MONUMENT HEALTH NETWORK INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MONUMENT HEALTH NETWORK INC (EIN 46-0360899)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-13
- IRS object ID
- 201531339349300723
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-13T07:46:54-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 554027033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460360899 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Regional Health Network Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | REGI | BusinessNameControlTxt |
| Phone | 6057559130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2925 Regional Way PO Box 6000 | AddressLine1 |
| City | Rapid City | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mark Thompson | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6057559130 | PhoneNum |
| Signature | 2015-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2015-05-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Brent Phillips | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2925 Regional Way PO Box 6000 | AddressLine1 |
| City | Rapid City | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $98,602,484 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.regionalhealth.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | To provide and support health care excellence in partnership with the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1018 | TotalEmployeeCnt |
| Total Volunteers | 195 | TotalVolunteersCnt |
| Total Gross UBI | $2,743,238 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$762,223 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $241,046 | PYContributionsGrantsAmt |
| CY Contributions Grants | $249,860 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $90,746,210 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $98,111,249 | CYProgramServiceRevenueAmt |
| PY Investment Income | $52,874 | PYInvestmentIncomeAmt |
| CY Investment Income | $152,544 | CYInvestmentIncomeAmt |
| PY Other Revenue | $47,202 | PYOtherRevenueAmt |
| CY Other Revenue | $44,880 | CYOtherRevenueAmt |
| PY Total Revenue | $91,087,332 | PYTotalRevenueAmt |
| CY Total Revenue | $98,558,533 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $46,376,571 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $48,507,925 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $36,683,071 | PYOtherExpensesAmt |
| CY Other Expenses | $40,468,400 | CYOtherExpensesAmt |
| PY Total Expenses | $83,059,642 | PYTotalExpensesAmt |
| CY Total Expenses | $88,976,325 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,027,690 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,582,208 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $54,401,427 | TotalAssetsBOYAmt |
| Total Assets EOY | $59,173,816 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,563,806 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,753,987 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $31,837,621 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $41,419,829 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To provide and support health care excellence in partnership with the communities we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,231,749 | ExpenseAmt |
| Revenue | $20,657,879 | RevenueAmt |
| Desc | Located in the Northern Black Hills of South Dakota, Spearfish Regional Hospital is a 44-bed hospital offering extensive patient services centralized at one location, which includes both the hospital and Spearfish Regional Medical Clinic. Patient care includes 24-hour emergency service, inpatient and outpatient care, labor and delivery, surgery, home health and hospice. Spearfish Regional Hospital is a certified Trauma Level III facility. Spearfish Regional Hospital serves the surgery and labor and delivery needs for a geographic area that extends into Wyoming and Montana. The next closest surgery department is more than an hour away in Rapid City. During FY2014, Spearfish Regional Hospital Surgery Department performed 1,647 total procedures--602 inpatient procedures and 1,045 outpatient procedures. Inpatient procedures included surgeries in the areas of orthopedics (354), general (41), obstetrics/gynecology (138) and other types (69). The outpatient area performed surgeries in the following categories orthopedics (580), general surgery (162), ENT (78) and other types (41). Spearfish Regional Hospital also performed 25 inpatient endoscopies and 41 outpatient endoscopies during FY2014.Total inpatients served in FY2014 were 1,713. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,265,411 | ExpenseAmt |
| Revenue | $4,435,956 | RevenueAmt |
| Desc | Custer Regional Senior Care is part of Custer Regional Hospital. Custer Regional Hospital's service area includes the central and southern Black Hills along with eastern Wyoming and northern Nebraska. Our primary care clinics are operated in Hill City (Rural Health Clinic), Custer (Provider Based Clinic) and Hot Springs.The nearest hospital is at least 45 minutes away if conditions are optimal. Rugged terrain, bad weather and an influx of tourists during summer months can make the commute to another facility take more than an hour.Our Long Term Care facility has 76 beds which includes a 16-bed secure Alzheimer's unit. The Assisted Living facility offers 16 private suites. The occupancy rate of the long-term care facility was 97.29 percent and for the assisted living facility it was 84.45 percent. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,063,831 | ExpenseAmt |
| Revenue | $2,265,936 | RevenueAmt |
| Desc | Custer Clinic is a department of Custer Regional Hospital. Custer Regional Hospital and Clinic service area includes the central and southern Black Hills, along with eastern Wyoming and northern Nebraska. Our primary care clinics are operated in Hill City (Rural Health Clinic), Custer (Provider Based Clinic) and Hot Springs. The nearest hospital is at least 45 minutes away if conditions are optimal. Rugged terrain, bad weather and an influx of tourists during summer months can make the commute to another facility take more than an hour.For fiscal year 2014, Custer Regional Hospital had 185 inpatient admissions; 28 Swing Bed admissions; 487 acute care patient days; 522 swing bed patient days; 2,800 emergency room visits; 20,049 outpatient registrations; 40,898 lab tests; 6,970 Radiology visits; and 32,464 clinic RVUs. The total uncompensated care was $1,411,293 and 54.2 percent of the inpatient stays were Medicare or Medicaid patients.All patients are treated regardless of ability to pay. Financial assistance is offered to patients that are uninsured or underinsured. Custer Regional Hospital and Clinics provide training sites for medical and nursing students interested in rural and/or family practice medicine. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $53,630,992 | ExpenseAmt |
