FREEMAN REGIONAL HEALTH SERVICES: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- FREEMAN REGIONAL HEALTH SERVICES (EIN 46-0232450)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-05
- IRS object ID
- 202023109349302442
- Schema version
- 2019v5.1
- 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 D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-05T15:41:14-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | 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 | 200 E 10TH ST STE 500 | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571046375 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460232450 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREEMAN REGIONAL HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FREE | BusinessNameControlTxt |
| Phone | 6059254000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 370 | AddressLine1Txt |
| City | FREEMAN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57029 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICHOLAS BRANDNER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6059254000 | PhoneNum |
| Signature | 2020-11-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURIE HANSON CPA | PreparerPersonNm |
| PTIN | P00851848 | PTIN |
| Phone | 6053391999 | PhoneNum |
| Preparation | 2020-11-05 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 184.83.199.194 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-05 | IPDt |
| IP Tm | 12:04:42 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 50CCFF325394DF76E401CCE6D67578A0FB45D135 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | NICHOLAS BRANDNER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 370 | AddressLine1Txt |
| City | FREEMAN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57029 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,056,162 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FREEMANREGIONAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1944 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE ACCESSIBLE, COMMUNITY BASED QUALITY CARE THAT IS COMPETENT, CREATIVE AND COMPASSIONATE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 200 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $193,893 | PYContributionsGrantsAmt |
| CY Contributions Grants | $421,965 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,591,628 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,280,803 | CYProgramServiceRevenueAmt |
| PY Investment Income | $107,868 | PYInvestmentIncomeAmt |
| CY Investment Income | $76,473 | CYInvestmentIncomeAmt |
| PY Other Revenue | $84,079 | PYOtherRevenueAmt |
| CY Other Revenue | $134,234 | CYOtherRevenueAmt |
| PY Total Revenue | $11,977,468 | PYTotalRevenueAmt |
| CY Total Revenue | $11,913,475 | 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 | $6,464,458 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,374,691 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $19,848 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,527,262 | PYOtherExpensesAmt |
| CY Other Expenses | $5,157,944 | CYOtherExpensesAmt |
| PY Total Expenses | $11,991,720 | PYTotalExpensesAmt |
| CY Total Expenses | $11,532,635 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$14,252 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $380,840 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,974,293 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,046,971 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,808,876 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,366,020 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,165,417 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,680,951 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF FREEMAN REGIONAL HEALTH SERVICES IS TO PROVIDE ACCESSIBLE, COMMUNITY-BASED QUALITY CARE THAT IS COMPETENT, CREATIVE AND COMPASSIONATE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,120,202 | ExpenseAmt |
| Revenue | $11,280,803 | RevenueAmt |
| Desc | FRHS IS COMPRISED OF A 49 BED NURSING HOME AND A 25 BED CRITICAL ACCESS HOSPITAL WITH A 24/7 EMERGENCY ROOM. THE EMERGENCY ROOM HAS LOCAL PROVIDERS ON CALL AND TELEMEDICINE CAPABILITIES WITH A REGIONAL TRAUMA CENTER. HOSPITAL ACUTE PATIENT DAYS= 418, SWING BED DAYS=410, NURSING HOME RESIDENT DAYS= 16,447. | Desc |
