2011-11-09T08:30:43-06:00 2010-12-31 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2010-01-01 460274380 WINNER REGIONAL HEALTHCARE CENTER WINN 6058427100 745 E 8TH ST WINNER SD 57580 CHRIS WORTHAM 6058427100 2011-11-08 1 LAURIE HANSON 6053391999 2011-11-08 2010 2016-02-24 21:20:13Z CHRIS WORTHAM 745 E 8TH ST WINNER SD 57580 16435622 0 X WWW.WINNERREGIONAL.ORG X 1961 SD TO PROVIDE HEALTHCARE SERVICES. 9 8 268 15 144998 -21262 49756 129500 15526370 16253699 84809 46573 5850 5850 15666785 16435622 0 0 0 0 8085432 8713679 0 0 0 7608156 7414122 15693588 16127801 -26803 307821 14407823 14479806 6595364 6409354 7812459 8070452 X THE SPIRITUAL, PHYSICAL AND MENTAL WELL-BEING OF OUR PATIENTS AND RESIDENTS IS OUR PRIMARY CONCERN. EXCELLENCE IN HEALTHCARE IS OUR TRADITION. 0 1 14455084 16108701 WINNER REGIONAL HEALTHCARE CENTER, A 25-BED CRITICAL ACCESS HOSPITAL AND 81 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 734 ACUTE ADMISSIONS AND 78 SWING BED ADMISSIONS; 168 LIVE BIRTHS; 1,743 EMERGENCY ROOM VISITS; AND 1,022 SURGICAL PROCEDURES. DURING THE CURRENT YEAR, THE FACILITY PROVIDED CHARITY CARE BASED ON THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES IN THE AMOUNT OF $453,662. 14455084 1 1 0 1 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 25 0 1 268 1 1 1 0 0 0 0 0 0 0 0 0 X 9 8 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X PHILLIP HUSHER 6058427213 745 EAST 8TH STREET WINNER SD 57580 TOM SCHRAMM 1.00 X X 0 0 0 MICK ROWE 1.00 X X 0 0 0 KEVIN OREL 1.00 X X 0 0 0 TOM KAUER 1.00 X X 0 0 0 MARY CARPENTER 1.00 X 0 0 0 DOUG KARTAK 1.00 X 0 0 0 BRIAN SCHAEFFER 1.00 X 0 0 0 ALICE DAUGHTERS 1.00 X 0 0 0 NEIL LANTZ 1.00 X 0 0 0 PHILLIP HUSHER 40.00 X 75000 0 13751 JAMES GISI 40.00 X 28764 0 1576 GORDON LARSON 40.00 X 122225 0 4100 LEE BALDWIN 40.00 X 27159 0 2751 RHONDA JORGENSEN 20.00 X 143011 0 10545 396159 0 32723 2 0 1 1 DMS HEALTH TECHNOLOGIES SDS12-2208 MINNEAPOLIS MN 55489 MRI 272311 WINNER PHYSICAL THERAPY PO BOX 435 WINNER SD 57580 THERAPY 259468 FAMILY PRACTICE ASSOCIATES PO BOX 110 WINNER SD 57580 EMERGENCY ROOM COVERAGE 230000 MEDICAL IMAGING INC 825 E 8TH ST WINNER SD 57580 IMAGING 177745 RURAL ANESTHESIA SERVICES PO BOX 246 GREGORY SD 57528 ANESTHESIA SERVICES 173575 5 43595 85905 129500 PATIENT SERVICE REV 622110 15960492 15960492 OTHER REVENUE 900099 148209 148209 REFERENCE LAB REV 621500 144998 144998 16253699 46573 46573 5850 5850 5850 5850 16435622 16108701 144998 52423 275501 275501 6919523 6232561 686962 112308 101077 11231 956277 871224 85053 450070 423620 26450 56145 56145 25106 25106 56482 56482 1822404 1730440 91964 76306 9437 66869 2866270 2738255 128015 81200 81200 479307 479307 74128 64454 9674 15737 9697 6040 284376 284376 834724 834724 131107 131107 BAD DEBT EXPENSE 422386 422386 REPAIRS & MAINTENANCE 103911 103785 126 LICENSES, DUES & SUBS 47803 14857 32946 SALES TAX 36730 3777 32953 16127801 14455084 1672717 0 5140857 5230103 2883409 3290868 39388 119074 576708 603702 28834 45800 14323820 9461540 5351768 4862280 217141 167313 169718 160666 14407823 14479806 1288764 1336099 3110000 2915000 2196600 2158255 6595364 6409354 X 7595318 7903139 217141 167313 7812459 8070452 14407823 14479806 X 307821 -49828 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 824 824 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: 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. 24638 24638 10471741 6796845 3674896 3827441 2664695 1162746 4862280 16435622 16127801 307821 -49828 -49828 257993 16435622 0 16435622 0 16435622 16127801 0 16127801 0 16127801 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER HAS ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION TOPIC ASC 740-10 (PREVIOUSLY FINANCIAL INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES), ON JANUARY 1, 2009. THE IMPLEMENTATION OF THIS STANDARD HAD NO IMPACT ON THE FINANCIAL STATEMENTS. AS OF BOTH THE DATE OF ADOPTION, AND AS OF DECEMBER 31, 2010, THE UNRECOGNIZED TAX BENEFIT ACCRUAL WAS ZERO. THE CENTER WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INCOME TAX EXPENSE IF INCURRED. THE ORGANIZATION IS NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2007. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -49,828. 1 1 X 0 0 1 1 1 0 0 296093 296093 0.01890 3870655 3652328 218327 0.01390 4166748 3652328 514420 0.03280 2130 1008 1122 0.00010 1240443 1067496 172947 0.01100 1950 1950 0.00010 1244523 1068504 176019 0.01120 5411271 4720832 690439 0.04400 2 225 10580 2200 8380 0.00050 3 50 456 50 406 0.00000 1 170 3394 983 2411 0.00020 6 445 14430 3233 11197 0.00070 0 275680 27570 5079477 4842447 237030 X 1 1 1 1 WINNER REGIONAL HEALTHCARE CENTER

