STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

PRAIRIE LAKES HEALTH CARE SYSTEM INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
PRAIRIE LAKES HEALTH CARE SYSTEM INC (EIN 46-0391067)
Tax period
2018-06-01 to 2019-05-31
Filed
2020-07-15
IRS object ID
202031979349307078
Schema version
2018v3.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-07-15T17:07:09-05:00ReturnTs
Tax Period End2019-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN460391067EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PRAIRIE LAKES HEALTH CARE SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPRAIBusinessNameControlTxt
Phone6058827000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1210AddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57201ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonADAM POPPPersonNm
Person TitleCFOPersonTitleTxt
Phone6058827000PhoneNum
Signature2020-07-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT E SCHILEPreparerPersonNm
Phone6123764500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-07-15IPDt
IP Tm13:10:11IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE168BB59A4AC1B98DF6FDFCBC72C1446FCA85D8BAtSubmissionCreationDeviceId
At Submission Filing Device Id39F506601BE52B1AEC27478C749FC3D7BEC65D0CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKC DEBOERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1210AddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57201ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$301,477,853GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PRAIRIELAKES.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateSDLegalDomicileStateCd
Activity Or MissionPROVIDE HIGH QUALITY, AFFORDABLE & COMPASSIONATE HEALTHCARE SERVICES FOR THE PEOPLE IN THE REGION.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee645TotalEmployeeCnt
Total Volunteers190TotalVolunteersCnt
Total Gross UBI$989,863TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$250,915NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$395,556PYContributionsGrantsAmt
CY Contributions Grants$632,539CYContributionsGrantsAmt
PY Program Service Revenue$95,150,271PYProgramServiceRevenueAmt
CY Program Service Revenue$102,566,717CYProgramServiceRevenueAmt
PY Investment Income$17,511,185PYInvestmentIncomeAmt
CY Investment Income$15,332,407CYInvestmentIncomeAmt
PY Other Revenue$1,716,644PYOtherRevenueAmt
CY Other Revenue$1,528,183CYOtherRevenueAmt
PY Total Revenue$114,773,656PYTotalRevenueAmt
CY Total Revenue$120,059,846CYTotalRevenueAmt
PY Grants And Similar Paid$428,079PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$293,785CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$48,200,470PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$50,433,086CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$48,667,500PYOtherExpensesAmt
CY Other Expenses$50,050,505CYOtherExpensesAmt
PY Total Expenses$97,296,049PYTotalExpensesAmt
CY Total Expenses$100,777,376CYTotalExpensesAmt
PY Revenues Less Expenses$17,477,607PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$19,282,470CYRevenuesLessExpensesAmt
Total Assets BOY$329,183,316TotalAssetsBOYAmt
Total Assets EOY$328,290,825TotalAssetsEOYAmt
Total Liabilities BOY$60,880,353TotalLiabilitiesBOYAmt
Total Liabilities EOY$54,681,592TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$268,302,963NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$273,609,233NetAssetsOrFundBalancesEOYAmt
MissionPRAIRIE LAKES HEALTH CARE SYSTEM, THROUGH THE EFFORTS OF ITS DEDICATED EMPLOYEES AND PHYSICIANS, PROVIDES HIGH QUALITY, AFFORDABLE, AND COMPASSIONATE HEALTHCARE SERVICES FOR THE PEOPLE IN THE REGION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$87,717,595ExpenseAmt
Grant$293,785GrantAmt
Revenue$102,566,717RevenueAmt
DescPRAIRIE LAKES HEALTH CARE SYSTEM SERVES TEN COUNTIES IN NORTHEASTERN SOUTH DAKOTA AND WESTERN MINNESOTA AS A RURAL, REGIONAL MEDICAL CENTER. IT IS COMMITTED TO PROVIDING ACCESSIBLE, HIGH QUALITY, COST-EFFECTIVE HEALTHCARE SERVICES AS IT MANAGES EFFECTIVELY THE TRANSITION TO NEW PAYMENT AND CARE DELIVERY MODELS. TWENTY-THREE SPECIALTY PHYSICIANS HAVE BEEN RECRUITED OVER THE PAST DECADE TO BUILD NEW SERVICES AND BETTER SERVE THE NEEDS OF THE REGION. A PULMONOLOGIST JOINED THE STAFF IN 2019 AFTER COMPLETING RESIDENCY.Desc
Total Program Service Expenses$87,717,595TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document89IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee645EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADAM POPPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6058827000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 9TH AVENUE NWAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57201ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JIM REDLINGER