| Total Program Service Expenses | $10,120,202 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 200 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| 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 | PHIL HUSHER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6059254000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 510 EAST 8TH STREET | AddressLine1Txt |
| City | FREEMAN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57029 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| NICHOLAS BRANDNER | |||||||
| CEO | 40.00 | Yes (X) | $157,596 | $0 | $11,146 | ||
| ANTHONY MILLER | |||||||
| THERAPY MANAGER | 40.00 | $119,922 | $0 | $3,551 | Yes (X) | ||
| PHILLIP HUSHER | |||||||
| CFO | 40.00 | Yes (X) | $99,503 | $0 | $6,648 | ||
| LORI UECKER | |||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| STEVE FUHRMANN | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JASON AANENSON | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CYNTHIA MUTCHELKNAUS | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CAMERON BECKER | |||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JAMES JULSON | |||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| DAN CRICK | |||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| GLENN ROTH | |||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| CORY SCHRAG | |||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $377,021 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $21,345 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| AVERA MCKENNAN HOSPITAL | |||||
| 800 E 21ST ST | SIOUX FALLS | SD | 57105 | PHYSICIAN SERVICES | $1,507,093 |
| NORTHERN X-RAY COMPANY | |||||
| 2118 4TH AVE S | MINNEAPOLIS | MN | 55404 | X-RAY MACHINE | $309,100 |
| AVERA SACRED HEART HOSPITAL | |||||
| 501 SUMMIT | YANKTON | SD | 57078 | IT SUPPORT | $287,406 |
| WAPITI MEDICAL GROUP | |||||
| 107 FLYNN DR SUITE 600 | MILBANK | SD | 57252 | LOCUMS | $214,307 |
| CARDINAL HEALTH | |||||
| 7000 CARDINAL PLACE | DUBLIN | OH | 43017 | SUPPLIES | $166,172 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $20,712 | FundraisingAmt |
| Government Grants | $15,690 | GovernmentGrantsAmt |
| All Other Contributions | $385,563 | AllOtherContributionsAmt |
| Total Contributions | $421,965 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $10,905,217 | $10,905,217 |
| COLLABORATIVE ARRANGEMENT | 900099 | $330,605 | $330,605 |
| MEALS ON WHEELS | 624210 | $16,712 | $16,712 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,269 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,269 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,280,803 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $76,473 | TotalRevenueColumnAmt |
| Exclusion | $76,473 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $216,160 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $129,390 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $86,770 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,770 | TotalRevenueColumnAmt |
| Exclusion | $86,770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $60,761 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $20,712 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $13,297 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,464 | TotalRevenueColumnAmt |
| Exclusion | $47,464 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,913,475 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,280,803 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $210,707 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,492 | TotalAmt |
| Management And General | $284,492 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,975,510 | TotalAmt |
| Program Services | $4,461,082 | ProgramServicesAmt |
| Management And General | $514,428 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,117 | TotalAmt |
| Program Services | $92,499 | ProgramServicesAmt |
| Management And General | $8,618 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $631,613 | TotalAmt |
| Program Services | $533,434 | ProgramServicesAmt |
| Management And General | $98,179 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,959 | TotalAmt |
| Program Services | $325,030 | ProgramServicesAmt |
| Management And General | $56,929 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,639 | TotalAmt |
| Management And General | $6,639 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,850 | TotalAmt |
| Management And General | $59,850 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,906,368 | TotalAmt |
