2025-03-27T16:38:52-05:00 2024-06-30 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2023-07-01 466015787 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION LAND 6055832226 600 BILLARS ST SCOTLAND SD 570592026 MELISSA GALE CEO 6055832226 2025-03-27 1 1 LAURIE HANSON CPA P00851848 6053391999 2025-03-27 X 2023 2025-03-06 01:10:19Z MELISSA GALE 600 BILLARS ST SCOTLAND SD 570592026 6907114 0 X WWW.AVERA.ORG/SCOTLAND X 1969 SD OPERATION OF A COMMUNITY CRITICAL ACCESS HOSPITAL. 7 7 50 9 0 0 202788 50441 6387218 6839141 12703 17532 0 0 6602709 6907114 0 0 0 0 3885147 3988353 0 0 0 3117706 3483226 7002853 7471579 -400144 -564465 5343296 5017540 1969886 2159594 3373410 2857946 LANDMANN-JUNGMAN MEMORIAL HOSPITAL IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTHCARE WITH COMPASSION AND RESPECT. OUR COMMITMENT SHALL BE TO THE ETHICAL TREATMENT OF ALL PEOPLE THROUGHOUT THE CONTINUUM OF LIFE. 0 0 6311985 6839141 LANDMANN-JUNGMAN MEMORIAL HOSPITAL (LJMH) IS A LICENSED CRITICAL ACCESS HOSPITAL WITH 20 ACUTE CARE BEDS, OF WHICH 10 MAY BE USED AS SWING BEDS. THE FACILITY ALSO OPERATES A 16-UNIT SENIOR HOUSING APARTMENT COMPLEX. THE FACILITY OFFERS INPATIENT, OUTPATIENT (THERAPIES, LABORATORY, IMAGING, CARDIAC REHABILITATION), AND PHYSICIAN CLINIC SERVICES TO RESIDENTS IN AND AROUND THE CITY OF SCOTLAND, SD. SPECIALTY SERVICES SUCH AS MOBILE IMAGING, HOME SLEEP STUDIES, CARDIOVASCULAR AND ULTRASOUND SERVICES ARE PROVIDED TO PATIENTS THROUGH CONTRACTED SERVICES. LJMH IS PROUD OF THE EXCELLENT CARE IT PROVIDES FOR PATIENTS OF THE SERVICE AREA. THE FACILITY IS ALSO NOTED FOR ITS COMMUNITY SERVICE WHICH INCLUDES COMMUNITY HEALTH EDUCATION AND HEALTH CARE SUPPORT. 6311985 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 20 0 1 50 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X ERIN ODENS 6055832226 600 BILLARS STREET SCOTLAND SD 57059 MELISSA GALE CEO 40.00 X 165518 0 23948 KENT MUNGER PHARMACIST 40.00 X 110089 0 17768 LAURIE MCKEE DIRECTOR OF PATIENT SERVICE 40.00 X 109656 0 5695 ERIN ODENS CFO 40.00 X 90347 0 19984 JARED SCHORTMAN PRESIDENT UNTIL 12/2023 1.00 X X 0 0 0 MARK VANVUUREN PHARMACIST 40.00 X 132752 0 19490 RHONDA BOUZA VP/PRESIDENT FROM 01/2024 0.50 X X 0 0 0 REBECCA PEDERSEN SECRETARY/ VP FROM 01/2024 0.50 X X 0 0 0 DEVIN LUBINUS TREASURER 0.50 X X 0 0 0 SARAH MEYER DIRECTOR/SECRETARY FROM 01/2024 0.50 X X 0 0 0 CARL FUERST DIRECTOR 0.50 X 0 0 0 MEGAN VAITH DIRECTOR UNTIL 12/2023 0.50 X 0 0 0 PAM STEWART DIRECTOR FROM 01/2024 0.50 X 0 0 0 STEVE LOWE DIRECTOR FROM 01/2024 0.50 X 0 0 0 608362 0 86885 3 0 1 1 AVERA MCKENNAN 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS SD 571175045 MANAGEMENT/OTHER HEALTHCARE 1567662 HEALTH CAROUSEL LLC PO BOX 714216 CINCINNATI OH 452714216 CONTRACT NURSING 344866 AVERA HEALTH 3900 W AVERA DR STE 301 