CHAIR1.000.00Yes (X)Yes (X)$0$0$0
ROBB PETERSON
VICE CHAIR1.000.00Yes (X)Yes (X)$0$0$0
DOUG SHARP
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
VINCE FOLEY
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
MARK ROBY
PAST CHAIR1.000.00Yes (X)$0$0$0
JOHN CALVIN
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHRIS CARTER
BOARD MEMBER1.000.00Yes (X)$0$0$0
ALAN CHRISTENSEN MD
BOARD MEMBER1.000.00Yes (X)$0$0$0
CATHERINE GERRISH MD
BOARD MEMBER1.000.00Yes (X)$0$0$0
BERNIE HANSON MD
BOARD MEMBER1.000.00Yes (X)$0$0$0
SHANNON KRUSE
BOARD MEMBER1.000.00Yes (X)$0$0$0
STACEY LEE
BOARD MEMBER1.000.00Yes (X)$0$0$0
GERALD RIEBER MD
BOARD MEMBER1.000.00Yes (X)$0$0$0
KC DEBOER
CHIEF EXECUTIVE OFFICER40.001.00Yes (X)$135,792$0$19,537
JILL FULLER
CEO (THROUGH AUGUST 2018)40.001.00Yes (X)$1,172,184$0$17,619
ADAM PAUL
CFO (THROUGH NOVEMBER 2018)40.001.00Yes (X)$232,432$0$30,089
D ADAM POPP
CHIEF FINANCIAL OFFICER40.001.00Yes (X)$207,204$0$29,905
MICHAEL ANDERSON
CHIEF INVESTMENT OFFICER40.000.00$379,188$0$24,525Yes (X)
NATE LAKE
VICE PRESIDENT40.001.00$236,022$0$37,523Yes (X)
TRACI RABINE
VICE PRESIDENT40.000.00$231,829$0$36,061Yes (X)
MICHELE TURBAK
CHIEF NURSING OFFICER40.000.00$238,221$0$30,192Yes (X)
GRANT TILLETT
CHIEF INFORMATION OFFICER40.000.00$221,819$0$32,797Yes (X)
SALEM MAALIKI MD
PHYSICIAN40.000.00$1,452,706$0$31,932Yes (X)
EVELIO GARCIA MD
PHYSICIAN40.000.00$1,324,160$0$31,932Yes (X)
JEFFREY SMITH MD
PHYSICIAN40.000.00$697,776$0$31,932Yes (X)
BIPIN AMIN MD
PHYSICIAN40.000.00$610,000$0$25,725Yes (X)
LEIGHTON SINGH MD
PHYSICIAN40.000.00$604,808$0$31,932Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,744,141TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$411,701TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K48IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COMPHEALTH
PO BOX 972651DALLASTX75397LOCUM PHYSICIANS$951,769
WAPITI MEDICAL GROUP
107 FLYNN DRIVE STE 600MILBANKSD57252LOCUM ER PHYSICIANS$401,121
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397LOCUM PHYSICIANS$325,420
DMS HEALTH TECHNOLOGIES
PO BOX 670747DALLASTX75267PET SCAN$203,794
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN55480LAB SERVICES$165,710
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
All Other Contributions$632,539AllOtherContributionsAmt
Total Contributions$632,539TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE621400$101,576,854$101,576,854
RETAIL PHARMACY446110$832,676$832,676
LAB SERVICE621500$157,187$157,187
FieldValueIRS element (for citing)
Total Program Service Revenue$102,566,717TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$174,068TotalRevenueColumnAmt
Exclusion-$174,068ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,069,729RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,069,729RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,069,729TotalRevenueColumnAmt
Exclusion$1,069,729ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$196,912,898SecuritiesAmt
Other$11,584OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$181,321,640SecuritiesAmt
Other$96,367OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$15,591,258SecuritiesAmt
Other-$84,783OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,506,475TotalRevenueColumnAmt
Exclusion$15,506,475ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA REVENUE722210$264,476$264,476
OTHER INCOME900099$191,809$191,809
VENDING MACHINES722210$1,859$1,859

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$310TotalRevenueColumnAmt
Exclusion$310ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$458,454OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$120,059,846TotalRevenueColumnAmt
Related Or Exempt Func Income$101,576,854RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$989,863UnrelatedBusinessRevenueAmt
Exclusion$16,860,590ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$293,785TotalAmt
Program Services$293,785ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,930,868TotalAmt
Management And General$2,930,868ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$40,775,264TotalAmt
Program Services$37,694,886ProgramServicesAmt
Management And General$3,080,378ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$910,341TotalAmt
Program Services$847,721ProgramServicesAmt
Management And General$62,620ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,046,379TotalAmt
Program Services$2,742,086ProgramServicesAmt
Management And General$304,293ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,770,234TotalAmt
Program Services$2,508,215ProgramServicesAmt
Management And General$262,019ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$24,259TotalAmt