| Program Services | $2,734,409 | ProgramServicesAmt |
| Management And General | $171,959 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,340 | TotalAmt |
| Program Services | $27,168 | ProgramServicesAmt |
| Management And General | $9,389 | ManagementAndGeneralAmt |
| Fundraising | $783 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,029 | TotalAmt |
| Program Services | $352,830 | ProgramServicesAmt |
| Management And General | $58,633 | ManagementAndGeneralAmt |
| Fundraising | $18,566 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,474 | TotalAmt |
| Program Services | $162,474 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,279 | TotalAmt |
| Program Services | $26,625 | ProgramServicesAmt |
| Management And General | $1,654 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,307 | TotalAmt |
| Program Services | $16,673 | ProgramServicesAmt |
| Management And General | $3,634 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,409 | TotalAmt |
| Program Services | $22,409 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,716 | TotalAmt |
| Program Services | $438,716 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,553 | TotalAmt |
| Program Services | $72,553 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $715,790 | $715,790 | ||
| EQUIPMENT RENTAL AND MA | $133,897 | $132,753 | $1,144 | |
| ALL OTHER EXPENSES | $123,293 | $5,757 | $117,037 | $499 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,532,635 | TotalAmt |
| Program Services | $10,120,202 | ProgramServicesAmt |
| Management And General | $1,392,585 | ManagementAndGeneralAmt |
| Fundraising | $19,848 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,116,136 | BOYAmt |
| EOY | $3,191,787 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,894,597 | BOYAmt |
| EOY | $1,608,356 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,417 | BOYAmt |
| EOY | $137,500 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,610 | BOYAmt |
| EOY | $131,001 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,872 | BOYAmt |
| EOY | $61,658 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,196,768 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,867,887 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,387,414 | BOYAmt |
| EOY | $5,328,881 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,993,404 | BOYAmt |
| EOY | $2,193,144 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,245 | BOYAmt |
| EOY | $3,249 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $378,598 | BOYAmt |
| EOY | $391,395 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,974,293 | BOYAmt |
| EOY | $13,046,971 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $887,801 | BOYAmt |
| EOY | $980,593 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,275 | BOYAmt |
| EOY | $2,275 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,206 | BOYAmt |
| EOY | $340,002 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,478 | BOYAmt |
| EOY | $1,515 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525,366 | BOYAmt |
| EOY | $394,885 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,009,750 | BOYAmt |
| EOY | $646,750 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,808,876 | BOYAmt |
| EOY | $2,366,020 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,165,417 | BOYAmt |
| EOY | $10,680,951 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,165,417 | BOYAmt |
| EOY | $10,680,951 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,974,293 | BOYAmt |
| EOY | $13,046,971 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $380,840 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $134,694 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $299,251 | OtherCostOrOtherBasisAmt |
| Book Value | $299,251 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,675,715 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,522,921 | DepreciationAmt |
| Book Value | $3,152,794 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,162,867 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,065,689 | DepreciationAmt |
| Book Value | $1,097,178 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,058,935 | OtherCostOrOtherBasisAmt |
| Depreciation | $279,277 | DepreciationAmt |
| Book Value | $779,658 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,328,881 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | APARTMENT DEPOSITS | Desc |