SIOUX FALLS SD 57108 HEALTH SERVICES 217628 AVEL E-CARE LLC 4500 N LEWIS AVE SIOUX FALLS SD 57104 E-HEALTH SERVICES 137426 EIDE BAILLY PO BOX 5125 SIOUX FALLS SD 571175045 ACCOUNTING SERVICES 126613 5 50441 50441 NET PATIENT SERVICE RE 621110 5632510 5632510 PHARMACY REVENUE 456110 1078656 1078656 WEST WINDS REVENUE 623990 109500 109500 18475 18475 6839141 17532 17532 6907114 6839141 0 17532 X 305555 305555 3325482 3145167 180315 28435 26397 2038 179064 136680 42384 149817 129839 19978 78788 78788 809244 698450 110794 10141 10141 299238 235787 63451 106466 106466 15390 14938 452 53710 42440 11270 367266 294728 72538 54887 43370 11517 MEDICAL SUPPLIES 1514668 1401651 113017 LICENSE AND PERMITS 149400 17694 131706 CONTINUING EDUCATION 8341 6839 1502 15687 1398 14289 7471579 6311985 1159594 0 313912 531992 649728 620520 15000 275000 180648 32117 36055 8371269 5332489 3273916 3038780 540623 594545 258000 0 5343296 5017540 799588 770900 1111258 1063654 59040 325040 1969886 2159594 X 3373410 2857946 3373410 2857946 5343296 5017540 X -564465 23649 25352 X 0 1 X 1 1 1 X 36163 36163 5771221 3887046 1884175 2452319 1360283 1092036 111566 85160 26406 3038780 INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION 115669 F ASSETS LIMITED AS TO USE 478876 F 594545 CONDITIONAL ASSET RETIREMENT OBLIGATION 59040 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 266000 325040 X 6956115 23649 25352 49001 6907114 0 6907114 7471579 0 7471579 0 7471579 PART X, LINE 2: THE HOSPITAL 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 HOSPITAL 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN AVERA FOUNDATION 25,352. 1 1 X 1 X 1 X 1 1 1 0 1 1 32000 32000 0.00430 0 0 32000 32000 0.00430 17 3530 21026 3100 17926 0.00240 1521655 1142615 379040 0.05070 1 75 75 75 0.00000 18 3605 1542756 1145715 397041 0.05310 18 3605 1574756 1145715 429041 0.05740 2 821 961 961 0.00010 2 821 961 961 0.00010 1 185646 24134 1955758 1969242 -13484 X 1 1 1 1 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION 600 BILLARS STREET SCOTLAND SD 57059 WWW.AVERA.ORG/SCOTLAND 10561 X X X X PROVIDER BASED CLINIC LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPO 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V, LINE 7D X X 1 21 1 SEE PART V, LINE 7D 0 1 X 150.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X SEE 16J NARRATIVE X SEE 16J NARRATIVE X SEE 16J NARRATIVE X X X X X X X 1 X 0 X X X X 1 X 0 0 LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 5: A VARIETY OF INDIVIDUALS FROM VARIOUS GROUPS AND ORGANIZATIONS WERE INVOLVED IN THE CHNA PROCESS FROM NOVEMBER 2021 THROUGH MARCH 2022. METHODS TO GATHER DATA INCLUDED: ANONYMOUS SURVEY SENT OUT ELECTRONICALLY AND PAPER SURVEYS; FORMAL INTERVIEWS GATHERED VIA TELEPHONE DUE TO THE COVID19 PANDEMIC AND PUBLIC HEALTH EMERGENCY; STATISTICAL