2023-11-14T15:52:26-05:00 2022-12-31 460393458 WOHLENBERG RITZMAN & CO LLC PO BOX 1018 YANKTON SD 57078 990 2022-01-01 460361016 PHILIP HEALTH SERVICES INC PHIL 6058592511 503 WEST PINE STREET PHILIP SD 57567 MAUREEN CADWELL CHIEF EXECUTIVE OFFI 6058593908 2023-11-15 true MAUREEN CADWELL XXX-XX-XXXX true KATHLEEN DOYLE P01322431 6056654401 2023-11-06 2022 2023-04-26 12:10:37Z MAUREEN CADWELL 18671227 false X WWW.PHILIPHEALTHSERVICES.COM X 1953 SD TO PROVIDE HEALTH CARE TO PHILIP, SD & SURROUNDING AREAS 7 7 190 20 0 1964988 540512 15804465 17506150 25567 -35095 443873 17795020 18455440 0 0 8985444 10080127 0 12205 5917430 7168628 14902874 17248755 2892146 1206685 22337668 25286939 7188058 8936541 15149610 16350398 TO PROVIDE HEALTH CARE TO PHILIP, SD & SURROUNDING AREAS false false 12670201 17506150 THE FACILITY OPERATES A CRITICAL ACCESS HOSPITAL IN PHILIP, SD PROVIDING SHORT TERM INPATIENT, OUTPATIENT AND EMERGENCY HEALTH CARE SERVICES. THE FACILITY ALSO OPERATES AN ASSISTED LIVING FACILITY PROVIDING RESIDENTIAL CARE SERVICES, A SKILLED NURSING FACILITY PROVIDING LONG TERM NURSING HOME CARE, AND CLINIC FACILITIES FOR PHYSICIAN SERVICES. 12670201 true true false false false false false false false false true false false false true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 9 0 true 190 true false false false false false false false false false false false false false false X 7 7 false false false false false true true true true false false false true true true true true true true false X X ORGANIZATION 6058592511 PO BOX 790 PHILIP SD 57567 DAVID HOLMAN MD EMPLOYEE 40.00 X 325077 0 15103 KERRY BLACKHAM EMPLOYEE 40.00 X 316826 0 11706 COENRAAD KLOPPER MD EMPLOYEE 40.00 X 264010 0 11705 JEREMY SCHULTES CHIEF EXECUT 40.00 X 0 186218 27680 TERRY HENRIE EMPLOYEE 40.00 X 177501 0 0 DON BURNS PRESIDENT 1.00 X X 0 0 0 LARRY GABRIEL VICE PRESIDE 1.00 X X 0 0 0 KAREN KROETCH DIRECTOR 1.00 X 0 0 0 RITA O'CONNELL DIRECTOR 1.00 X 0 0 0 RUSTY OLNEY DIRECTOR 1.00 X 0 0 0 DJ RUSH DIRECTOR 1.00 X 0 0 0 RAY SMITH DIRECTOR 1.00 X 0 0 0 MAUREEN CADWELL CHIEF EXECUT X 0 0 0 1083414 186218 66194 21 false true false RANGEL CONSTRUCTION 2626 W MAIN STREET RAPID CITY SD 57702 CONTRACTOR 1443735 MONUMENT HEALTH PO BOX 3450 RAPID CITY SD 57709 STAFFING/IT 1201590 ROVE STAFFING LLC PO BOX 31001 PASADENA CA 91110 NURSES 932243 COUNTRY CARPET & FLOORING 414 EAST SIOUX PIERRE SD 57501 CONTRACTOR 246416 ONE STAFF MEDICAL PO BOX 3544 OMAHA NE 68103 NURSES 213255 9 480598 59914 540512 PATIENT SERVICE REVENUE 621990 17371195 17371195 OTHER OPERATING REVENUE 621990 134955 134955 17506150 62053 62053 118639 215787 -97148 -97148 -97148 CAPITAL INSURANCE PROCEEDS 621990 443873 443873 443873 18455440 17852875 62053 X 213897 213897 8254516 6786951 1467565 179532 161579 17953 889104 698924 190180 543078 442362 100716 15720 15720 37681 37681 2738228 2295193 430830 12205 50281 3332 46949 50259 6868 43391 21000 21000 2927750 1627345 1300405 123704 99657 