| Amt | $646,750 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $646,750 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $12,190,856 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $134,694 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $134,694 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,056,162 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$142,687 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$142,687 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,913,475 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,675,322 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $142,687 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $142,687 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,532,635 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,532,635 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION MAINTAINS SEPARATE ACCOUNTS FOR ITS PATIENTS AND USES THE FUNDS FOR PURCHASES AS DIRECTED BY PATIENTS. |
| PART X, LINE 2: | THE FACILITY BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE FACILITY WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES RECLASSIFIED -129,390. DIRECT FUNDRAISING EXPENSES -13,297. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES RECLASSIFIED 129,390. DIRECT FUNDRAISING EXPENSES 13,297. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $61,833 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,843 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $45,990 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $200 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $590 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $5,233 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $1,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,988 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF TOURNAMENT | Event2Nm |
| Gross Receipts Event2 | $19,640 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $4,869 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $14,771 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $491 | CashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $1,380 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $800 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $1,615 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $81,473 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $20,712 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $60,761 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $691 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,970 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $6,033 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $1,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $3,603 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $13,297 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $47,464 | 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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,191,284 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,041,386 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $149,898 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,216,284 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,041,386 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $174,898 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01520 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,404,235 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,662,779 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $741,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06430 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,404,235 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,662,779 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $741,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06430 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,620,519 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,704,165 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $916,354 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07950 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,210,220 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,228,943 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$18,723 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREEMAN REGIONAL HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 370 | AddressLine1Txt |