DATA FROM RELIABLE DATA REPOSITORIES OR AGENCIES; INFORMAL DISCUSSIONS; REVIEW OF CLINICAL/MEDICAL SERVICES AND GRANT PROJECTS AT LJMH. ORGANIZATIONS TAKING PART IN THE INTERVIEWS INCLUDED: BON HOMME COUNTY HEALTH NURSE, LJMH AND SCOTLAND CLINIC, SCOTLAND PHARMACY, FIRST CHIROPRACTIC CLINIC, BON HOMME COUNTY DEPARTMENT OF SOCIAL SERVICES, SCOTLAND SCHOOL DISTRICT, PARENT TEACHER ASSOCIATION, SCOTLAND PUBLIC LIBRARY, SCOTLAND YOUTH CENTER, SCOTLAND RODEO CLUB, SCOTLAND ATHLETIC ASSOCIATION, SCOTLAND TRAP SHOOTING CLUB, SCOTLAND DAWSON CREEK GOLF COURSE, SCOTLAND WELLNESS CENTER, SCOTLAND PUBLIC POOL AND PARKS, LOCAL DAYCARE FACILITIES, CITY OF SCOTLAND, SCOTLAND FIRE DEPARTMENT, SCOTLAND EMS, SCOTLAND ECONOMIC DEVELOPMENT, SCOTLAND CHAMBER OF COMMERCE, SCOTLAND HOUSING DEVELOPMENT CORPORATION, LOW INCOME APARTMENT MANAGEMENT IN SCOTLAND, SCOTLAND FOOD PANTRY, THE GOOD STUFF, MEALS ON WHEELS, SCOTLAND ROTARY CLUB, POET RESEARCH CENTER, VFW, VFW AUXILIARY, AMERICAN LEGION. RESPONDENTS INCLUDED REPRESENTATION FROM LOW-INCOME, UNDERSERVED POPULATIONS. LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 7D: CHNA: HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/56B3DB72-76ED-46AA-B49E-CBE0BE6ED6B6/2022-CHNA-LANDMANN-JUNGMAN.PDFIMPLEMENTATION STRATEGY: HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/B671C745-8D1C-4662-A2FF-B2C6FE300D9F/2022-CHNA-LANDMANN-IMPLEMENTATION-PLAN.PDF LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 11: LANDMANN JUNGMAN MEMORIAL HOSPITAL CONDUCTED A CHNA FROM NOVEMBER 2021-MARCH 2022. THE PRIORITIES FROM THE NEEDS ASSESSMENT WERE BEHAVIORAL HEALTH CONCERNS, HEALTH EDUCATION, ACCESS TO HEALTH CARE FROM PEDIATRIC TO GERIATRIC, CHRONIC DISEASE TREATMENT AND PREVENTION AND SOCIAL DETERMINANTS OF HEALTH. TO ADDRESS THESE NEEDS, AN IMPLEMENTATION PLAN WAS APPROVED WITH MANY GOALS IN EACH AREA AND CORRESPONDING ACTION PLANS. HEALTH EDUCATION - HEALTH EDUCATION FOR MANY TOPICS WAS ASSESSED AND IDENTIFIED AS A NEED. SOME OF THE EXAMPLES OF NEEDED HEALTH EDUCATION INCLUDE MORE HEALTH EDUCATION IN THE SCHOOL NOT ONLY WITH STUDENTS BUT ALSO WITH STAFF, IMMUNIZATION EDUCATION, YOUTH HEALTH EDUCATION, HEALTHY LIVING EDUCATION SPECIFICALLY INCLUDING HEALTHY EATING AND PREVENTION OF OBESITY, BENEFITS OF TELEHEALTH EDUCATION, AS WELL AS ALCOHOL AND SUBSTANCE ABUSE EDUCATION. BEHAVIORAL HEALTH CONCERNS - BEHAVIORAL HEALTH NEEDS IDENTIFIED DURING THE PROCESS INCLUDED MULTIPLE DIFFERENT TOPICS AND AREAS OF NEED. THESE NEEDS INCLUDED SUBSTANCE USE, LOCAL FACE-TO-FACE MENTAL HEALTH COUNSELING ACCESS, LACK OF ACCESS FOR BEHAVIORAL HEALTH CARE, SUBSTANCE USE EDUCATION, AND OTHER HEALTH BEHAVIOR EDUCATION FOR THE TEEN POPULATION IN GENERAL. SOCIAL DETERMINANTS OF HEALTH - MANY DIFFERENT SOCIAL DETERMINANTS OF HEALTH WERE IDENTIFIED AS