Management And General$24,259ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$110,926TotalAmt
Management And General$110,926ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,996,899TotalAmt
Program Services$5,548,533ProgramServicesAmt
Management And General$1,448,366ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$541,794TotalAmt
Management And General$541,794ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,515,274TotalAmt
Program Services$1,046,665ProgramServicesAmt
Management And General$468,609ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$729,847TotalAmt
Program Services$70,458ProgramServicesAmt
Management And General$659,389ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$973,380TotalAmt
Program Services$22,439ProgramServicesAmt
Management And General$950,941ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$476,222TotalAmt
Program Services$417,324ProgramServicesAmt
Management And General$58,898ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$210,510TotalAmt
Program Services$101,121ProgramServicesAmt
Management And General$109,389ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$774,183TotalAmt
Program Services$774,183ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,267,057TotalAmt
Program Services$4,978,703ProgramServicesAmt
Management And General$1,288,354ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$403,785TotalAmt
Program Services$403,785ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
UBI TAXES$52,692$52,692
MEDICAL SUPPLIES$11,591,515$11,591,515
DRUGS$11,372,044$11,372,044
PROVISION FOR BAD DEBT$4,558,120$4,558,120

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,451,998TotalAmt
Program Services$2,746,012ProgramServicesAmt
Management And General$705,986ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$100,777,376TotalAmt
Program Services$87,717,595ProgramServicesAmt
Management And General$13,059,781ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,573BOYAmt
EOY$1,573EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,533,318BOYAmt
EOY$7,528,469EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,794,983BOYAmt
EOY$11,761,509EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$481,528BOYAmt
EOY$543,256EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,155,497BOYAmt
EOY$3,127,153EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$807,293BOYAmt
EOY$919,979EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$160,708,206LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$76,648,109LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$81,966,223BOYAmt
EOY$84,060,097EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$199,971,967BOYAmt
EOY$195,398,639EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$4,820,482BOYAmt
EOY$4,217,679EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$2,481,359BOYAmt
EOY$2,392,565EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,169,093BOYAmt
EOY$18,339,906EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$329,183,316BOYAmt
EOY$328,290,825EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,519,382BOYAmt
EOY$13,546,513EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$71,097EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,874,579BOYAmt
EOY$34,390,295EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,331,918BOYAmt
EOY$887,945EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,154,474BOYAmt
EOY$5,785,742EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$60,880,353BOYAmt
EOY$54,681,592EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$263,785,014BOYAmt
EOY$269,695,989EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,517,949BOYAmt
EOY$3,913,244EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$268,302,963BOYAmt
EOY$273,609,233EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$329,183,316BOYAmt
EOY$328,290,825EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$19,282,470ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$13,371,495NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$604,705OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,421,875OtherCostOrOtherBasisAmt
Book Value$3,421,875BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$85,061,170OtherCostOrOtherBasisAmt
Depreciation$26,655,262DepreciationAmt
Book Value$58,405,908BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,903,610OtherCostOrOtherBasisAmt
Depreciation$2,042,133DepreciationAmt
Book Value$861,477BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$69,136,588OtherCostOrOtherBasisAmt
Depreciation$47,950,714DepreciationAmt
Book Value$21,185,874BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$184,963OtherCostOrOtherBasisAmt