| City | FREEMAN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57029 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.FREEMANREGIONAL.COM | WebsiteAddressTxt |
| State License | 10541 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | PROVIDER BASED CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREEMAN REGIONAL HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE LINE 7D | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE LINE 7D | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FREEMAN REGIONAL HEALTH SERVICES | PART V, SECTION B, LINE 5: THE FOCUS GROUPS UTILIZED FOR THE CHNA WERE COMPRISED OF INVITED COMMUNITY/SERVICE AREA RESIDENTS WHO WERE SELECTED BASED ON OBTAINING AN ADEQUATE CROSS SECTION OF GENDER AND OCCUPATION. OTHER CRITERIA CONSIDERED DURING THE PROCESS WERE FINDING INDIVIDUALS THAT REPRESENTED TWO MAIN GROUPS: RETIRED SENIORS AND WORKING ADULTS, AND THE BROAD INTEREST OF OUR SERVICE AREA. THESE GROUPS WERE ALSO KEPT TO A REASONABLE NUMBER TO FACILITATE DISCUSSION. THIS PROCESS WAS FACILITATED WITH THE ASSISTANCE OF A COMMUNITY DEVELOPMENT SPECIALIST WITH THE SOUTH DAKOTA PLANNING AND DEVELOPMENT DISTRICT III. |
| FREEMAN REGIONAL HEALTH SERVICES | PART V, SECTION B, LINE 7D: WWW.FREEMANREGIONAL.COM/COMMUNITY-NEEDS |
| FREEMAN REGIONAL HEALTH SERVICES | PART V, SECTION B, LINE 11: PURSUANT TO THE 2019 IMPLEMENTATION STRATEGY ADOPTED BY FRHS, THE FOLLOWING NEEDS WERE ADDRESSED AS OF THE END OF THE YEAR FOR THIS 990:FREEMAN REGIONAL HEALTH SERVICES REMAINS COMMITTED TO PROMOTING HEALTH AND WELLNESS AND WILL CONTINUE EFFORTS ON MEETING THE NEEDS OF THE COMMUNITY. TO THIS END, FRHS WILL WORK TOWARDS THE FOLLOWING:CONTINUE TO PROMOTE COMMUNITY-BASED EDUCATION PROGRAMS WHICH FOCUS ON HEALTH-RELATED TOPICS OF INTEREST AND WHICH TARGET SPECIFIC COMMON INTEREST GROUPS AND THE COMMUNITY AS A WHOLE.CONTINUE TO WORK WITH THE WELLMARK BLUE CROSS AND BLUE SHIELD COLLABORATIVE ON AN EFFORT TO MAKE FREEMAN A COHESIVE, HIGH ENERGY COMMUNITY WITH AN INFRASTRUCTURE THAT CONNECTS RESIDENTS TO OTHER PEOPLE, PLACES, AND HEALTHY FOODS SO THAT RESIDENTS CAN LIVE ACTIVE, HEALTHY LIFESTYLES. HOW WE ADDRESSED THE ABOVE NEEDS.-HEALTHY HOMETOWN BLUECROSS BLUESHIELD-MARKET IN THE PARK ON AUGUST 7TH, 2019 (ABOUT 200 PEOPLE IN ATTENDANCE) AND "BUMP OUTS" FOR THE MAIN STREET IN OCTOBER WITH FRHS TRAUMA PROGRAM.- HELPING THE LION'S IN FREEMAN FOR FREE VISION SCREENINGS AT THE OCTOBERFEST AT FREEMAN PUBLIC SCHOOL.- BABYSITTING CLINIC IN MAY FOR HIGH SCHOOLERS TO BECOME CPR TRAINED WITH SAFE SLEEP EDUCATION.- BREASTFEEDING FRIENDLY FACILITY - WORKING WITH OTHER AREA COMMUNITIES TO HAVE THEM TAKE THE PLEDGE TO BE BREASTFEEDING FRIENDLY.-CAREER FAIRS FOR NURSING-DAKOTA WESLEYAN UNIVERSITY AND SOUTHEAST TECHNICAL INSTITUTEFRHS RECOGNIZES THE IMPORTANCE OF COMMUNITY OUTREACH AND THE VALUE OUR ORGANIZATION AND ITS EMPLOYEES BRING TO THE COMMUNITY. TO PROMOTE COMMUNITY OUTREACH AND VOLUNTEERISM, FRHS COMMITS TO THE FOLLOWING:FRHS WILL CONTINUE TO UNDERTAKE COMMUNITY OUTREACH INITIATIVES AIMED AT BENEFITING OUR COMMUNITIES. WE WILL CONTINUE TO EVALUATE UNMET COMMUNITY NEEDS AND WILL ORGANIZE EFFORTS, WHEN POSSIBLE, TO ADDRESS THOSE NEEDS. AS A MEANS TO ENCOURAGE COMMUNITY VOLUNTEERISM, FRHS WILL CONTINUE TO SUPPORT AND ADVOCATE TO ITS EMPLOYEES THE VALUE AND IMPORTANCE OF BEING INVOLVED IN THEIR COMMUNITIES. FRHS WILL ENCOURAGE VOLUNTEERISM BY ITS EMPLOYEES AND WILL CONTINUALLY EXPLORE OPPORTUNITIES THAT SERVE AS A BENEFIT TO THE COMMUNITY. HOW WE ADDRESSED THE ABOVE NEEDS.SEPT 5TH, 2019 FRHS DECON/HAZ-MAT DRILL - FULL SCALE DRILL EXERCISE INCLUDED STAFF FROM FREEMAN REGIONAL HEALTH SERVICES, HUTCHINSON AND TURNER COUNTY EMERGENCY MANAGERS, AVERA MCKENNAN EMERGENCY MANAGEMENT COORDINATOR AND SOUTH DAKOTA HIGHWAY PATROL. A DECONTAMINATION TENT WAS SET UP WITH STAFF BEING ABLE TO RUN THROUGH THE SCENARIO OF A HAZ-MAT CASUALTY INCIDENT. STAFF WERE ABLE TO WORK WITH COMMUNITY RESPONDERS AND AGENCIES TO BRING RESOLUTION TO THE INCIDENT.FRHS RECOGNIZES THE CHANGING DYNAMICS OF THE DIVERSE POPULATION WITHIN OUR SERVICE AREA. WE REMAIN COMMITTED TO PROVIDING SERVICES AIMED DIRECTLY AT MEETING THE CHANGING NEEDS OF THE COMMUNITIES WE SERVE. OUR EFFORTS WILL INCLUDE:CONTINUE TO UPDATE AND REMODEL OUR FACILITY TO MEET THE NEEDS AND PREFERENCES OF INCOMING PATIENTS AND