24047 122702 87844 34858 1081303 439146 642157 17248755 12670201 4566349 12205 6817228 8619754 198036 114053 2751986 1984889 64919 107450 296758 320451 37860 75730 21599749 8682783 10125866 12916966 31322 25826 2013693 1121820 22337668 25286939 1722427 1465059 436677 4953676 7422004 75278 49478 7188058 8936541 X 14853411 16180518 296199 169880 15149610 16350398 22337668 25286939 1206685 -5897 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 123035 123035 15439198 5627839 9811359 4396338 2630119 1766219 1641178 424825 1216353 12916966 CAPITAL LEASE OBLIGATION 49478 49478 X 18449543 -5897 -5897 18455440 18455440 17248755 17248755 17248755 SCHEDULE D, PAGE 3, PART X THE FACILITY IS A NOT-FOR-PROFIT 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. HOWEVER, THE FACILITY CAN BE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE FACILITY HAS NO RESERVE FOR UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. ADDITIONALLY, THE FACILITY HAS NOT RECOGNIZED ANY INTEREST OR PENALTIES IN RELATION TO INCOME TAX FILINGS AS OF OR FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021. true true X true X true X true true false false 46169 46169 0.00270 1626731 2063194 1672900 2063194 46169 0.00270 1001401 460071 541330 0.03140 1001401 460071 541330 0.03140 2674301 2523265 587499 0.03410 85774 85774 0.00500 85774 85774 0.00500 true 463082 8423096 8359331 63765 true true 1 1 HANS P PETERSON MEMORIAL HOSPITAL 503 W PINE ST PHILIP SD 57567 WWW.PHILIPHEALTHSERVICES.COM 10555 X X X HANS P PETERSON MEMORIAL HOSPITAL 1 false false true X X X X X X X 21 true true false true X WWW.PHILIPHEALTHSERVICES.COM false false true X 100.000000000000 200.000000000000 X true true X X X X true X WWW.PHILIPHEALTHSERVICES.COM X WWW.PHILIPHEALTHSERVICES.COM X X X X true X false true X false false FACILITY 1, HANS P PETERSON MEMORIAL HOSPITAL - PART V, LINE 5 AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THERE WERE KEY INFORMANT FOCUS GROUPS HELD IN THE REGION - THESE FOCUS GROUPS ALLOWED FOR INPUT FROM PERSONS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH, AS WELL AS OTHERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. 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. TO OBTAIN ADDITIONAL INPUT FROM LOCAL RESIDENTS AND HEALTH CARE STAKEHOLDERS, THE HOSPITAL CONDUCTED AN ADDITIONAL SERIES OF FOCUS GROUPS IN 2021 WITH RESIDENTS FROM PHILIP, HAAKON COUNTY AND JACKSON COUNTY. FACILITY 1, HANS P PETERSON MEMORIAL HOSPITAL - PART V, LINE 6A THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS SPONSORED BY A PARTNERSHIP BETWEEN HANS P PETERSON MEMORIAL HOSPITAL AND MONUMENT HEALTH FACILITY 1, HANS P PETERSON MEMORIAL HOSPITAL - PART V, LINE 11 AREAS OF OPPORTUNITY WERE PRIORITIZED AS FOLLOWS: 1.) MENTAL HEALTH; 2.) SUBSTANCE ABUSE; 3.) DIABETES; 4.) NUTRITION, PHYSICAL ACTIVITY & WEIGHT; 5.) TOBACCO USE; 6.) CANCER; 7.) INJURY & VIOLENCE PREVENTION; 8.) HEART DISEASE & STROKE; 9.) INFANT HEALTH & FAMILY PLANNING; 