580906 191547113 62559953 1021106059 918466588 45708857 46303449 158935392 149788896 42084105 98516931 246728354 294609276 X 758912073 607693923 13802703 14500460 1662929 1662929 774377705 623857312 1021106059 918466588 X 49744413 -4233153 -196031653 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 37716 37716 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 2015 dues, which were paid in fiscal year 2015, in the amount of $288,702, 7.00% 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 2015 dues, which were paid in fiscal year 2015, in the amount of $59,687, 22.80% 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 2015 dues, which were paid in fiscal year 2015, in the amount of $9,996, 39.00% was used for lobbying purposes. 1662929 1662929 1662929 1662929 1747979 10000 95050 1662929 1747979 1747979 1747979 1747979 0.00000 1.00000 0.00000 0 0 4054096 4054096 262327152 137774896 124552256 245259923 194539188 50720735 18777025 7466496 11310529 190637616 Other Receivables 2184353 Other Long Term Assets 60375600 62559953 Payable Under Interest Rate Swap 9775307 Other Long Term Liabilities 27408451 Accrued Pension Liability 12007416 Intercompany Payable 49325757 98516931 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 temporarily 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. 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 2011. Duck Race 99207 99207 49871 Tough Enough to Wear Pink 151758 151758 99855 8 134325 134325 49135 385290 385290 198861 198861 186429 1 1 X 1 X 1 X 1 1 1 0 0 11800970 11800970 0.02580 53286320 43658841 9627479 0.02100 65087290 43658841 21428449 0.04680 6 4048 47106 47106 0.00010 3 668 5627329 3935790 1691539 0.00370 8637677 8125426 512251 0.00110 1858069 1255868 602201 0.00130 4 344 357410 357410 0.00080 13 5060 16527591 13317084 3210507 0.00700 13 5060 81614881 56975925 24638956 0.05380 1 1599 1599 0.00000 2 280 10122 10122 0.00000 2 60 12832 12832 0.00000 1 70 70 0.00000 6 340 24623 24623 1 35731006 908144 137405630 132344336 5061294 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.regionalhealth.com 10581 X Rapid City Regional Hospital Inc 1 0 0 1 X X X X X X X X X 12 1 1 0 1 X www.regionalhealth.com/chna X 1 12 1 www.regionalhealth.com/chna 0 0 1 X 200.000000000000 250.000000000000 X X 1 1 X X X X 1 X See 16i description X See 16i description X See 16i description 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 12 1 1 0 1 X See URL in 7d description X www.regionalhealth.com/chna X X 1 12 1 www.regionalhealth.com/chna 0 0 1 X 200.000000000000 250.000000000000 X X 1 1 X X X X 1 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, one focus group was held on September 24, 2012. The focus group participants were comprised of 13 key informants, including representatives from public health, Indian Health Services, other health professionals, social service providers, and 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. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. Same Day Surgery Center Part V, Section B, Line 5: As part of the community health needs assessment, one focus group was held on September 24, 2012. The focus group participants were comprised of 13 key informants, including representatives from public health, Indian Health Services, other health professionals, social service providers, and 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. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. 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, Spearfish Regional Surgery Center, 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, Spearfish Regional Surgery Center, 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 7d: The CHNA is on the hospital website at: http://www.samedaysurgerycenter.org/community-health-needs-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: Rapid City Regional Hospital partners with All Women Count program promoting early detection for women who might have financial barriers to breast cancer screening. Awareness activities through the American Cancer Society currently exist in the community and surrounding area. 2) Conditions of Aging: In the area of Alzheimer's deaths, there are local licensed skilled nursing facilities providing services to the elderly of the community, including those with Alzheimer's Disease. Other organizations provide in-home services and case management to elders in the community with conditions of aging, such as difficulty seeing and hearing, assisting in obtaining adaptive equipment and transportation. 3) Maternal, Infant, Child Health: As a provider of maternal, infant and child hospital care in the community, Rapid City Regional Hospital believes it fulfills its role in this area. It was therefore given a lower priority that excluded this as an area chosen for action. Rapid City Regional Hospital supports programs that address these issues, such as the Cribs for Kids program through the South Dakota Department of Health.4) Oral Health: Rapid City Regional Hospital has limited 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 expertise excluded this as an area chosen for action.5) Respiratory Diseases: Rapid City Regional Hospital believes this priority area falls within the purview of other available community resources, including outpatient clinical settings. 