Book Value$184,963BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$84,060,097TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
DUE FROM 457(B) PLAN$5,107,789
ACCRUED INTEREST RECEIVABLE$210,967
TRUSTEE HELD FUNDS$248,627
ACCRUED REAL ESTATE$10,797,298
DUE FROM RELATED PARTY$1,975,225
FieldValueIRS element (for citing)
Total Book Value Other Assets$18,339,906TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
457(B) PAYABLE$5,107,789
LONG-TERM PTO$586,053
ASSET RETIREMENT OBLIGATION$91,900
FieldValueIRS element (for citing)
Total Liability$5,785,742TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT PRAIRIE LAKES IS A TAX-EXEMPT, NOT-FOR-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE HEALTH SYSTEM FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE HEALTH SYSTEM'S FINANCIAL STATEMENTS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,943,938TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,943,938NetCommunityBenefitExpnsAmt
Total Expense0.02020TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,584,302TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,528,611DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,055,691NetCommunityBenefitExpnsAmt
Total Expense0.02140TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,528,240TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,528,611DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,999,629NetCommunityBenefitExpnsAmt
Total Expense0.04160TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,032,760TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,359,339DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,673,421NetCommunityBenefitExpnsAmt
Total Expense0.05900TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,032,760TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,359,339DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,673,421NetCommunityBenefitExpnsAmt
Total Expense0.05900TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,561,000TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,887,950DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,673,050NetCommunityBenefitExpnsAmt
Total Expense0.10060TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,276TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,276NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,370TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,370NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,646TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$41,646NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$4,558,120BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$36,486,575ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$34,300,663CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$2,185,912MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PRAIRIE LAKES HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 9TH AVE NWAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57201ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.PRAIRIELAKES.COMWebsiteAddressTxt
State License10572StateLicenseNum
Subordinate Hospital EIN460391067SubordinateHospitalEIN
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PRAIRIE LAKES HEALTH CARE SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE LINE 7DOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE LINE 16JFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE LINE 16JFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE LINE 16JFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PRAIRIE LAKES HEALTH CARE SYSTEMPART V, SECTION B, LINE 5: TO ENSURE INPUT FROM PERSONS WITH BROAD KNOWLEDGE OF THE COMMUNITY, TWO FOCUS GROUP MEETINGS WERE CONDUCTED (NOVEMBER 7TH AND 8TH 2018) WITH INDIVIDUALS IN THE COMMUNITY. INVITATIONS WERE SENT TO INDIVIDUALS REPRESENTING VARIOUS COMMUNITY, BUSINESS, AND EDUCATIONAL ORGANIZATIONS. REPRESENTATIVES FROM LOCAL HEALTH CARE PROVIDERS AND THE COMMUNITY HEALTH DEPARTMENTS WERE INCLUDED TO BRING IN ADDITIONAL PROFESSIONAL PERSPECTIVE. FOR INVITEES UNABLE TO ATTEND THE FOCUS GROUP SESSIONS, INPUT WAS GATHERED VIA EMAIL OR PHONE INTERVIEW. THE INDIVIDUALS IDENTIFIED TO PARTICIPATE IN THE PROCESS HAVE DIRECT ACCESS TO INDIVIDUALS ACROSS ALL SUBSECTIONS OF THE COMMUNITY AND THEREFORE CAN ADDRESS NEEDS THAT MAY IMPACT THOSE POPULATIONS THAT ARE MEDICALLY UNDERSERVED OR MOST IN NEED. SEE PAGE 17 OF THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT, WHICH IS AVAILABLE ON OUR WEBSITE, FOR A FULL LIST OF PARTICIPATING ORGANIZATIONS.
PRAIRIE LAKES HEALTH CARE SYSTEMPART V, SECTION B, LINE 7D: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT WWW.PRAIRIELAKES.COM/ABOUT-PRAIRIE-LAKES/COMMUNITY-BENEFITS-513.HTML.