| Revenue | $70,751,478 | RevenueAmt |
| Desc | The Regional Health Network, Inc. is a network of small hospitals, nursing homes, and assisted living facilities in western South Dakota. These hospitals and long-term care facilities are located in small rural towns and provide a very necessary rural healthcare safety net. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $53,630,992 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $70,751,478 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $65,191,983 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1018 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mark Thompson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6057559127 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2925 Regional Way | AddressLine1 |
| City | Rapid City | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Ross Lamphere | ||||||||||
| Chairman | 1.70 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Richard Tysdal | ||||||||||
| Vice Chairman | 1.10 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| David Thom | ||||||||||
| Secretary | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Dusty Pinske | ||||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $879 | $0 | $0 | |||
| Lee B Bailey MD | ||||||||||
| Director | 40.60 | 0.00 | Yes (X) | $314,012 | $0 | $35,596 | ||||
| Peter J Cappa | ||||||||||
| Director | 1.80 | 1.70 | Yes (X) | $0 | $0 | $0 | ||||
| Terry Graber MD | ||||||||||
| Director | 1.10 | 41.10 | Yes (X) | $0 | $431,010 | $38,518 | ||||
| Thomas Groeger MD | ||||||||||
| Director | 0.80 | 40.00 | Yes (X) | $0 | $195,519 | $29,835 | ||||
| Robert Haivala | ||||||||||
| Director | 1.70 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Judith Larson | ||||||||||
| Director | 1.10 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Charles E Hart MD | ||||||||||
| President & CEO | 8.40 | 51.60 | Yes (X) | Yes (X) | $0 | $1,054,199 | $24,693 | |||
| Timothy H Sughrue | ||||||||||
| CEO RCRH, RHN & COO RHI | 8.90 | 46.10 | Yes (X) | Yes (X) | $0 | $645,768 | $26,548 | |||
| Mark A Thompson | ||||||||||
| VP CFO | 7.70 | 47.30 | Yes (X) | $0 | $407,685 | $49,642 | ||||
| David L Klocke MD | ||||||||||
| Chief Medical Officer | 7.70 | 47.30 | $0 | $311,124 | $31,522 | Yes (X) | ||||
| Joseph C Sluka Jr | ||||||||||
| Executive VP/CAO | 7.70 | 47.30 | $0 | $485,122 | $52,696 | Yes (X) | ||||
| Richard S Latuchie | ||||||||||
| VP Info Technology, CIO | 7.70 | 47.30 | $0 | $307,590 | $18,302 | Yes (X) | ||||
| Mary E Masten | ||||||||||
| VP Legal Services | 7.70 | 47.30 | $0 | $345,898 | $28,736 | Yes (X) | ||||
| Sharmila M Chandran | ||||||||||
| VP Corp Responsibilty | 7.70 | 47.30 | $0 | $156,536 | $11,749 | Yes (X) | ||||
| Mark F Brodin | ||||||||||
| VP Decision Support | 7.70 | 47.30 | $0 | $209,138 | $19,660 | Yes (X) | ||||
| Dale E Gisi | ||||||||||
| VP Human Resources (Thru 8/14/13) | 7.70 | 47.30 | $0 | $272,869 | $16,357 | Yes (X) | ||||
| Jennifer D Horton | ||||||||||
| VP PR Marketing | 7.70 | 47.30 | $0 | $184,553 | $27,854 | Yes (X) | ||||
| Michael G Diedrich | ||||||||||
| VP Human Resources - Interim | 7.70 | 47.30 | $0 | $192,861 | $13,852 | Yes (X) | ||||
| Glenn E Bryant | ||||||||||
| COO | 55.00 | 0.00 | $353,706 | $0 | $20,843 | Yes (X) | ||||
| Larry W Veitz | ||||||||||
| CEO of Spearfish Regional Hospital | 55.00 | 0.00 | $220,286 | $0 | $29,612 | Yes (X) | ||||
| Sherry Bea Smith | ||||||||||
| CEO of Lead-Deadwood Regional Hospital | 55.00 | 0.00 | $166,598 | $0 | $19,330 | Yes (X) | ||||
| Van Hyde | ||||||||||
| CEO of Sturgis Regional Hospital | 55.00 | 0.00 | $183,568 | $0 | $14,943 | Yes (X) | ||||
| Krista B Birkelo DO | ||||||||||
| Family Medicine | 40.00 | 0.00 | $298,525 | $0 | $23,163 | Yes (X) | ||||
| Christopher K Fromm MD | ||||||||||
| Family Medicine | 40.00 | 0.00 | $290,987 | $0 | $35,961 | Yes (X) | ||||
| Curtis J Liedtke DO | ||||||||||
| Family Medicine | 40.00 | 0.00 | $205,455 | $0 | $7,615 | Yes (X) | ||||
| Donald M Potts MD | ||||||||||
| Family Medicine | 40.00 | 0.00 | $258,967 | $0 | $28,391 | Yes (X) | ||||
| Thomas Reid | ||||||||||
| Nurse Anesthetist | 40.00 | 0.00 | $185,329 | $0 | $13,549 | Yes (X) | ||||
| Veronica L Schmidt | ||||||||||
| CEO of Custer Regional Hospital | 55.00 | 0.00 | $144,548 | $0 | $24,672 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,622,860 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,199,872 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $643,639 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Alliance Recruiting Resources Inc | |||||
| PO Box 670416 | Dallas | TX | 752670416 | Temporary Physician Staffing Services | $1,024,446 |
| GE Medical Systems | |||||
| PO Box 414 | Milwaukee | WI | 53201 | Repairs & Support | $416,765 |
| Aegis Therapies Inc | |||||
| PO Box 8103 | Fort Smith | AR | 72902 | Patient Therapy Services | $331,040 |
| Sentra Data System Inc | |||||
| 800 Fairway Drive Suite 400 | Deerfield Beach | FL | 33441 | Pharmacy Claims Processing | $321,412 |
| DMS Health Technologies Inc | |||||
| 2101 N University Dr | Fargo | ND | 58102 | Mobil MRI Diagnostic Services | $269,549 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $39,280 | FundraisingAmt |
| Government Grants | $117,355 | GovernmentGrantsAmt |
| All Other Contributions | $93,225 | AllOtherContributionsAmt |
| Total Contributions | $249,860 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Acute Care Hospital IP and OP | 623000 | $62,815,000 | $62,815,000 |
| Long Term Care Facilities | 623000 | $9,959,000 | $9,959,000 |
| Physician Clinics | 621110 | $2,849,000 | $2,849,000 |
| Assisted Living Facilities | 623000 | $2,247,000 | $2,247,000 |
