MONUMENT HEALTH RAPID CITY HOSPITAL INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: MONUMENT HEALTH RAPID CITY HOSPITAL INC (EIN 46-0319070)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-05-15
IRS object ID: 202021369349301042
Schema version: 2018v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule G
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-05-15T09:25:28-05:00	ReturnTs
Tax Period End	2019-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450250958	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Eide Bailly LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	800 Nicollet Mall Ste 1300	AddressLine1Txt
City	Minneapolis	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554027033	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460319070	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Monument Health Rapid City Hospital Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MONU	BusinessNameControlTxt
Phone	6057559130	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	353 Fairmont Blvd PO Box 6000	AddressLine1Txt
City	Rapid City	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	577096000	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Mark Thompson	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	6057559130	PhoneNum
Signature	2020-05-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kim Hunwardsen CPA	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2020-05-14	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	216.147.181.49	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-05-14	IPDt
IP Tm	09:28:00	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC	AtSubmissionCreationDeviceId
At Submission Filing Device Id	EFC25E59FA7409AE560978A003AFB9E955B778C6	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-23 17:36:50Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Paulette Davidson	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	353 Fairmont Blvd PO Box 6000	AddressLine1Txt
City	Rapid City	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	577096000	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$809,375,030	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.monument.health	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1973	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	Monument Health is dedicated to improving the health of individuals and our communities.	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	4903	TotalEmployeeCnt
Total Volunteers	308	TotalVolunteersCnt
Total Gross UBI	$11,664,775	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$1,079,753	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$2,375,680	PYContributionsGrantsAmt
CY Contributions Grants	$2,376,782	CYContributionsGrantsAmt
PY Program Service Revenue	$704,972,214	PYProgramServiceRevenueAmt
CY Program Service Revenue	$780,413,572	CYProgramServiceRevenueAmt
PY Investment Income	$37,860,710	PYInvestmentIncomeAmt
CY Investment Income	$25,367,998	CYInvestmentIncomeAmt
PY Other Revenue	$236,746	PYOtherRevenueAmt
CY Other Revenue	$414,940	CYOtherRevenueAmt
PY Total Revenue	$745,445,350	PYTotalRevenueAmt
CY Total Revenue	$808,573,292	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$287,244,751	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$291,320,600	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$1,043,771	CYTotalFundraisingExpenseAmt
PY Other Expenses	$411,789,680	PYOtherExpensesAmt
CY Other Expenses	$467,433,326	CYOtherExpensesAmt
PY Total Expenses	$699,034,431	PYTotalExpensesAmt
CY Total Expenses	$758,753,926	CYTotalExpensesAmt
PY Revenues Less Expenses	$46,410,919	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$49,819,366	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,131,251,656	TotalAssetsBOYAmt
Total Assets EOY	$1,161,098,499	TotalAssetsEOYAmt
Total Liabilities BOY	$408,174,755	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$407,173,139	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$723,076,901	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$753,925,360	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Our vision at Monument Health is to be one team, to listen, to be inclusive, and to show we care. Monument Health is dedicated to improving the health of individuals and our communities. Values: Trust, Respect, Compassion, Community, Excellence	MissionDesc
Significant New Program Srvc	Yes (1)	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$478,801,732	ExpenseAmt
Revenue	$537,707,420	RevenueAmt
Desc	Monument Health Rapid City Hospital, Inc. (MHRCH) offers both inpatient and outpatient health services. Its tertiary hospital, Rapid City Hospital (RCH), serves Western South Dakota. The nearest larger hospital is in Sioux Falls, SD, more than 350 miles away. As such, the services provided by MHRCH are truly a healthcare safety net for Western South Dakota. The hospital provides comprehensive care, including Level II Trauma Care. MHRCH also includes Monument Health Orthopedic and Specialty Hospital (MHOSH). MHOSH focuses on orthopedics, neurosurgery and podiatry, as well as related outpatient services, related therapy services and sports performance services.MHRCH is also the single member of Monument Health Home Plus, LLC.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$31,272,192	ExpenseAmt
Revenue	$29,607,803	RevenueAmt
Desc	Monument Health Home Plus, LLC Specialty Pharmacy offers high-cost, high-touch medication therapy for patients with complex diseases. These include cancer, multiple sclerosis, Crohn's disease, hepatitis C, psoriasis, rheumatoid arthritis and rare genetic conditions. The medications often require special storage, handling, and/or administration.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$24,853,107	ExpenseAmt
Revenue	$120,333,598	RevenueAmt
Desc	RCH Surgical Services - provide in and out-patient surgical services to acute care patients.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$22,417,006	ExpenseAmt
Revenue	$81,412,091	RevenueAmt
Desc	RCH Pharmacy - provide pharmaceuticals in support of acute care hospital patients.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$22,417,006	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$81,412,091	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$557,344,037	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	584	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	4903	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Mark Thompson	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6057559127	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	353 Fairmont Blvd PO Box 6000	AddressLine1Txt
City	Rapid City	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	577096000	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Jack Lynass
Chairman	0.75	0.00	Yes (X)	Yes (X)	$0	$0	$0
Andrea Baier MD
Board Member/Employed Physician	40.74	0.00	Yes (X)		$323,371	$0	$55,927
Deidre Budajhl
Board Member	0.95	0.00	Yes (X)		$0	$0	$0
Sandra Burns
Board Member	0.38	0.00	Yes (X)		$0	$0	$0
Timothy Frost MD
Board Member	0.48	0.00	Yes (X)		$2,500	$0	$0
Srinivas Gangineni MD
Board Member/Employed Physician	40.62	0.00	Yes (X)		$542,373	$0	$79,862
Lia Green
Board Member	2.58	0.02	Yes (X)		$0	$0	$0
Rich Kinzley
Board Member	0.16	0.00	Yes (X)		$0	$0	$0
Kelly Manning MD
Board Member	0.48	0.00	Yes (X)		$0	$0	$0
Robert Mudge
Board Member	0.16	0.00	Yes (X)		$0	$0	$0
Tom Rau
Board Member	0.51	0.00	Yes (X)		$0	$0	$0
Alex Schabauer MD
Board Member/Employed Physician	40.97	0.00	Yes (X)		$810,383	$0	$88,788
Michael Statz MD
Board Member/Employed Physician	40.71	0.00	Yes (X)		$178,060	$0	$0
Brent Phillips
President & CEO Until 07/2018	48.43	11.57	Yes (X)	Yes (X)	$0	$510,692	$108,854
Paulette R Davidson
President & CEO	48.43	11.57	Yes (X)	Yes (X)	$0	$949,112	$99,787
Mark A Thompson
CFO/Treasurer	44.39	10.61		Yes (X)	$618,307	$0	$90,672
Teresa Burroff
General Counsel/Secretary	44.39	10.61		Yes (X)	$526,037	$0	$46,994
Brad Archer MD
Chief Medical Officer	44.39	10.61			$610,756	$0	$85,102	Yes (X)
Tresha Moreland
VP Human Resources Operations	44.39	10.61			$290,407	$0	$33,887	Yes (X)
Nicole Kerkenbush
Chief Performance Officer	44.39	10.61			$289,126	$0	$33,392	Yes (X)
Stephanie Lahr MD
CIO/CMIO	44.39	10.61			$514,675	$0	$82,542	Yes (X)
Mary Masten
General Counsel, Emeritus	44.39	10.61			$286,202	$0	$35,070	Yes (X)
Laura C Wightman
Chief Nursing Officer Until 04/2019	44.39	10.61			$373,183	$0	$47,623	Yes (X)
John Pierce
President Rapid City Market	55.00	0.00			$388,593	$0	$69,325	Yes (X)
Douglas Koch
VP Rapid City Market	55.00	0.00			$260,753	$0	$34,375	Yes (X)
Michael Tilles
President Home Plus	55.00	0.00			$355,563	$0	$52,489	Yes (X)
Michael Latour
System Director of Musculoskeletal Care	30.00	25.00			$99,137	$85,263	$34,113	Yes (X)
Mark Longacre
President - Monument Health Ortho Specialty Hosp	23.30	31.70			$0	$339,032	$44,091	Yes (X)
John Karl Heilman III MD
Physician - Cardiology	40.00	0.00			$944,409	$0	$38,966		Yes (X)
James Takara MD
Physician - Cardiac Surgery	40.00	0.00			$1,020,709	$0	$90,367		Yes (X)
Bhaskar Purushottam MD
Physician - Cardiology	40.00	0.00			$1,022,878	$0	$116,840		Yes (X)
Joseph Tuma MD
Physician - Cardiology	40.00	0.00			$1,118,542	$0	$95,629		Yes (X)
Roger Knutsen MD
Physician - Dermatology	40.00	0.00			$967,816	$0	$24,544		Yes (X)
Thomas Worsley
President Spearfish Market	0.00	55.00			$0	$385,312	$57,515			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$11,543,780	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,269,411	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,546,754	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	342	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Layton Gustafson
9090 South Sandy Parkway	Sandy	UT	84070	Construction	$79,417,227
Crothall Healthcare
13028 Collection Center Drive	Chicago	IL	60693	Contract Labor	$8,969,674
Medefis
10826 Old Mill Rd 101	Omaha	NE	68105	Temporary Medical Staff Coverage	$8,652,491
Weatherby Locums
PO BOX 972633	Dallas	TX	75397	Contract Labor	$6,832,362
Morrison Management Specialists Inc
PO BOX 102289	Atlanta	GA	30368	Professional Services	$6,189,918