NEEDS, RANGING FROM DILAPIDATED HOMES, RUNDOWN SIDEWALKS, POVERTY, AFFORDABLE HEALTHCARE NEEDS, AND TRANSPORTATION ISSUES, HOUSING NEEDS INCLUDING LOW INCOME HOUSING AND ASSISTED LIVING CENTERS, TO LACK OF CHILDCARE OPTIONS. CHRONIC DISEASE TREATMENT AND PREVENTION - NEEDS IDENTIFIED INCLUDE PROVIDING CARE FOR CHRONIC DISEASES AS WELL AS PREVENTING DISEASES IN OUR COMMUNITY. DIABETES, CANCERS, AND CARDIAC DISEASES ALL RANKED HIGH AS NEEDS IDENTIFIED IN OUR SERVICE AREA.ACCESS TO HEALTH CARE FROM PEDIATRIC TO GERIATRIC - HAVING HEALTHCARE AND MAINTAINING HEALTHCARE IN THE SERVICE AREA WAS A RECURRENT THEME AS A HEALTH NEED IDENTIFIED, INCLUDING THE NEED TO KEEP CARE LOCAL WITH HAVING SPECIALTY CARE ONSITE VERSUS SENDING PATIENTS TO SPECIALISTS OR UTILIZING TELEMED OPTIONS. THIS RANGED FROM CLINIC CARE, SPECIALTY ACCESS, EMERGENCY ROOM CARE, THERAPY SERVICES, EMS SHORTAGE, DENTAL SERVICES, OPTOMETRY SERVICES, PEDIATRIC AND GERIATRIC CARE, URGENT CARE CLINIC HOURS OR EXTENDED HOURS DURING INCREASED ILLNESS SEASONS, AND EXPANDED PHARMACY SERVICES.WE ARE ADDRESSING CHRONIC DISEASE WITHIN THE OTHER THREE IDENTIFIED NEEDS OF HEALTH EDUCATION, BEHAVIORAL HEALTH, AND ACCESS TO HEALTH CARE.ALTHOUGH MANY SOCIAL DETERMINANTS OF HEALTH FACTORS AND BUILT ENVIRONMENT NEEDS WERE CONSIDERED A NEED IN THE COMMUNITY, THE COMMITTEE FELT AT THIS TIME THAT THE HOSPITAL CANNOT ADDRESS THE BUILT ENVIRONMENT, CONCERNS OVER LACK OF HEALTHY FOOD ACCESS, DILAPIDATED HOMES AND CITY SIDEWALKS, POVERTY, LACK OF CHILD CARE OPTIONS, AND TRANSPORTATION ISSUES IN THE COMMUNITY ALONE. TO HELP ADDRESS THESE NEEDS, THE HOSPITAL WILL COMMIT TO HAVING A REPRESENTATIVE AT THE TABLE WITH LOCAL PROGRAMS AND PROJECTS THAT WORK TOGETHER TO ADDRESS BUILT ENVIRONMENT ISSUES RELATED TO EXERCISE AND HEALTHY EATING, AS WELL AS RELATED SOCIAL DETERMINANTS OF HEALTH.HEALTH EDUCATION - OVERARCHING GOAL: PROVIDE HEALTH AND BEHAVIORAL HEALTH EDUCATION IN A VARIETY OF LEARNING PLATFORMS TO LANDMANN JUNGMAN'S SERVICE AREA. UTILIZED OUR SOCIAL MEDIA PLATFORM AND LOCAL NEWSPAPER ON A VARIETY OF HEALTH ISSUES. PROVIDED HEALTHCARE EDUCATION TO COMMUNITY DURING SUMMER EVENTS. HELD FOOT CLINIC DAYS TO EDUCATE PEOPLE, ESPECIALLY PEOPLE LIVING WITH DIABETES, ABOUT THE IMPORTANCE OF PROPER FOOT CARE. EDUCATED IMPORTANCE OF IMMUNIZATIONS WHILE HOLDING FLU AND COVID SHOT CLINICS AT FACILITY, SCHOOL, AND OTHER BUSINESSES. TAUGHT HANDS ONLY CPR AND STOP THE BLEED AT SCOTLAND MIDDLE SCHOOL. FACILITATED HEALTH CARE PREVENTION GAMES FOR ANNUAL FALL FESTIVAL. HIGHLIGHTED HEALTHCARE CAREERS AT CAREER FAIR FOR GRADES 8-12.BEHAVIORAL HEALTH CONCERNS - OVERARCHING GOAL: PROVIDE ACCESS TO BEHAVIORAL HEALTH CARE AND EDUCATION ON WAYS TO ACCESS BEHAVIORAL HEALTH SUPPORT IN OUR COMMUNITY. PROVIDED BEHAVIORAL HEALTH CARE ACCESS THROUGH