2024-11-11T11:15:55-06:00 2023-12-31 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2023-01-01 460274380 WINNER REGIONAL HEALTHCARE CENTER WINN 6058427100 745 E 8TH ST WINNER SD 57580 AMANDA SOESBE CFO 6058427100 2024-11-11 1 1 LAURIE HANSON CPA P00851848 6053391999 2024-11-12 2023 2024-10-15 13:58:12Z ROGER KINGSBURY 745 E 8TH ST WINNER SD 57580 28422776 0 X WWW.WINNERREGIONAL.ORG X 1961 SD TO IMPROVE THE QUALITY OF LIFE IN OUR REGION. 9 7 215 9 499017 0 4184768 605804 25870238 27749920 3357 14890 15576 52162 30073939 28422776 0 0 0 0 10773997 10987916 0 0 0 19385110 19082440 30159107 30070356 -85168 -1647580 30658854 28997040 19072816 18951864 11586038 10045176 X TO IMPROVE THE QUALITY OF LIFE IN OUR REGION BY PROVIDING COMPREHENSIVE HEALTHCARE IN A LOCAL, NURTURING ENVIRONMENT. THROUGH PROFESSIONALS WHO CONSIDER HEALTHCARE A CALLING, WE WILL EXCEED THE EXPECTATIONS OF THOSE WE SERVE. OUR ROLE AS A COMMITTED STEWARD TO OUR REGION WILL BE SUSTAINED THROUGH FISCAL RESPONSIBILITY, ENSURING PERSONALIZED HEALTHCARE FOR GENERATIONS TO COME. 0 0 24832892 27250903 WINNER REGIONAL HEALTHCARE CENTER, A 25-BED CRITICAL ACCESS HOSPITAL AND 60-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 NEWBORN CARE. THE FACILITY ALSO OPERATES A HOME HEALTH AGENCY, HOMEMAKER PROGRAM, A PROVIDER-BASED RURAL HEALTH CLINIC, A RETAIL PHARMACY AVAILABLE TO ANYONE IN THE PUBLIC, A COMMUNITY HEALTH PROGRAM AND PROVIDES COMMUNITY EDUCATION PROGRAMS THROUGHOUT THE SERVICE AREA. IN JUNE 2023, A PODIATRY OUTREACH CLINIC WAS STARTED THAT IS MOSTLY HOSPITAL OUTPATIENT-BASED BUT PERFORMS SOME SMALL PROCEDURES AS WELL. WINNER REGIONAL HEALTHCARE CENTER HAD 1,277 ACUTE PATIENT DAYS; 1,235 SWING BED PATIENT DAYS; 195 NEWBORN PATIENT DAYS; 118 BIRTHS; 11,152 RESIDENT DAYS; 1,793 HOME HEALTH VISITS; 12,095 RURAL HEALTH CLINIC VISITS; 8,079 OBSERVATION HOURS; 1,897 SPECIALTY OUTREACH VISITS; AND 272 LABOR AND DELIVERY DAYS. 24832892 1 1 0 1 0 0 0 0 1 0 1 0 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 1 0 0 0 0 0 0 0 0 0 0 1 57 0 1 215 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X X AMANDA SOESBE 6058427213 745 E 8TH ST WINNER SD 57580 RICK WAGNER MD DIRECTOR, CHIEF OF STAFF 30.00 X 219000 0 0 ROGER KINGSBURY PRESIDENT 1.00 X X 0 0 0 BETSY PRAVECEK VICE PRESIDENT 1.00 X X 0 0 0 KIM VANNEMAN TREASURER 1.00 X X 0 0 0 CASEY HEENAN SECRETARY 1.00 X X 0 0 0 JUSTIN NELSON DIRECTOR 1.00 X 0 0 0 SARA PETERSEK DIRECTOR 1.00 X 0 0 0 DIONE ROWE DIRECTOR 1.00 X 0 0 0 SARA HAMMERBECK DIRECTOR 1.00 X 0 0 0 AMANDA SOESBE CFO 40.00 X 99007 0 32270 CHARISSE OLAND INTERIM CEO - LEFT 6/2023 40.00 X 0 0 0 BRIAN WILLIAMS CEO - JOINED 6/2023 40.00 X 0 0 0 NICOLE OLSON DIRECTOR OF CLINIC OPERATIONS 40.00 X 122803 0 16510 MARLA HAYES