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	306	CntrctRcvdGreaterThan100KCnt
Fundraising	$167,429	FundraisingAmt
Related Organizations	$20,058	RelatedOrganizationsAmt
Government Grants	$305,026	GovernmentGrantsAmt
All Other Contributions	$1,884,269	AllOtherContributionsAmt
Total Contributions	$2,376,782	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
In Patient Pharmacy	446110	$159,844,777	$159,844,777
Surgical Services	622110	$136,382,527	$136,382,527
Cardiac Services	622110	$134,759,916	$134,759,916
Laboratory	621500	$132,243,504	$132,243,504
MIS CT Scan	621500	$71,797,074	$71,797,074

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$145,385,774	TotalRevenueColumnAmt
Related Or Exempt Func Income	$133,878,969	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$11,506,805	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$780,413,572	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,672,911	TotalRevenueColumnAmt
Exclusion	$8,672,911	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,664,089	TotalRevenueColumnAmt
Exclusion	$1,664,089	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$590,318	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$441,574	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$148,744	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$148,744	TotalRevenueColumnAmt
Exclusion	$148,744	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$15,030,998	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$15,030,998	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,030,998	TotalRevenueColumnAmt
Exclusion	$15,030,998	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$199,822	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$167,429	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$150,610	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$49,212	TotalRevenueColumnAmt
Exclusion	$49,212	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$268,568	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$209,554	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$59,014	TotalRevenueColumnAmt
Related Or Exempt Func Income	$59,014	RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	UBI from Partnerships	Desc
Business	900099	BusinessCd
Total Revenue Column	$157,970	TotalRevenueColumnAmt
Unrelated Business Revenue	$157,970	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$157,970	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$808,573,292	TotalRevenueColumnAmt
Related Or Exempt Func Income	$768,965,781	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$11,664,775	UnrelatedBusinessRevenueAmt
Exclusion	$25,565,954	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$8,973,635	TotalAmt
Program Services	$1,944,774	ProgramServicesAmt
Management And General	$7,028,861	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$388,771	TotalAmt
Program Services	$388,771	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$257,829,280	TotalAmt
Program Services	$221,666,004	ProgramServicesAmt
Management And General	$35,430,784	ManagementAndGeneralAmt
Fundraising	$732,492	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,179,838	TotalAmt
Program Services	$1,647,800	ProgramServicesAmt
Management And General	$526,746	ManagementAndGeneralAmt
Fundraising	$5,292	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,334,059	TotalAmt
Program Services	$4,032,163	ProgramServicesAmt
Management And General	$1,288,947	ManagementAndGeneralAmt
Fundraising	$12,949	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$16,615,017	TotalAmt
Program Services	$12,444,315	ProgramServicesAmt
Management And General	$4,129,649	ManagementAndGeneralAmt
Fundraising	$41,053	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$509,311	TotalAmt
Program Services	$152	ProgramServicesAmt
Management And General	$509,159	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$427,850	TotalAmt
Program Services	$12,771	ProgramServicesAmt
Management And General	$415,079	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$56,693	TotalAmt
Management And General	$56,693	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$69,465,212	TotalAmt
Program Services	$39,031,624	ProgramServicesAmt
Management And General	$30,430,673	ManagementAndGeneralAmt
Fundraising	$2,915	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$909,382	TotalAmt
Program Services	$84,367	ProgramServicesAmt
Management And General	$787,901	ManagementAndGeneralAmt
Fundraising	$37,114	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$13,660,051	TotalAmt
Program Services	$6,739,763	ProgramServicesAmt
Management And General	$6,763,953	ManagementAndGeneralAmt
Fundraising	$156,335	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$14,289,019	TotalAmt
Program Services	$3,012,029	ProgramServicesAmt
Management And General	$11,236,538	ManagementAndGeneralAmt
Fundraising	$40,452	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$23,270,239	TotalAmt
Program Services	$8,116,697	ProgramServicesAmt
Management And General	$15,152,095	ManagementAndGeneralAmt
Fundraising	$1,447	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,087,914	TotalAmt
Program Services	$1,280,951	ProgramServicesAmt
Management And General	$798,522	ManagementAndGeneralAmt
Fundraising	$8,441	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$414,527	TotalAmt
Program Services	$57,152	ProgramServicesAmt
Management And General	$357,375	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,267,580	TotalAmt
Program Services	$7,479	ProgramServicesAmt
Management And General	$4,260,101	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$36,271,681	TotalAmt
Program Services	$10,457,157	ProgramServicesAmt
Management And General	$25,809,832	ManagementAndGeneralAmt
Fundraising	$4,692	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,994,303	TotalAmt
Program Services	$881,996	ProgramServicesAmt
Management And General	$2,112,307	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medical Supplies	$140,589,772	$140,589,183	$0	$589
Interco. Serv. & Suppl.	$81,113,431	$30,053,794	$51,059,637
Bad Debt Expense	$74,631,947	$74,631,947
All other expenses	$2,474,414	$263,148	$2,211,266