RESIDENTS. DEVELOP COLLABORATIVE EFFORTS WITH THE SALEM MENNONITE HOME TO PROVIDE PROGRAMS AND SERVICES FOCUSED SPECIFICALLY ON THE NEEDS AND INTERESTS OF THE ELDERLY. HOW WE ADDRESSED THE ABOVE NEEDS.FREEMAN REGIONAL HEALTH SERVICES CONTINUES TO WORK WITH THE SALEM MENNONITE HOME ASSISTED LIVING CENTER ON A JOINT PROJECT TO PROVIDE THE AREA WITH A FULL CONTINUUM OF CARE. THE SALEM MENNONITE HOME CURRENTLY PROVIDES ASSISTED LIVING SERVICES. FREEMAN REGIONAL PROVIDES CLINIC, HOSPITAL, AND LONG-TERM CARE SERVICES. THE PLAN FOR THE FUTURE IS TO BUILD ON A NEW SITE TOGETHER TO PROVIDE EASIER ACCESS PHYSICALLY AND OFFER BROADER HEALTHCARE SERVICES FROM ONE LOCATION. THE MISSION OF FRHS IS TO PROVIDE ACCESSIBLE, COMMUNITY BASED QUALITY CARE THAT IS COMPETENT, CREATIVE AND COMPASSIONATE. TO MEET THESE NEEDS, FRHS WILL:CONTINUE TO RECRUIT AND EMPLOY QUALITY PROVIDERS WHO ARE COMPETENT AND COMPASSIONATE TO MEET THE HEALTH CARE NEEDS OF THOSE WITHIN OUR SERVICE AREA.PROVIDE PRIMARY CARE SERVICES THAT ARE APPROPRIATE FOR OUR RURAL SETTING.HOW WE ADDRESSED THE ABOVE NEEDS.FREEMAN REGIONAL HEALTH SERVICES HAS RECRUITED AND SUCCESSFULLY ENGAGED TWO PHYSICIANS WITH START DATES OF OCTOBER 2019 AND AUGUST 2020. IN ADDITION, WE HAVE CONTINUED TO EMPLOY TWO PHYSICIANS, ONE PHYSICIAN ASSISTANT, AND 4 CERTIFIED NURSE PRACTITIONERS TO SERVE THE GREATER FREEMAN AREA AND OUR SATELLITE CLINIC LOCATIONS. THESE PROVIDERS MEET MONTHLY TO REVIEW THE SERVICES THEY PROVIDE TO THE AREAS. THE GOAL OF THE MEETINGS ARE TO ADJUST SERVICES TO MEET THE NEEDS OF THE FREEMAN AREA RURAL COMMUNITIES. FRHS RECOGNIZES THE INCREASING DIFFICULTY IN FINDING THE RESOURCES REQUIRED TO STAFF THE VARIOUS DEPARTMENTS OF THE HOSPITAL, CLINIC, AND NURSING HOME. TO MEET THESE NEEDS FRHS WILL:CONTINUE TO WORK WITH LOCAL SCHOOLS AND CHURCHES TO PROMOTE AN INTEREST IN HEALTHCARE CAREERS. -THIS INCLUDES PARTICIPATING IN THE SD HOSA PROGRAM; A COMPREHENSIVE, RIGOROUS, AND RELEVANT PROGRAM THAT ENGAGES STUDENTS INTERESTED IN HEALTH CARE CAREERS, AS WELL AS AN EVALUATION SYSTEM THAT HAS BEEN CONTINUOUSLY TESTED, REFINED, AND VALIDATED OVER THREE DECADES OF USE. 2019 MARKED THE 1ST YEAR OF PARTICIPATION OF THIS PROGRAM. FRHS ALSO HOSTS AN ANNUAL SCRUBS CAMP IN FEBRUARY TO STIMULATE STUDENTS' INTERESTS IN THE HEALTH CARE FIELD. COLLEGES AND TECHNICAL INSTITUTIONS PRESENT ON CERTAIN HEALTH FIELDS TO HELP ASSIST WHAT TYPES OF HEALTHCARE CAREERS CAN BE EXPLORED. PROMOTE FRHS TO THE PUBLIC AS AN EXCELLENT PLACE TO WORK AND TO RECEIVE SERVICES. - EMPLOYMENT: ADVERTISE JOB OPPORTUNITIES TO LOCAL PAPERS, SOCIAL MEDIA, AND UTILIZE EXISTING STAFF TO PROMOTE FRHS IN THE PUBLIC. FRHS ALSO HOSTS A JOB FAIR IN FEBRUARY DURING THE ANNUAL SCRUBS CAMP TO PROMOTE RECRUITMENT. - SERVICES: FRHS PROMOTES SERVICES THROUGH AVERA HEALTH, LOCAL NEWSPAPERS AND SOCIAL MEDIA, AS WELL AS WITHIN THE OUTREACH PROVIDERS THAT VISIT FRHS. A ROUTINE CALENDAR OF OUTREACH SERVICES IS AVAILABLE ON WWW.FREEMANREGIONAL.COM. CONDUCT COMMUNITY RELATED HEALTH ACTIVITIES THAT ATTRACT PEOPLE TO THE COMMUNITY. - ANNUAL FUNDRAISERS WITHIN THE COMMUNITY; FRHS GOLF EVENT IN JUNE AND FRHS GALA IN JANUARY. COLLABORATE WITH THE LOCAL COMMUNITY TO PROMOTE AFFORDABLE HOUSING FOR THE REQUIRED WORKFORCE.- CEO AND CNO ARE CURRENT MEMBERS OF THE FREEMAN COMMUNITY DEVELOPMENT CORPORATION, AN ORGANIZATION DEDICATED TO PROMOTING THE ECONOMIC VITALITY OF THE COMMUNITY AND PROMOTING THE HIGHEST QUALITY OF LIFE FOR RESIDENTS AND THOSE WHO VISIT THE FREEMAN COMMUNITY. |
| FREEMAN REGIONAL HEALTH SERVICES | PART V, SECTION B, LINE 13H: THE FACILITY MAY USE PRESUMPTIVE ELIGIBILITY IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED. |
| FREEMAN REGIONAL HEALTH SERVICES | 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - OAKVIEW TERRACE | ||||
| 510 E 8TH STREET | FREEMAN | SD | 57029 | LONG TERM CARE FACILITY |
| 2 - MENNO CLINIC | ||||
| 301 SOUTH HIGH STREET | MENNO | SD | 57045 | RURAL MEDICAL CLINIC |
| 3 - MARION CLINIC | ||||
| 307 STATE | MARION | SD | 57043 | RURAL MEDICAL CLINIC |
| 4 - BRIDGEWATER CLINIC | ||||
