2015-10-09T15:23:42-05:00 2014-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2014-01-01 460274380 WINNER REGIONAL HEALTHCARE CENTER WINN 6058427100 745 E 8TH ST WINNER SD 57580 KEVIN COFFEY CEO 6058427100 2015-10-06 1 LAURIE HANSON P00851848 6053391999 2015-10-06 2014 2016-03-07 17:11:31Z KEVIN COFFEY 745 E 8TH ST WINNER SD 57580 20431699 0 X WWW.WINNERREGIONAL.ORG X 1961 SD PROFESSIONAL CARE WITH A PERSONAL TOUCH. 9 8 290 12 0 0 273633 201727 18860630 20184307 24273 23146 20577 22519 19179113 20431699 0 0 0 0 10036225 9266662 0 0 0 11724393 11321735 21760618 20588397 -2581505 -156698 14981565 13733635 6626413 5549416 8355152 8184219 THE SPIRITUAL, PHYSICAL AND MENTAL WELL-BEING OF OUR PATIENTS AND RESIDENTS IS OUR PRIMARY CONCERN. EXCELLENCE IN HEALTHCARE IS OUR TRADITION. 0 0 18440226 20184307 WINNER REGIONAL HEALTHCARE CENTER, A 25-BED CRITICAL ACCESS HOSPITAL AND 79 BED LONG TERM CARE CENTER, PROMOTES HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF HEALTH CARE SERVICES INCLUDING ACUTE PATIENT TREATMENT, SWING BED, LONG-TERM CARE, AND NEW BORN CARE. THE FACILITY ALSO OPERATES A HOME HEALTH AGENCY, HOMEMAKER PROGRAM, A PROVIDER BASED RURAL HEALTH CLINIC, A COMMUNITY HEALTH PROGRAM AND PROVIDES COMMUNITY EDUCATION PROGRAMS THROUGHOUT THE SERVICE AREA. WINNER REGIONAL HEALTHCARE CENTER HAD 1,626 ACUTE PATIENT DAYS; 1,157 SWING BED PATIENT DAYS; 341 NEWBORN PATIENT DAYS; 24,931 RESIDENT DAYS; 3,282 HOME HEALTH VISITS; 15,042 RURAL HEALTH CLINIC VISITS; 348 OBSERVATION DAYS; AND 60 LABOR AND DELIVERY DAYS. 18440226 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 40 0 1 290 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X PHILLIP HUSHER 6058427213 745 EAST 8TH STREET WINNER SD 57580 BRIAN SCHAEFFER PRESIDENT 1.00 X X 0 0 0 MICK ROWE PRESIDENT (LEFT SEPT 2014) 1.00 X X 0 0 0 JOEL LEYDEN VICE PRESIDENT 1.00 X X 0 0 0 TOM KAUER TREASURER 1.00 X X 0 0 0 KEVIN OREL SECRETARY 1.00 X X 0 0 0 NEIL LANTZ DIRECTOR 1.00 X 0 0 0 DOUG KARTAK DIRECTOR 1.00 X 0 0 0 DR TONY L BERG DIRECTOR, FAMILY PRACTICE 1.00 X 243092 0 57014 REBECCA LITTAU DIRECTOR 1.00 X 0 0 0 BETSY PRAVECEK DIRECTOR 1.00 X 0 0 0 DR GREGG TOBIN DIRECTOR,SURGEON (LEFT MAR 2014) 1.00 X 0 0 0 ALICE DAUGHTERS DIRECTOR (LEFT APRIL 2014) 1.00 X 0 0 0 KEVIN COFFEY CEO 40.00 X 0 0 0 PHILLIP HUSHER CFO 40.00 X 0 0 0 RHONDA JORGENSEN CRNA 42.00 X 153173 0 38598 MARLA HAYES PHARMACIST 40.00 X 132934 0 3028 BECKY OLSON CNP 50.00 X 127180 0 11826 656379 0 110466 4 0 1 0 SANFORD HEALTH NETWORK 1305 W 18TH ST SIOUX FALLS SD 57117 MGMT FEES/SALARY REIMB/IT SUPPORT 379597 WINNER PHYSICAL THERAPY PO BOX 435 WINNER SD 57580 THERAPY 292627 RURAL ANESTHESIA SERVICES PO BOX 246 GREGORY SD 57528 ANESTHESIA SERVICES 202300 GREGG TOBIN 825 EAST 8TH ST WINNER SD 57580 ER COVERAGE AND SCOPE RENTAL 189412 MEDICAL IMAGING