2022-11-14T16:51:34-06:00 2021-12-31 450250958 EIDE BAILLY LLP 200 E 10TH ST STE 500 SIOUX FALLS SD 571046375 990 2021-01-01 460274380 WINNER REGIONAL HEALTHCARE CENTER WINN 6058427100 745 E 8TH ST WINNER SD 57580 AMANDA SOESBE CFO 6058427100 2022-11-14 1 AMANDA SOESBE 999009999 LAURIE HANSON CPA P00851848 6053391999 2022-11-12 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z KEVIN COFFEY 745 E 8TH ST WINNER SD 57580 28331447 0 X WWW.WINNERREGIONAL.ORG X 1961 SD TO IMPROVE THE QUALITY OF LIFE IN OUR REGION. 9 7 236 8 375211 0 3550579 5096922 22385846 23160517 23875 11929 -45050 -26817 25915250 28242551 0 0 0 0 10582383 10529950 0 0 0 14606369 17292544 25188752 27822494 726498 420057 34350216 30381417 23206155 18786360 11144061 11595057 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 23411877 22785306 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 NEWBORN CARE. THE FACILITY ALSO OPERATES A HOME HEALTH AGENCY, HOMEMAKER PROGRAM, A PROVIDER BASED RURAL HEALTH CLINIC, A RETAIL PHARMACY, AND A COMMUNITY HEALTH PROGRAM AND PROVIDES COMMUNITY EDUCATION PROGRAMS THROUGHOUT THE SERVICE AREA. WINNER REGIONAL HEALTHCARE CENTER HAD 1,305 ACUTE PATIENT DAYS; 978 SWING BED PATIENT DAYS; 243 NEWBORN PATIENT DAYS; 156 BIRTHS; 13,157 RESIDENT DAYS; 2,302 HOME HEALTH VISITS; 10,264 RURAL HEALTH CLINIC VISITS; 7,023 OBSERVATION HOURS; AND 320 LABOR AND DELIVERY DAYS. 23411877 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 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 23 0 1 236 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 KEVIN COFFEY 6058427213 745 EAST 8TH STREET WINNER SD 57580 RICK WAGNER MD DIRECTOR, CHIEF OF STAFF 30.00 X 200750 0 0 RHONDA JORGENSEN CRNA 32.00 X 180706 0 14418 MARLA HAYES PHARMACIST 40.00 X 165761 0 4973 REBECCA OLSON CNP 40.00 X 147692 0 4942 KORIE PRAVECEK CNP 40.00 X 141564 0 8798 NAKAYLA BURNHAM CNP 40.00 X 122998 0 12377 AMANDA SOESBE CFO 40.00 X 82406 0 9602 KEVIN COFFEY CEO 40.00 X 0 0 0 ROGER KINGSBURY PRESIDENT 1.00 X X 0 0 0 NEIL LANTZ VICE PRESIDENT 1.00 X X 0 0 0 KIM VANNEMAN TREASURER 1.00 X X 0 0 0 BETSY PRAVECEK SECRETARY 1.00 X X 0 0 0 JUSTIN NELSON DIRECTOR 1.00 X 0 0 0 DIONE ROWE DIRECTOR 1.00 X 0 0 0 CASEY HEENAN DIRECTOR 1.00 X 0 0 0 SARA PETERSEK DIRECTOR 1.00 X 0 0 0 1041877 0 55110 13 0 1 1 FASTAFF PO BOX 911452 DENVER CO 802911452 CONTRACTED NURSING 2068326 SANFORD HEALTH PO BOX 5074 SIOUX FALLS SD 57117 MGMT FEES/SALARY REIMB/IT SUPPORT 1927542 GLOBAL MEDICAL STAFFING PO BOX 733375 DALLAS TX 753973375 CONTRACT PHYSICIANS FOR ER COVERAGE 714605 FOCUSONE SOLUTIONS LLC PO BOX 3037 OMAHA NE 681030037 CONTRACTED NURSING 590894 RURAL PARTNERS IN MEDICINE LLC PO BOX 772519 STEAMBOAT SPRINGS CO 80477 ORTHOPEADIC/UROLOGY SERVICES 555472 16 4772579 324343 5096922 PATIENT AND RESIDENT SERVICE REVE 621110 21102617 21102617 PHARMACY REVENUE 900099 1727793 1352582 375211 PHYSICIAN OUTREACH 621110 48323 48323 281784 281784 23160517 11929 11929 62079 88896 -26817 -26817 -26817 28242551 22785306 375211 -14888 X 292825 200750 92075 55799 55799 8239511 6888081 1351430 170658 143841 26817 1155868 910156 245712 615289 508847 106442 275289 275289 4405 4405 114513 26491 88022 2018 2018 8906173 8201187 704986 144966 7876 137090 518805 312689 206116 672221 346609 325612 305920 297538 8382 21377 16828 4549 444915 295083 149832 1663250 1296369 366881 255144 89570 165574 MEDICAL SUPPLIES 3610808 3569842 40966 FOOD 200042 200042 LICENSES, DUES & SUBSCR 52936 38492 14444 99762 5787 93975 27822494 23411877 4410617 0 1212229 373 3129280 3708426 197785 133511 719124 671295 38751 39611 37242209 17175431 21357322 20066778 6453218 3842187 1085507 1216445 157000 702791 34350216 30381417 5030977 2703506 2705168 736622 4470 3530 15465540 15342702 23206155 18786360 X 9958554 10378611 1185507 1216446 11144061 11595057 34350216 30381417 X 420057 30939 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2018 2018 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 29750849 11832439 17918410 5683844 4676315 1007529 1782878 666677 1116201 20066778 X 28331447 0 28331447 -88896 -88896 28242551 27911390 88896 88896 27822494 0 27822494 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. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -88,896. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 88,896. 1 1 X 1 X 1 X 150.000000000000 1 1 0 0 153000 153000 0.00550 3675743 2348120 1327623 0.04770 3828743 2348120 1480623 0.05320 46200 49950 0 0.00000 10743087 6129459 4613628 0.16580 10789287 6179409 4613628 0.16580 14618030 8527529 6094251 0.21900 1 1903598 367394 6159942 6098638 61304 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 19 1 1 0 1 X SEE LINE 7D NARRATIVE X X 1 19 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: AN ONLINE SURVEY WAS CONDUCTED WITH IDENTIFIED COMMUNITY KEY STAKEHOLDERS. RESPONDENTS WERE ASKED TO RANK COMMUNITY NEEDS BASED ON A SCALE OF 1-5, WITH 5 BEING THE GREATEST NEEDS. THE STUDY CONCENTRATED ON THE STAKEHOLDER'S CONCERNS FOR THE COMMUNITY SPECIFIC TO ECONOMIC WELL-BEING, TRANSPORTATION, CHILDREN AND YOUTH, THE AGING POPULATION, SAFETY, HEALTH CARE AND WELLNESS, MENTAL HEALTH AND SUBSTANCE ABUSE. THE STUDY WAS CONDUCTED THROUGH A PARTNERSHIP BETWEEN SANFORD HEALTH AND THE CENTER FOR SOCIAL RESEARCH (CSR) AT NORTH DAKOTA STATE UNIVERSITY. THE CSR DEVELOPED AND MAINTAINED LINKS TO THE ONLINE SURVEY TOOL. SANFORD HEALTH DISTRIBUTED THE SURVEY LINK VIA EMAIL TO STAKEHOLDERS AND KEY LEADERS IN TRIPP COUNTY. DATA COLLECTION OCCURRED DURING DECEMBER 2017 AND JANUARY 2018. A TOTAL OF 7 COMMUNITY STAKEHOLDERS PARTICIPATED IN THE SURVEY. THE RESIDENT SURVEY TOOL INCLUDED QUESTIONS ABOUT THE RESPONDENT'S PERSONAL HEALTH. AN ONLINE SURVEY WAS DEVELOPED IN PARTNERSHIP WITH PUBLIC HEALTH EXPERTS FROM ACROSS THE SANFORD FOOTPRINT. THE MINNESOTA HEALTH DEPARTMENT REVIEWED AND ADVISED SANFORD ABOUT KEY QUESTIONS THAT THEY REQUEST FOR THE SHIP SURVEYS AND THOSE QUESTIONS WERE INCLUDED IN THE RESIDENT SURVEY. QUESTIONS SPECIFIC TO AMERICAN INDIAN RESIDENTS WERE DEVELOPED BY THE NORTH DAKOTA PUBLIC HEALTH ASSOCIATION. THE SURVEY WAS POSTED ON FACEBOOK AND A LINK TO THE SURVEY WAS PUBLISHED IN THE LOCAL NEWSPAPER. A TOTAL OF 35 COMMUNITY RESIDENTS PARTICIPATED IN THE SURVEY. 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://WINNERREGIONAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ WINNER REGIONAL HEALTHCARE CENTER PART V, SECTION B, LINE 11: THE GOAL FOR THE 2020-2022 COMMUNITY HEALTH NEEDS ASSESSMENT IS TWO-FOLD. PRIORITY 1 IS TO FOCUS ON CHILDREN AND YOUTH, AND PRIORITY 2 IS TO FOCUS ON HEALTHCARE AND WELLNESS.DUE TO COVID, PROVIDING EDUCATION TO STUDENTS ON MAKING HEALTHY FOOD CHOICES AND LIVING AN ACTIVE LIFESTYLE HAS NOT BEEN ACCOMPLISHED.THE HEALTH AND WELLNESS COMMITTEE HAS BEEN VERY ACTIVE WITH WINNER REGIONAL STAFF. THERE HAVE BEEN SEVERAL ACTIVITIES THROUGHOUT THE YEAR. MOST RECENTLY, HEALTHY SMOOTHIES WERE AVAILABLE FOR STAFF TO PURCHASE, A POKER RUN/WALK EVENT OCCURRED, AND WE CELEBRATED NATIONAL NUTRITION MONTH. THE ORGANIZATION HAD TO MODIFY ITS GOALS DUE TO COVID. INSTEAD OF DOING EDUCATION OUT IN THE PUBLIC, THE ORGANIZATION FOCUSED ON THE IMPORTANCE OF BEING HEALTHY AND ACTIVE INTERNALLY BY EDUCATING STAFF ON EXERCISE AND HEALTHY EATING THROUGH PLACING EDUCATIONAL INFORMATION IN RESTROOMS THROUGHOUT THE ORGANIZATION.THE ORGANIZATION SUPPORTS A PROGRAM "BETTER CHOICES BETTER HEALTH". AS A RESULT OF COVID, THE PROGRAM TRANSITIONED TO ONLINE AND OF RECENT CAN AGAIN BE ATTENDED IN PERSON AS ANOTHER OPTION. IT IS TAUGHT THROUGHOUT SOUTH DAKOTA. ANOTHER PROGRAM CALLED "A MATTER OF BALANCE" IS SUPPORTED BY WRH. THIS PROGRAM IS IN PERSON AND OPEN TO THE PUBLIC.A PRESS RELEASE WAS DONE REGARDING VISITOR RESTRICTIONS AND ADDRESSING WHAT PATIENTS SHOULD DO PRIOR TO COMING IN FOR MEDICAL ATTENTION. THERE WAS COMMUNICATION TO THE PUBLIC WHEN COVID VACCINATIONS WERE AVAILABLE. WRH DID HOLD A HEALTH AND WELLNESS FAIR IN JUNE 2022 THAT WAS WELL ATTENDED. 