| 209 N MAIN | BRIDGEWATER | SD | 57319 | RURAL MEDICAL CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FREEMAN REGIONAL HEALTH SERVICES (FRHS) REQUIRES THAT THE PATIENT COMPLETE A FINANCIAL ASSISTANCE APPLICATION SHOWING HIS/HER INCOME AND EXPENSES. THE APPLICATION IS REVIEWED TO SEE WHAT FUNDS AND ASSETS THE PATIENT HAS AND WHETHER THE PATIENT HAS THE RESOURCES TO PAY HIS/HER MEDICAL BILLS. FOR SOME PATIENTS, FRHS USES DOCUMENTATION FROM OTHER GOVERNMENT BASED AGENCIES OF THE PATIENT'S FINANCIAL SITUATION AND RESOURCES AS A WAY TO HELP DETERMINE THE PATIENT'S FINANCIAL SITUATION. THE CHIEF FINANCIAL OFFICER REVIEWS ALL APPLICATIONS AND MAKES THE DETERMINATION OF ASSISTANCE OFFERED. THE FACILITY MAY USE PRESUMPTIVE ELIGIBILITY IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED. |
| PART I, LINE 7: | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINES 7B AND 7G WERE OBTAINED FROM THE MEDICAID AND MEDICARE COST REPORTS, RESPECTIVELY. |
| PART I, LN 7 COL(F): | PAGES 15-16 OF THE ATTACHED AUDITED FINANCIAL STATEMENT DISCUSSES IMPLICIT PRICE CONCESSION AND BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEAR ENDED DECEMBER 31, 2019 WAS NOT SIGNIFICANT. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2019. MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY.THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | 30-DAY NOTICE- OUR STATEMENTS INCLUDING THE FIRST STATEMENT HAVE A CHARITY CARE/FINANCIAL ASSISTANCE WEB SITE LISTED AT THE BOTTOM. THE SITE PROVIDES THE FINANCIAL ASSISTANCE POLICY AND FOLLOWS THE 30-DAY NOTICE GUIDELINES. 120 DAY NOTICE-FREEMAN REGIONAL DOES NOT INITIATE ANY ECA'S UNTIL AFTER THE 4TH MONTHLY STATEMENT. 240 DAY NOTICE-IF THE APPLICATION IS COMPLETE WE MAKE A DETERMINATION BY 240 DAYS. IF THE DETERMINATION IS AVERSE A 30-DAY NOTICE IS AGAIN GIVEN OUT. |
| PART V, LINE 7, COMMUNITY HEALTH NEEDS ASSESSMENT | DESCRIPTION OF FAILURETYPE OF FAILURE: 501(R)(3) - THE HOSPITAL DID NOT POST ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT TO THEIR WEBSITE ON OR BEFORE DECEMBER 31, 2019.CAUSE OF THE FAILURE: THE HOSPITAL WAS IN A TIME OF TRANSITION AS THE MARKETING DIRECTOR AT THE TIME RESIGNED. THE DIRECTOR HAD EXCLUSIVE ACCESS TO THE WEB SITE AND WEB SITE CHANGES. WE WERE ALSO CONSIDERING A WEBSITE VENDOR CHANGE AS COSTS WERE RUNNING HIGH WITH THIS SITE. FACILITY OR FACILITIES WHERE THE FAILURE OCCURRED: THE FAILURE OCCURRED AT FREEMAN REGIONAL HEALTH SERVICES.THE DATE(S) OF THE FAILURE AND ITS DISCOVERY: DECEMBER 31, 2019 AND MARCH 26, 2020, RESPECTIVELY.DESCRIPTION OF THE CORRECTION OF THE FAILUREMETHOD OF CORRECTION: THE COMMUNITY HEALTH NEEDS ASSESSMENT HAS BEEN MADE AVAILABLE ON THE WEBSITE.DATE OF CORRECTION: 03/27/2020DESCRIPTION OF THE PRACTICES OR PROCEDURES PUT INTO PLACETHE COMMUNITY HEALTH NEEDS ASSESSMENT WAS POSTED ON THE WEBSITE AT: HTTPS://WWW.FREEMANREGIONAL.COM/COMMUNITY-NEEDS |
| PART VI, LINE 2: | ANNUALLY, ON THE 4TH MONDAY OF FEBRUARY, FREEMAN REGIONAL HEALTH SERVICES (FRHS) HAS A COMMUNITY MEETING THAT IS ADVERTISED IN THE LOCAL NEWSPAPERS INVITING THE COMMUNITY TO ATTEND AND PROVIDE INPUT REGARDING ITS NEEDS AND IDEAS ON HOW FRHS CAN IMPROVE ITS SERVICES. ON A QUARTERLY BASIS, FRHS MEETS WITH THE MEDICAL STAFF TO DISCUSS OPERATIONS AND ANY SUGGESTIONS THEY MAY HAVE ON SERVICES PROVIDED BY FRHS AND THE NEEDS OF THE COMMUNITY. FRHS HAS A MONTHLY DEPARTMENT MANAGER MEETING WHERE THE NEEDS OF THE COMMUNITY AND OTHER ISSUES CAN BE DISCUSSED. COMMUNITY MEMBERS ARE ENCOURAGED TO COME TO THE FACILITY AT ANY TIME TO DISCUSS CONCERNS OR ISSUES WITH THE ADMINISTRATION.IN ADDITION, FRHS PREPARED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019. PLEASE SEE PART V, SECTION B, LINE 3 FOR MORE INFORMATION. |
| PART VI, LINE 3: | FRHS HAS POSTED SIGNAGE ABOUT CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. FRHS ADDRESSES THE FINANCIAL ASSISTANCE PROGRAM AND PROVIDES INFORMATION ON HOW TO APPLY FOR ASSISTANCE AT DISCHARGE AND IN PATIENT BILLS. THE BUSINESS OFFICE AND SOCIAL WORKERS ADVISE PATIENTS ON THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. A NOTICE RELATED TO AVAILABLE CHARITY CARE IS PRINTED AT THE BOTTOM OF ALL SERVICE STATEMENTS. |
| PART VI, LINE 4: | FRHS IS A HEALTHCARE FACILITY THAT PRIMARILY SERVES RESIDENTS IN RURAL HUTCHINSON, MCCOOK AND TURNER COUNTIES IN SOUTHEASTERN SOUTH DAKOTA. SERVICE AREA DEMOGRAPHICS HUTCHINSON MCCOOK TURNERPOPULATION (2019 DATA) 7,291 5,586 8,384HOUSEHOLDS 2,862 2,209 3,470AVERAGE HOUSEHOLD SIZE (PEOPLE) 2.43 2.38 2.33MEDIAN HOUSEHOLD INCOME $54,868 $62,234 $55,380MEDIAN AGE 43.8 40 43% OF POPULATION UNDER 18 25.3% 27.8% 24.4%% OF POPULATION 19-64 51.8% 53.3% 54.2%% OF POPULATION 65+ 22.9% 18.9% 21.4%% OF POPULATION BELOW POVERTY INCOME LEVEL 11.5% 9.6% 9.4%A MAJORITY OF THE EMPLOYERS IN THESE AREAS ARE SMALL EMPLOYERS WHO OFFER LITTLE TO NO EMPLOYEE BENEFITS. OF THE EMPLOYERS WHO DO OFFER HEALTH INSURANCE TO THEIR EMPLOYEES, DEDUCTIBLES AND CO-PAYS HAVE RISEN FROM 300-500% OVER THE PAST 10 YEARS. MANY EMPLOYERS HAVE PASSED THE INCREASE IN HEALTH INSURANCE PREMIUMS TO THEIR EMPLOYEES MAKING PAYING THE HIGHER DEDUCTIBLES AND CO-PAYS VERY DIFFICULT. |