6) Substance Abuse: Rapid City Regional Hospital believes efforts outlined in its plan for mental health and mental health resources will also have a positive impact on substance abuse. A separate set of specific initiatives in this area is not justified at this time.7) Tobacco Use: Rapid City Regional Hospital is a tobacco-free facility. The facility provides smoking cessation screening to our patients and refers patients and employees to the South Dakota Quit Line for ongoing support. Lower priority excluded this as an area chosen for action.Rapid City Regional Hospital continued to execute the implementation strategy during fiscal year 2015 to address the needs of the community that the Hospital has determined it will address. The needs that are being addressed are as follows: 1) access to health services; 2) diabetes; 3) injury and violence prevention; 4) mental health and mental disorders; and 5) nutrition, physical activity and weight status. 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) Access to Health Services: Same Day Surgery Center felt that more pressing health needs existed. Lower priority excluded this as an area chosen for action.2) Conditions of Aging: Limited resources and population served excluded this as an area chosen for action.3) Maternal, Infant, Child Health: Same Day Surgery Center does not have an obstetrics program. Limited resources and lower priority excluded this as an area chosen for action.4) Mental Health & Mental Disorders: The community currently has several programs and services in place to assist in addressing mental health issues. Mental health issues are best addressed as a community as a whole and deemed out of the scope for a surgical hospital.5) Nutrition, Physical Activity & Weight Status: Same Day Surgery Center contracts dietary and physical therapy services through Rapid City Regional Hospital. Limited resources excluded this as an area chosen for action.6) Oral Health: Same Day Surgery Center provides general anesthesia dental service, however limited resources and lower priority excluded this as an area chosen for action.7) Respiratory Diseases: Same Day Surgery Center contracts respiratory therapy services through Rapid City Regional Hospital. Limited resources and lower priority excluded this as an area chosen for action.8) Substance Abuse: Same Day Surgery Center believes this priority area falls more within the purview of the county health department and other community organizations. Limited resources and lower priority excluded this as an area chosen for action.9) Tobacco Use: Same Day Surgery Center is a tobacco-free facility. The facility provides smoking cessation screening to our 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.Same Day Surgery Center continued to execute the implementation strategy during fiscal year 2015 to address the needs of the community that the Same Day Surgery Center has determined it will address. The needs that are being addressed are as follows: 1) cancer; and 2) injury and violence prevention. 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 revising the FAP and once complete the revised full policy will be available on the hospital's website.The complete URL for the FAP application and plain language summary is:http://www.regionalhealth.com/Patients-Visitors/Financial-Assistance/Financial-Assistance-Program.aspx 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 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. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Rapid City Regional Hospital, Inc. Part V, Section B, line 16a website: See 16i description Rapid City Regional Hospital, Inc. Part V, Section B, line 16b website: See 16i description Rapid City Regional Hospital, Inc. Part V, Section B, line 16c website: See 16i description 4 Rapid City Regional Hospice House 224 Elk St Rapid Ctiy SD 57701 End of Life Care Regional Dialysis Center - Spearfish 132 Yanke St Spearfish SD 57783 Dialysis Center Wall Regional Medical Clinic 112 7th Ave Wall SD 57790 Clinic 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. 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 $35,731,006. 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 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) Proposed Regulations timelines for notifications and collections. Part VI, Line 2: The Community Health Needs Assessment was conducted in FY2013 by Regional Health, including: Rapid City Regional Hospital, Same Day Surgery Center, Spearfish Regional Hospital, Spearfish Regional Surgery Center, Sturgis Regional Hospital, Lead-Deadwood Regional Hospital, Custer Regional Hospital, and Hans P. Peterson Memorial Hospital. In July 2012, we 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. The assessment incorporated data from both quantitative and qualitative sources. Quantitative data input included primary research (the PRC Community Health Survey, November 2012) and secondary research (vital statistics and other existing health-related data); these quantitative components allowed for trending and comparison to benchmark data at the state and national levels. Qualitative data input included primary research gathered through a Key Informant Focus Group.A variety of existing (secondary) data sources was consulted to complement the research quality of the Community Health Needs Assessment. Data for the service area were obtained from the following sources: * Centers for Disease Control & Prevention* GeoLytics Demographic Estimates & Projections* National Center for Health Statistics* South Dakota Department of Public Health* US Census Bureau* US Department of Health and Human Services* US Department of Justice, Federal Bureau of InvestigationAs part of the needs assessment, one focus group was held on September 24, 2012. The focus group participants were comprised of 13 key informants, including representatives from public health, Indian Health Services, other health professionals, social service providers, and other community leaders. 