PRAIRIE LAKES HEALTH CARE SYSTEMPART V, SECTION B, LINE 11: DURING THE FISCAL YEAR ENDED MAY 31, 2019, PRAIRIE LAKES HEALTHCARE SYSTEM TOOK THE FOLLOWING STEPS TO ADDRESS SIGNIFICANT COMMUNITY HEALTH NEEDS AS IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. 1. BEHAVIORAL HEALTH: PRAIRIE LAKES CURRENTLY: - SCREENS HOSPITAL PATIENTS TO ASSESS FOR RISK OF SELF-HARM - PROVIDES A MONTHLY GRIEF SUPPORT GROUP FOR COMMUNITY MEMBERS - OFFERS AN ANNUAL ALLOWANCE FOR AN ASSISTANCE PROGRAM TO EMPLOYEES AND THEIR IMMEDIATE FAMILY MEMBERS TO SEEK MENTAL HEALTH SERVICES - EDUCATE PATIENTS ON AVAILABLE MENTAL HEALTH SERVICES AND DISTRIBUTE LOCAL RESOURCE MATERIALS - HELPS COORDINATE A "MENTAL HEALTH FIRST AID TRAINING" THROUGH HUMAN SERVICE AGENCY (HSA) - ASSIST HSA WITH EFFORTS TO RECRUIT A PSYCHIATRIST - PROVIDES FINANCIAL SUPPORT TO: WATERTOWN SCHOOL DISTRICT "SEE SOMETHING, SAY SOMETHING" INITIATIVE, HSA SUICIDE PREVENTION SERVICED AND ANNUAL SUICIDE AWARENESS WALK, AND SERENITY HILLS, AN HSA RESIDENTIAL FACILITY AND SAFE HOUSE FOR THOSE SUFFERING FROM MENTAL ILLNESS OR ADDICTIONS2. TRANSPORTATIONPRAIRIE LAKES CURRENTLY: - PROVIDES FINANCIAL SUPPORT TO WATERTOWN AREA TRANSIT TO PROVIDE TRANSPORTATION FOR INDIVDUALS TO THEIR MEDICAL APPOINTMENTS3. CHRONIC DISEASE MANAGEMENTPRAIRIE LAKES CURRENTLY: - PROVIDES HEART AND STROKE SCREENING AT A REDUCED COST - PROVIDES REMOTE MONITORING OF CARDIAC PATIENTS - PROVIDES EDUCATION AND MONITORING OF HOME DIALYSIS PATIENTS - HAS RECRUITED A PULMONOLOGIST TO EXPAND RESPIRATORY SERVICES4. HEALTH LITERACYPRAIRIE LAKES CURRENTLY: - OFFERS VARIOUS HEALTH TALKS WITHIN THE COMMUNITY
PRAIRIE LAKES HEALTH CARE SYSTEMPART V, SECTION B, LINE 16J: HTTPS://WWW.PRAIRIELAKES.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-PROGRAM-510.HTML
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - SISSETON SATELLITE DIALYSIS
5 EAST CHESTNUTSISSETONSD57262DIALYSIS UNIT
2 - MALLARD POINTE SURGICAL CENTER
1425 MICKELSON DRIVEWATERTOWNSD57201OUTPATIENT SURGERY CENTER
3 - ORTONVILLE SATELLITE DIALYSIS
450 EASTVOLD AVENUEORTONVILLEMN56278DIALYSIS UNIT
4 - PRAIRIE LAKE PULMONOLOGY CLINIC
600 4TH STREET NEWATERTOWNSD57201PULMONOLOGY CLINIC

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:IN ADDITION TO INCOME BASED CRITERIA FOR DETERMINING THE AMOUNT OF FINANCIAL ASSISTANCE SERVICES FOR WHICH A PATIENT IS ELIGIBLE AT THE TIME OF SERVICE OR DURING THE BILLING-AND-COLLECTION PROCESS, PLHS USES AN ASSET TEST. ASSET EXCLUSIONS THAT ARE CONSIDERED IN QUALIFYING FOR FINANCIAL ASSISTANCE ARE: (A) EQUITY IN PRIMARY RESIDENCE UP TO $15,000(B) EQUITY IN AUTOMOBILE UP TO $5,000(C) 70% OF VALUE OF ASSETS IN RETIRMENT ACCOUNTS(D) ASSETS IN CHECKING/SAVINGS/ETC. UP TO $15,000(E) OTHER ASSETS USED FOR INCOME PRODUCING PURPOSES.
PART I, LINE 7:THE COSTS OF THE SUBSIDIZED SERVICES ARE BASED ON DIRECT COST PROVIDED BY THE DEPARTMENTS FOR THE SERVICES.
PART I, LINE 7G:THE SUBSIDIZED HEALTH SERVICES INCLUDED IN SCHEDULE H, PART I, LINE 7G RELATE TO THE EMERGENCY ROOM, CARDIOLOGY CLINIC, ONCOLOGY CLINIC, NEPHROLOGY CLINIC, UROLOGY CLINIC, PULMONOLOGY CLINIC, AND ENT CLINIC.
PART I, LN 7 COL(F):$4,558,120 OF BAD DEBT EXPENSE WAS ELIMINATED WHEN CALCULATING PART I, LINE 7, COLUMN F.