| Home Care Services | 621610 | $2,064,000 | $2,064,000 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,177,249 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,434,011 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,743,238 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $98,111,249 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $152,544 | TotalRevenueColumnAmt |
| Exclusion | $152,544 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $88,831 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $39,280 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $43,951 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,880 | TotalRevenueColumnAmt |
| Exclusion | $44,880 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,558,533 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $95,368,011 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,743,238 | UnrelatedBusinessRevenueAmt |
| Exclusion | $197,424 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,381,550 | TotalAmt |
| Program Services | $398,728 | ProgramServicesAmt |
| Management And General | $982,822 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,814,638 | TotalAmt |
| Program Services | $30,513,843 | ProgramServicesAmt |
| Management And General | $6,300,795 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $752,304 | TotalAmt |
| Program Services | $623,548 | ProgramServicesAmt |
| Management And General | $128,756 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,072,671 | TotalAmt |
| Program Services | $5,862,189 | ProgramServicesAmt |
| Management And General | $1,210,482 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,486,762 | TotalAmt |
| Program Services | $2,017,746 | ProgramServicesAmt |
| Management And General | $469,016 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,182 | TotalAmt |
| Management And General | $53,182 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100 | TotalAmt |
| Management And General | $100 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,008 | TotalAmt |
| Management And General | $13,008 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,278,451 | TotalAmt |
| Program Services | $3,326,900 | ProgramServicesAmt |
| Management And General | $951,551 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,102 | TotalAmt |
| Program Services | $29,218 | ProgramServicesAmt |
| Management And General | $49,884 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,143 | TotalAmt |
| Program Services | $164,529 | ProgramServicesAmt |
| Management And General | $113,614 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $628,068 | TotalAmt |
| Program Services | $529,656 | ProgramServicesAmt |
| Management And General | $98,412 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,033,060 | TotalAmt |
| Program Services | $748,517 | ProgramServicesAmt |
| Management And General | $1,284,543 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,224 | TotalAmt |
| Program Services | $160,905 | ProgramServicesAmt |
| Management And General | $29,319 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,826 | TotalAmt |
| Program Services | $130,072 | ProgramServicesAmt |
| Management And General | $11,754 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,769 | TotalAmt |
| Program Services | $15 | ProgramServicesAmt |
| Management And General | $19,754 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,984,301 | TotalAmt |
| Program Services | $2,170,254 | ProgramServicesAmt |
| Management And General | $1,814,047 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,422 | TotalAmt |
| Program Services | $53,386 | ProgramServicesAmt |
| Management And General | $225,036 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Intercompany Supplies a | $10,669,194 | $2,245,835 | $8,423,359 |
| Medical Supplies | $7,452,745 | $7,452,745 | |
| Bad Debt Expense | $5,470,634 | $5,470,634 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,898,171 | TotalAmt |
| Program Services | $3,293,263 | ProgramServicesAmt |
| Management And General | $1,604,908 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,976,325 | TotalAmt |
| Program Services | $65,191,983 | ProgramServicesAmt |
| Management And General | $23,784,342 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,242 | BOYAmt |
| EOY | $42,948 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,612,167 | BOYAmt |
| EOY | $13,675,818 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,357,499 | BOYAmt |
| EOY | $1,400,821 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $451,839 | BOYAmt |
| EOY | $482,432 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $94,258,158 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,610,485 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,116,228 | BOYAmt |
| EOY | $41,647,673 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,573 | BOYAmt |
| EOY | $288,886 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,430 | BOYAmt |
| EOY | $62,430 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,341,449 | BOYAmt |
| EOY | $1,572,808 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,401,427 | BOYAmt |
| EOY | $59,173,816 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,074,410 | BOYAmt |
| EOY | $4,482,708 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,489,396 | BOYAmt |
| EOY | $13,271,279 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,563,806 | BOYAmt |
| EOY | $17,753,987 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,640,869 | BOYAmt |
| EOY | $40,079,421 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,096,752 | BOYAmt |
| EOY | $1,240,408 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $100,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,837,621 | BOYAmt |
| EOY | $41,419,829 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,401,427 | BOYAmt |