| PART VI, LINE 5: | FRHS'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. FRHS EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN ITS COMMUNITY AND SURROUNDING AREA. FRHS REINVESTS SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, INCLUDING BUT NOT LIMITED TO EXPANSION OF SERVICES OFFERED, PATIENT EDUCATION, EMPLOYEE EDUCATION, AND EQUIPMENT AND FACILITY RENOVATIONS. FRHS IS COMPRISED OF A 49 BED NURSING HOME AND A 25 BED CRITICAL ACCESS HOSPITAL WITH A 24/7 EMERGENCY ROOM. THE EMERGENCY ROOM HAS LOCAL PROVIDERS ON CALL AND TELEMEDICINE CAPABILITIES WITH A REGIONAL TRAUMA CENTER. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | SD |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICHOLAS BRANDNER | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $157,596 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $4,702 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $6,444 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $168,742 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF FREEMAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 466000164 | BondIssuerEIN |
| Bond Issued | 2006-09-29 | BondIssuedDt |
| Issue Price | $750,000 | IssuePriceAmt |
| Purpose | TO HELP FINANCE CONGREGATE LIVING UNITS. | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $409,998 | RetiredAmt |
| Total Proceeds | $750,000 | TotalProceedsAmt |
| Capital Expenditures | $750,000 | CapitalExpendituresAmt |
| Substantial Completion | 2006 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UECKER PHARMACY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | OWNED BY LORI UECKER, BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $119,374 | TransactionAmt |
| Transaction | PHARMACY SUPPLIES AND SERVICES PURCHASED | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | FREEMAN REGIONAL HEALTH SERVICES DOES NOT UTILIZE COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CFO REVIEW THE FORM 990 IN DETAIL, IT IS THEN PRESENTED AND REVIEWED BY THE BOARD AT A BOARD MEETING PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | FRHS REQUIRES ANNUAL COMPLIANCE WITH AND DISCLOSURE OF CONFLICTS IN ACCORDANCE WITH THE WRITTEN POLICY. CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST MUST BE REPORTED TO THE COMPLIANCE OFFICER. IF A CONFLICT IS DEEMED TO EXIST, APPROPRIATE ACTION IS TAKEN SUCH AS A BOARD MEMBER MAY BE REQUIRED TO ABSTAIN FROM DISCUSSION, DELIBERATION, AND VOTING ON THE ISSUE AT HAND. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS INITIALLY SET BY THE BOARD AND/OR ADMINISTRATION FOLLOWING A REVIEW AND ASSESSMENT OF THE SDAHO COMPARABILITY STUDY. THE ANNUAL INCREASES ARE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST |
| FORM 990, PART IX, LINE 11G | COLLECTION FEES: PROGRAM SERVICE EXPENSES 4,256. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,256. PURCHASE OTHER CLINIC: PROGRAM SERVICE EXPENSES 1,298,652. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,298,652. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 588,020. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 588,020. PURCHASE COURIER: PROGRAM SERVICE EXPENSES 16,502. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,502. CONSULTING FEES: PROGRAM SERVICE EXPENSES 23,038. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,038. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 658,548. MANAGEMENT AND GENERAL EXPENSES 2,750. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 661,298. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 83,945. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83,945. ULTRASOUND AND MRI CONTRACTS: PROGRAM SERVICE EXPENSES 61,448. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,448. PT FINANCIAL SVC COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 25,617. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,617. ADMINISTRATION CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 143,592. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 143,592. |