PART II, COMMUNITY BUILDING ACTIVITIES:THE ORGANIZATION SUPPORTS COMMUNITY BUILDING ACTIVITIES THROUGH DONATIONS TO COMMUNITY PROJECTS SUCH AS THE WATERTOWN DEVELOPMENT COMPANY FOUNDATION, WHICH WORKS TO BRING NEW BUSINESSES TO WATERTOWN; JOY RANCH, WHICH PROVIDES CAMP EXPERIENCE TO DISABLED CHILDREN; LAKE AREA TECHNICAL INSTITUTE, WHICH PROVIDES EDUCATION AND TRAINING FOR HEALTH PROFESSIONALS; AND THE BOYS AND GIRLS CLUB, WHICH PROVIDES RESOURCES FOR COMMUNITY YOUTH.
PART III, LINE 2:IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.
PART III, LINE 3:THE ORGANIZATION DOES NOT HAVE A WAY TO IDENTIFY THE NUMBER OF PEOPLE WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE SO WE HAVE REPORTED $0 IN PART III, LINE 3.
PART III, LINE 4:SEE THE "PATIENT ACCOUNTS RECEIVABLE" PARAGRAPH ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:THERE WAS NO SHORTFALL CALCULATED IN PART III, LINE 7.THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WAS DERIVED USING THE 2019 FILED MEDICARE COST REPORT.
PART III, LINE 9B:BILLING STATEMENTS AND COLLECTION LETTERS WILL CONTAIN INFORMATION DIRECTING PATIENTS TO CONTACT THE HOSPITAL FOR INFORMATION ABOUT FINANCIAL ASSISTANCE OR PAYMENT PLANS IF THE PATIENTS ARE UNABLE TO PAY THE FULL OUTSTANDING ACCOUNT BALANCE BY THE DUE DATE. IF A COMPLETE ASSISTANCE APPLICATION IS RECEIVED, A DETERMINATION OF THE PATIENT'S ELIGIBILITY WILL BE DOCUMENTED APPROPRIATELY AND COMMUNICATED TO THE PATIENT IN WRITING. IF ELIGIBLE, THE HOSPITAL WILL ISSUE A BILLING STATEMENT WITH THE AMOUNT NOW OWED (ALONG WITH THE AMOUNT GENERALLY BILLED AND HOW IT WAS CALCULATED), REFUND ANY CREDIT BALANCES, AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS. IF AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION (FAA) IS RECEIVED BY THE HOSPITAL, THE HOSPITAL WILL CEASE COLLECTION ACTIONS AND ALLOW 30 DAYS FOR THE FAA TO BE FULLY COMPLETED.
PART VI, LINE 2:THE FACILITY CONDUCTS NEEDS ASSESSMENT SURVEYS IN THE COMMUNITY AND SURROUNDING AREA TO DETERMINE WHAT HEALTH CARE SERVICES NEED TO BE ADDRESSED.
PART VI, LINE 3:PLHS INFORMS AND EDUCATES PATIENTS ABOUT FINANCIAL ASSISTANCE THROUGH INFORMATION PROVIDED ON THE PLHS WEBSITE. FURTHERMORE, HOSPITAL STAFF PROVIDE INFORMATION REGARDING FINANCIAL ASSISTANCE ELIGIBILITY.
PART VI, LINE 4:PRAIRIE LAKES HEALTH CARE SYSTEM'S PRIMARY SERVICE AREA COVERS 3 COUNTIES IN SOUTH DAKOTA WITH A POPULATION OF APPROXIMATELY 36,000. IT'S SECONDARY SERVICE AREA COVERS 4 COUNTIES IN SOUTH DAKOTA AND 3 COUNTIES IN MINNESOTA WITH A POPULATION OF 54,000.
PART VI, LINE 5:THE ORGANIZATION OFFERS FREE HEALTH SEMINARS TO COMMUNITY MEMBERS COVERING A VARIETY OF HEALTH TOPICS IN AN EFFORT TO EDUCATE PEOPLE ABOUT LEADING HEALTHY LIVES. COMMUNITY FORUMS ARE HELD TO UPDATE ATTENDEES ABOUT NEW EVENTS AND TECHNOLOGY AT THE FACILITY. THE ORGANIZATION WORKS WITH THE TECHNICAL INSTITUTE AND TWO STATE UNIVERSITIES TO HELP TRAIN MEDICAL STUDENTS. THE ORGANIZATION IS DEDICATED TO IMPLEMENTING AND MAINTAINING THE MOST CURRENT TECHNOLOGY IN PROVIDING CARE.