PHARMACIST/DIRECTOR OF PHARMACY 40.00 X 178740 0 5356 REBECCA OLSON CNP 40.00 X 149259 0 5304 KORIE PRAVECEK CNP 40.00 X 128984 0 11660 KEN NOGUCHI MD 40.00 X 335583 0 23597 1233376 0 94697 11 0 1 1 FASTAFF LLC PO BOX 911452 DENVER CO 802911452 CONTRACTED NURSING 1348796 SANFORD HEALTH PO BOX 5074 SIOUX FALLS SD 57117 MGMT FEES/SALARY REIMB/IT SUPPORT 1006163 FUSION MEDICAL STAFFING LLC PO BOX 30131 OMAHA NE 68103 CONTRACTED NURSING 895177 ROCK MEDICAL GROUP PO BOX 31246 TAMPA FL 33631 CONTRACTED NURSING 814841 UNITIMED LLC PO BOX 31001-2434 PASADENA CA 911102434 CONTRACTED NURSING 412395 27 367408 238396 605804 PATIENT AND RESIDENT SERVICE REVE 621110 25194620 25194620 PHARMACY REVENUE 900099 2206026 1707009 499017 PHYSICIAN OUTREACH 621110 53024 53024 296250 296250 27749920 14390 14390 52162 0 52162 52162 52162 500 0 500 500 500 28422776 27250903 499017 67052 X 354315 219000 135315 44450 44450 8591536 7098211 1493325 178463 140359 38104 1174077 858232 315845 645075 527295 117780 418676 418676 20008 20008 112850 6141 106709 794 794 9461379 8626714 834665 27572 2840 24732 534330 352527 181803 896167 367726 528441 171056 153554 17502 59402 34487 24915 447337 296689 150648 1665097 1231126 433971 308596 96464 212132 MEDICAL SUPPLIES 4485014 4465092 19922 FOOD 269172 269172 LICENSES, DUES & SUBSCR 54265 28718 25547 SALES TAX 28782 8005 20777 121943 6090 115853 30070356 24832892 5237464 0 402402 10385 7506093 6838768 256785 156828 622170 657798 2676 30717 38984604 20136049 19171982 18848555 749467 1025777 1292595 1399313 654684 28899 30658854 28997040 4086683 3927460 0 10433 6255 6524 14834512 14610768 145366 396679 19072816 18951864 X 10293443 8645863 1292595 1399313 11586038 10045176 30658854 28997040 X -1647580 106718 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 794 794 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF DUES THAT WERE USED FOR LOBBYING. ORGANIZATION OFFICERS AND DIRECTORS WILL ALSO FROM TIME TO TIME CONTACT LEGISLATORS CONCERNING HEALTH CARE ISSUES AND BILLS. 0 1 X 24638 24638 31234289 14360083 16874206 5929553 4941530 988023 1796124 834436 961688 18848555 FINANCE LEASE LIABILITIES 396679 396679 X 28422776 0 28422776 0 28422776 30070356 0 30070356 0 30070356 PART IV, LINE 2B: LONG-TERM CARE RESIDENTS REQUEST THE FACILITY TO HANDLE THEIR FINANCIAL AFFAIRS. THIS IS DIRECTED BY A WRITTEN AGREEMENT BETWEEN THE FACILITY AND THE RESIDENT. SOME EXAMPLES OF FINANCIAL AFFAIRS ARE SOCIAL SECURITY CHECKS, NURSING HOME PAYMENTS, AND HAIRCUTS. PART X, LINE 2: THE CENTER 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. 