10.) ACCESS TO HEALTH CARE SERVICES; 11.) POTENTIALLY DISABLING CONDITIONS; 12.) SEXUAL HEALTH. IN ACKNOWLEDGING THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, THE HOSPITAL DETERMINED THAT IT COULD ONLY EFFECTIVELY FOCUS ON THOSE WHICH IT DEEMED MOST PRESSING, MOST UNDERADDRESSED, AND MOST WITHIN ITS ABILITY TO INFLUENCE. DUE TO LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS THESE HEALTH PRIORITIES, THE FOLLOWING WERE NOT CHOSEN FOR ACTION: SUBSTANCE ABUSE AND TOBACCO USE AND CANCER. REGARDING INJURY & VIOLENCE PREVENTION, THE HOSPITAL BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY AND LAW ENFORCEMENT ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA FOR ACTION. 4 PHILIP NURSING HOME 503 WEST PINE PHILIP SD 57567 NURSING HOME SILVERLEAF ASSISTED LIVING FACILTIY 519 WEST PINE PHILIP SD 57567 ASSISTED LIVING FACILITY PHILIP CLINIC 507 WEST PINE PHILIP SD 57567 RURAL HEALTH CLINIC KADOKA CLINIC 601 CHESTNUT STREET KADOKA SD 57543 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 3C PATIENT COMPLETES AN APPLICATION WHICH GATHERS FINANCIAL INFORMATION RELATED TO THE PATIENT. NET WORTH IS CONSIDERED IN DETERMINING FREE OR DISCOUNTED CARE. DEBT OWED TO THE HOSPITAL MUST BE MORE THAN 20% OF THE PATIENT'S NET WORTH TO QUALIFY FOR FREE OR DISCOUNTED CARE. FAP ELIBIBLE INDIVIDUALS ARE NEVER CHARGED MORE THAN AGB. SCHEDULE H, PART III, LINE 2 THE FACILITY PROVIDES ALLOWANCES FOR DOUBTFUL RECEIVABLES EQUAL TO THE ESTIMATED COLLECTION LOSSES. THE ESTIMATED COLLECTION LOSSES ARE BASED ON HISTORICAL COLLECTION EXPERIENCE COUPLED WITH REVIEW OF THE CURRENT STATUS OF THE EXISTING RECEIVABLES. SCHEDULE H, PART VI, LINE 2 FACILITY MANAGEMENT, AS PART OF ITS OPERATIONAL PLANNING PROCESS, CONTINUALLY EVALUATES OPPORTUNITIES TO ADD NEW SERVICES TO THE CLINICAL SPECTRUM. SERVICES AVAILABLE IN THE REMOTE LOCATION ARE EVALUATED BASED ON THE CLINIAL CAPABILITIES OF THE AVAILABLE MEDICAL STAFF PROVIDERS AND SUPPORTIVE CLINICAL RESOURCES. THOSE FACTORS ARE BALANCED WITH THE NUMBER OF PEOPLE IN THE SERVICE AREA WHO DEMONSTRATE THE NEED FOR THOSE SERVICES. CLINICAL MODELS AND BUSINESS MODELS ARE MATCHED AND MONITORED OVER THE COURSE OF TIME TO DETERMINE THE FEASIBILITY OF NEW AND/OR EXISTING SERVICESS OFFERD IN THE COMMUNITY. SCHEDULE H, PART VI, LINE 3 SIGNS ARE POSTED AT ENTRANCES INFORMING THE PUBLIC OF THE COMMUNITY BENEFIT PROGRAM. SCHEDULE H, PART VI, LINE 4 THE ORGANIZATION SERVES THE SMALL TOWNS (POPULATIONS ARE LESS THAN 700) OF PHILIP, KADOKA, MIDLAND, WALL AND OTHERS, AS WELL AS THE RURAL RESIDENTS OF WESTERN SOUTH DAKOTA. THERE IS NO OTHER AVAILABLE HEALTH CARE WITHIN 90 MILES. SCHEDULE H, PART VI, LINE 5 PHILIP HEALTH SERVICES, INC, A NON-PROFIT COMMUNITY OWNED CORPORATION, HAS BEEN ABLE TO CONTINUE TO OFFER PRIMARY MEDICAL CARE TO THIS AREA IN LARGE PART DUE TO THE SUPPORT OF THE COMMUNITY AND THE LEARDERSHIP OF THE BOARD OF DIRECTORS. ALL NET GAINS ARE INVESTED BACK INTO THE ORGANIZATION TO