| EOY | $59,173,816 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $9,582,208 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $13,008 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $13,008 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | 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 2014 dues, which were paid in fiscal year 2014, in the amount of $86,703.70, 4.443% was used for lobbying purposes. In addition, annual dues were paid to the American Hospital Association, a portion of which is applicable to lobbying activities. For calendar year 2014 dues, which were paid in fiscal year 2014, in the amount of $38,713.00, 23.65% was used for lobbying purposes. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $100,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $16,730 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $116,730 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $100,000 | BeginningYearBalanceAmt |
| End Year Balance | $100,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $100,000 | BeginningYearBalanceAmt |
| End Year Balance | $100,000 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $100,000 | BeginningYearBalanceAmt |
| End Year Balance | $100,000 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $100,000 | BeginningYearBalanceAmt |
| End Year Balance | $100,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.85670 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.14330 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,868,079 | OtherCostOrOtherBasisAmt |
| Book Value | $8,868,079 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,990,515 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,365,774 | DepreciationAmt |
| Book Value | $24,624,741 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,312,505 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,636,098 | DepreciationAmt |
| Book Value | $7,676,407 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,087,059 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,608,613 | DepreciationAmt |
| Book Value | $478,446 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $41,647,673 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Related Parties-Investment | Desc |
| Amt | $13,271,279 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $13,271,279 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Endowed funds are permanently restricted from use and are held in an interest bearing account. The interest earned may be used by the organization at its discretion. |
| Part X, Line 2: | Regional Health Network, Inc. is organized as a nonprofit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Regional Health Network, Inc. is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). In addition, Regional Health Network, Inc. may be subject to income tax on income that is derived from business activities that are unrelated to its tax exempt purpose. Regional Health Network, Inc. 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 Network, Inc. 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 Network's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2010. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Hospice Ball | NameOfEvent1Amt |
| Gross Receipts Event1 | $73,423 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $3,075 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $70,348 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $7,780 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $17,715 | RentFacilityCostsEvent1Amt |
| Entertainment Event1 | $2,775 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $4,834 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | Hospice Golf Tournament | NameOfEvent2Amt |
| Gross Receipts Event2 | $21,643 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $3,160 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $18,483 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $700 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $176 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $9,268 | RentFacilityCostsEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $33,045 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $33,045 | CharitableContriOtherEventsAmt |
| Food And Beverage Other Events | $359 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $344 | EntertainmentOtherEventsAmt |
| Gross Receipts Total | $128,111 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $39,280 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $88,831 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $700 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $7,956 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $26,983 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $359 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $3,119 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,834 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $43,951 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $44,880 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,700,114 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,700,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03230 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,115,836 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,937,453 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,178,383 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01410 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,815,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,937,453 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,878,497 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04640 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Persons Served | 1409 | PersonsServedCnt |
| Total Community Benefit Expns | $18,151 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,151 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 603 | PersonsServedCnt |
| Total Community Benefit Expns | $71,939 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $71,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 20 | ActivitiesOrProgramsCnt |
| Persons Served | 2012 | PersonsServedCnt |
| Total Community Benefit Expns | $90,090 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $90,090 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 20 | ActivitiesOrProgramsCnt |
| Persons Served | 2012 | PersonsServedCnt |
| Total Community Benefit Expns | $12,906,040 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,937,453 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,968,587 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04750 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 43 | PersonsServedCnt |
| Total Community Benefit Expns | $20,724 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,724 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 43 | PersonsServedCnt |