1 1 X 1 X 1 X 150.000000000000 1 1 0 0 43000 43000 0.00140 4018134 2701639 1316495 0.04380 4061134 2701639 1359495 0.04520 7500265 4019784 3480481 0.11570 7500265 4019784 3480481 0.11570 11561399 6721423 4839976 0.16090 1 1724374 377638 8582618 8636314 -53696 X 1 1 1 1 WINNER REGIONAL HEALTHCARE CENTER 745 E 8TH ST WINNER SD 57580 WWW.WINNERREGIONAL.ORG 51775 X X X X PROVIDER BASED RHC-WINNER REGIONAL CLINIC WINNER REGIONAL HEALTHCARE CENTER 1 0 0 1 X X X X X X X X X 22 1 1 0 1 X SEE LINE 7D NARRATIVE X X 1 22 1 SEE LINE 7D NARRATIVE 0 1 X 100.000000000000 150.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V, LINE 16J NARRATIVE X SEE PART V, LINE 16J NARRATIVE X SEE PART V, LINE 16J NARRATIVE X X X X X X 1 X 0 X X X X 1 X 0 0 WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 5: COMMUNITY MEMBERS INVOLVED IN COLLECTING THE DATA AND PREPARING THE REPORT INCLUDED ONE REPRESENTATIVE FROM THE GOVERNING BOARD, THE EXECUTIVE DIRECTOR OF THE CHAMBER OF COMMERCE, AND THE PRESIDENT OF THE TRIPP COUNTY ECONOMIC DEVELOPMENT BOARD. THOSE INDIVIDUALS, IN ADDITION TO SURVEY RESPONDENTS, OTHER HEALTHCARE EMPLOYEES, WRHC ADMINISTRATION, AND SECONDARY DATA SOURCES HELPED REPRESENT ALL INDIVIDUALS IN THE TRIPP COUNTY COMMUNITY, GIVING THEM AN OPPORTUNITY TO PROVIDE INSIGHT ON THE AREAS NEEDING THE BIGGEST IMPROVEMENTS TO CARE. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 6A: WINNER REGIONAL WORKED IN PARTNERSHIP WITH SANFORD HEALTH. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 7D: BOUND COPIES ARE DISPLAYED IN OPEN SITTING AREAS THROUGHOUT THE FACILITY FOR READING BY ANY CUSTOMER OR EMPLOYEE. THE CHNA REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE AT HTTPS://WWW.SANFORDHEALTH.ORG/-/MEDIA/ORG/FILES/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/2022/WINNER-CHNA-REPORT-2022-2024.PDF WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 11: SIGNIFICANT NEEDS IDENTIFIED IN THE 2022 CHNA REPORT INCLUDED AFFORDABLE HOUSING; EMPLOYMENT AND ECONOMIC OPPORTUNITIES; LONG-TERM CARE, NURSING HOMES, SENIOR HOUSING; ACCESS TO HEALTH CARE PROVIDERS; AND HEALTHY LIVING.THE ORGANIZATION WILL NOT ADDRESS THE FOLLOWING NEEDS:- AFFORDABLE HOUSING WILL NOT BE ADDRESSED WITH THIS CHNA AS RENTAL OPTIONS HAVE IMPROVED SOMEWHAT OVER THE PAST FEW YEARS. WRHC WILL CONTINUE TO WATCH FOR OPPORTUNITIES TO PARTNER WITH OTHER COMMUNITY ENTITIES IN THIS AREA. - EMPLOYMENT AND ECONOMIC OPPORTUNITIES WILL NOT BE ADDRESSED WITH THIS CHNA AS JOB OPPORTUNITIES, DAYCARE, PRE-SCHOOL, AND OTHER ECONOMIC ITEMS WILL REQUIRE BROAD COMMUNITY-BASED SUPPORT AND PARTNERSHIP BEYOND WHAT A LOCAL HOSPITAL CAN DO ON ITS OWN. THIS INFORMATION WILL BE SHARED WITH COMMUNITY MEMBERS. - HEALTHY LIVING WILL NOT BE ADDRESSED WITH THIS CHNA AS WRHC ALREADY HELPS PROMOTE HEALTH WITH EDUCATIONAL OPPORTUNITIES SUCH AS BETTER CHOICES BETTER HEALTH AND MATTER OF BALANCE CLASSES IMPLEMENTED RECENTLY. IN 2023, THE