2013-11-14T15:15:36-06:00 2012-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2012-01-01 460274380 WINNER REGIONAL HEALTHCARE CENTER WINN 6058427100 745 E 8TH ST WINNER SD 57580 KEVIN COFFEY 6058427100 2013-11-13 1 LAURIE HANSON P00851848 6053391999 2013-11-13 2012 2016-02-24 21:20:13Z KEVIN COFFEY 745 E 8TH ST WINNER SD 57580 20000607 0 X WWW.WINNERREGIONAL.ORG X 1961 SD TO PROVIDE HEALTHCARE SERVICES. 10 10 512 16 0 0 3377795 854223 17352854 19083539 36276 43637 19389 19208 20786314 20000607 0 0 0 0 8998769 10243233 0 0 0 8012410 10589675 17011179 20832908 3775135 -832301 20728010 18029583 8883705 7127663 11844305 10901920 THE SPIRITUAL, PHYSICAL AND MENTAL WELL-BEING OF OUR PATIENTS AND RESIDENTS IS OUR PRIMARY CONCERN. EXCELLENCE IN HEALTHCARE IS OUR TRADITION. 0 0 18668744 19083539 WINNER REGIONAL HEALTHCARE CENTER, A 25-BED CRITICAL ACCESS HOSPITAL AND 79 BED LONG TERM CARE CENTER, PROMOTES HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF HEALTH CARE SERVICES INCLUDING ACUTE PATIENT TREATMENT, SWING BED, LONG-TERM CARE, AND NEW BORN CARE. THE FACILITY ALSO OPERATES A HOME HEALTH AGENCY, HOMEMAKER PROGRAM AND A COMMUNITY HEALTH PROGRAM AND PROVIDES COMMUNITY EDUCATION PROGRAMS THROUGHOUT THE SERVICE AREA. WINNER REGIONAL HEALTHCARE CENTER HAD 649 ACUTE ADMISSIONS AND 68 SWING BED ADMISSIONS; 168 LIVE BIRTHS; 1,802 EMERGENCY ROOM VISITS; AND 1,161 SURGICAL PROCEDURES. 18668744 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 1 512 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X PHILLIP HUSHER 6058427213 745 EAST 8TH STREET WINNER SD 57580 MICK ROWE 1.00 X X 0 0 0 BRIAN SCHAEFFER 1.00 X X 0 0 0 TOM KAUER 1.00 X X 0 0 0 KEVIN OREL 1.00 X X 0 0 0 TOM SCHRAMM UNTIL AUGUST 2012 1.00 X X 0 0 0 ALICE DAUGHTERS 1.00 X 0 0 0 NEIL LANTZ 1.00 X 0 0 0 JOEL LEYDEN 1.00 X 0 0 0 RICK WAGNER MD 1.00 X 0 0 0 DOUG KARTAK 1.00 X 0 0 0 MARY CARPENTER 1.00 X 0 0 0 PHILLIP HUSHER 40.00 X 80806 0 16207 CHRIS WORTHAM THRU JUNE 2012 40.00 X 61230 0 6145 JOHN OSSE JUNE 2012 - DEC 2012 40.00 X 93331 0 0 RHONDA JORGENSEN 20.00 X 149889 0 27835 385256 0 50187 1 0 1 1 SANDFORD HEALTH 745 E 8TH ST WINNER SD 57580 IT MAINTENANCE, COMPENSATION AND MANAGE 307036 WINNER PHYSICAL THERAPY PO BOX 435 WINNER SD 57580 THERAPY 253422 RURAL ANESTHESIA SERVICES PO BOX 246 GREGORY SD 57528 ANESTHESIA SERVICES 193963 MEDICAL IMAGING INC 825 E 8TH ST WINNER SD 57580 IMAGING 170900 4 670038 184185 18940 854223 PROG.SERV.REVENUE-RELATED-990 622110 19083539 19083539 19083539 43637 43637 19208 0 19208 19208 19208 20000607 19083539 0 62845 X 175571 175571 8312009 8002973 309036 97348 95293 2055 1119282 1044214 75068 539023 511468 27555 33786 33786 65349 65349 3835862 3138862 697000 123545 20866 102679 617077 527087 89990 242171 8908 233263 665354 665354 24851 24851 103064 77331 25733 310099 310099 979940 979940 175357 175357 MEDICAL SUPPLIES 2327093 2327093 BAD DEBTS 788219 788219 LICENSES, DUES & SUBSCR 151097 59630 91467 EQUIPMENT & MAINTENANCE 75745 75445 300 71066 11111 59955 20832908 18668744 2164164 0 5826046 5143220 8746496 6287440 0 0 110542 70680 617312 583166 17489 16263646 10775023 4866593 5488623 166031 193726 225886 59251 151615 203477 20728010 18029583 3843701 1788104 2710000 2410000 8260 2330004 2921299 8883705 7127663 X 11678274 10708194 166031 193726 11844305 10901920 20728010 18029583 X -832301 -110084 X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 957 957 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF DUES THAT WERE USED FOR LOBBYING. ORGANIZATION OFFICERS AND DIRECTORS WILL ALSO FROM TIME TO TIME CONTACT LEGISLATORS CONCERNING HEALTH CARE ISSUES AND BILLS. 