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$758,753,926	TotalAmt
Program Services	$557,344,037	ProgramServicesAmt
Management And General	$200,366,118	ManagementAndGeneralAmt
Fundraising	$1,043,771	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$8,012,424	BOYAmt
EOY	$20,575,182	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,658,134	BOYAmt
EOY	$6,596,505	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$83,644,994	BOYAmt
EOY	$91,316,552	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$17,282,863	BOYAmt
EOY	$17,333,404	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$9,662,027	BOYAmt
EOY	$11,259,472	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$666,269,366	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$238,442,442	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$333,165,133	BOYAmt
EOY	$427,826,924	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$588,826,079	BOYAmt
EOY	$264,562,046	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$64,271,229	BOYAmt
EOY	$318,224,096	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,580,906	BOYAmt
EOY	$3,404,318	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$20,147,867	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,131,251,656	BOYAmt
EOY	$1,161,098,499	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$62,300,320	BOYAmt
EOY	$53,511,322	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$292,151,374	BOYAmt
EOY	$283,109,330	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$53,723,061	BOYAmt
EOY	$70,552,487	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$408,174,755	BOYAmt
EOY	$407,173,139	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$700,627,981	BOYAmt
EOY	$731,470,655	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,785,991	BOYAmt
EOY	$20,791,776	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,662,929	BOYAmt
EOY	$1,662,929	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$723,076,901	BOYAmt
EOY	$753,925,360	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,131,251,656	BOYAmt
EOY	$1,161,098,499	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$49,819,366	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$10,809,071	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$8,161,836	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$56,693	OtherActivitiesAmt
Total Lobbying Expenditures	$56,693	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	Annual dues are paid to the South Dakota Association of Healthcare Organizations. A portion of the dues are applicable to lobbying activities. For calendar year 2019 dues, which were paid in fiscal year 2019, in the amount of $215,307.70, 10.87% was used for lobbying purposes. Annual dues were paid to the American Hospital Association, a portion of which is applicable to lobbying activities. For calendar year 2019 dues, which were paid in fiscal year 2019, in the amount of $65,081, 22.73% was used for lobbying purposes. Annual dues were paid to the American Medical Rehab Providers Association, a portion of which is applicable to lobbying activities. For calendar year 2019 dues, which were paid in fiscal year 2019, in the amount of $10,926, 32.00% was used for lobbying purposes. In fiscal year 2019, $15,000 of consulting expense was incurred in regard to lobbying.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,662,929	BeginningYearBalanceAmt
End Year Balance	$1,662,929	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,662,929	BeginningYearBalanceAmt
End Year Balance	$1,662,929	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,662,929	BeginningYearBalanceAmt
End Year Balance	$1,662,929	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,662,929	BeginningYearBalanceAmt
End Year Balance	$1,662,929	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,662,929	BeginningYearBalanceAmt
End Year Balance	$1,662,929	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,346,017	OtherCostOrOtherBasisAmt
Book Value	$8,346,017	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$320,668,418	OtherCostOrOtherBasisAmt
Depreciation	$117,843,197	DepreciationAmt
Book Value	$202,825,221	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,186,635	OtherCostOrOtherBasisAmt
Depreciation	$3,861,648	DepreciationAmt
Book Value	$6,324,987	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$200,459,721	OtherCostOrOtherBasisAmt
Depreciation	$116,737,597	DepreciationAmt
Book Value	$83,722,124	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$126,608,575	OtherCostOrOtherBasisAmt
Book Value	$126,608,575	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$427,826,924	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (8 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Private Equity/Debt	$33,809,276	F
Real Estate Funds	$10,958,098	F
Investment in West Dakota Health Care/Monument Health Network	$43,000,231	C
Investment in Privately Held Companies	$23,645,070	F
Equity Securities and Funds - Domestic	$30,952,983	F
Equity Securities and Funds - International	$99,347,659	F
Fixed Income - Bond Funds & Corp Bonds - Domestic	$61,820,823	F
Absolute Return Assets - Hedge Funds	$14,689,956	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$318,224,096	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Payable Under Interest Rate Swap	$6,223,434
Other Long Term Liabilities	$16,905,786
Accrued Pension Liability	$36,853,032
Due from related party	$10,570,235

Field	Value	IRS element (for citing)
Total Liability	$70,552,487	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Part V, Line 4:

Endowed funds are held in an interest bearing account subject to the terms as specified by the donor and Board of Directors. The earnings on the endowment funds become temporarily restricted funds and therefore are not part of the endowment balance. The earnings are used to support the activities and programs in proportion to the restricted balances. Of the $1,662,929 endowment funds, $692,332 are restricted to be used for grants/scholarships to students in a healthcare program, $512,197 is restricted for use in the pediatrics unit, $100,000 for promotion of a healthy community, $197,400 for cardiac services, $100,000 for hospice patients, $36,000 for plants in public areas and $25,000 for cancer care.