FACILITY CONTINUED TO PARTNER WITH OTHER ENTITIES BASED ON THE BETTER CHOICES BETTER HEALTH AND MATTER OF BALANCE CLASSES TO CONTINUE THAT COMMUNITY OUTREACH WORK. ADDITIONALLY, THE FACILITY WORKED MORE CLOSELY WITH THE COMMUNITY AND THE SCHOOL DISTRICT TO GET MORE STUDENTS INVOLVED WITH HEALTHCARE FACILITIES AND INTERESTED IN HEALTHCARE DELIVERY AND BECOMING PROVIDERS; THE FACILITY DOES PART OF THIS THROUGH SCRUBS CAMP EACH YEAR. THE FACILITY ALSO WELCOMES VARIOUS COLLEGE STUDENT PROGRAMS TO THE FACILITY FOR LEARNING AND ROTATIONS INTO RURAL HEALTHCARE. WRH HAS BEEN ACTIVELY RECRUITING FOR MORE PHYSICIANS AND WAS ABLE TO SECURE ANOTHER CNP ON STAFF. ADDITIONALLY, THE FACILITY HAS BEEN FOCUSING NEW AND CONSISTENT LEADERSHIP AND STAFF IN LONG-TERM CARE TO HIRE MORE EMPLOYEES TO DECREASE CONTRACTED TRAVEL STAFF AND IMPROVE CARE OUTCOMES AND PERCEPTION. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 13B: PATIENTS WHOSE FAMILY INCOME IS OVER 100% AND BELOW 150% OF THE FPL ARE ELIGIBLE FOR UP TO A 50% DISCOUNT. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 13H: IN ADDITION TO UTILIZING THE FACTORS IDENTIFIED IN LINE 13, THE ORGANIZATION CONSIDERS THE INDIVIDUAL'S LIABILITIES, NET WORTH, EMPLOYMENT STATUS OR EARNING CAPACITY, OTHER FINANCIAL OBLIGATIONS, FREQUENCY OF HEALTH SERVICES AND OTHER SOURCES OF PAYMENT FOR HEALTHCARE SERVICES RENDERED.PATIENTS WHOSE FAMILY INCOME EXCEEDS 150% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF WINNER REGIONAL HEALTHCARE. HOWEVER, THE DISCOUNTED RATES SHALL NOT BE LESS THAN THE AMOUNTS GENERALLY BILLED COMMERCIALLY INSURED PATIENTS. ONCE THE PATIENT HAS BEEN DEEMED ELIGIBLE, WINNER REGIONAL WILL APPLY THE FAP DISCOUNT TO THE PATIENT'S ACCOUNT. PRESUMPTIVE ELIGIBILITY MAY ALSO BE USED IF OTHER AVENUES FOR FINANCIAL ASSISTANCE HAVE BEEN EXHAUSTED. WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 16J: PART V, SECTION B, LINE 16A-C: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION, AND FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY ARE POSTED AT HTTPS://WWW.WINNERREGIONAL.ORG/FINANCIAL-ASSISTANCEPART V, SECTION B, LINE 16I: PLEASE REFER TO THE NARRATIVE PROVIDED IN PART VI, LINE 3 REGARDING ADDITIONAL MEANS OF EDUCATING PATIENTS ABOUT OUR CHARITY CARE POLICY. WINNER REGIONAL HEALTHCARE CENTER 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. 