0 1 X 24638 24638 10546028 7277195 3268833 5157000 3144098 2012902 535980 353730 182250 5488623 X 19212388 -788219 -788219 20000607 0 20000607 20182469 137780 137780 20044689 788219 788219 20832908 PART IV, LINE 2B: LONG-TERM CARE RESIDENTS REQUEST THE FACILITY TO HANDLE THEIR FINANCIAL AFFAIRS. THIS IS DIRECTED BY A WRITTEN AGREEMENT BETWEEN THE FACILITY AND THE RESIDENT. SOME EXAMPLES OF FINANCIAL AFFAIRS ARE SOCIAL SECURITY CHECKS, NURSING HOME PAYMENTS, AND HAIRCUTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CENTER BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE CENTER WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. THE CENTER'S FEDERAL FORM 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -788,219. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON IMPAIRMENT 137,780. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 788,219. 1 1 X 1 X 1 X 150.000000000000 1 1 0 0 135000 135000 0.00650 2553173 2006543 546630 0.02620 2688173 2006543 681630 0.03270 2918 1380 1538 0.00010 2000 2000 0.00010 4692869 3137774 1555095 0.07460 4697787 3139154 1558633 0.07480 7385960 5145697 2240263 0.10750 17388 5704 11684 0.00060 988 988 0.00000 4848 4848 0.00020 23224 5704 17520 0.00080 0 788219 78822 4430361 4386496 43865 X 1 1 1 1 WINNER REGIONAL HEALTHCARE CENTER

745 E 8TH ST WINNER SD 57580

X X X X WINNER REGIONAL HEALTHCARE CENTER 1 0 1 1 100.000000000000 1 150.000000000000 1 X X X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 2 WINNER REGIONAL NURSING HOME

745 EAST 8TH STREET WINNER SD 575802631

SKILLED NURSING FACILITY WINNER REGIONAL CLINIC

745 EAST 8TH STREET WINNER SD 575802631

RURAL HEALTH CLINIC PART I, LINE 3C: IN ADDITION TO UTILIZING FEDERAL POVERTY GUIDELINES, THE FOLLOWING ITEMS ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: PERSONAL ASSETS, LIABILITIES, INDIVIDUAL AND/OR FAMILY INCOME, NET WORTH, EMPLOYMENT STATUS OR EARNING CAPACITY, FAMILY SIZE, OTHER FINANCIAL OBLIGATIONS, FREQUENCY OF HEALTH SERVICES AND OTHER SOURCES OF PAYMENT FOR HEALTHCARE SERVICES RENDERED. THIS INFORMATION IS REVIEWED AND A DETERMINATION OF ELIGIBILITY FOR ASSISTANCE IS MADE BY THE PATIENT SERVICES REPRESENTATIVE AND THE CFO. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINES 7E AND 7F WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINES 7B AND 7G WERE DETERMINED USING THE COST REPORTS. PART I, L7 COL(F): BAD DEBT EXPENSE OF $788,219 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. PART II: WINNER REGIONAL HEALTHCARE CENTER FEELS THAT THE HEALTH AND WELLNESS OF OUR COMMUNITY ARE OF UTMOST IMPORTANCE. AS THE LARGEST HEALTHCARE LEADER IN THE COMMUNITY, WE ARE A CENTRALIZED RESOURCE THAT NOT ONLY PROVIDES COMPASSIONATE PATIENT CARE, BUT ALSO WELLNESS COUNSELING, CLASSES, PRESENTATIONS AND EVENTS, ALONG WITH FOCUSED EDUCATION AND LOW COST AND COMPLIMENTARY MEDICINE AND HEALTHY FITNESS PROGRAMS AND INFORMATION. WE WORK TO ENHANCE THE QUALITY OF LIFE AND EMPOWER OUR PATIENTS, CARE-GIVERS AND OUR COMMUNITY WITH THE RESOURCES THEY NEED WHEN THEY NEED THEM. OUR FREE AND LOW COST SEMINARS ARE OF GREAT BENEFIT TO THE COMMUNITY AND SERVE TO EDUCATE AND PROMOTE HEALTH AND WELLNESS. PART III, LINE 4: A) BASED ON THE DEMOGRAPHICS OF THE AREA, APPROXIMATELY 10% OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY.B) BAD DEBT EXPENSE IS RECORDED AT GROSS CHARGES. IF AN ACCOUNT IS WRITTEN OFF TO BAD