Part X, Line 2:

References to "Monument Health" apply to all entities controlled by Monument Health, Inc. and its subsidiaries. This includes the reporting entity. Monument Health 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 consolidated financial statements. Monument Health 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.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	Investment	TypeOfActivitiesConductedTxt
Region Total Expenditures	$18,870,000	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$18,870,000	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$18,870,000	TotalSpentAmt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	0	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (1)	PassiveForeignInvestmestCoInd
Foreign Partnership	Yes (1)	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	The organization does not award grants or assistance outside the United States. The organization has investment activities outside the United States. Part IV, Line 4: The organization invests in partnerships that hold direct or indirect interests in passive foreign investment companies. The investment partnerships have properly filed Form 8621, or the underlying investments did not generate any unrelated business income. Under these facts, it is not necessary for the organization to file an additional Form 8621. Part IV, Line 5: The organization has an ownership interest in a foreign partnership. However, the organization is below the ownership percentage that would trigger the filing of the Form 8865 and also does not meet the dollar threshold for transfers during the year. Therefore, no Form 8865 has been filed.	ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Duck Race	Event1Nm
Gross Receipts Event1	$97,877	GrossReceiptsEvent1Amt
Charitable Contri Event1	$84,864	CharitableContriEvent1Amt
Gross Revenue Event1	$13,013	GrossRevenueEvent1Amt
Other Direct Expenses Event1	$46,500	OtherDirectExpensesEvent1Amt
Event2	Tough Enough to Wear Pink	Event2Nm
Gross Receipts Event2	$82,565	GrossReceiptsEvent2Amt
Charitable Contri Event2	$82,565	CharitableContriEvent2Amt
Other Direct Expenses Event2	$52,500	OtherDirectExpensesEvent2Amt
Other Events Total	5	OtherEventsTotalCnt
Gross Receipts Other Events	$186,809	GrossReceiptsOtherEventsAmt
Gross Revenue Other Events	$186,809	GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events	$51,610	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$367,251	GrossReceiptsTotalAmt
Charitable Contributions Tot	$167,429	CharitableContributionsTotAmt
Gross Revenue Total Events	$199,822	GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events	$150,610	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$150,610	DirectExpenseSummaryEventsAmt
Net Income Summary	$49,212	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent250	Yes (X)	Percent250Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,332,814	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$9,332,814	NetCommunityBenefitExpnsAmt
Total Expense	0.01360	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$56,626,504	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$39,502,896	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,123,608	NetCommunityBenefitExpnsAmt
Total Expense	0.02500	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$65,959,318	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$39,502,896	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,456,422	NetCommunityBenefitExpnsAmt
Total Expense	0.03860	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	3549	PersonsServedCnt
Total Community Benefit Expns	$3,524,919	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,524,919	NetCommunityBenefitExpnsAmt
Total Expense	0.00520	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	255	PersonsServedCnt
Total Community Benefit Expns	$5,876,356	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,891,955	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,984,401	NetCommunityBenefitExpnsAmt
Total Expense	0.00290	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,119,605	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,586,401	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,533,204	NetCommunityBenefitExpnsAmt
Total Expense	0.01690	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,860,992	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,474,116	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$386,876	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Persons Served	500	PersonsServedCnt
Total Community Benefit Expns	$409,038	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$409,038	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	4304	PersonsServedCnt
Total Community Benefit Expns	$27,790,910	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,952,472	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,838,438	NetCommunityBenefitExpnsAmt
Total Expense	0.02620	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	4304	PersonsServedCnt
Total Community Benefit Expns	$93,750,228	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$49,455,368	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$44,294,860	NetCommunityBenefitExpnsAmt
Total Expense	0.06480	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$8,457	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,457	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$3,600	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,600	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	400	PersonsServedCnt
Total Community Benefit Expns	$2,371	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,371	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$8,184	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,184	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$19,461	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19,461	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	400	PersonsServedCnt
Total Community Benefit Expns	$42,073	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$42,073	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$74,631,947	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$181,690,225	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$176,572,321	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$5,117,904	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (5 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 Black Hills Medical Office BD LLC
Office Building	0.67930	0.32070
2 Medical & Dental Building
Office Building	0.71450	0.28550
3 The Imaging Center LLC
Medical Imaging	0.50000	0.50000
4 Same Day Surgery Center
Specialty and Ambulatory Srvcs	0.40000	0.60000
5 Western Providers Inc
PHO	0.50000	0.50000

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc
Monument Health Rapid City Hospital
1	353 Fairmont Blvd	Rapid City	SD	57701	www.monument.health	10558	Yes (X)	Yes (X)	Yes (X)	Yes (X)	1 Specialty Hosp; 8 PB clinics; 1 behavioral health facility
Same Day Surgery Center
2	651 Cathedral Drive	Rapid City	SD	57701	www.samedaysurgerycenter.org	10581	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Residency CriteriaResidencyCriteriaInd	Other CriteriaOtherCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Provided Nonprofit ContactProvidedNonprofitContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	Provided Written NoticeProvidedWrittenNoticeInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Prospective Medicare MedicaidProspectiveMedicareMedicaidInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd	No Emergency CareNoEmergencyCareInd
Monument Health Rapid City Hospital Inc
1	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	18	Yes (1)	Yes (1)	0	Yes (1)	Yes (X)	See Section C, Line 7d	Yes (X)	Yes (X)	Yes (1)	18	Yes (1)	See Section C, Line 7d	0	Yes (1)	Yes (X)	200.000000000000	250.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Section C, Line 16a-c	Yes (X)	See Section C, Line 16a-c	Yes (X)	See Section C, Line 16a-c	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0
Same Day Surgery Center
2	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	18	Yes (1)	Yes (1)	0	Yes (1)	Yes (X)	See Section C, Line 7d	Yes (X)	Yes (X)	Yes (1)	18	Yes (1)	See Section C, Line 7d	0	Yes (1)	Yes (X)	200.000000000000	250.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Section C, Line 16a-c	Yes (X)	See Section C, Line 16a-c	Yes (X)	See Section C, Line 16a-c	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	0	Yes (X)	0	0	Yes (X)