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. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. The needs assessment report was completed in February 2013. After reviewing the findings, the Community Health Needs Assessment Steering Committee met regularly during the month of March, to determine the health needs to be prioritized for action in FY2014-FY2016. Following a detailed presentation of the Community Health Needs Assessment findings by PRC, steering committee members were led through a process of understanding key local data findings (Areas of Opportunity) and ranked identified health issues against the following established, uniform criteria: * Magnitude. The number of persons affected, also taking into account variance from benchmark data and Healthy People targets. * Impact/Seriousness. The degree to which the issue affects or exacerbates other quality of life and health-related issues. * Feasibility. The ability to reasonably impact the issue, given available resources. * Consequences of Inaction. The risk of not addressing the problem at the earliest opportunity. A proposed Implementation Strategy was then written to address the community's health needs. In the months of May and June, 2013, the organization's Board as well as the Board of Regional Health reviewed, discussed and approved the implementation strategies for addressing the community health priorities identified through the Community Health Needs Assessment. Part VI, Line 3: We provide information on all statements, on our website, and at all admission areas. We contract with Midland Medical Group (an unrelated entity) to meet with all 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 is an integrated health care system with the purpose of helping patients and communities live well. The organization, with headquarters in Rapid City, S.D., provides community-based health care to more than 20 communities in two states and 32 specialty areas of medicine. Regional Health serves a large geographical area through its hospitals, clinics and senior care facilities. There are a large percentage of government payers within the patient mix cared for in Regional Health's area, including Medicare, Medicaid, Indian Health Services and Veteran's Affairs. Regional Health serves a largely rural geographic area with only one city with more than 50,000 people in the service area. In addition to quality health care, Regional Health supports health care education within its communities with diabetes education, grief support groups and wellness screenings. Regional Health partners with United Way of the Black Hills, Community Health Center, Diabetes Inc., and American Heart Association to support healthy lifestyles and increase access to health care in the community. Part VI, Line 5: Regional Health is governed by a community board that provides leadership to the organization to meet the community needs. Regional Health partners with the educational institutions to provide numerous clinical training programs, that if they were not provided by Regional Health, would 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. 0 1 0 0 0 0 0 1 0 Michael Gibbs Directors 308229 0 34492 0 0 0 32020 0 21127 0 395868 0 0 0 Joseph Tuma MD Directors 869798 0 51703 0 18975 0 59174 0 21481 0 1021131 0 0 0 Charles E Hart MD President & CEO (July-February) 0 822401 0 152408 0 4520 0 21682 0 17388 0 1018399 0 0 Timothy H Sughrue - CEO RCRH & RHN/COO RHI (July-March) 584475 0 88650 0 1823 0 24219 0 23231 0 722398 0 0 0 Mark A Thompson VP CFO 355658 0 63697 0 6090 0 57755 0 15956 0 499156 0 6090 0 Joseph C Sluka Jr Executive VP/CAO 395997 0 75194 0 30176 0 14160 0 20652 0 536179 0 20782 0 Allan Berreth VP Ancillary Serv. 215472 0 24151 0 0 0 17920 0 1213 0 258756 0 0 0 Mark F Brodin VP Decision Support 180608 0 20802 0 0 0 16102 0 21127 0 238639 0 0 0 Sharmila M Chandran VP Corp Responsibility 182434 0 22387 0 0 0 14814 0 4248 0 223883 0 0 0 Paul W Clemments VP Professional Services 163789 0 19594 0 0 0 19710 0 21481 0 224574 0 0 0 Jeanne A Galbraith VP Qual Safety Risk Mgmt 164636 0 17679 0 0 0 20001 0 8651 0 210967 0 0 0 Rita K Haxton VP Patient Care (July-February) 250661 0 28492 0 0 0 15875 0 16388 0 311416 0 0 0 Maureen G Henson VP Human Resources 171543 0 0 0 0 0 15826 0 1065 0 188434 0 0 0 Jennifer D Horton VP PR Marketing (July-April) 161539 0 20248 0 9357 0 23245 0 23277 0 237666 0 9357 0 Robert L Houser MD VP Medical Affairs 284071 0 19737 0 24258 0 21783 0 21127 0 370976 0 20226 0 David L Klocke MD Chief Medical Officer 358521 0 65879 0 0 0 27293 0 23271 0 474964 0 0 0 Suzanne P Koehler VP Operations (July-December) 178975 0 22399 0 0 0 6723 0 23481 0 231578 0 0 0 Richard S Latuchie VP Info Technology CIO 279031 0 32281 0 0 0 14822 0 17180 0 343314 0 0 0 Mary E Masten General Counsel 308434 0 34657 0 0 0 25714 0 17416 0 386221 0 0 0 Michael P D'urso MD Cardiology 647588 0 51703 0 0 0 48836 0 28627 0 776754 0 0 0 Norman Lewis Ferrier MD Cardiology 716622 0 51703 0 89083 0 13696 0 21981 0 893085 0 89083 0 John K Heilman III MD Cardiac Device Implantation, Cardiol 861475 0 51703 0 193793 0 8988 0 17888 0 1133847 0 193793 0 Jose M Teixeira MD Cardiology, Electrophysiology 664148 0 51703 0 0 0 8988 0 17138 0 741977 0 0 0 Amad Zineldine MD Cardiology 730543 0 51703 0 42195 0 59155 0 22377 0 905973 0 42195 0 Part I, Line 3 The audit and compliance 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. Please see Form 990, part VI, Lines 15a & 15b disclosure on Schedule O. Part I, Line 4b 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: Sharmila M. Chandran 8,453 Maureen G. Henson 10,660 Jennifer Horton 12,331 David L. Klocke MD 19,202 Mark A. Thompson 38,769 Paul W. Clemments 10,394 Michael E. Gibbs 20,280 Robert L. Houser MD 12,266 Michael P. D'Urso MD 39,848 Norman Lewis Ferrier MD 4,708 Amad Zineldine MD 35,222 Joseph Tuma MD 41,562 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 of Directors will review and approve all incentives as recommended from the Compensation Committee. 