DEBTS, PAYMENTS RECEIVED AFTER THE WRITE OFF FOR THAT ACCOUNT ARE POSTED TO THE CURRENT YEAR BAD DEBT ACCOUNT AS AN OFFSET AGAINST THE EXPENSE. C) FOOTNOTE FROM FINANCIAL STATEMENT: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CENTER'S PROCESS FOR CALCULATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS HAS NOT SIGNIFICANTLY CHANGED FROM DECEMBER 31, 2011 TO DECEMBER 31, 2012. THE CENTER DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE OFFS FROM THIRD-PARTY PAYORS. THE HOSPITAL HAS NOT SIGNIFICANTLY CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2012 OR 2011. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2012. PART III, LINE 9B: THE COLLECTION POLICY ALLOWS FOR CHARITY CARE TO BE OBTAINED DURING THE COLLECTION PROCESS IF THE PATIENT DID NOT QUALIFY DUE TO A LACK OF DOCUMENTATION IN THE PATIENT'S FILE. THE POLICY SPECIFICALLY STATES "A PATIENT WILL NOT BE DENIED CHARITY CARE CONSIDERATION BECAUSE OF A LACK OF DOCUMENTATION TO VERIFY INCOME." WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 80% OF GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 20%. THE HOSPITAL WILL REVIEW THE PROPOSED METHODS TO DETERMINE AMOUNTS GENERALLY BILLED TO ENSURE ITS DISCOUNT UNDER THE FINANCIAL ASSISTANCE POLICY MEETS THE REQUIREMENTS OF 501(R). PART VI, LINE 2: WINNER REGIONAL HEALTHCARE CENTER IS PROUD TO BE THE HEALTHCARE LEADER IN THE COMMUNITY AND SOUTHERN TRIPP COUNTY. ONE OF OUR PRIORITIES IS TO PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY - NOT ONLY TO INDIVIDUALS, BUT TO THE COMMUNITY AS A WHOLE. IN 2012, WE INDIVIDUALLY AND IN CONCERT WITH OTHER ORGANIZATIONS, HELD EIGHTEEN EVENTS OF BENEFIT TO THE COMMUNITY. THROUGH OUTREACH TO OUR COMMUNITY, INCLUDING OUR HOME HEALTH DEPARTMENT, OUR PUBLIC SAFETY LIAISON, AND THROUGH WORKING WITH LOCAL, STATE AND FEDERAL DEPARTMENTS, WE DETERMINE THE HEALTH CARE NEEDS OF OUR COMMUNITY, AND WORK TO ENSURE THE SERVICES AND EVENTS WE PROVIDE TO THE COMMUNITY ARE BENEFICIAL AND IN ACCORDANCE WITH NEED. PART VI, LINE 3: OUR PROCESS FOR NOTIFYING PATIENTS OF FINANCIAL ASSISTANCE IS TO VISIT WITH THEM WHILE THEY ARE IN THE FACILITY. OUR PATIENT FINANCIAL REPRESENTATIVE REVIEWS THE CENSUS EVERY MORNING TO DETERMINE IF A PATIENT IS PRIVATE PAY. THE REPRESENTATIVE VISITS WITH THE PATIENT TO DETERMINE WHETHER THEY HAVE INSURANCE IN ADDITION TO WHAT HAS BEEN PROVIDED TO THE HOSPITAL, AND WHETHER THEY NEED ASSISTANCE WITH APPLYING FOR MEDICAID (IF APPLICABLE). THE REPRESENTATIVE PROVIDES CHARITY CARE INFORMATION IF THE PATIENT BELIEVES THIS TYPE OF FINANCIAL ASSISTANCE MAY BE NEEDED. CHARITY CARE APPLICATIONS ARE ALSO PROVIDED UPON REQUEST AND TO PERSONS WHO HAVE NOT BEEN MAKING PAYMENTS AS SCHEDULED. PART VI, LINE 4: WINNER REGIONAL HEALTHCARE CENTER (WRHC) IS LOCATED IN WINNER, SOUTH DAKOTA WHICH IS AT THE CENTER OF TRIPP COUNTY. COMMUNITIES IN TRIPP COUNTY INCLUDE CARTER, CLEARFIELD, COLOME, HAMILL, IDEAL AND WINNER. WRHC'S SERVICE AREA EXTENDS INTO GREGORY, MELLETTE, AND TODD COUNTIES IN SOUTH DAKOTA AND INCLUDES THE CITIES OF MISSION, WOOD, WHITE RIVER, GREGORY, BURKE, DALLAS, HERRICK, BONESTEEL AND FAIRFAX. THE SERVICE AREA INCLUDES NORTHERN CHERRY AND KEYA PAHA COUNTIES IN NEBRASKA AND ENCOMPASSES THE CITIES OF SPRINGVIEW, SPARKS AND VALENTINE. FARMING AND RANCHING ARE THE PRIMARY INDUSTRIES IN THIS RURAL AREA. THE POPULATION OF THE AREA IS 28,324. AVERAGE INCOME IS $34,992. PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS 27.89%. OTHER HOSPITALS SERVING THE AREA INCLUDE VALENTINE