MAINTAIN CURRENT SERVICES AND EXPAND SERVICES. SCHEDULE H, PART VI PART III, SEC B, LINE 8 - COMMUNITY BENEFIT THE MEDICARE SHORT FALL IS ALL CONSIDERED COMMUNITY BENEFIT. THERE IS NO ADDITIONAL FUNDING SOURCE TO OFFSET THE MEDICARE SHORTFALL. SERVICES ARE PROVIDED TO MEDICARE BENEFICIARIES IN ALL AREAS OF THE HOSPITAL KNOWING THAT MEDICARE COSTS WILL NOT BE FULLY RECOVERED. false false false false false false false false false DAVID HOLMAN MD EMPLOYEE 325077 15103 340180 KERRY BLACKHAM EMPLOYEE 316826 11706 328532 COENRAAD KLOPPER MD EMPLOYEE 264010 11705 275715 JEREMY SCHULTES CHIEF EXECUTIVE OFFI 186218 7991 19689 213898 TERRY HENRIE EMPLOYEE 177501 177501 FORM 990, PAGE 1, PART I, LINE 6 BOARD MEMBERS SERVE WITHOUT COMPENSATION VOLUNTEERS ENTERTAIN NURSING RESIDENTS FORM 990, PAGE 6, PART VI, LINE 7A MEMBERS ELECT THE GOVERNING BOARD AT THE ANNUAL MEETING FORM 990, PAGE 6, PART VI, LINE 7B BOARD DECISIONS ARE NOT SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 11B CHIEF EXECUTIVE REVIEWS 990 WHICH IS PREPARED BY AN AUDITING FIRM FORM 990, PAGE 6, PART VI, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES REQUIRED TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS FORM 990, PAGE 6, PART VI, LINE 15A ANNUAL BOARD EVALUATION CONDUCTED WITH INPUT FROM REGIONAL HEALTH PERSONNEL FORM 990, PAGE 6, PART VI, LINE 15B PHYSICIANS HAVE EMPLOYMENT CONTRACTS FORM 990, PAGE 6, PART VI, LINE 18 GUIDESTAR.COM FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE ON REQUEST FORM 990, PART IX, LINE 11G CONSULTANT & MGMT 145,116 393,270 0 EDUCATION/TRAINING 21,066 1,860 0 MAINTENANCE CONTRACT 96,095 34,242 0 PHYSICIAN FEES 54,841 0 0 PROFESSIONAL FEES-OTHER 0 0 12,205 RECRUITMENT 91,002 1,458 0 REFERENCE LAB 168,883 0 0 NURSING SERVICES-NON PHYS 1,718,190 0 0 TOTAL 2,295,193 430,830 12,205 MONUMENT HEALTH PO BOX 6000 RAPID CITY SD 57709 REIMBURSEM SD 501 3 N/A false false false false false false false false false false false false false false false false true false false false MONUMENT HEALTH P 1216451 CASH EXPENDITURES SCHEDULE R ON OCTOBER 1, 2011, THE FACILITY ENTERED INTO A MANAGEMENT AGREEMENT WITH MONUMENT HEALTH (MH) TO PROVIDE SERVICES TO THE HOSPITAL, CLINICS AND ASSISTED LIVING FACILITY. MH PROVIDES THE FOLLOWING SERVICES; ADMINISTRATOR, SUPPORTING SERVICES, OTHER SPECIFIC SERVICES, ATTENDANCE AT MEETINGS, REPORTS AND EDUCATION. IN CONSIDERATION FOR THESE SERVICES, THE FACILITY REIMBURSES MH 100% OF THE ADMINISTRATORS BASE SALARY AND BENEFITS, REIMBURSES MH 2,582 PER MONTH FOR OTHER SPECIFIC SERVICES AND REIMBURSES MH THE ACTUAL COST OF SUPPORTING SERVICES. THE AGREEMENT TERMINATED ON SEPTEMBER 30,2021. THE FACILITY ENTERED INTO A NEW MANAGEMENT AGREEMENT WITH MONUMENT HEALTH (MH) FOR THE SAME SERVICES AS THE PRIOR AGREEMENT ON OCTOBER 1, 2021. THE NEW AGREEMENT EXPIRES SEPTEMBER 30, 2031. EITHER PARTY MAY TERMINATE THE AGREEMENT SOONER, WITH OR WITHOUT CAUSE, BY GIVING 90 DAYS WRITTEN NOTICE OF TERMINATION.