TELEMEDICINE OPTIONS, INCLUDING ETRIAGE. RENTED SPACE TO RISING HOPE COUNSELING SERVICES TO HAVE FACE TO FACE COUNSELING AVAILABLE WITHIN OUR COMMUNITY.SOCIAL DETERMINANTS OF HEALTH - OVERARCHING GOAL: PARTNERED WITH COMMUNITY DECISION MAKERS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. CONTINUED "WALK WITH EASE" IN PERSON. STAFF DELIVERED MEALS ON WHEELS. CONTINUED THE RURAL HEALTH SCHOLARSHIP THROUGH OUR FOUNDATION TO BE GIVEN TO A LOCAL STUDENT PURSUING AN EDUCATION IN THE MEDICAL FIELD. DONATED TO COMMUNITY YOUTH NEEDS INCLUDING NATIONAL CHILD SAFETY COUNCIL AND LOCAL 4H CLUB.ACCESS TO HEALTH CARE FROM PEDIATRIC TO GERIATRIC - OVERARCHING GOALS: IMPROVE ACCESS TO HEALTH CARE IN THE SERVICE AREA. CONTINUED PHARMACY DELIVERY SERVICE. CONTINUED CHRONIC CARE RN SERVICES. EXTENDED PHARMACY HOURS. PROVIDED REDUCED RATE FEE FOR SPORTS PHYSICALS REQUIRED BY THE SDHSAA. PERFORMED FREE BLOOD PRESSURE SCREENING AND WEIGHT CHECKS AT SCOTLAND MEDICAL CLINIC. PROVIDED FREE TAPING AND NEEDLING THERAPY SERVICES IN PHYSICAL THERAPY. PROVIDED STAFF AT CROSS COUNTRY MEET TO ASSESS INJURED ATHLETES. PROVIDED LOCATION FOR BLOOD DRIVES THROUGHOUT THE YEAR. SENIOR YOGA IS OFFERED THREE DAYS A WEEK FREE OF CHARGE TO COMMUNITY MEMBERS. CONDUCTED IMPACT CONCUSSION TESTING TO SCOTLAND HIGH SCHOOL ATHLETES 7-12. READ BOOKS FOCUSING ON SAFETY AND EDUCATION WELLNESS FOR THE LIBRARY READERS PROGRAM. LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE USED AS A LAST RESORT. LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 16J: A NOTICE IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS OR WAITING ROOMS AND IN THE FACILITY'S ADMISSIONS OFFICE ALERTING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INSTRUCTIONS FOR OBTAINING A COPY OF THE FULL POLICY. A NOTICE IS ALSO PROVIDED ON ALL BILLING STATEMENTS SENT TO PATIENTS.PART V, SECTION B, LINES 16A-BFINANCIAL ASSISTANCE POLICY:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/02867F2E-3328-4709-BB3C-96AF68D90DAC/FINANCIAL-ASSISTANCE-POLICY-LANDMANN-JUNGMAN-MEMORIAL-HOSPITAL.PDFFINANCIAL ASSISTANCE APPLICATION:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/9F539DC5-0762-4F95-9EA9-E525715FA825/PDF-AVERA-CORP-AVERA-FINANCIAL-ASSISTANCE-APPLICATION.PDFFINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/2B9F148C-B2E4-475B-AF66-65830F670E7E/SUMMARY-OF-FINANCIAL-ASSISTANCE-LANDMANN-JUNGMAN-MEMORIAL-HOSPITAL.PDF LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 24: THE HOSPITAL FINANCIAL ASSISTANCE POLICY DOES NOT COVER ELECTIVE PROCEDURES. THE HOSPITAL MAY HAVE CHARGED FAP ELIGIBLE PATIENTS GROSS CHARGES FOR SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY. 2 1 - WEST WINDS APARTMENTS 1140 WASHINGTON STREET SCOTLAND SD 57059 INDEPENDENT SENIOR LIVING CENTER 2 - SCOTLAND PHARMACY 620 BILLARS STREET SCOTLAND SD 57059 RETAIL PHARMACY PART I, LINE 3C: IN ADDITION TO USING FPG TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE FACILITY ALSO CONSIDERS ASSET LEVEL AND INSURANCE STATUS, AND MAY PROVIDE PRESUMPTIVE CARE IF WARRANTED. PART I, LINE 6A: LJMH PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY. THE REPORT IS AVAILABLE TO THE PUBLIC UPON REQUEST. 