1 1 - WINNER REGIONAL NURSING HOME 745 EAST 8TH STREET WINNER SD 575802631 SKILLED NURSING FACILITY PART I, LINE 3C: IN ADDITION TO UTILIZING FEDERAL POVERTY LEVELS (FPL), THE ORGANIZATION REVIEWS INCOME LEVEL OTHER THAN FPL, ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS AND UNDERINSURANCE STATUS. THIS INFORMATION IS REVIEWED AND A DETERMINATION OF ELIGIBILITY FOR ASSISTANCE IS MADE BY THE PATIENT SERVICES REPRESENTATIVE AND THE CFO. PATIENTS WHOSE FAMILY INCOME EXCEEDS 150% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF WINNER REGIONAL HEALTHCARE. HOWEVER, THE DISCOUNTED RATES SHALL NOT BE LESS THAN THE AMOUNTS GENERALLY BILLED COMMERCIALLY INSURED PATIENTS. ONCE THE PATIENT HAS BEEN DEEMED ELIGIBLE, WINNER REGIONAL WILL APPLY THE FAP DISCOUNT TO THE PATIENT'S ACCOUNT. PRESUMPTIVE ELIGIBILITY MAY ALSO BE USED IF OTHER AVENUES FOR FINANCIAL ASSISTANCE HAVE BEEN EXHAUSTED. 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 7B AND 7G WERE DETERMINED USING THE COST REPORTS. PART I, LINE 7G: PHYSICIAN CLINIC NET REVENUE OF $2,613,937 AND COSTS OF $3,609,812 ARE INCLUDED ON LINE 7G FOR A NET COMMUNITY BENEFIT OF $995,875. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THE RESPECTIVE CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT RELATED TO CHARITY CARE IS 21.9% OF IMPLICIT PRICE CONCESSIONS, WHICH IS BASED ON THE POVERTY LEVEL OF THE SERVICE AREA FOR 2023. PART III, LINE 4: FOOTNOTE FROM FINANCIAL STATEMENT: PLEASE SEE FINANCIAL STATEMENT NOTE 2 - PATIENT AND RESIDENT SERVICE REVENUE ON PAGES 16-18 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 12/31/2023. 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: THE COLLECTION POLICY ALLOWS FOR CHARITY CARE TO BE OBTAINED DURING THE COLLECTION PROCESS IF THE PATIENT DID NOT QUALIFY DUE TO A LACK OF DOCUMENTATION IN THE PATIENT'S FILE. THE POLICY SPECIFICALLY STATES "A PATIENT WILL NOT BE DENIED CHARITY CARE CONSIDERATION BECAUSE OF A LACK OF DOCUMENTATION TO VERIFY INCOME." IF A PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE AND IS IN COMPLIANCE WITH FINANCIAL ARRANGEMENTS MADE DURING THE FINANCIAL ASSISTANCE PROCESS, THEIR ACCOUNT WILL NOT BE SENT TO COLLECTION. IF A PATIENT IS FOUND TO POTENTIALLY QUALIFY FOR FINANCIAL ASSISTANCE AND THE ACCOUNT IS IN COLLECTION, COLLECTION ACTIVITY WILL CEASE WHILE THE PATIENT COMPLETES THE APPLICABLE PAPERWORK. PART VI, LINE 2: WRHC HAS STAFF INVOLVED WITH VARIOUS COMMITTEES, PROGRAMS, AND BOARDS THROUGHOUT THE COMMUNITY. THIS GETS THE FACILITY ENGAGED WITH THE COMMUNITY AND ALLOWS FOR THE COMMUNITY TO COMMUNICATE AREAS OF CONCERN AND CREATES AN INCREASED AWARENESS OF NEEDS. THE FACILITY THEN WORKS WITH THOSE INDIVIDUALS AND/OR WRHC STAFF TO ALLOW FOR BETTER PARTNERSHIP ON HEALTHCARE NEEDS. PART VI, LINE 3: OUR PROCESS FOR NOTIFYING PATIENTS OF FINANCIAL ASSISTANCE IS TO VISIT WITH THEM WHILE THEY ARE IN THE FACILITY. OUR PATIENT FINANCIAL REPRESENTATIVE REVIEWS THE CENSUS EVERY MORNING TO DETERMINE IF A PATIENT IS PRIVATE PAY. THE REPRESENTATIVE VISITS WITH THE PATIENT TO DETERMINE WHETHER THEY HAVE INSURANCE IN ADDITION TO WHAT HAS BEEN PROVIDED TO THE