745 E 8TH ST WINNER SD 57580

X X X X NA 1 1 WINNER REGIONAL NURSING HOME

745 EAST 8TH STREET WINNER SD 575802631

SKILLED NURSING FACILITY PART I, LINE 3C: 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: LINES 7A AND 7B WERE DETERMINED USING THE RATIO OF PATIENT CARE COSTS TO CHARGES CALCULATED IN IRS WORKSHEET 2. LINES 7E AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINE 7G WAS DETERMINED USING THE COST REPORT. PART I, L7 COL(F): BAD DEBT EXPENSE OF $422,386 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 OUR FACILITY HOLDS AND PROMOTES SEVERAL EVENTS EACH YEAR (18 IN 2010) THAT SERVE TO EDUCATE AND PROMOTE HEALTH AND WELLNESS. PART III, LINE 4: A) THE COST TO CHARGE RATIO WAS CALCULATED ON IRS WORKSHEET 2 FOR THE FISCAL YEAR ENDING 12/31/2010.B) ALL ACCOUNTS ARE CONSIDERED AT FACE VALUE. WHEN THE DEMOGRAPHICS OF THE AREA ARE CONSIDERED 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.C) WINNER REGIONAL OFFERS A DISCOUNT THE FIRST 30 DAYS AFTER THE BILL DATE. THE FACILITY SENDS STATEMENTS AFTER 30, 60, AND 90 DAYS. AT 120 DAYS IF THE PATIENT HAS NOT GIVEN ANY RETURN CORRESPONDENCE (I.E. CHARITY CARE, PAYMENT PLAN, ETC.), THE ACCOUNT IS CONSIDERED FOR COLLECTIONS. 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. D) FOOTNOTE FROM FINANCIAL STATEMENT: THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT AND RESIDENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND RESIDENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2010. 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." 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, AS WELL. IN 2010, 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 27,957. AVERAGE INCOME IS $31,721. PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS 26.24%. 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 6: THE FACILITY HAS A NINE MEMBER BOARD COMPRISED OF CITIZENS THAT OCCUPY 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. X 1 1 X X 0 0 0 0 0 0 0 0 0 PHILLIP HUSHER 75000 0 0 0 0 0 2281 0 11596 0 88877 0 0 0 JAMES GISI 28762 0 0 0 2 0 225 0 1367 0 30356 0 0 0 GORDON LARSON 122096 0 0 0 129 0 1060 0 3040 0 126325 0 0 0 RHONDA JORGENSEN 143011 0 0 0 0 0 4706 0 5839 0 153556 0 0 0 PART I, LINE 1A ROTARY CLUB DUES SUPPLEMENTAL INFORMATION PART III THE CEO OF THE ORGANIZATION, GORDON LARSON, THE CFO OF THE ORGANIZATION, PHILLIP HUSHER, AND THE LTC ADMINISTRATOR, JAMES GISI, ARE PAID THROUGH AN AGREEMENT WITH SANFORD HEALTH, SIOUX FALLS, SD. RHONDA JORGENSEN, CRNA, IS COMPENSATED BY WINNER REGIONAL HEALTHCARE CENTER. FAMILY PRACTICE ASSOCIATES DIRECTOR ON BOARD 230000 DR. CARPENTER IS A DIRECTOR ON THE BOARD AND A PARTNER IN FAMILY PRACTICE ASSOCIATES. FAMILY PRACTICE ASSOCIATES PROVIDES EMERGENCY ROOM COVERAGE AS AN INDEPENDENT CONTRACTOR. 0 CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 AS OF SEPTEMBER 2010, THE OUTREACH ONCOLOGIST NO LONGER SERVES WINNER REGIONAL HEALTHCARE CENTER. FORM 990, PART VI, SECTION A, LINE 3 SANFORD HEALTH NETWORK, AN UNRELATED ORGANIZATION, MANAGES THE FACILITY. THE CEO, CFO, DON OF LT CARE, LT CARE ADMINISTRATOR, AND DON 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. AS A RESULT, COMMITTEE MINUTES ARE NOT FORMALLY DOCUMENTED. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 2010 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 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -49,828. TOTAL TO FORM 990, PART XI, LINE 5: -49,828.