INC 825 EAST 8TH ST WINNER SD 55402 IMAGING 174134 6 114052 87675 201727 PATIENT AND RESIDENT SERVICE REVE 622110 19621177 19621177 OTHER REVENUE 900099 300880 300880 MEDICAID EMR INCENTIVE 900099 262250 262250 20184307 23146 23146 22519 0 22519 22519 22519 20431699 20184307 0 45665 X 7317632 6852667 464965 133979 128052 5927 1284085 1173083 111002 530966 499576 31390 286515 286515 28768 28768 73283 73283 4775002 4359461 415541 137053 27000 110053 284041 242031 42010 326102 36482 289620 697830 697830 35935 35935 57597 47107 10490 205610 166830 38780 1171976 1171976 147404 147404 MEDICAL SUPPLIES 1783120 1783120 BAD DEBTS 824061 824061 FOOD 299305 299305 EQUIPMENT & MAINTENANCE 75023 73148 1875 113110 22562 90548 20588397 18440226 2148171 0 6232762 5827717 3079795 2956496 85450 80832 507363 468708 0 22807 16440943 12422981 4626779 4017962 228463 214228 30396 8207 190557 136678 14981565 13733635 1705308 1978256 2175000 0 7939 11199 2031058 3559961 707108 0 6626413 5549416 X 8126689 7969991 228463 214228 8355152 8184219 14981565 13733635 X -156698 -14235 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 920 920 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF DUES THAT WERE USED FOR LOBBYING. ORGANIZATION OFFICERS AND DIRECTORS WILL ALSO FROM TIME TO TIME CONTACT LEGISLATORS CONCERNING HEALTH CARE ISSUES AND BILLS. 0 1 X 24638 24638 10689927 8041910 2648017 5190398 3985425 1204973 535980 395646 140334 4017962 X 19607638 -824061 -824061 20431699 0 20431699 19764336 0 19764336 824061 824061 20588397 PART IV, LINE 2B: LONG-TERM CARE RESIDENTS REQUEST THE FACILITY TO HANDLE THEIR FINANCIAL AFFAIRS. THIS IS DIRECTED BY A WRITTEN AGREEMENT BETWEEN THE FACILITY AND THE RESIDENT. SOME EXAMPLES OF FINANCIAL AFFAIRS ARE SOCIAL SECURITY CHECKS, NURSING HOME PAYMENTS, AND HAIRCUTS. PART X, LINE 2: THE CENTER IS ORGANIZED AS A SOUTH DAKOTA 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 CENTER IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE CENTER IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE CENTER FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THE 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 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 CENTER'S FEDERAL FORM 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2011. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -824,061. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 824,061. 