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 17310000 57312811 785667 24925832 31601312 2013 1 0 1 1 B 8480000 54610462 709782 30161279 23739401 2013 1 0 1 1 C 67210000 250000 66960000 2015 1 0 1 1 A 0 1 1 0 1 0 0.00710 0.00000 0.00710 0 0 1 B 0 1 1 0 1 0 0.00050 0.00250 0.00300 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 12.200000000000 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 Black Hills Pediatrics Board member Stephen Kovarik, MD is greater than 5% owner 153767 Professional services agreement 0 Geib Elston Frost Professional Assoc (James Frost MD) Brother of board member Timothy Frost, MD is a greater than 5% owner 769149 Pathology and laboratory medical directorship services 0 Heart Center Building LLC Highest compensated employee Lewis N. Ferrier is a 10% owner 695178 Buildings lease 0 Lindsey Seaman Daughter of board member, Lisa Seaman 45714 Employed by RCRH 0 West River Anesthesiology Associates (Steve Frost MD) Brother of board member Timothy Frost, MD is a greater than 5% owner 351651 Professional services agreement 0 Scott Eccarius Family member of Mary Masten, VP of Legal Services 26904 Employed by RCRH 0 Gregg Radtke Son of board member Sandra Burns 32628 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 CEO. 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 1 The organization considers some members of the Board to not be independent because they are actively practicing physicians on its or its related entities' medical staffs or, are employees of a supported organization. Form 990, Part VI, Section A, line 2 Charles E. Hart, MD (retired 02/28/15) and Brent Phillips have 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 individuals: Timothy Sughrue, Joseph Sluka Jr., Mark Thompson, Allan Berreth, Mark Brodin, Sharmila Chandran, Paul Clemments, Jeanne Galbraith, Michael Gibbs, Rita Haxton, Maureen Henson, Jennifer Horton, Robert Houser MD, David Klocke MD, Suzanne Koehler, Richard Latuchie, and Mary Masten. 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 business decisions made by 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 trustees 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 receive a copy of the conflict of interest policy and sign an acknowledgement they have read and understand it. Additionally, they are each 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 B, line 15b The Compliance and Audit committee of the sole member's board, a committee that includes only board members deemed "independent", determines all elements of compensation for the member's CEO (base salary, total cash compensation, benefits and total compensation). For other executive staff, the committee determines the appropriate base salary, cash compensation and total compensation ranges. The CEO of the member or his designee determines the actual base salary of the other executives within the committee-approved base salary range based on performance, while the committee authorizes any incentive compensation awarded to executives and any additional benefits offered to executives. The committee retains an independent compensation consultant, Sullivan & Cotter, to provide peer group market comparative data for base salary, total cash compensation, benefits and total compensation for executives. Sullivan and Cotter most recently completed a market assessment, and the committee approved compensation elements and ranges based thereon, in April and June of 2015. 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 at the Secretary of State's website. 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 -1,516,978. Medical Staff Net Income 28,327. Net Assets Released from Restriction 544,196. Gift Shop Net Income -91,395. Auxiliary Net Income 35,909. Amortized Bond Premium 463,224. Change in Interest Swap -2,118,435. Temporarily Restricted Net Asset Changes -1,271,880. Loss on Early Extinguishment of Debt -496,096. Transfer of unrestricted net assets from Regional Health Physicians Inc -190,608,525. Community Health Center Capital Campaign -1,000,000. 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 1 Regional Health Physicians Inc 353 Fairmont Blvd Rapid City SD 57701 460372454 Healthcare SD 501(c)(3) Line 3 Regional Health Inc 1 Medical & Dental Building 2805 S 5th St Rapid City SD 57701 460339629 Medical Office Bldg SD Rapid City Regional Hospital Inc Investment -23098 859446 0 0 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 -14743 1624746 0 0 0.67930 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 1 0 0 0 Regional Health Physicians Inc J 1334987 Cost Regional Health Network Inc L 6162818 Cost Regional Health Physicians Inc L 6044933 Cost Regional Health Network Inc P 2080354 Cost Regional Health Physicians Inc P 1982972 Cost Regional Health Physicians Inc K 106033 Cost Regional Health Physicians Inc H 190608525 Cost