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. LINE 7G WAS OBTAINED UTILIZING THE COST REPORT. LINES 7E AND 7I WERE OBTAINED USING GENERAL LEDGER DETAIL. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSION. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATIONS' IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN 2024. THE BON HOMME COUNTY POVERTY RATE IS 13% ACCORDING TO THE UNITED STATES CENSUS BUREAU. THAT WAS APPLIED TO THE $185,646 AS IT CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSION IS ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 6/30/24. 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. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED PATIENTS AND IS COOPERATING WITH THE ORGANIZATION WITH REGARD TO EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN CURRENT SELF-PAY COLLECTION POLICY GUIDELINES AND TIMEFRAMES, THE ORGANIZATION OR ITS AGENT SHALL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE COLLECTION AGENCY. LANDMANN-JUNGMAN MEMORIAL HOSPITAL (LJMH) ALLOWS INDIVIDUALS 120 DAYS FROM THE FIRST POST DISCHARGE STATEMENT TO APPLY FOR FINANCIAL ASSISTANCE BEFORE SENDING A LETTER OUTLINING OUR PAYMENT OPTIONS. IF THERE IS STILL NO RESPONSE AFTER 150 DAYS THE PATIENT RECEIVES ANOTHER LETTER. IF THERE IS NO REPLY AFTER 180 DAYS THE PATIENT RECEIVES A FINAL NOTICE THAT THE BILL WILL BE TURNED OVER TO COLLECTIONS IF THERE IS NO CONTACT TO LJMH WITHIN 10 DAYS OF THE FINAL NOTICE. IF THE PATIENT QUALIFIES FOR 100% CHARITY CARE, NO FURTHER BILLS WILL BE SENT. A LETTER WILL BE SENT INSTEAD INDICATING THAT THE PATIENT'S BILL HAS BEEN COMPLETELY FORGIVEN. PART VI, LINE 2: LANDMANN JUNGMAN MEMORIAL HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE FISCAL YEAR ENDING JUNE 30, 2022.LJMH REGULARLY CONDUCTS PATIENT SATISFACTION SURVEYS WHICH CAN LEAD TO INFORMATION REGARDING NEEDED SERVICES. ADDITIONALLY, INTERACTIVE QUESTIONS ARE ASKED ABOUT SERVICES DURING HEALTH SCREENINGS. RESULTS OF THE QUESTIONNAIRE ARE REPORTED BACK TO THE OFFICERS AND BOARD. PART VI, LINE 3: THE FINANCIAL ASSISTANCE APPLICATION AND INSTRUCTIONS ARE AVAILABLE UPON REQUEST AT THE BUSINESS OFFICE OR AVAILABLE ON OUR WEBSITE. THE PATIENT IS INSTRUCTED AND ENCOURAGED TO COMPLETE THE APPLICATION THAT UTILIZES A COMBINATION OF INCOME, ASSETS, AND EXPENSES TO DETERMINE WHAT PERCENTAGE IF ANY OF CHARITY CARE THEY WOULD QUALIFY FOR. PART VI, LINE 4: LANDMANN JUNGMAN MEMORIAL