Supplemental Information SupplementalInformationGrp (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Monument Health Rapid City Hospital, Inc.	Part V, Section B, Line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. 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.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. A total of 134 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Monument Health service area.
Same Day Surgery Center	Part V, Section B, Line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. 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. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. A total of 134 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Monument health service area.
Monument Health Rapid City Hospital, Inc.	Part V, Section B, Line 6a: The Community Health Needs Assessment was undertaken by Monument Health, including: Monument Health Rapid City Hospital, Same Day Surgery Center, and Monument Health Network (Monument Health Spearfish Hospital, Monument Health Sturgis Hospital, Monument Health Lead-Deadwood Hospital, and Monument Health Custer Hospital). Under a management contract with Monument Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment.
Same Day Surgery Center	Part V, Section B, Line 6a: The Community Health Needs Assessment was undertaken by Monument Health, including: Monument Health Rapid City Hospital, Same Day Surgery Center, and Monument Health Network (Monument Health Spearfish Hospital, Monument Health Sturgis Hospital, Monument Health Lead-Deadwood Hospital, and Monument Health Custer Hospital). Under a management contract with Monument Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment.
Monument Health Rapid City Hospital, Inc.	Part V, Section B, Line 7d: https://monument.health/about-us/community-health-needs-assessment/
Same Day Surgery Center	Part V, Section B, Line 7d: https://monument.health/about-us/community-health-needs-assessment/
Monument Health Rapid City Hospital, Inc.	Part V, Section B, Line 11: During FY19, Monument Health focused on the following three priority areas identified through the most recent CHNA: Access to Healthcare Services, Mental Health, and Wellness (Physical Activity, Nutrition, and Weight). Teams comprised of representatives from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and the community to work on the priority areas selected for each facility's Health Improvement Plan (CHIP).Access to Health Services-Piloted 24/7 call center for primary care patients from Flormann Street Clinic in Rapid City - will grow to serve additional Monument Health locations.-Implemented physician work standards across the system in July 2018 to increase access to care.-System diabetes work to standardize care and improve access.-Primary Case Management program developed that serves Rapid City, Spearfish, Lead/Deadwood, Sturgis, Custer, Hot Springs, and Hill City.-Awarded funding from SD Department of Health to send out reminder letters to more than 14,000 patients that showed they were due or overdue for their breast, cervical, and/or colorectal cancer screenings.Wellness (Physical Activity, Nutrition, Weight)-Worked on expanding access to Monument Health Diabetes Prevention Program. In FY19 a Master Trainer became certified to train new instructors for the program.-Implemented the CATCH (Coordinated Approach to Child Health) evidence-based curriculum in 5 Spearfish locations, 4 Rapid City locations, and 1 Blackhawk location.-Held three KidShape 2.0 workshops in FY19-Increased access to the Better Choices, Better Health program by providing workshop locations at Monument Health and nine leaders from within the system. -Continued partnership with Live Well Black Hills and Healthy Hometown (SM) powered by Wellmark working in the Rapid City, Spearfish, Custer, and Lead/Deadwood communities.Mental Health-Zero Suicide initiative - began implementation in FY18 with initial focus on hospital emergency departments and inpatient behavioral health.-Hosted a community meeting to discuss suicide prevention attended by more than 50 people representing a variety of community organizations.-Opened 8 additional adult inpatient beds at the Behavioral Health Center.-Partnered with Avera Health to provide E-care Telepsychiatry in the Rapid City Hospital Emergency Department with goal to expand to other Monument Health hospitals.Many of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.
Same Day Surgery Center	Part V, Section B, Line 11: During FY19, Same Day Surgery Center focused on the following two priority areas identified through the most recent CHNA: Cancer and Diabetes. Teams comprised of representatives from Rapid City Hospital, Same Day Surgery Center, Monument Health Network, and the community to work on the priority areas selected for each facility's Health Improvement Plan (CHIP).Cancer-Implement Lifestyle Medicine to assist individuals and families to adopt and sustain health behaviors that affect health and quality of life.-Participate in area wellness fairs, in collaboration with Dermatology and Mammography, to provide education on cancer screening opportunities.-Improve patient education materials and offerings.-Partner with the Susan G. Komen Foundation for education and awareness events.Diabetes-Utilize a system-wide approach to education and documentation in the electronic medical record.-Provide education and equipment to patients.-Integrate pharmacists in medication management for diabetes patients.Many of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.
Monument Health Rapid City Hospital, Inc.	Part V, Section B, Line 13h: Must reside within 200 mile radius of the location where the service was received.Presumptive eligibility may be used.
Same Day Surgery Center	Part V, Section B, Line 13h: Must reside within 200 mile radius of the location where the service was received.Presumptive eligibility may be used.
Monument Health Rapid City Hospital, Inc.	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.
Same Day Surgery 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.
Part V, Lines 16a-c Monument Health Rapid City Hospital	The Financial Assistance Policy, Application form, and plain language summary are available at https://monument.health/patient-visitor-guide/financial-assistance/
Part V, Lines 16a-c Same Day Surgery Center	The Financial Assistance Policy, Application form, and plain language summary are available at http://www.samedaysurgerycenter.org/financial-assistance/
Part V, Line 11, Implementation Strategy - Same Day Surgery Center	Description of failure:Type of failure: 501(r)(3) - The most current CHNA Implementation Strategy for Same Day Surgery Center was not posted to the website on or before November 15, 2019.Cause of the failure: Due to staff turnover. Facility or facilities where the failure occurred: The failure occurred at Same Day Surgery Center.The date(s) of the failure and its discovery: March 30, 2020Description of the correction of the failure:Method of correction: The Implementation Strategy was posted to the website.Date of correction: April 13, 2020Description of the practices or procedures put into placeThe Implementation Strategy was posted on the website at: https://monument.health/about-us/community-health-needs-assessment/

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - Monument Health Home Hospice House
224 Elk St	Rapid Ctiy	SD	57701	End of Life Care
2 - Monument Health Rapid City Hospice House
224 Elk St	Rapid Ctiy	SD	57701	End of Life Care
3 - Monument Health Dermatology
717 Meade Street 100	Rapid Ctiy	SD	57701	Clinic
4 - Monument Health Dialysis Center
132 Yankee St	Spearfish	SD	57783	Dialysis Center
5 - Monument Health HomeHospice-Spearfish
1440 North Main Street	Spearfish	SD	57783	End of Life Care
6 - Monument Health Medical Clinic
112 7th Ave	Wall	SD	57790	Clinic
7 - Monument Health Pine Ridge Med Clinic
East Highway 18	Pine Ridge	SD	57702	Clinic

