2019-11-07T09:51:54-06:00 2018-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2018-01-01 460232450 FREEMAN REGIONAL HEALTH SERVICES FREE 6059254000 PO BOX 370 FREEMAN SD 57029 NICHOLAS BRANDNER CEO 6059254000 2019-11-04 1 LAURIE HANSON P00851848 6053391999 2019-11-04 216.147.181.46 2019-11-04 10:40:16 CS P C5ADF3E96DC5FD5E5884512D59AB882B10EDFEC1 2498296C43E1E89153AA0CA2385E379BE62769D4 2018 2020-01-14 16:20:31Z NICHOLAS BRANDNER PO BOX 370 FREEMAN SD 57029 12124827 0 X WWW.FREEMANREGIONAL.COM X 1944 SD PROVIDE ACCESSIBLE, COMMUNITY BASED QUALITY CARE THAT IS COMPETENT, CREATIVE AND COMPASSIONATE. 9 9 208 0 0 0 149298 193893 11293666 11591628 58548 107868 74638 84079 11576150 11977468 0 0 0 0 5949014 6464458 0 0 6076 5498486 5527262 11447500 11991720 128650 -14252 13324845 12974293 2988048 2808876 10336797 10165417 THE MISSION OF FREEMAN REGIONAL HEALTH SERVICES IS TO PROVIDE ACCESSIBLE, COMMUNITY-BASED QUALITY CARE THAT IS COMPETENT, CREATIVE AND COMPASSIONATE. 0 0 10703461 11591628 TO OPERATE ON A NON-PROFIT AND PURELY CHARITABLE BASIS, A HOSPITAL AND NURSING HOME FOR THE CARE AND TREATMENT OF THOSE IN NEED. FRHS IS COMPRISED OF A 56 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= 538, SWING BED DAYS= 861, NURSING HOME RESIDENT DAYS= 17,509. 10703461 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 50 0 1 208 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X X PHIL HUSHER 6059254000 510 EAST 8TH STREET FREEMAN SD 57029 LORI UECKER PRESIDENT 2.00 X X 0 0 0 STEVE FUHRMANN VICE PRESIDENT 2.00 X X 0 0 0 JASON AANENSON TREASURER 2.00 X X 0 0 0 CYNTHIA MUTCHELKNAUS SECRETARY 2.00 X X 0 0 0 CAMERON BECKER TRUSTEE 2.00 X 0 0 0 JAMES JULSON TRUSTEE 2.00 X 0 0 0 DAN CRICK TRUSTEE 2.00 X 0 0 0 GLENN ROTH TRUSTEE 2.00 X 0 0 0 CORY SCHRAG TRUSTEE 2.00 X 0 0 0 NICHOLAS BRANDNER CEO 40.00 X 152938 0 11009 PHILLIP HUSHER CFO 40.00 X 92460 0 12499 ANTHONY MILLER THERAPY MANAGER 40.00 X 116734 0 3449 SARAH FODNESS NURSE PRACTITIONER 40.00 X 108094 0 9686 470226 0 36643 3 0 1 0 AVERA MCKENNAN 800 E 21ST ST SIOUX FALLS SD 57105 E-SERVICES 1460294 AVERA SACRED HEART HOSPITAL 501 SUMMIT SUMMIT ST YANKTON SD 57078 IT SUPPORT 314193 WAPITI MEDICAL GROUP 107 FLYNN DR SUITE 600 MILBANK SD 57252 LOCUMS 206510 CARDINAL HEALTH 7000 CARDINAL PLACE DUBLIN OH 43017 SUPPLIES 205257 MCKESSON PLASMA AND BIOLOGY 16578 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 REFERENCE LAB SERVICE 179771 8 57439 46309 90145 193893 PATIENT SERVICE REVENUE 622110 11300569 11300569 COLLABORATIVE ARRANGEMENT 900099 186014 186014 MEALS ON WHEELS 624210 12276 12276 92769 92769 11591628 103288 103288 221175 136457 84718 84718 84718 4580 0 4580 4580 4580 10263 57439 10902 -639 -639 11977468 11591628 0 191947 X 289827 289827 4955520 4544637 410883 83640 78831 4809 755188 678855 76333 380283 331414 48869 26575 26575 72955 72955 2852652 2712039 140613 36979 24229 8978 3772 407151 332031 73466 1654 163628 163628 24310 22953 1357 15977 11106 4871 31035 28047 2988 454410 420253 34157 66175 62072 4103 MEDICAL SUPPLIES 882700 882700 PROVISION FOR BAD DEBTS 302565 302565 EQUIPMENT RENTAL AND MA 112129 83432 28697 78021 24669 52702 650 11991720 10703461 1282183 6076 3288703 3116136 1942592 1894597 22917 10417 130949 135610 108232 54872 14875822 9488408 5699374 5387414 2053471 1993404 3242 3245 2781 72584 378598 13324845 12974293 844710 887801 5700 2275 420516 381206 3967 2478 641655 525366 1071500 1009750 2988048 2808876 X 10336797 10165417 10336797 10165417 13324845 12974293 -14252 -157128 0 X 0 1 X 1 0 X 0 1 X 299251 299251 8675715 5302965 3372750 4911596 3913633 997963 989260 271810 717450 5387414 APARTMENT DEPOSITS 1009750 1009750 X 11665134 -157128 -302565 -459693 12124827 -147359 -147359 11977468 11836514 147359 147359 11689155 302565 302565 11991720 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 IS ORGANIZED AS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE FACILITY IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE FACILITY IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE FACILITY HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. 