1 1 X 1 X 1 X 150.000000000000 1 1 0 1 1 192000 192000 0.00970 1757323 1583876 173447 0.00880 1949323 1583876 365447 0.01850 4185 1160 3025 0.00020 25067 25000 67 0.00000 9215482 4926885 4288597 0.21700 120000 24 119976 0.00610 9364734 4953069 4411665 0.22330 11314057 6536945 4777112 0.24180 20984 11091 9893 0.00050 1064 1064 0.00010 10712 10712 0.00050 32760 11091 21669 0.00110 0 824061 82406 4599490 4622598 -23108 X 1 1 1 1 WINNER REGIONAL HEALTHCARE CENTER 745 E 8TH ST WINNER SD 57580 WWW.WINNERREGIONAL.ORG 10713 X X X X PROVIDER BASED RHC-WINNER REGIONAL CLINIC WINNER REGIONAL HEALTHCARE CENTER 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X WWW.WINNERREGIONAL.ORG X X 1 13 1 WWW.WINNERREGIONAL.ORG 0 0 1 X 100.000000000000 150.000000000000 X X X X X X X 1 1 X X X X 1 X X 1 X 0 X X X X 1 X 0 0 WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 5: RESIDENTS THROUGHOUT THE COMMUNITY PARTICIPATED IN THE ONLINE SURVEY PROVIDING THEIR FEEDBACK ON THE NEEDS OF THE COMMUNITY. PERSONS WITH SPECIALIZED KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH WERE INVOLVED IN THE NEEDS ASSESSMENT, AND INCLUDED THE DIRECTOR OF SOUTHERN PLAINS MENTAL HEALTH, THE WINNER MIDDLE SCHOOL COUNSELOR, A PHYSICIAN AND A NURSE. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 7D: BOUND COPIES ARE DISPLAYED IN OPEN SITTING AREAS THROUGHOUT THE FACILITY FOR READING BY ANY CUSTOMER OR EMPLOYEE. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 11: THE IMPLEMENTATION STRATEGY IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AND ON OUR WEBSITE.BASED ON THE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A PRIORITIZATION WORKSHEET WAS COMPLETED BY THE CHNA STEERING GROUP. THE HOSPITAL IS WORKING TOWARD MEETING IDENTIFIED NEEDS. PRIORITY 1 IS PHYSICIAN RECRUITMENT. THE HOSPITAL HAS RECRUITED A FAMILY PRACTICE PHYSICIAN AND CERTIFIED NURSE PRACTITIONER FOR THE FAMILY PRACTICE CLINIC ON LOCATION. IN ADDITION A SPECIALTY OBGYN OUTREACH PHYSICIAN HAS BEEN BROUGHT ON STAFF. THE FACILITY IS ACTIVELY RECRUITING A SEDATION DENTIST, ORTHOPEDIC SURGEON, UROLOGIST, AND ONCOLOGIST. PATIENT VISITS PER CLINIC PROVIDER HAVE INCREASE FROM 1,228 IN 2013 TO 1,324 IN 2014. PRIORITIES 2 AND 3 ARE EMPLOYEE-BASED WELLNESS PROGRAM AND EVALUATE CHRONIC HEALTH ISSUES IN THE COMMUNITY. A COORDINATOR WAS ASSIGNED TO EACH OF THESE ASSESSMENTS. DUE TO CHANGEOVER IN KEY POSITIONS (HR, CNO, CLINIC DIRECTOR AND DON) SOME OF THE GROUND LAYING HAS NOT STARTED. DIABETES SCREENING IN TRIPP COUNTY IS HIGHER THAN BOTH NATIONAL AND STATE BENCHMARKS, 89% AND 83%, RESPECTIVELY. ADULT OBESITY IS BETWEEN 30 AND 33.9% IN TRIPP COUNTY. AS A RESULT OF THE TWO FACTORS, WHICH HAVE A TENDENCY TO GO HAND-IN-HAND, THESE TWO TARGET AREAS WILL BE FOCUSED ON IN THE NEXT THREE YEARS. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 13B: PATIENTS WHOSE FAMILY INCOME IS OVER 100% AND BELOW 150% OF THE FPL ARE ELIGIBLE FOR UP TO A 50% DISCOUNT. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 13H: PATIENTS WHOSE FAMILY INCOME EXCEEDS 150% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF WINNER REGIONAL HEALTHCARE. HOWEVER, THE DISCOUNTED RATES SHALL NOT BE GREATER THAN THE AMOUNTS GENERALLY BILLED COMMERCIALLY INSURANCE PATIENTS. ONCE THE PATIENT HAS BEEN DEEMED ELIGIBLE, WINNER REGIONAL WILL APPLY THE FAP DISCOUNT TO THE PATIENT'S ACCOUNT. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 16I: PLEASE REFER TO THE NARRATIVE PROVIDED IN PART VI, LINE 3 REGARDING ADDITIONAL MEANS OF EDUCATING PATIENTS ABOUT OUR CHARITY CARE POLICY. 1 WINNER REGIONAL NURSING HOME 745 EAST 8TH STREET WINNER SD 575802631 SKILLED NURSING FACILITY PART I, LINE 3C: IN ADDITION TO UTILIZING FEDERAL POVERTY GUIDELINES, THE FOLLOWING ITEMS ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: PERSONAL ASSETS, LIABILITIES, INDIVIDUAL AND/OR FAMILY INCOME, NET WORTH, EMPLOYMENT STATUS OR EARNING CAPACITY, FAMILY SIZE, OTHER FINANCIAL OBLIGATIONS, FREQUENCY OF HEALTH SERVICES AND OTHER SOURCES OF PAYMENT FOR HEALTHCARE SERVICES RENDERED. THIS INFORMATION IS REVIEWED AND A DETERMINATION OF ELIGIBILITY FOR ASSISTANCE IS MADE BY THE PATIENT SERVICES REPRESENTATIVE AND THE CFO. PLEASE REFER TO PART V, LINE 13 FOR ADDITIONAL INFORMATION.PART I, LINE 6: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT CAN BE FOUND ON ITS WEBSITE AT HTTP://WWW.WINNERREGIONAL.ORG/ PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINES 7E, 7F AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINES 7B AND 7G WERE DETERMINED USING THE COST REPORTS. PART I, LN 7 COL(F): BAD DEBT BASED ON CHARGES OF $824,061 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: WRHC IS VERY INVOLVED WITH THE WINNER CHAMBER OF COMMERCE AND PARTICIPATES IN THEIR ACTIVITIES AND MEETINGS. THE WINNER SCHOOL DISTRICT IS ALSO A PARTNER WITH WRHC AND OUR FACILITY SUPPORTS THE SCHOOL DISTRICT IN MANY WAYS. THE FACILITY ALSO SUPPORTS THE WINNER SCHOOL DISTRICT, COLOME SCHOOL DISTRICT, WHITE RIVER SCHOOL DISTRICT AND THE MISSION SCHOOL DISTRICT WITH THEIR FUND-RAISERS AND SEVERAL EVENTS. THIS YEAR EMPLOYEES HELD A BACK-TO-SCHOOL SUPPLY DRIVE FOR LOCAL SCHOOL DISTRICTS AND EMPLOYEES BROUGHT IN OVER 400 ITEMS FOR CHILDREN IN NEED. WRHC ALSO HELD A BOXED/CANNED FOOD DRIVE LAST FALL, AND BROUGHT IN OVER 200 POUNDS OF FOOD FOR THE WINNER FOOD PANTRY. EMPLOYEES ARE INVOLVED IN PHILANTHROPIC GROUPS SUCH AS ROTARY, THE PINK POSSE (AREA BREAST CANCER SUPPORT GROUP) AND WRHC IS A CORPORATE SPONSOR AND SUPPORTS THE LOCAL AMERICAN CANCER SOCIETY RELAY FOR LIFE. OUR EMPLOYEES ARE OFFERED THE OPPORTUNITY TO VOLUNTEER IN THE COMMUNITY THROUGH MANY DIFFERENT VENUES. WE HELD A BACK-TO-SCHOOL SUPPLY DRIVE AND A FOOD DRIVE. WRHC HELD A COMMUNITY WIDE EASTER EGG HUNT LAST APRIL, WITH ALL THE WORKERS BEING EMPLOYEES OF WRHC. OVER 500 COMMUNITY MEMBERS (MOSTLY CHILDREN) ENJOYED THE EASTER EGG HUNT AND THE OPPORTUNITY TO SPEAK AND PLAY WITH THE HOSPITAL EMPLOYEES DURING THE EVENT. THE HOSPITAL BRINGS A LABOR DAY ROAD RACE TO WINNER EVERY LABOR DAY. THIS EVENT, HELD TO