| Total Community Benefit Expns | $20,724 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,724 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,470,634 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $149,505 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $22,952,827 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,495,891 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$543,064 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 4 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (4 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Spearfish Regional Hospital | |||||||||||
| 1 | 1440 N Main Street | Spearfish | SD | 57783 | www.regionalhealth.com | 10566 | Yes (X) | Yes (X) | Yes (X) | A | |
| Custer Regional Hospital | |||||||||||
| 2 | 1039 Montgomery Street | Custer | SD | 57730 | www.regionalhealth.com | 47660 | Yes (X) | Yes (X) | Yes (X) | A | Yes (X) |
| Sturgis Regional Hospital | |||||||||||
| 3 | 949 Harmon Street | Sturgis | SD | 57785 | www.regionalhealth.com | 10567 | Yes (X) | Yes (X) | Yes (X) | A | Yes (X) |
| Lead-Deadwood Regional Hospital | |||||||||||
| 4 | 61 Charles Street | Deadwood | SD | 57732 | www.regionalhealth.com | 10535 | Yes (X) | Yes (X) | Yes (X) | A | Yes (X) |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Facility Reporting Group - A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.regionalhealth.com/chna | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Other Needs Addressed | Yes (X) | OtherNeedsAddressedInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (26 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section B | Facility Reporting Group A |
| Facility Reporting Group A consists of: | - Facility 1: Spearfish Regional Hospital, - Facility 2: Custer Regional Hospital, - Facility 3: Sturgis Regional Hospital, - Facility 4: Lead-Deadwood Regional Hospital |
| Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 3: | 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. |
| Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 4: | 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. |
| Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 6i: | The implementation strategy is available at: http://www.regionalhealth.com/About-Us/Community-Needs-Assessment.aspx?furl=chna or upon request. |
| Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 7: | In review of the needs identified in the CHNA, Spearfish Regional Hospital has identified the areas below that will not be addressed due to prioritization of health needs:1) Maternal, Infant, Child Health: As a provider of maternal, infant and child hospital care in the community, SPRH believes it fulfills its role in this area. It was therefore given a lower priority that excluded this as an area chosen for action.2) Oral Health: SPRH 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.3) Nutrition, Physical Activity & Weight Status: It was determined that more pressing health needs exist. Limited resources and lower priority excluded this as an area chosen for action.4) Respiratory Diseases: SPRH believes this priority area falls within the purview of other available community resources, including outpatient clinical settings. Participation with the Good Shepherd Clinic positively impacts the ability for those with chronic respiratory disease to access the health care system.5) Substance Abuse: SPRH 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.6) Tobacco Use: SPRH 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.SPRH began to execute the implementation strategy during fiscal year 2014. The needs that are being addressed are as follows: 1) access to health services; 2) conditions of aging; 3) diabetes; 4) injury and violence prevention; and 5) mental health and mental disorders. |
| Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 14g: | A summary of the Hospital's financial assistance policy is posted for all patients at various points of entry, on the facility website, emergency and waiting rooms, and admissions office. The policy in its entirety is also available upon request. |
| Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 22: | All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
| Facility 2 -- Custer Regional Hospital Part V, Section B, line 3: | 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. |
| Facility 2 -- Custer Regional Hospital Part V, Section B, line 4: | 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. |
| Facility 2 -- Custer Regional Hospital Part V, Section B, line 6i: | The implementation strategy is available at: http://www.regionalhealth.com/About-Us/Community-Needs-Assessment.aspx?furl=chna or upon request. |
| Facility 2 -- Custer Regional Hospital Part V, Section B, line 7: | In review of the needs identified in the CHNA, Custer Regional Hospital has identified the areas below that will not be addressed due to prioritization of health needs:1) Access to Health Services: The specific concern identified here was annual checkups for children ages 0-17. National standards deem a checkup every three years as the standard of care for children older than three years of age. Local medical staff adheres to this standard. CRH was a recipient of a grant in FY 12 providing wellness checkups for kids when finances are a barrier to receiving care. 2) Cancer: CRH partners with the All Women Count program promoting early detection for women who have financial barriers to breast cancer screening. Awareness activities through the American Cancer Society currently exist in the community and surrounding area. The provider for mobile mammography services discontinued services in Western South Dakota in 2012. Efforts continue to replace this service yet won't have impact in the timeline and scope of this implementation plan.3) Conditions of Aging: In the area of Alzheimer's deaths, Custer Regional Senior Care is a licensed skilled nursing facility providing services to the elderly of the community. Services include a special care unit specifically serving residents with Alzheimer's and dementia related diagnoses. The Department of Social Services Adult Services and Aging department provides 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. 