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3c:	References to "Monument Health" apply to all entities controlled by Monument Health, Inc. and its subsidiaries. This includes the reporting entity.Financial assistance debt reduction write-offs for free or discounted care are based on an income matrix utilizing the current Federal Poverty Level (FPL) income guidelines after satisfying applicable co-pay requirements. The income matrix may be updated annually as the FPL income guidelines are released.Presumptive eligibility may be used if all other financial assistance avenues are exhausted.
Part I, Line 6a:	The organization's community benefit report can be found on its website at https://monument.health/about-us/mission-vision-values/
Part I, Line 7:	Ratio of patient care cost to charges is used for the calculation of cost of services provided for lines 7a, 7b, and 7g. Actual costs are used for the calculation of costs of services provided for lines 7e, 7f, 7h, and 7i.
Part I, Ln 7 Col(f):	The bad debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column, is $74,631,947.
Part II, Community Building Activities:	Monument Health provides numerous community benefit health events and screenings throughout the Black Hills Region. Monument Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Monument Health provides in-kind support and employee volunteers to help support community heath events and activities.
Part III, Line 2:	The bad debt reported on line 2 is at charges as reported on the financial statements.
Part III, Line 4:	The footnote to the Organization's financial statements can be found on page ten of the attached audited financial statements.
Part III, Line 8:	The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. 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 communities.
Part III, Line 9b:	The collection policy requires invoking of the financial assistance policy (FAP) at any time a patient expresses financial difficulty in meeting their debt obligation. Upon invoking the FAP, all collection activity is suspended. If the patient is approved for charity, then the account is closed out of the collection process and classified as charity. If a patient expresses financial concern but fails to complete the application process, additional notification is sent to the patient prior to re-instituting collection activity. We are following the 501(r) Final Regulations timelines for notifications and collections.
Part VI, Line 2:	We gather additional data on needed services from patient surveys, advisory councils and patient and family advisory councils.
Part VI, Line 3:	Financial Assistance Program brochures explaining the policy, a copy of the policy and Financial Assistance applications are available at each point of entry. Signs alerting patients to the availability of Financial Assistance are prominently displayed and a plain language summary describing the Financial Assistance program accompanies one billing statement for hospital services sent to the patient. The Financial Assistance policy, plain language summary and Financial Assistance application are provided free upon request and are also available on the hospital website at www.monument.health. Monument Health contracts with Midland Medical Group (an unrelated entity) to meet with uninsured patients to assist them with finding a funding source or applying for financial assistance; and our self-pay outsource partner also communicates any funding and financial assistance opportunities with our patients.
Part VI, Line 4:	Monument Health and its affiliates provide health care services to the 380,000 people who live in the Black Hills of South Dakota and the surrounding region, as well as thousands of visitors each year. Monument Health serves a 38-county region comprised of western South Dakota, southeastern Montana, northeastern Wyoming, southwestern North Dakota and northwestern Nebraska.
Part VI, Line 5:	Monument Health collaborates with agencies and community-wide coalitions to address prioritized health needs within the communities we serve. Monument Health addresses its community's health needs by: 1) Community members serve on governing boards, advisory councils and family member councils; 2) developing new programs and initiatives to address identified health needs: and 3) promoting an understanding of these health needs among other community organizations and within the public itself. Monument Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Monument Health provides in-kind support and employee volunteers to help support community health events and activities.
Part VI, Line 6:	Monument Health is committed to partnering with the communities it serves to meet the needs of each respective community. Monument Health, Inc. is the parent organization of Monument Health Rapid City Hospital, Inc., Monument Health Network, Inc., and Monument Health Physicians, Inc. These corporations work together to meet the health care needs of the region.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Andrea Baier MD
Board Member/Employed Physician	$303,371	$0	$20,000	$0	$0	$0	$23,529	$0	$32,398	$0	$379,298	$0	$0	$0
Srinivas Gangineni MD
Board Member/Employed Physician	$486,684	$0	$55,689	$0	$0	$0	$36,211	$0	$43,651	$0	$622,235	$0	$0	$0
Alex Schabauer MD
Board Member/Employed Physician	$701,929	$0	$53,920	$0	$54,534	$0	$61,171	$0	$27,617	$0	$899,171	$0	$54,534	$0
Michael Statz MD
Board Member/Employed Physician	$178,060	$0	$0	$0	$0	$0	$0	$0	$0	$0	$178,060	$0	$0	$0
Brent Phillips
President & CEO Until 07/2018	$0	$510,692	$0	$0	$0	$0	$0	$90,834	$0	$18,020	$0	$619,546	$0	$0
Paulette R Davidson
President & CEO	$0	$540,024	$0	$409,088	$0	$0	$0	$71,640	$0	$28,146	$0	$1,048,898	$0	$0
Mark A Thompson
CFO/Treasurer	$399,842	$0	$105,656	$0	$112,809	$0	$65,580	$0	$25,091	$0	$708,978	$0	$112,809	$0
Teresa Burroff
General Counsel/Secretary	$346,644	$0	$179,393	$0	$0	$0	$46,918	$0	$76	$0	$573,031	$0	$0	$0
Brad Archer MD
Chief Medical Officer	$424,818	$0	$185,938	$0	$0	$0	$57,303	$0	$27,799	$0	$695,858	$0	$0	$0
Tresha Moreland
VP Human Resources Operations	$223,087	$0	$67,320	$0	$0	$0	$25,307	$0	$8,580	$0	$324,294	$0	$0	$0
Nicole Kerkenbush
Chief Performance Officer	$199,126	$0	$90,000	$0	$0	$0	$30,957	$0	$2,435	$0	$322,518	$0	$0	$0
Stephanie Lahr MD
CIO/CMIO	$359,425	$0	$155,250	$0	$0	$0	$47,519	$0	$35,023	$0	$597,217	$0	$0	$0
Mary Masten
General Counsel, Emeritus	$286,202	$0	$0	$0	$0	$0	$13,750	$0	$21,320	$0	$321,272	$0	$0	$0
Laura C Wightman
Chief Nursing Officer Until 04/2019	$271,820	$0	$101,363	$0	$0	$0	$28,983	$0	$18,640	$0	$420,806	$0	$0	$0
John Pierce
President Rapid City Market	$290,689	$0	$79,248	$0	$18,656	$0	$38,681	$0	$30,643	$0	$457,917	$0	$18,656	$0
Douglas Koch
VP Rapid City Market	$185,421	$0	$30,000	$0	$45,332	$0	$20,472	$0	$13,903	$0	$295,128	$0	$0	$0
Michael Tilles
President Home Plus	$258,063	$0	$97,500	$0	$0	$0	$27,977	$0	$24,512	$0	$408,052	$0	$0	$0
Michael Latour
System Director of Musculoskeletal C	$99,137	$85,263	$0	$0	$0	$0	$0	$13,575	$11,001	$9,537	$110,138	$108,375	$0	$0
Mark Longacre
President - Monument Health Ortho Sp	$0	$271,079	$0	$48,125	$0	$19,828	$0	$28,875	$0	$15,216	$0	$383,123	$0	$0
John Karl Heilman III MD
Physician - Cardiology	$890,489	$0	$53,920	$0	$0	$0	$12,922	$0	$26,044	$0	$983,375	$0	$0	$0
James Takara MD
Physician - Cardiac Surgery	$983,248	$0	$0	$0	$37,461	$0	$59,653	$0	$31,553	$0	$1,111,915	$0	$37,461	$0
Bhaskar Purushottam MD
Physician - Cardiology	$968,958	$0	$53,920	$0	$0	$0	$80,937	$0	$35,903	$0	$1,139,718	$0	$0	$0
Joseph Tuma MD
Physician - Cardiology	$1,021,307	$0	$53,920	$0	$43,315	$0	$69,728	$0	$30,504	$0	$1,218,774	$0	$43,315	$0
Roger Knutsen MD
Physician - Dermatology	$965,016	$0	$2,800	$0	$0	$0	$8,250	$0	$16,294	$0	$992,360	$0	$0	$0
Thomas Worsley
President Spearfish Market	$0	$300,322	$0	$84,990	$0	$0	$0	$32,000	$0	$25,516	$0	$442,828	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3	The Executive Committee, which is a committee of the Monument Health (parent) Board, reviews and approves base salary and total compensation ranges for all executives within the Monument Health System.
Part I, Line 4b	Monument Health provides a supplemental nonqualified retirement plan and a flexible benefit plan that can include deferred compensation for its executives. The following individuals had amounts deferred into the account as reported in column c on Schedule J: Teresa Burroff 38,441 Paulette Davidson 62,930 Stephanie Lahr, MD 38,813 Tresha Moreland 16,830 Brent Phillips 82,008 John Pierce 24,159 Mark Thompson 45,281 Michael Tilles 19,500 Laura Wightman 20,273 Sri, Gangineni, MD 27,269 Bhaskar Purushottam, MD 72,227 James Takara, MD 46,731 Joseph Tuma, MD 56,806 Brad Archer, MD 49,053 Nicole Kerkenbush 22,500 Doug Koch 12,500 Andrea Baier 14,823 Alex Schabauer, MD 48,249 Thomas Worsley 23,290 Mark Longacre 20,625 The following individuals had supplemental non-qualified retirement plan amounts included in schedule J, column B(iii) that were previously reported as deferred compensation on Form 990. These amounts are identified in Schedule J, column f. John Pierce 18,656 Mark Thompson 112,809 James Takara, MD 37,461 Joseph Tuma, MD 43,315 Alex Schabauer, MD 54,534
Part I, Line 7	Executives and Other Employees of System Entities will be eligible to receive annual incentive awards that are competitive with the incentives offered by the organizations in the System's Peer group(s) in accordance with the terms of the Monument Health, Inc. Annual Incentive Plan for Selected Executives and Other Employees (Incentive Plan). In accordance with this plan, the parent Board's Executive Committee will review and approve all incentive compensation performance measures and all awards, if any.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd	CUSIPCUSIPNum
SD Health & Educational Facilities Authority
A	460315509	2015-01-27	$67,210,000	Refund Series 2008 bonds issued 8/14/08	0	0	0
SD Health & Educational Facilities Authority
B	460315509	2017-09-07	$238,488,122	Refund Series 2010 and 2011 Bonds; Hospital buildings and equipment	0	0	0	83755VE26