HOSPITAL, AND WHETHER THEY NEED ASSISTANCE WITH APPLYING FOR MEDICAID (IF APPLICABLE). THE REPRESENTATIVE PROVIDES CHARITY CARE INFORMATION IF THE PATIENT BELIEVES THIS TYPE OF FINANCIAL ASSISTANCE MAY BE NEEDED. CHARITY CARE APPLICATIONS ARE ALSO PROVIDED UPON REQUEST AND TO PERSONS WHO HAVE NOT BEEN MAKING PAYMENTS AS SCHEDULED. PART VI, LINE 4: WINNER REGIONAL HEALTHCARE CENTER (WRHC) IS LOCATED IN WINNER, SOUTH DAKOTA WHICH IS AT THE CENTER OF TRIPP COUNTY. COMMUNITIES IN TRIPP COUNTY INCLUDE CARTER, CLEARFIELD, COLOME, HAMILL, IDEAL AND WINNER. WRHC'S SERVICE AREA EXTENDS INTO GREGORY, MELLETTE, LYMAN AND TODD COUNTIES IN SOUTH DAKOTA AND INCLUDES THE CITIES OF PRESHO, MISSION, WOOD, WHITE RIVER, GREGORY, BURKE, DALLAS, HERRICK, BONESTEEL AND FAIRFAX. THE SERVICE AREA INCLUDES NORTHERN CHERRY, BROWN AND KEYA PAHA COUNTIES IN NEBRASKA AND ENCOMPASSES THE CITIES OF SPRINGVIEW, SPARKS, AINSWORTH AND VALENTINE. FARMING AND RANCHING ARE THE PRIMARY INDUSTRIES IN THIS RURAL AREA. THE POPULATION OF TRIPP COUNTY, THE PRIMARY SERVICE AREA, IS 5,569. THE AVERAGE MEDIAN INCOME IS $54,054. PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS 19.3%. 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.THE DATA ABOVE IS FROM 2020. THE COMMUNITY DEMOGRAPHICS REMAIN STABLE. PART VI, LINE 5: THE WINNER REGIONAL GOVERNING BOARD IS A 9 MEMBER VOLUNTEER BOARD COMPRISED OF BOTH MEN AND WOMEN THAT RESIDE IN THE WINNER REGIONAL HEALTHCARE CENTER SERVICE AREA. WINNER REGIONAL HEALTHCARE CENTER EXTENDS PRIVILEGES TO PHYSICIANS IN THE IMMEDIATE AREA. WINNER REGIONAL HEALTHCARE CENTER UTILIZES SURPLUS FUNDS TO FUND BUILDING IMPROVEMENTS AND TO ENHANCE SERVICES TO PATIENTS. X 0 0 0 0 0 0 0 0 0 KEN NOGUCHI MD 279506 0 56077 0 0 0 4191 0 19483 0 359257 0 0 0 RICK WAGNER MD DIRECTOR, CHIEF OF STAFF 219000 0 0 0 0 0 0 0 0 0 219000 0 0 0 MARLA HAYES PHARMACIST/DIRECTOR OF PHARMACY 178740 0 0 0 0 0 5356 0 78 0 184174 0 0 0 REBECCA OLSON CNP 149259 0 0 0 0 0 4503 0 1174 0 154936 0 0 0 PART I, LINE 3 THE CEO IS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH SANFORD HEALTH NETWORK, AN UNRELATED ORGANIZATION. SANFORD HEALTH NETWORK USES THE PROCESSES DESCRIBED IN PART I, QUESTION 3 TO DETERMINE APPROPRIATE COMPENSATION FOR THE CEO. PART II, LINE 1 DR. RICK WAGNER IS A BOARD MEMBER OF WINNER REGIONAL HEALTHCARE CENTER AND CHIEF OF STAFF AT THE WINNER REGIONAL CLINIC. HE IS AN INDEPENDENT CONTRACTOR PAID BY WINNER REGIONAL HEALTHCARE CENTER. LORI KINGSBURY FAMILY MEMBER OF ROGER KINGSBURY, BOARD PRESIDENT 44450 INDEPENDENT CONTRACTOR PAYMENTS 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS A MANAGEMENT AGREEMENT WITH SANFORD HEALTH NETWORK. THE CEO IS AN EMPLOYEE OF THE MANAGEMENT COMPANY. SANFORD HEALTH IS LOCATED AT 