HOSPITAL, BURKE COMMUNITY MEMORIAL, GREGORY HOSPITAL AND ROSEBUD HOSPITAL. ALL COUNTIES IN THE SERVICE AREA ARE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS. PART VI, LINE 5: THE FACILITY HAS A NINE MEMBER BOARD COMPRISED OF CITIZENS THAT LIVE IN THE PRIMARY SERVICE AREA. THE FACILITY EXTENDS PRIVILEGES TO PHYSICIANS IN THE IMMEDIATE AREA. THE FACILITY USES SURPLUS FUNDS TO FUND BUILDING IMPROVEMENTS TO ENHANCE SERVICES TO OUR PATIENTS. THE FACILITY RECENTLY REMODELED THE LABORATORY AND CONSTRUCTED A HEALING GARDEN TO ENHANCE THE PATIENT'S EXPERIENCE. PART VI, LINE 6: SANFORD HEALTH NETWORK PROVIDES MANAGEMENT SERVICES TO WINNER REGIONAL HEALTHCARE. X 1 1 X X 0 0 0 0 0 0 0 0 0 PHILLIP HUSHER 80159 0 0 0 647 0 3196 0 13010 0 97012 0 0 0 CHRIS WORTHAM THRU JUNE 2012 60986 0 0 0 244 0 1225 0 4920 0 67375 0 0 0 JOHN OSSE JUNE 2012 - DEC 2012 93331 0 0 0 0 0 0 0 0 0 93331 0 0 0 RHONDA JORGENSEN 149889 0 0 0 0 0 4864 0 22971 0 177724 0 0 0 PART I, LINE 1A ROTARY CLUB DUES SUPPLEMENTAL INFORMATION PART III THE CEO OF THE ORGANIZATION, JOHN OSSE, AND CHRIS WORTHAM, AND THE CFO OF THE ORGANIZATION, PHILLIP HUSHER, ARE PAID THROUGH AN AGREEMENT WITH SANFORD HEALTH, SIOUX FALLS, SD. RHONDA JORGENSEN, CRNA, IS COMPENSATED BY WINNER REGIONAL HEALTHCARE CENTER. A CITY OF WINNER 466000552 97477JBG2 2012-11-01 2410000 REFUNDING OF DECEMBER 1ST, 1998 ECONOMIC DEVELOPMENT HOSPITAL REVENUE BONDS 0 0 0 A 2481982 341450 112200 2507475 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 A 0 SCHEDULE K SUPPLENTAL INFORMATION PART II LINE 3, RECONCILIATION OF TOTAL PROCEEDS OF ISSUE TO ISSUE PRICE: $2,410,000.00 ISSUE PRICE 64,000.00 EQUITY CONTRIBUTION FOR COI OVER 2.00% 7,981.27 NET REQUIRED FOR CALL DATE INTEREST $2,481,981.27 TOTAL SOURCES FORM 990, PART VI, SECTION A, LINE 3 SANFORD HEALTH NETWORK, AN UNRELATED ORGANIZATION, MANAGES THE FACILITY. THE CEO, CFO, DIRECTOR OF NURSING OF LONG-TERM CARE, LONG-TERM CARE ADMINISTRATOR, AND DIRECTOR OF NURSING OF THE HOSPITAL ARE EMPLOYEES OF THE MANAGEMENT COMPANY. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEES MAKE RECOMMENDATIONS TO THE GOVERNING BODY, WHICH APPROVES ALL ACTIONS. NO COMMITTEES HAVE BROAD AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 2012 FORM 990 WAS PROVIDED TO THE GOVERNING BODY ELECTRONICALLY PRIOR TO FILING. THE CFO REVIEWS A DRAFT OF THE FORM 990 IN DETAIL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE IS MONITORED THROUGH THE USE OF ANNUAL QUESTIONNAIRES THAT EACH OFFICER, DIRECTOR, TRUSTEE, AND KEY EMPLOYEE MUST COMPLETE. THE FULL BOARD SHALL BE ADVISED OF DEALINGS AND CONTRACTS TO BE MADE WITH ANY BOARD MEMBER(S), PHYSICIAN(S) OR EMPLOYEE(S). THE BOARD AND THE CEO IMPLEMENT AND CONTROL ALL CONFLICTS THAT MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION OF THE CEO AND OTHER EMPLOYEES OF THE MANAGEMENT COMPANY ARE DETERMINED BY THE WINNER REGIONAL HEALTHCARE BOARD WHO EVALUATES SALARIES ANNUALLY USING COMPARABLE DATA FOR OTHER FACILITIES WITHIN THE STATE. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST OTHER FEES FORM 990, PART IX, LINE 11G HM PRODUCTION FEE: PROGRAM SERVICE EXPENSES 32,257. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,257. NUTRITION SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 253. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 253. ENVIRONMENTAL SERICES CONTRACTS: PROGRAM SERVICE EXPENSES 371. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 371. CENTRAL SUPPLY SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 108. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 108. PLANT MAINT AND REPAIR SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 15,313. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,313. GENERAL MED ROUTINE SERVICE: PROGRAM SERVICE EXPENSES 112,509. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 112,509. RADIOLOGY DIAGNOSTICS SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 317,274. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 317,274. MRI: PROGRAM SERVICE EXPENSES 99,520. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,520. MAMMOGRAM SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 34,492. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,492. BLOOD BANK PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 24,342. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,342. CORE LAB SERVICE: PROGRAM SERVICE EXPENSES 164,445. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,445. SURGERY SERVICE: PROGRAM SERVICE EXPENSES 41,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,000. ANESTHESIA SERVICE: PROGRAM SERVICE EXPENSES 199,247. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 199,247. EMERGENCY DEPARTMENT MEDICAL: PROGRAM SERVICE EXPENSES 310,128. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 310,128. PHARMACEUTICAL SERVICES SERVICE: PROGRAM SERVICE EXPENSES 57,414. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,414. PHYSICAL THERAPY PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 153,127. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 153,127. OCCUPATIONAL THERAPY PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 23,707. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,707. SPEECH PATHOLOGY PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 2,485. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,485. OUTPATIENT SERVICES SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 60,377. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,377. EEG SCANNING OUTSIDE MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,470. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,470. NUCLEAR MEDICINE: PROGRAM SERVICE EXPENSES 99,168. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,168. NURSING ADMINISTRATION PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 91,151. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,151. WINNER CLINIC MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 369,134. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 369,134. ROUTINE NURSING HOME: PROGRAM SERVICE EXPENSES 834,523. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 834,523. HOME HEALTH FEES: PROGRAM SERVICE EXPENSES 93,047. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,047. ADMINISTRATION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 551,411. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 551,411. BUSINESS OFFICE SERVICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 37,341. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,341. RISK MANAGEMENT SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 79,878. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,878. MARKETING PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 14,185. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,185. FOUNDATION PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 14,185. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,185. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 27,696. LOSS ON IMPAIRMENT -137,780.