PROMOTE WELLNESS IN THE COMMUNITY, ANNUALLY HAS ABOUT 100 RUNNERS/WALKERS EVERY YEAR, AND IS RUN BY WRHC EMPLOYEE VOLUNTEERS. EMPLOYEES WORK WITHIN THE COMMUNITY AS JUNIOR ACHIEVEMENT VOLUNTEERS (TEACHING SCHOOL AGE CHILDREN TO BE LEADERS IN THEIR COMMUNITY), PINK POSSE AND SISTERS AND SURVIVORS (BOTH BREAST CANCER SUPPORT GROUPS), ROTARY, WINNER QUARTERBACK CLUB (YOUTH SPORTS VOLUNTEER GROUP) AND MORE. PART III, LINE 2: BAD DEBT EXPENSE ON LINE 2 IS REPORTED AT CHARGES AS PRESENTED ON THE FINANCIAL STATEMENTS. IF AN ACCOUNT IS WRITTEN OFF TO BAD DEBTS, PAYMENTS RECEIVED AFTER THE WRITE OFF FOR THAT ACCOUNT ARE POSTED TO THE CURRENT YEAR BAD DEBT ACCOUNT AS AN OFFSET AGAINST THE EXPENSE. PART III, LINE 3: BASED ON THE DEMOGRAPHICS OF THE AREA, APPROXIMATELY 10% OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS ON PAGE 8 OF NOTE 1 - ORGANIZATION AND SIGNIFICANT ACCOUNTING POLICIES UNDER PATIENT AND RESIDENT RECEIVABLES FROM THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2014. THE ENTIRE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SHORTFALL IS THE DIRECT RESULT OF SEQUESTRATION ENACTMENTS PUT IN PLACE BY THE FEDERAL GOVERNMENT. PART III, LINE 9B: THE COLLECTION POLICY ALLOWS FOR CHARITY CARE TO BE OBTAINED DURING THE COLLECTION PROCESS IF THE PATIENT DID NOT QUALIFY DUE TO A LACK OF DOCUMENTATION IN THE PATIENT'S FILE. THE POLICY SPECIFICALLY STATES "A PATIENT WILL NOT BE DENIED CHARITY CARE CONSIDERATION BECAUSE OF A LACK OF DOCUMENTATION TO VERIFY INCOME." IF A PATIENT IS IN COMPLIANCE WITH FINANCIAL ARRANGEMENTS MADE DURING THE FINANCIAL ASSISTANCE PROCESS, THEIR ACCOUNT WILL NOT BE SENT TO COLLECTION. IF A PATIENT IS FOUND TO POTENTIALLY QUALIFY FOR FINANCIAL ASSISTANCE AND THE ACCOUNT IS IN COLLECTION, COLLECTION ACTIVITY WILL CEASE WHILE THE PATIENT COMPLETES THE APPLICABLE PAPERWORK. PART VI, LINE 2: THE COMMUNITY HEALTH NEEDS REPORT INCLUDES A DESCRIPTION OF WINNER REGIONAL HEALTHCARE CENTER (WRHC) AND A DESCRIPTION OF THE COMMUNITY IT SERVES. THE DESIGN STUDY AND METHODOLOGY INCLUDED QUALITATIVE AND QUANTITATIVE DATA, WHICH WAS CONDUCTED WITHIN THE QUALITY AND DECISION SUPPORT TEAMS FROM SANFORD HEALTH. WRHC IS A MANAGED FACILITY OF THE SANFORD HEALTH NETWORK. THE SECONDARY DATA MODELED THE ROBERT WOOD JOHNSON FRAMEWORK FOR COUNTY PROFILES. ASSET MAPPING WAS BASED ON THE MCKNIGHT FOUNDATION MODEL. PRIMARY DATA WAS OBTAINED VIA A SURVEY THAT WAS AVAILABLE THROUGH THE WRHC WEBSITE USING SURVEYMONKEY. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE IN THE COMMUNITY TO ADDRESS THE NEEDS. PART VI, LINE 3: OUR PROCESS FOR NOTIFYING PATIENTS OF FINANCIAL ASSISTANCE IS TO VISIT WITH THEM WHILE THEY ARE IN THE FACILITY. OUR PATIENT FINANCIAL REPRESENTATIVE REVIEWS THE CENSUS EVERY MORNING TO DETERMINE IF A PATIENT IS PRIVATE PAY. THE REPRESENTATIVE VISITS WITH THE PATIENT TO DETERMINE WHETHER THEY HAVE INSURANCE IN ADDITION TO WHAT HAS BEEN PROVIDED TO THE HOSPITAL, AND WHETHER THEY NEED ASSISTANCE WITH APPLYING FOR MEDICAID (IF APPLICABLE). THE REPRESENTATIVE PROVIDES CHARITY CARE INFORMATION IF THE PATIENT BELIEVES THIS TYPE OF FINANCIAL ASSISTANCE MAY BE NEEDED. CHARITY CARE APPLICATIONS ARE ALSO PROVIDED UPON REQUEST AND TO PERSONS WHO HAVE NOT BEEN MAKING PAYMENTS AS SCHEDULED. PART VI, LINE 4: WINNER REGIONAL HEALTHCARE CENTER (WRHC) IS LOCATED IN WINNER, SOUTH DAKOTA WHICH IS AT THE CENTER OF TRIPP COUNTY. COMMUNITIES IN TRIPP COUNTY INCLUDE CARTER, CLEARFIELD, COLOME, HAMILL, IDEAL AND WINNER. WRHC'S SERVICE AREA EXTENDS INTO GREGORY, MELLETTE, AND TODD COUNTIES IN SOUTH DAKOTA AND INCLUDES THE CITIES OF MISSION, WOOD, WHITE RIVER, GREGORY, BURKE, DALLAS, HERRICK, BONESTEEL AND FAIRFAX. THE SERVICE AREA INCLUDES NORTHERN CHERRY AND KEYA PAHA COUNTIES IN NEBRASKA AND ENCOMPASSES THE CITIES OF SPRINGVIEW, SPARKS AND VALENTINE. FARMING AND RANCHING ARE THE PRIMARY INDUSTRIES IN THIS RURAL AREA. THE POPULATION OF THE AREA IS 28,283. AVERAGE INCOME IS $34,793. PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS 27.55%. OTHER HOSPITALS SERVING THE AREA INCLUDE VALENTINE HOSPITAL, BURKE COMMUNITY MEMORIAL, GREGORY HOSPITAL AND ROSEBUD HOSPITAL. ALL COUNTIES IN THE SERVICE AREA ARE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS. PART VI, LINE 5: THE WINNER REGIONAL GOVERNING BOARD IS A 9 MEMBER VOLUNTEER BOARD COMPRISED OF BOTH MEN AND WOMEN THAT RESIDE IN THE WINNER REGIONAL HEALTHCARE CENTER SERVICE AREA. WINNER REGIONAL HEALTHCARE CENTER EXTENDS PRIVILEGES TO PHYSICIANS IN THE IMMEDIATE AREA. WINNER REGIONAL HEALTHCARE CENTER UTILIZES SURPLUS FUNDS TO FUND BUILDING IMPROVEMENTS AND TO ENHANCE SERVICES TO PATIENTS. THE FACILITY RECENTLY UPDATED THE X-RAY MACHINE TO PROVIDE HIGH QUALITY, STATE OF THE ART X-RAYS FOR PHYSICIANS TO REVIEW AND ANALYZE. THE HOSPITAL ALSO PURCHASED AN INFANT MONITORING SYSTEM THAT PROVIDES ADDITIONAL SAFETY FOR INFANTS DURING THEIR STAY AT WINNER REGIONAL AND NEW VITAL SIGNS MONITORS. THE EASE OF USE OF THE MONITORS ALLOWS THE STAFF TO FOCUS ON PATIENT SAFETY AND COMFORT. 1 0 0 0 0 0 0 0 0 0 DR TONY L BERG DIRECTOR, FAMILY PRACTICE 243092 0 0 0 0 0 0 0 57014 0 300106 0 0 0 RHONDA JORGENSEN CRNA 153173 0 0 0 0 0 5327 0 33428 0 191928 0 0 0 PART I, LINE 3 THE CEO AND CFO ARE COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH SANFORD HEALTH NETWORK, AN UNRELATED ORGANIZATION. SANFORD HEALTH NETWORK USES THE PROCESSES DESCRIBED IN PART I, QUESTION 3 TO DETERMINE APPROPRIATE COMPENSATION FOR THE CEO AND CFO. PART II, LINE 1 DR. TONY BERG IS A BOARD MEMBER OF WINNER REGIONAL HEALTHCARE CENTER AND A FAMILY PRACTICE PHYSICIAN AT THE WINNER REGIONAL CLINIC. HE IS EMPLOYED BY SANFORD