1305 W 18TH STREET, SIOUX FALLS, SD. WRHC PAID SANFORD HEALTH NETWORK FOR SERVICES PROVIDED BY CHARISSE OLAND, INTERIM CEO (LEFT JUNE 2023), AND BRIAN WILLIAMS, CEO (STARTED IN JUNE 2023). COMPENSATION AND BENEFITS FOR CHARISSE OLAND WERE $149,987. COMPENSATION AND BENEFITS FOR BRIAN WILLIAMS WERE $197,072. THE CEO IS RESPONSIBLE FOR LOCAL PLANNING AND MANAGEMENT OF ALL ACTIVITIES IN THE ORGANIZATION, INCLUDING TASKS SUCH AS MANAGING HUMAN AND FINANCIAL RESOURCES, DIRECTING STAFF, AND CONTROLLING THE OPERATIONS. 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 11B A COPY OF 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 INVESTIGATE AND MAKE A DETERMINATION REGARDING ALL CONFLICTS THAT MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15A CEO: SANFORD PRESENTS A COMPARATIVE SCHEDULE ON CEO SALARIES WITH MEDIAN AND HIGH/LOW SALARIES, FOR COMPARABLE POSITIONS AND AREAS OF RESPONSIBILITIES. THE CURRENT MARKET AND LONGEVITY IS ALSO INCLUDED IN THE EVALUATION OF COMPENSATION. THE SANFORD NETWORK VICE PRESIDENT PRESENTS THE COMPENSATION SUBSTANTIATION TO THE BOARD OF DIRECTORS AT A MEETING THAT EXCLUDES THE CEO. PERFORMANCE EVALUATIONS ARE COMPLETED BY EACH BOARD MEMBER, THE VICE PRESIDENT AND CEO SELF EVALUATION. ADMINISTRATIVE STAFF (CFO, DIRECTOR OF HR/MATERIALS, DIRECTOR OF SUPPORT SERVICES, HOSPITAL DON, LTC DON): THE CEO COMPARES COMPENSATION TO SDAHO SALARY SURVEY. SALARY INCREASES ARE PRESENTED TO THE BOARD OF DIRECTORS AS PART OF THE BUDGET APPROVAL PROCESS. THIS PROCESS IS UNDERTAKEN ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST FORM 990, PART IX, LINE 11G SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 448,027. MANAGEMENT AND GENERAL EXPENSES 283,550. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 731,577. OUTSIDE MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 518,453. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 518,453. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 49,025. MANAGEMENT AND GENERAL EXPENSES 79,552. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 128,577. CONSULTING: PROGRAM SERVICE EXPENSES 22,900. MANAGEMENT AND GENERAL EXPENSES 57,310. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,210. OTHER: PROGRAM SERVICE EXPENSES 311. MANAGEMENT AND GENERAL EXPENSES 33,954. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,265. SOFTWARE MAINTENANCE: PROGRAM SERVICE EXPENSES 48,016. MANAGEMENT AND GENERAL EXPENSES 335,531. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 383,547. PURCHASED STAFFING/CONTRACT PHYSICIANS: PROGRAM SERVICE EXPENSES 7,539,982. MANAGEMENT AND GENERAL EXPENSES 44,768. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,584,750. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 106,718.