4) Injury & Violence Prevention: There are numerous activities currently provided to the community in the area of injury prevention which CRH will continue to be open to for opportunities for partnerships. CRH currently provides physician education presentations to employee groups surrounding safe logging practices and the Custer High School students on healthy decisions; CRH partners with the Custer School District in providing hands-on, experiential education, namely Freshman Impact, on distracted driving and driving under the influence and the negative consequences associated with those unsafe practices; Custer School District has an active Students Against Destructive Decisions group; firearm and hunter safety courses are currently provided; Custer Rotary Club provides area youth bicycle helmets at a community bike rodeo. 5) Mental Health & Mental Disorders: The Service Area 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 although deemed out of the scope for a Critical Access Hospital, CRH will continue to seek opportunities for partnerships with area entities to assist in addressing this issue in its primary service area. Current programs include the Helpline Center; Front Porch Coalition; Suicide Awareness Education in the schools; Veteran Administration Hospital in Fall River County addresses mental health concerns for military veterans; licensed mental health professionals provide counseling services; Department of Social Services provide case management services. 6) Oral Health: Insurance coverage for dental insurance was considered the barrier to adequate oral health and is currently addressed by a Mobile Dental Program providing no cost dental exams to area youth; local dentists provide in-class oral health education to elementary students and provide free dental screenings to children entering kindergarten.7) Respiratory Diseases: Tobacco Use was not an area of need identified. Chronic respiratory disease and pneumonia/influenza are currently addressed through community flu shot clinics and education of the public and health care personnel on importance of flu shots.8) Substance Abuse: Substance abuse issues are currently addressed with existing area programs and services to include Custer Regional Hospital's existing partnership with the Freshman Impact program previously noted. Other area programs and services include Custer Schools Students Against Destructive Decisions group; Southern Hills Alcohol and Drug Center provides substance abuse related services; Veteran's Administration in Fall River County provides Substance Abuse treatment for military veterans.CRH has began to execute the implementation strategy during fiscal year 2014. The needs that are being addressed are as follows: 1) diabetes; 2) heart disease and stroke; and 3) nutrition, physical activity and weight status. |
| Facility 2 -- Custer Regional Hospital Part V, Section B, line 14g: | A summary of the Hospital's financial assistance policy is posted for all patients at various points of entry, on the facility website, emergency and waiting rooms, and admissions office. The policy in its entirety is also available upon request. |
| Facility 2 -- Custer Regional Hospital Part V, Section B, line 22: | All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
| Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 3: | 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. |
| Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 4: | 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. |
| Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 6i: | The implementation strategy is available at: http://www.regionalhealth.com/About-Us/Community-Needs-Assessment.aspx?furl=chna or upon request. |
| Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 7: | In review of the needs identified in the CHNA, Sturgis Regional Hospital has identified the areas below that will not be addressed due to prioritization of health needs:1) Access to Health Services: SRH believes more pressing health needs existed. Lower priority excluded this as an area chosen for action.2) Injury & Violence Prevention: SRH has limited expertise available to address injury and violence prevention. The facility will work in collaboration with community partners as opportunity arises.3) Maternal, Infant, Child Health: SRH does not provide obstetrical services at the facility. There are other available resources in the community that serve this need. Limited expertise excluded this as an area chosen for action. 4) Oral Health: SRH has limited expertise available to address oral health. The facility will work in collaboration with community partners as opportunity arises.5) Respiratory Diseases: SRH believes more pressing health needs exist. Lower priority excluded this as an area chosen for action.6) Substance Abuse: SRH has limited expertise available to address alcohol and other drug issues. Other community organizations have infrastructure and programs in place to better meet this need. Limited expertise excluded this as an area chosen for action.7) Tobacco Use: Lower priority excluded this as an area chosen for action.SRH began to execute the implementation strategy. The needs that are being addressed are as follows: 1) conditions of aging; 2) diabetes; 3) mental health and mental disorders; and 4) nutrition, physical activity and weight status. |
| Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 14g: | A summary of the Hospital's financial assistance policy is posted for all patients at various points of entry, on the facility website, emergency and waiting rooms, and admissions office. The policy in its entirety is also available upon request. |
| Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 22: | All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
| Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 3: | 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. |
| Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 4: | 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. |
| Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 6i: | The implementation strategy is available at: http://www.regionalhealth.com/About-Us/Community-Needs-Assessment.aspx?furl=chna or upon request. |
| Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 7: | In review of the needs identified in the CHNA, Lead-Deadwood Regional Hospital has identified the areas below that will not be addressed due to prioritization of health needs:1) Access to Health Services: LDRH believes more pressing health needs existed. Lower priority excluded this as an area chosen for action.2) Conditions of Aging: In the area of Alzheimer's deaths, Golden Ridge Regional Senior Care is a licensed assisted living facility providing services to the elderly of the community. 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: LDRH does not provide obstetrical services at the facility. There are other available resources in the community that serve this need. Limited expertise excluded this as an area chosen for action. 4) Oral Health: LDRH 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: LDRH believes this priority area falls within the purview of other available community resources, including outpatient clinical settings. 6) Substance Abuse: LDRH 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: LDRH 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.LDRH began to execute the implementation strategy during fiscal year 2014. The needs that are being addressed are as follows: 1) diabetes; 2) injury and violence prevention; 3) mental health and mental disorders; and 4) nutrition, physical activity and weight status. |
| Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 14g: | A summary of the Hospital's financial assistance policy is posted for all patients at various points of entry, on the facility website, emergency and waiting rooms, and admissions office. The policy in its entirety is also available upon request. |
| Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 22: | All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| Custer Regional Senior Care | ||||
| 1065 Montgomery Street | Custer | SD | 57730 | Skilled long-term nursing home facility |
| Sturgis Regional Senior Care | ||||
| 949 Harmon Street | Sturgis | SD | 57785 | Skilled long-term nursing home facility |
| Hill City Clinic | ||||
| 238 Elm Street | Hill City | SD | 57745 | Clinic |
| Hot Springs Regional Medical Clinic | ||||
| 130 North 15th St | Hot Springs | SD | 57747 | Clinic |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Form 990, Schedule H: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 6a: | A community benefit report is completed by Regional Health, the parent organization, for all related organizations and made available to the public on its website at http://www.regionalhealth.com/About-Us/Community-Report.aspx |
| 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 and 7i. |
| Part I, Line 7, Column (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 $ 5,470,634. |
| Part II, Community Building Activities: | Regional Health provides numerous community benefit health 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. |
| 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 financial statements that describes bad debt expense is located on pages seven and eight of the audited financials. |
| Part III, Line 8: | The Medicare shortfall is derived from the actual payments received from the Medicare program for services provided to patients with Medicare coverage. The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. The result is a shortfall with costs exceeding the reimbursement.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, we have information available 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 serves the people of the Black Hills Region. The area is mostly rural in nature with only one city of over 50,000 people. Regional Health is the primary medical services provider for the region. |
| 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lee B Bailey MD | ||||||||||||||
| Director | $314,012 | $0 | $0 | $0 | $0 | $0 | $29,596 | $0 | $6,000 | $0 | $349,608 | $0 | $10,644 | $0 |
| Terry Graber MD | ||||||||||||||
| Director | $0 | $413,510 | $0 | $0 | $0 | $17,500 | $0 | $33,768 | $0 | $4,750 | $0 | $469,528 | $0 | $0 |
| Thomas Groeger MD | ||||||||||||||
| Director | $0 | $180,677 | $0 | $3,400 | $0 | $11,442 | $0 | $22,231 | $0 | $7,604 | $0 | $225,354 | $0 | $0 |
| Charles E Hart MD | ||||||||||||||
| President & CEO | $0 | $895,584 | $0 | $135,197 | $0 | $23,418 | $0 | $18,626 | $0 | $6,067 | $0 | $1,078,892 | $0 | $135,856 |
| Timothy H Sughrue | ||||||||||||||
| CEO RCRH, RHN & COO RHI | $0 | $543,030 | $0 | $83,267 | $0 | $19,471 | $0 | $20,444 | $0 | $6,104 | $0 | $672,316 | $0 | $0 |
| Mark A Thompson | ||||||||||||||
| VP CFO | $0 | $330,359 | $0 | $59,826 | $0 | $17,500 | $0 | $45,407 | $0 | $4,235 | $0 | $457,327 | $0 | $4,370 |
| David L Klocke MD | ||||||||||||||
| Chief Medical Officer | $0 | $286,933 | $0 | $17,191 | $0 | $7,000 | $0 | $24,752 | $0 | $6,770 | $0 | $342,646 | $0 | $0 |
| Joseph C Sluka Jr | ||||||||||||||
| Executive VP/CAO | $0 | $386,747 | $0 | $70,627 | $0 | $27,748 | $0 | $46,446 | $0 | $6,250 | $0 | $537,818 | $0 | $0 |
| Richard S Latuchie | ||||||||||||||
| VP Info Technology, CIO | $0 | $259,771 | $0 | $30,319 | $0 | $17,500 | $0 | $13,092 | $0 | $5,210 | $0 | $325,892 | $0 | $7,430 |
| Mary E Masten | ||||||||||||||
| VP Legal Services | $0 | $313,345 | $0 | $32,553 | $0 | $0 | $0 | $21,516 | $0 | $7,220 | $0 | $374,634 | $0 | $14,707 |
| Sharmila M Chandran | ||||||||||||||
| VP Corp Responsibilty | $0 | $139,503 | $0 | $17,033 | $0 | $0 | $0 | $11,477 | $0 | $272 | $0 | $168,285 | $0 | $0 |
| Mark F Brodin | ||||||||||||||
| VP Decision Support | $0 | $172,099 | $0 | $19,539 | $0 | $17,500 | $0 | $14,550 | $0 | $5,110 | $0 | $228,798 | $0 | $6,497 |
| Dale E Gisi | ||||||||||||||
| VP Human Resources (Thru 8/14/13) | $0 | $155,652 | $0 | $18,717 | $0 | $98,500 | $0 | $11,610 | $0 | $4,747 | $0 | $289,226 | $0 | $0 |
| Jennifer D Horton | ||||||||||||||
| VP PR Marketing | $0 | $165,535 | $0 | $19,018 | $0 | $0 | $0 | $20,104 | $0 | $7,750 | $0 | $212,407 | $0 | $0 |
| Michael G Diedrich | ||||||||||||||
| VP Human Resources - Interim | $0 | $159,109 | $0 | $33,752 | $0 | $0 | $0 | $6,240 | $0 | $7,612 | $0 | $206,713 | $0 | $0 |
| Glenn E Bryant | ||||||||||||||
| COO | $205,325 | $0 | $24,468 | $0 | $123,913 | $0 | $16,970 | $0 | $3,873 | $0 | $374,549 | $0 | $0 | $0 |
| Larry W Veitz | ||||||||||||||