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://WINNERREGIONAL.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/.PART 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 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, OTHER FINANCIAL OBLIGATIONS, FREQUENCY OF HEALTH SERVICES, INSURANCE STATUS, UNDERINSURANCE STATUS 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. 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. LINE 7F WAS OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINES 7B AND 7G WERE DETERMINED USING THE COST REPORTS. PART I, LINE 7G: PHYSICIAN CLINIC NET REVENUE OF $2,442,243 AND COSTS OF $3,589,506 ARE INCLUDED ON LINE 7G FOR A NET COMMUNITY BENEFIT OF $1,147,263. 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 19.3% OF IMPLICIT PRICE CONCESSIONS, WHICH IS BASED ON THE POVERTY LEVEL OF THE SERVICE AREA. PART III, LINE 4: FOOTNOTE FROM FINANCIAL STATEMENT: PLEASE SEE FINANCIAL STATEMENT NOTE 2 - PATIENT AND RESIDENT SERVICE REVENUE ON PAGES 16-17 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 12/31/2021. 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 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 HOLDS PUBLIC AFFAIRS MEETINGS THREE TIMES PER YEAR IN WHICH IT REQUESTS INPUT FROM PROFESSIONALS AND COMMUNITY MEMBERS REGARDING NEEDS OF THE COMMUNITY. 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 RICK WAGNER MD DIRECTOR, CHIEF OF STAFF 200750 0 0 0 0 0 0 0 0 0 200750 0 0 0 RHONDA JORGENSEN CRNA 180706 0 0 0 0 0 5621 0 8863 0 195190 0 0 0 MARLA HAYES PHARMACIST 165761 0 0 0 0 0 4973 0 66 0 170800 0 0 0 REBECCA OLSON CNP 147692 0 0 0 0 0 4457 0 551 0 152700 0 0 0 KORIE PRAVECEK CNP 141564 0 0 0 0 0 0 0 8864 0 150428 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. KYLE COFFEY FAMILY MEMBER OF KEVIN COFFEY, CEO 26137 BASE WAGES AND BENEFITS 0 LORI KINGSBURY FAMILY MEMBER OF ROGER KINGSBURY, BOARD PRESIDENT 29662 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 KEVIN COFFEY, CEO. COMPENSATION AND BENEFITS FOR THE CEO WERE $260,836 AND $14,453 RESPECTIVELY. 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 THE 2021 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 391,832. MANAGEMENT AND GENERAL EXPENSES 160,723. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 552,555. OUTSIDE MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 457,701. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 457,701. PURCHASED STAFFING/CONTRACT PHYSICIANS: PROGRAM SERVICE EXPENSES 7,259,265. MANAGEMENT AND GENERAL EXPENSES 47,085. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,306,350. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 29,627. MANAGEMENT AND GENERAL EXPENSES 74,776. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 104,403. CONSULTING: PROGRAM SERVICE EXPENSES 23,000. MANAGEMENT AND GENERAL EXPENSES 73,200. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,200. OTHER: PROGRAM SERVICE EXPENSES 2,031. MANAGEMENT AND GENERAL EXPENSES 3,034. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,065. SOFTWARE MAINTENANCE: PROGRAM SERVICE EXPENSES 37,731. MANAGEMENT AND GENERAL EXPENSES 346,168. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 383,899. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 30,939.