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capital ExpendituresCapitalExpendituresAmt
A	$13,245,000	$67,210,000	$250,000	$66,960,000	2015	Yes (1)	0	Yes (1)	Yes (1)
B	$3,345,000	$240,199,216	$1,807,893	$54,521,227	2019	0	Yes (1)	0	Yes (1)	$183,870,096

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd
A	0	0	0	0	0.00020	0.00030	0.00050	0	0	Yes (1)
B	0	Yes (1)	Yes (1)	Yes (1)	0.00690	0.00860	0.01550	0	0	Yes (1)	0	0

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
US Bank NA
A	0	0	0	0	Yes (1)	Yes (1)	9.200000000000	0	0	0	0	Yes (1)
(no name)
B	0	0	0	0	0	0				0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule K, Part II, Line 3, Bond B	FormAndLineReferenceDesc
Explanation	The issue price on Part I, column (e) is different than the amount on Part II, line 3 due to interest earned during the construction phase on the proceeds of $1,711,094.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Gregg Radtke
Family member of Director Sandra Burns	$43,801	Employee compensation	0
Erika L Radtke
Family member of Director Sandra Burns	$66,476	Employee compensation	0
Shelby Lynass
Family member of Director Jack Lynass	$60,150	Employee compensation	0
Pamela Kim Phillips MD
Family member of Prior CEO	$166,351	Employee compensation	0
Nadine Radtke
Family member of Director Sandra Burns	$51,994	Employee compensation	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Page 1, Section C, Name of Organization	Monument Health Rapid City Hospital, Inc. was known as Rapid City Regional Health, Inc. during fiscal year ended June 30, 2019. The organization changed its name in January, 2020, and filed the name change with the IRS prior to filing of this return.
Form 990, Part III, line 2	On January 6, 2019, Monument Health Rapid City Hospital opened a new facility, the Monument Health Orthopedic and Specialty Hospital (MHOSH). MHOSH is a department of, and a remote location of, Monument Health Rapid City Hospital. It is located approximately 4.5 miles from Monument Health Rapid City Hospital's Main Campus and its address is 1635 Caregiver Circle in Rapid City, SD. MHOSH provides four surgery suites and ten inpatient rooms, with surgical procedures primarily focusing on orthopedics, neurosurgery and podiatry. It offers several related outpatient services (orthopedic surgery, neurosurgery, physiatry, primary care sports medicine, sports medicine, regenerative medicine, podiatry, pain management, wound care and weight management); therapy services (physical, speech and occupational therapy); and sports performance services.
Form 990, Part VI, Section A, line 1	The membership of the Executive Committee of the Corporation shall consist of the following: Chair of the Board of Directors, Vice Chair of the Board of Directors, two other Board members appointed by the Chair, and the Corporation's President. The Chair of the Board of Directors shall serve as the Chair of the Executive Committee. Directors on the Executive Committee shall serve during the term of office they hold which places them on the Executive Committee, or, for the two Chair-appointed members, for a term of one (1) year or until their successors are appointed. The Executive Committee, when the Board of Directors is not in session, shall have and may exercise all of the authority of the Board of Directors, except to the extent, if any, that such authority shall be limited by a motion or resolution of the Board of Directors or that is authority reserved to the Member. It is intended that the powers of the Executive Committee to act for the whole Board be confined to such urgent matters as reasonably should not be deferred until the next regularly-scheduled meeting of the full Board.
Form 990, Part VI, Section A, line 2	Brent Phillips has a business relationship with the following individuals due to being the CEO (Until 07/2018) of the supporting organization that exercises reserve powers over the supported organizations that employ each of these key employees: Teresa Burroff; Stephanie Lahr MD; Mary Masten; Tresha Moreland; Brad Archer MD; Nicole Kerkenbush; John Pierce; Michael Tilles; Mark Thompson; Laura Wightman; Doughlas Koch; Mark Longacre; and employed Board Members: Sri Gangineni MD; Alex Schabauer MD; Andrea Baier MD. Paulette Davidson has a business relationship with the following individuals due to being the CEO of the supporting organization that exercises reserve powers over the supported organizations that employ each of these key employees: Teresa Burroff; Stephanie Lahr MD; Mary Masten; Tresha Moreland; Brad Archer MD; Nicole Kerkenbush; John Pierce; Michael Tilles; Mark Thompson; Laura Wightman; Doughlas Koch; Mark Longacre; and employed Board Members: Sri Gangineni MD; Alex Schabauer MD; Andrea Baier MD.
Form 990, Part VI, Section A, line 6	Monument Health, Inc. is the sole member of Monument Health Rapid City Hospital, Inc.
Form 990, Part VI, Section A, line 7a	The organization's sole member and supporting organization, Monument Health, Inc., appoints the members of Monument Health Rapid City Hospital's governing body. The bylaws require that at least one member of Monument Health Rapid City Hospital's board also serves as a voting member of the sole member's board to better assure the sole member's continued responsiveness to Monument Health Rapid City Hospital.
Form 990, Part VI, Section A, line 7b	Monument Health, Inc. provides compliance, governance, financial, and planning support to its Supported Organizations to best assure the functions and services of the Supported Organizations are coordinated and supported in a manner that furthers the shared charitable mission of the Supported Organizations and MHI, as a whole (the System). Monument Health, Inc. has final authority in significant business decisions affecting Supported Organizations.
Form 990, Part VI, Section B, line 11b	The 990 is prepared and reviewed by an independent accounting firm. It is then reviewed internally by finance and legal management. The Form 990 is further reviewed, prior to filing, by the organization's board of directors through a portal to the organization's internal information system, to which each board member has access. Educational sessions have been provided to board members on how to access the portal.