| CEO of Spearfish Regional Hospital | $179,533 | $0 | $23,253 | $0 | $17,500 | $0 | $23,920 | $0 | $5,692 | $0 | $249,898 | $0 | $0 | $0 |
| Sherry Bea Smith | ||||||||||||||
| CEO of Lead-Deadwood Regional Hospit | $149,476 | $0 | $16,761 | $0 | $361 | $0 | $13,690 | $0 | $5,640 | $0 | $185,928 | $0 | $0 | $0 |
| Van Hyde | ||||||||||||||
| CEO of Sturgis Regional Hospital | $147,574 | $0 | $18,494 | $0 | $17,500 | $0 | $8,839 | $0 | $6,104 | $0 | $198,511 | $0 | $0 | $0 |
| Krista B Birkelo DO | ||||||||||||||
| Family Medicine | $298,195 | $0 | $0 | $0 | $330 | $0 | $21,344 | $0 | $1,819 | $0 | $321,688 | $0 | $0 | $0 |
| Christopher K Fromm MD | ||||||||||||||
| Family Medicine | $290,627 | $0 | $0 | $0 | $360 | $0 | $30,925 | $0 | $5,036 | $0 | $326,948 | $0 | $0 | $0 |
| Curtis J Liedtke DO | ||||||||||||||
| Family Medicine | $205,095 | $0 | $0 | $0 | $360 | $0 | $6,752 | $0 | $863 | $0 | $213,070 | $0 | $0 | $0 |
| Donald M Potts MD | ||||||||||||||
| Family Medicine | $258,607 | $0 | $0 | $0 | $360 | $0 | $24,495 | $0 | $3,896 | $0 | $287,358 | $0 | $0 | $0 |
| Thomas Reid | ||||||||||||||
| Nurse Anesthetist | $182,254 | $0 | $3,075 | $0 | $0 | $0 | $6,698 | $0 | $6,851 | $0 | $198,878 | $0 | $0 | $0 |
| Veronica L Schmidt | ||||||||||||||
| CEO of Custer Regional Hospital | $129,148 | $0 | $15,400 | $0 | $0 | $0 | $17,136 | $0 | $7,536 | $0 | $169,220 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, Lines 4a-b | Regional Health made severance payments to the following: Dale Gisi - $98,500 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: Lee B. Bailey, MD $16,842 Terry Graber, MD $20,483 Thomas Groeger, MD $11,384 Mark A. Thompson $28,714 David L. Klocke, MD $17,102 Joseph C. Sluka, Jr. $33,829 Sharmila M. Chandran $6,773 Jennifer Horton $10,543 Larry W. Veitz $12,891 Krista B. Birkelo, DO $13,546 Christopher K. Fromm, MD $18,729 Donald M. Potts, MD $16,334 Veronica L. Schmidt $7,871 |
| 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. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Custer Community Health Services Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Board Director David Thom is Board Director of CCHSI | RelationshipDescriptionTxt |
| Transaction | $264,688 | TransactionAmt |
| Transaction | Lease payments to Wedgwood Regional Senior Care and Custer Regional Senior Care, facilities owned by Custer Community Health Services, Inc. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part IV, Line 24a | Bond Issues: All related corporations are equally liable for the repayment of the bonds reported on the Rapid City Regional Hospital Form 990. |
| Form 990, Part V, Line 1a: | All 1099's are issued centrally by Rapid City Regional Hospital, Inc., a related organization. |
| 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, CEO, and 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). The Chairman of the Board of Directors shall serve as Chairman of the Executive Committee. 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. |
| 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, in one instance, is an employee of the organization. |
| Form 990, Part VI, Section A, line 2 | Charles E. Hart, MD has 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: Lee Bailey, MD, Thomas Groeger, MD, Terry Graber, Timothy Sughrue, Joseph Sluka Jr., Mark Thompson, Mark Brodin, Sharmila Chandran, Michael Diedrich, Dale Gisi, Jennifer Horton, Richard Latuchie, Mary Masten, and David Klocke. |
| Form 990, Part VI, Section A, line 6 | Regional Health, Inc. is the sole member of Regional Health Network, Inc. |
| Form 990, Part VI, Section A, line 7a | Regional Health, Inc., being the sole member of Regional Health Network, Inc., has the ability to appoint or remove all members of Regional Health Network, Inc.'s board members. |
| 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 directors 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 the appropriate base salary range of the CEO of the organization and its other executive staff. The CEO of the member or his designee then determines the actual base salary of the other executives within the committee-approved ranges based on a performance evaluation conducted by the CEO or designee. For determination of the base salary ranges, as well as incentive compensation, benefit plans and perquisites (total compensation), the compliance and audit committee retains an independent consultant, Sullivan and Cotter, to provide survey/comparability data for both base salary and total compensation at least every three years. The survey/compatibility data was provided in February 2013 and new market ranges were approved by the compliance and audit committee in October 2013 based on this information. |
| 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. |
| Part XII, Line 2c Explanation: | Committee Assuming Responsibility for Oversight of Audit: Independent auditors are engaged by the compliance and audit committee of the Regional Health, Inc. Board of Trustees. Final audit results, on a consolidated basis, are reported by the independent auditors directly to the compliance and audit committee. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Regional Health Inc | |||||||||||
| 353 Fairmont Blvd | Rapid City | SD | 57701 | 201487506 | Healthcare | SD | 501(c)(3) | Line 11c, III-FI | N/A | 0 | |
| Rapid City Regional Hospital Inc | |||||||||||
| 353 Fairmont Blvd | Rapid City | SD | 57701 | 460319070 | Healthcare | SD | 501(c)(3) | Line 3 | Yes (1) | Regional Health Inc | |
| Regional Health Physicians Inc | |||||||||||
| 353 Fairmont Blvd | Rapid City | SD | 57701 | 460372454 | Healthcare | SD | 501(c)(3) | Line 3 | Yes (1) | Regional Health Inc | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Medical & Dental Building | |||||||
| 2805 S 5th St | Rapid City | SD | 57701 | 460339629 | Medical Office Bldg | SD | N/A |
| Black Hills Medical Office BD LLC | |||||||
| 353 Fairmont Blvd | Rapid City | SD | 57701 | 411992146 | Medical Office Bldg | SD | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Regional Health Physicians Inc | ||
| J | $427,944 | Cost |
| Rapid City Regional Hospital Inc | ||
| K | $1,140,068 | Cost |
| Rapid City Regional Hospital Inc | ||
| M | $5,760,527 | Cost |
| Rapid City Regional Hospital Inc | ||
| Q | $1,859,617 | Cost |