HOSPITAL IS LOCATED IN SCOTLAND, S.D IN BON HOMME COUNTY, S.D., IN THE SOUTH-CENTRAL PART OF THE STATE. AGRICULTURE IS THE PRIMARY ECONOMIC DRIVER IN THE COUNTY. LANDMANN JUNGMAN'S PRIMARY SERVICE AREA IS BON HOMME COUNTY. IN FISCAL YEAR 2024, 74 PERCENT OF INPATIENT DISCHARGES AND 75 PERCENT OF ER PATIENTS WERE FROM BON HOMME COUNTY. ACCORDING TO THE U.S. CENSUS BUREAU'S JULY 2023 ESTIMATED DATA, THE POPULATION OF BON HOMME COUNTY WAS ABOUT 7,065 PEOPLE AND IS PREDOMINATELY WHITE/CAUCASIAN (88.2 PERCENT). ABOUT 22 PERCENT OF THE POPULATION IS OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME OF BON HOMME COUNTY IS $61,275, COMPARED WITH THE STATE OF SOUTH DAKOTA'S $72,421 MEDIAN HOUSEHOLD INCOME. THE PERCENTAGE OF PERSONS BELOW THE FEDERAL POVERTY LEVEL WAS 13 PERCENT, WHILE THE STATE OF SD HAS A RATE OF 11.8 PERCENT. US CENSUS DATA SHOWS HIGH SCHOOL GRADUATION IN THE COUNTY AT 89.8 PERCENT, WHILE THE STATE RATE IS 93 PERCENT, AND REPORTS ADULTS OVER 25 YEARS OF AGE WITH A BACHELOR'S DEGREE OR HIGHER AT 20.1 PERCENT COMPARED TO THE STATE RATE OF 31.1 PERCENT. SOUTH DAKOTA DEPARTMENT OF LABOR AND REGULATION ASSESSES THE UNEMPLOYMENT RATE OF BON HOMME COUNTY AND THE STATE OF SOUTH DAKOTA AT 1.7 PERCENT IN NOVEMBER 2023. THE SECONDARY SERVICE AREA INCLUDES PORTIONS OF HUTCHINSON AND YANKTON COUNTIES. HUTCHINSON AND YANKTON COUNTIES ARE DEMOGRAPHICALLY SIMILAR TO BON HOMME COUNTY WITH RURAL, AGRICULTURAL LIFESTYLES. IN FISCAL YEAR 2024, THESE TWO COUNTIES MADE UP 21 PERCENT OF INPATIENT DISCHARGES AND 18 PERCENT OF ER PATIENTS. LANDMANN JUNGMAN HAS ABOUT 5,359 CLINIC VISITS IN FISCAL YEAR 2024. PART VI, LINE 5: LJMH IS FOCUSED ON SERVING THE NEEDS OF THE COMMUNITY. THE GOVERNING BODY OF THE HOSPITAL IS MADE UP ENTIRELY OF VOLUNTEERS FOR THE COMMUNITY. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN ITS COMMUNITY. EXCESS FUNDS ARE USED FOR THE IMPROVEMENT OF PATIENT CARE AND FACILITIES. THE HOSPITAL IS CONTRACTED WITH SEVERAL HIGHER LEARNING HEALTH CARE RELATED INSTITUTIONS TO BE A CLINICAL SITE FOR VARIOUS HEALTH CARE FIELDS. THE FACILITY IS OPEN TO ANYONE WHO WANTS TO LEARN ABOUT CAREERS IN THE HEALTH CARE INDUSTRY THROUGH THE CLINICAL PROGRAM AND THROUGH A HIGH SCHOOL SHADOWING PROGRAM.THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL ADMINISTRATION IS VERY RECEPTIVE TO INPUT FROM THE COMMUNITY.AVERA HEALTH AND LJMH DEDICATE RESOURCES TO ENDEAVORS THAT MAKE A POSITIVE DIFFERENCE TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. THESE ACTIVITIES INCLUDE LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENTS IN THE COMMUNITY, CONTRIBUTIONS TO NONPROFIT COMMUNITY ORGANIZATIONS, NONPROFIT EVENT SPONSORSHIPS, DONATED MEDICAL SUPPLIES, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH SCREENINGS, FLU SHOT CLINICS, COMMUNITY HEALTH