PART VI, LINE 7, REPORTS FILED WITH STATESSD

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
BOYS & GIRLS CLUB OF WATERTOWN
PO BOX 833WATERTOWNSD57201460311845501(C)(3)$125,000CAPITAL CAMPAIGN FOR FACILITY IMPROVEMENTS.
WATERTOWN UNITED WAY
PO BOX 283WATERTOWNSD57201460359557501(C)(3)$35,000SUPPORT OF UNITED WAY AGENCIES.
LAKE AREA TECHNICAL INSTITUTE FOUNDATION
PO BOX 730WATERTOWNSD57201363860861501(C)(3)$9,000SCHOLARSHIPS.
HUMAN SERVICE AGENCY
PO BOX 1030WATERTOWNSD57201460275247501(C)(3)$10,000DETOX UNIT SUPPORT
WATERTOWN DEVELOPMENT CORP
PO BOX 1267WATERTOWNSD57201466012194501(C)(6)$35,000ASSIST WITH BRINGING NEW BUSINESSES TO TOWN.
SANFORD CLINIC
901 4TH STREET NWWATERTOWNSD57201460447693501(C)(3)$15,000SUPPORT OF FAMILY PLANNING CLINIC.
FieldValueIRS element (for citing)
Total501c3 Org5Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationFUNDS ARE GRANTED BASED ON ORGANIZATIONS AND INTERNAL REQUESTS. GRANT REQUESTS ARE REVIEWED AND APPROVED BY ADMINISTRATIVE LEADERSHIP TO BE USED FOR THE PURPOSES REQUESTED BY THE ORGANIZATION. FURTHER MONITORING IS NOT DONE ON A REGULAR BASIS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KC DEBOER
CHIEF EXECUTIVE OFFICER$112,792$0$23,000$0$0$0$4,777$0$14,760$0$155,329$0$0$0
JILL FULLER
CEO (THROUGH AUGUST 2018)$308,984$0$863,200$0$0$0$10,038$0$7,581$0$1,189,803$0$0$0
ADAM PAUL
CFO (THROUGH NOVEMBER 2018)$232,432$0$0$0$0$0$15,072$0$15,017$0$262,521$0$0$0
D ADAM POPP
CHIEF FINANCIAL OFFICER$183,767$0$23,437$0$0$0$7,085$0$22,820$0$237,109$0$0$0
MICHAEL ANDERSON
CHIEF INVESTMENT OFFICER$229,188$0$150,000$0$0$0$12,864$0$11,661$0$403,713$0$0$0
NATE LAKE
VICE PRESIDENT$184,109$0$51,913$0$0$0$13,841$0$23,682$0$273,545$0$0$0
TRACI RABINE
VICE PRESIDENT$179,929$0$51,900$0$0$0$12,379$0$23,682$0$267,890$0$0$0
MICHELE TURBAK
CHIEF NURSING OFFICER$184,904$0$53,317$0$0$0$12,717$0$17,475$0$268,413$0$0$0
GRANT TILLETT
CHIEF INFORMATION OFFICER$174,121$0$47,698$0$0$0$9,977$0$22,820$0$254,616$0$0$0
SALEM MAALIKI MD
PHYSICIAN$1,445,206$0$7,500$0$0$0$8,250$0$23,682$0$1,484,638$0$0$0
EVELIO GARCIA MD
PHYSICIAN$1,217,160$0$107,000$0$0$0$8,250$0$23,682$0$1,356,092$0$0$0
JEFFREY SMITH MD
PHYSICIAN$697,776$0$0$0$0$0$8,250$0$23,682$0$729,708$0$0$0
BIPIN AMIN MD
PHYSICIAN$610,000$0$0$0$0$0$8,250$0$17,475$0$635,725$0$0$0
LEIGHTON SINGH MD
PHYSICIAN$604,808$0$0$0$0$0$8,250$0$23,682$0$636,740$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A46031550983755VRN62010-12-08$21,672,812CURRENT REFUNDING OF SERIES 1998 BONDS & ADVANCE REFUNDING OF SERIES 2002000
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
B4603155092017-01-27$36,000,000FUNDING OF THE NEW SPECIALTY CLINIC BUILDING000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndCapital ExpendituresCapitalExpendituresAmt
A$18,095,000$25,166,290$3,303$431,508$24,731,4802010Yes (1)Yes (1)Yes (1)Yes (1)
B$3,965,000$36,000,000$397,999201700Yes (1)Yes (1)$35,602,001

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceBBondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)0000Yes (1)
B0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMEDISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2013