HEALTH NETWORK, BUT WINNER REGIONAL HEALTHCARE CENTER REIMBURSES SANFORD DOLLAR FOR DOLLAR FOR DR. BERG'S COMPENSATION AND BENEFITS. FORM 990, PART VI, SECTION A, LINE 3 SANFORD HEALTH NETWORK, A MANAGEMENT COMPANY, MANAGES THE FACILITY. THE CEO, CFO, CNO AND CLINIC DIRECTOR ARE EMPLOYEES OF THE MANAGEMENT COMPANY. SANFORD HEALTH IS LOCATED AT 1305 W 18TH STREET, SIOUX FALLS, SD. WRHC PAID SANFORD HEALTH NETWORK FOR SERVICES PROVIDED BY KEVIN COFFEY, CEO, AND PHILLIP HUSHER, CFO. COMPENSATION AND BENEFITS FOR THE CEO WERE $157,039 AND $22,546 RESPECTIVELY, AND COMPENSATION AND BENEFITS FOR THE CFO WERE $80,031 AND $25,042 RESPECTIVELY. THE CEO IS RESPONSIBLE FOR LOCAL PLANNING AND MANAGEMENT OF ALL ACTIVITIES IN THE ORGANIZATION, INCLUDING TASKS SUCH AS MANAGING HUMAN AND FINANCIAL RESOURCES, DIRECTING STAFF, AND CONTROLLING THE OPERATIONS. THE CFO IS RESPONSIBLE FOR SUPERVISING, PLANNING, AND DIRECTING FINANCIAL ACTIVITY. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEES MAKE RECOMMENDATIONS TO THE GOVERNING BODY, WHICH APPROVES ALL ACTIONS. NO COMMITTEES HAVE BROAD AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 2014 FORM 990 WAS PROVIDED TO THE GOVERNING BODY ELECTRONICALLY PRIOR TO FILING. THE CFO REVIEWS A DRAFT OF THE FORM 990 IN DETAIL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE IS MONITORED THROUGH THE USE OF ANNUAL QUESTIONNAIRES THAT EACH OFFICER, DIRECTOR, TRUSTEE, AND KEY EMPLOYEE MUST COMPLETE. THE FULL BOARD SHALL BE ADVISED OF DEALINGS AND CONTRACTS TO BE MADE WITH ANY BOARD MEMBER(S), PHYSICIAN(S) OR EMPLOYEE(S). THE BOARD AND THE CEO IMPLEMENT AND CONTROL ALL CONFLICTS THAT MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION OF THE CEO AND OTHER EMPLOYEES OF THE MANAGEMENT COMPANY IS DETERMINED BY THE WINNER REGIONAL HEALTHCARE BOARD WHO EVALUATES SALARIES ANNUALLY USING COMPARABLE DATA FOR OTHER FACILITIES WITHIN THE STATE. THE DETERMINATION OF COMPENSATION IS DOCUMENTED IN WRITING. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST FORM 990, PART IX, LINE 11G SERVICE CONTRACTS : PROGRAM SERVICE EXPENSES 228,519. MANAGEMENT AND GENERAL EXPENSES 102,156. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 330,675. OUTSIDE MEDICAL SERVICES : PROGRAM SERVICE EXPENSES 431,497. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 431,497. PURCHASED STAFFING : PROGRAM SERVICE EXPENSES 2,134,746. MANAGEMENT AND GENERAL EXPENSES 227,673. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,362,419. CONTRACT PHYSICIANS : PROGRAM SERVICE EXPENSES 1,533,469. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,533,469. CONSULTING AND OTHER : PROGRAM SERVICE EXPENSES 31,230. MANAGEMENT AND GENERAL EXPENSES 85,712. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 116,942. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -14,235.