EDUCATION AND VARIOUS OTHER ACTIVITIES. WE ALSO HAVE A FITNESS CENTER SO PATIENTS AND THE COMMUNITY CAN MAINTAIN A HEALTHY LIFESTYLE. PART VI, LINE 6: LJMH IS A MANAGED FACILITY OF AVERA HEALTH. AVERA HEALTH AND THE HOSPITAL WORK COOPERATIVELY TO ENHANCE HEALTH CARE THROUGHOUT THE COMMUNITY SERVICED BY LJMH.LJMH ALSO HAS ACCESS TO "BACK OFFICE" SUPPORT SERVICES, SUCH AS LEGAL CONSULTATION, QUALITY BENCHMARKING, CODING, COMPUTER SERVICES, CONTRACT NEGOTIATIONS, ADMINISTRATIVE CONSULTATION, GROUP PURCHASING, HUMAN RESOURCE ASSISTANCE, AND MANY OTHER SERVICES. AVERA HEALTH IS ABLE TO PROVIDE THESE SERVICES TO LJMH AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT AND RESIDENT CARE. X X 0 0 0 0 0 0 0 0 0 MARK VANVUUREN PHARMACIST 132752 0 0 0 0 0 1431 0 18059 0 152242 0 0 0 MELISSA GALE CEO 165377 0 0 0 141 0 3426 0 22082 0 191026 0 0 0 FORM 990 PART VII, LINE 5 MELISSA GALE, CEO, WAS COMPENSATED THROUGH AN ARRANGEMENT WITH AVERA MCKENNAN, 1325 S CLIFF AVE, SIOUX FALLS, SD 57108. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS COMPRISED OF THE PRESIDENT, VICE-PRESIDENT, SECRETARY, AND ONE ADDITIONAL BOARD MEMBER OF THE BOARD OF TRUSTEES ELECTED BY THE BOARD. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE FACILITY DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF DIRECTORS AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE CEO WILL REVIEW THE 990 IN DETAIL. A COPY OF THE 990 IS GIVEN TO THE BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS AND MANAGEMENT. BOARD MEMBERS ARE RESPONSIBLE FOR DETERMINING WHETHER A POTENTIAL CONFLICT EXISTS WITH THE ADMINISTRATOR AND BOARD MEMBERS. THE ADMINISTRATOR IS RESPONSIBLE FOR DETERMINING IF THERE ARE POTENTIAL CONFLICTS OF INTEREST AMONGST MANAGEMENT. THE BOARD IS ULTIMATELY RESPONSIBLE FOR DETERMINING WHETHER AN ACTUAL CONFLICT EXISTS. ANY BOARD MEMBER WITH A CONFLICT IS REQUIRED TO ABSTAIN FROM VOTING ON THE MATTER OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AVERA MCKENNAN AND LANDMANN-JUNGMAN MEMORIAL HOSPITAL CORPORATION USE COMPARABILITY DATA TO DETERMINE APPROPRIATE COMPENSATION OF THE ADMINISTRATOR BASED ON EXPERIENCE AND PERFORMANCE. THE COMPENSATION AMOUNT IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS. FOR OTHER KEY EMPLOYEES AVERA MCKENNAN DOES A SALARY SURVEY THAT IS THEN APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC DURING ITS ANNUAL BOARD MEETING AND UPON REQUEST. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHYISICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 496,423. MANAGEMENT AND GENERAL EXPENSES 110,794. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 607,217. OTHER FEES: PROGRAM SERVICE EXPENSES 202,027. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 202,027. FORM 990, PART XI, LINE 9: CHANGE IN AVERA FOUNDATION 25,352.