SCHEDULE K, PART II, LINE 3:THE DIFFERENCE IN THE ISSUANCE PRICE INCLUDED IN PART I, LINE A, COLUMN E OF $21,672,812 IS DIFFERENT THAN THE TOTAL PROCEEDS OF ISSUANCE INCLUDED IN PART II, LINE 3 OF $25,166,290 BECAUSE OF THE TRUSTEE FUNDS UTILIZED DURING THE REFINANCING.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREGORY GERRISH MDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionCATHERINE GERRISH IS A BOARD MEMBER AND THE MOTHER OF GREGORY GERRISHRelationshipDescriptionTxt
Transaction$448,606TransactionAmt
TransactionRESIDENCY STIPEND AND EMPLOYEE COMPENSATIONTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL BE COMPRISED OF THE OFFICERS OF THE CORPORATION. EXCEPT AS MAY BE LIMITED BY THE BOARD, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL ACT IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD AND SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL ALSO SERVE AS THE CORPORATION'S COMPENSATION COMMITTEE, UNLESS IT OR THE BOARD DELEGATES THOSE RESPONSIBILITIES TO ANOTHER COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL NOT USURP THE FUNCTIONS OF THE OTHER STANDING COMMITTEES, ALTHOUGH IT WILL COORDINATE PROJECTS, TASKS AND COMMUNICATIONS AMONG SUCH COMMITTEES. A MAJORITY OF THE EXECUTIVE COMMITTEE SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF ANY BUSINESS.
FORM 990, PART VI, SECTION B, LINE 11BEXECUTIVE MANAGEMENT REVIEWED THE FORM 990 IN DETAIL. THEY THEN PRESENTED THE FORM 990 TO THE FINANCE COMMITTEE CHAIR FOR FINAL REVIEW PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CA CONFLICT OF INTEREST STATEMENT IS SIGNED BY ALL BOARD MEMBERS ANNUALLY. THIS STATEMENT DISCLOSES ANY AREAS THAT MAY POTENTIALLY PRESENT A CONFLICT OF INTEREST WITH THEMSELVES OR FAMILY MEMBERS. THE CONFLICT OF INTREST POLICY IS MONITORED BY THE CEO AND THE BOARD. MEMBERS WILL EXCUSE THEMSELVES DURING A BOARD MEETING FROM ANY DISCUSSION OR VOTING ON AN ISSUE WHERE THERE MAY BE A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION COMPARABILITY STUDIES ARE REVIEWED EACH YEAR FOR ALL POSITIONS BY THE HUMAN RESOURCES DEPARTMENT. THE HUMAN RESOURCES DEPARTMENT HAS ACCESS TO VARIOUS COMPENSATION SURVEYS, WHICH ARE REVIEWED TO DETERMINE IF THE HOSPITAL'S COMPENSATION IS REASONABLE COMPARED TO OTHER FACILITIES. THE BOARD APPROVES THE SALARY OF THE CEO THROUGH THE EXECUTIVE COMMITTEE, WHICH SERVES AS THE COMPENSATION COMMITTEE. THE BOARD DELEGATES VICE PRESIDENT EXECUTIVE COMPENSATION APPROVAL TO THE CEO BASED ON THE ORGANIZATION'S COMPENSATION PHILOSOPHY IN CONJUNCTION WITH MARKET BECHNMARKS. THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE SALARIES OF OTHER KEY EMPLOYEES. THIS PROCESS WAS LAST COMPLETED IN 2018.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS ARE AVAILABLE THROUGH FILINGS WITH BONDING AUTHORITY. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9:CHANGE IN BENEFICIAL INTEREST IN PRAIRIE LAKES FOUNDATION -604,705.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PRAIRIE LAKES HOME CONNECTIONS INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 9TH AVE NWAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57201ZIPCd
FieldValueIRS element (for citing)
EIN460394984EIN
Primary ActivitiesHOMEMAKER & NURSING SERVICESPrimaryActivitiesTxt
Legal Domicile StateSDLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 10PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PRAIRIE LAKES HEALTH CARE SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PRAIRIE LAKES HOME CONNECTIONS INC
L$95,061GAAP
PRAIRIE LAKES HOME CONNECTIONS INC
O$115,410GAAP