Form 990, Part VI, Section B, line 12c	As part of the annual disclosure of potential conflicts process, all board members, officers, and management are required to complete an annual disclosure statement on financial interests and conflicting interests. At Board and Board Committee meetings, the meeting agenda includes an initial item "Conflicts of Interest" where the Chair asks members if they have any conflicting interests or financial interests related to an agenda item. If a conflicting or financial interest is disclosed, it is noted in the minutes and there is discussion or determination of whether the disclosure requires the board or committee member to be excused from discussion or action on that agenda item. Board or committee members whose disclosure is found to be a conflict may be invited to speak on the matter by the Chair, but are not permitted to vote on the matter and may be required to leave the meeting during discussion, after they have made any comments invited by the Chair. Failure to comply with the Conflict of Interest policy constitutes grounds for removal from office or membership on the Board or Board Committee and, in the case of all employees, termination of employment.
Form 990, Part VI, Section B, line 15a	The Executive Committee of Monument Health Inc. (MHI; parent) engaged an independent third party compensation firm to conduct a review of all executives, Vice President level and above, to determine an appropriate compensation range in which their compensation would be established. The independent compensation consultant provided peer group market comparative data for base salary, total cash compensation, benefits and total compensation for executives. The CEO or her designee determines the actual base salary of the executives within the committee-approved base salary range based on experience and performance, providing the total compensation is within the targeted market percentile, e.g. 50th percentile. In May 2017, the independent consultant met with Committee members and presented 2017 data upon which the Committee determined all elements of compensation for the member's CEO (base salary, total cash compensation, benefits and total compensation) and reaffirmed the organization's executive compensation philosophy, which includes the targeted market percentile for all other executives.
Form 990, Part VI, Section C, line 19	The Articles of Incorporation of the organization are filed in the office of the Secretary of State of South Dakota and are available to the public from the Office of the Secretary of State. Other documents (Bylaws, conflict of interest policy and financial statements) are not posted for the public but are available or described in other public documents or sites such as offering statements in bond issues or municipal securities rulemaking board's electronic municipal market access (EMMA) data port.
Form 990, Part VII	Mark Longacre, President of Monument Health Orthopedic and Specialty Hospital, worked continuously for Monument Health throughout the fiscal year. The Hospital was operated in Monument Health Physicians for a portion of the year. In February, the Board of Directors made the decision to transfer the Hospital operations to Monument Health Rapid City Hospital, his hours have been allocated accordingly.
Form 990, Part XI, line 9:	Adj to the Funded Status of the Pension Plan -4,246,910. Medical Staff Net Income -47,887. Temporarily Restricted Net Asset Changes -3,415,535. Auxiliary Net Income -5,292. Transfers with related organizations -446,212.
Form 990, Part X, Line 20:	The issue price of the bonds includes the filing organization's share of the entire bond issue, which was issued to Monument Health, Inc. on behalf of the Monument Health Obligated Group. The Monument Health Obligated Group consists of Monument Health, Inc., Monument Health Rapid City Hospital, Inc., Monument Health Network, Inc. and Monument Health Physicians, Inc.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Monument Health Home Plus LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2925 Regional Way PO Box 6000	AddressLine1Txt
City	Rapid City	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57701	ZIPCd

Field	Value	IRS element (for citing)
EIN	364841157	EIN
Primary Activities	Healthcare Services	PrimaryActivitiesTxt
Legal Domicile State	SD	LegalDomicileStateCd
Total Income	$63,240,780	TotalIncomeAmt
End Of Year Assets	$13,310,649	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Monument Health Rapid City Hospital Inc	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Monument Health Inc
353 Fairmont Blvd	Rapid City	SD	57701	201487506	Healthcare	SD	501(c)(3)	Line 12c, III-FI	N/A	0
Monument Health Network Inc
353 Fairmont Blvd	Rapid City	SD	57701	460360899	Healthcare	SD	501(c)(3)	Line 3		0	Monument Health Inc
Monument Health Physicians Inc
353 Fairmont Blvd	Rapid City	SD	57701	460372454	Healthcare	SD	501(c)(3)	Line 10		0	Monument Health Inc

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
Medical & Dental Building
2805 S 5th St	Rapid City	SD	57701	460339629	Medical Office Bldg	SD	Monument Health Rapid City Hospital Inc	Investment	-$68,734	$1,047,865	0	Yes (1)	0.71450
Black Hills Medical Office BD LLC
353 Fairmont Blvd	Rapid City	SD	57701	411992146	Medical Office Bldg	SD	Monument Health Rapid City Hospital Inc	Investment	-$6,684	$1,497,696	0	0	0.67930
Same Day Surgery Center
651 Cathedral Drive	Rapid City	SD	57701	411889892	Medical Services	SD	Monument Health Rapid City Hospital Inc	RELATED	$312,960	$1,795,562	0	Yes (1)	0.40000

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	Yes (1)	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Same day Surgery Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	F	TransactionTypeTxt
Involved	$1,120,000	InvolvedAmt
Method Of Amount Determination	Cash	MethodOfAmountDeterminationTxt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule R, Part I	FormAndLineReferenceDesc
Explanation	Monument Health Home Plus, LLC has submitted its name change documentation to the IRS but has not yet received notification from the IRS that the name change has been processed. Therefore, IRS record show the name of the organization as Regional Health Home Plus, LLC.	ExplanationTxt