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 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -302,565. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES RECLASSIFIED -136,457. DIRECT FUNDRAISING EXPENSES -10,902. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES RECLASSIFIED 136,457. DIRECT FUNDRAISING EXPENSES 10,902. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 302,565. GALA 50972 44174 6798 625 995 4779 1000 GOLF TOURNAMENT 16730 13265 3465 822 1379 441 861 67702 57439 10263 822 2004 1436 5640 1000 10902 -639 1 1 X 1 X 1 X 1 1 1 0 1 1 16000 16000 0.00140 956899 799447 157452 0.01350 972899 799447 173452 0.01490 3596417 2843717 752700 0.06440 3596417 2843717 752700 0.06440 4569316 3643164 926152 0.07930 23311 8878 14433 0.00120 23311 8878 14433 0.00120 0 302565 39242 3364536 3383648 -19112 X 1 1 1 1 FREEMAN REGIONAL HEALTH SERVICES PO BOX 370 FREEMAN SD 57029 WWW.FREEMANREGIONAL.COM 10541 X X X X PROVIDER BASED CLINIC FREEMAN REGIONAL HEALTH SERVICES 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X SEE LINE 7D X X 1 16 1 SEE LINE 7D 0 1 X 150.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE X WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE X WWW.FREEMANREGIONAL.COM/SERVICES/CHARITY-CARE X X X X X X 1 X 0 X X X X 1 X 0 0 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 ERIC AMBROSON, 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/SERVICES/HOSPITAL/COMMUNITY-NEEDS FREEMAN REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 11: PURSUANT TO THE 2016 IMPLEMENTATION STRATEGY ADOPTED BY FRHS, THE FOLLOWING NEEDS WERE ADDRESSED AS OF THE END OF THE YEAR FOR THIS 990:- FREEMAN REGIONAL HEALTH SERVICES CONTINUES TO PROMOTE HEALTH AND WELLNESS THROUGHOUT THE COMMUNITY. THE COMMUNITY HAS A LARGE ELDERLY POPULATION THAT WILL CONTINUE TO GROW. THEREFORE, EDUCATIONAL MEETINGS ON DEMENTIA WERE HELD AND WELL ATTENDED. WEIGHT MANAGEMENT CLASSES WERE OFFERED AND TWENTY PEOPLE WERE IN ATTENDANCE. COMMUNITY CPR/AED EDUCATION/TRAINING CLASSES WERE OFFERED IN CONJUNCTION WITH THE CITY AMBULANCE STAFF. FREEMAN JR. SR. HIGH SCHOOL, FREEMAN ACADEMY, AND MENNO HIGH SCHOOL FACULTY WERE INCLUDED. APPROXIMATELY SEVENTY-FIVE PEOPLE ATTENDED THESE SESSIONS. A TOTAL OF SEVENTY TO EIGHTY KIDS FROM AREA SCHOOLS AND THE HUTTERITE COLONIES ATTENDED OUR EDUCATION SEMINARS RELATED TO HYGIENE, NUTRITION, AND ORAL HEALTH. BABYSITTING CLINICS WERE HELD AT OUR FACILITY ON MAY 29TH AND JUNE 26TH. ON THESE DATES, FRHS HAD APPROXIMATELY FOURTEEN KIDS COMPLETE HANDS ONLY CPR AND FIRST AID TRAINING. THEY WERE ALSO EDUCATED ON CAR SEATS AND SAFE SLEEP, AND WERE PROVIDED NUTRITIONAL SNACKS. FREEMAN REGIONAL HEALTH SERVICES PROVIDED STOP THE BLEED EDUCATION FOR THE FREEMAN REGIONAL EMPLOYEES AND THE PUBLIC. STOP THE BLEED EDUCATION WAS ALSO PROVIDED TO FREEMAN JR. SR. HIGH SCHOOL, FREEMAN ACADEMY, AND BRIDGEWATER HIGH SCHOOL. FREEMAN REGIONAL PROVIDED MANY LUNCH AND LEARNS TO THE PUBLIC. FOR EXAMPLE, IN NOVEMBER WE HAD A FLU EPIDEMIC PRESENTATION WITH THIRTY PEOPLE IN ATTENDANCE. FRHS SUPPORTED THE FREEMAN'S LIONS CLUB WITH A VISION SCREENING AT OCTOBERFEST AT FREEMAN PUBLIC SCHOOL. A TOTAL OF TEN KIDS WERE SCREENED AND TWO KIDS WERE REFERRED. FREEMAN REGIONAL'S RADIOLOGY DIRECTOR WENT TO THREE OF OUR LOCAL COLONIES TO PROMOTE MAMMOGRAMS TO THE HUTTERITE COLONY POPULATION. FRHS BECAME A BREASTFEEDING FRIENDLY FACILITY BY PROVIDING AN AREA FOR MOTHERS TO NURSE. - FRHS CONTINUES TO FOSTER AND PROMOTE COMMUNITY OUTREACH AND VOLUNTEERISM.FRHS ADDRESSES THIS NEED BY GETTING STAFF INVOLVED IN COMMUNITY EVENTS SUCH AS OLD FASHION SATURDAY NIGHT, THE WINTER FAIR, HIGH SCHOOL HOMECOMING PARADES, AND OTHER COMMUNITY PARADES. THE FACILITY'S CHIEF EXECUTIVE OFFICER (CEO) AND OTHER EMPLOYEES ARE MEMBERS OF THE LOCAL LIONS CLUB PROVIDING VOLUNTEER SERVICES TO THE LOCAL COMMUNITY. OUR STAFF VOLUNTEERS FOR THE FEEDING SOUTH DAKOTA PROJECT, WHICH DISTRIBUTES FOOD TO COMMUNITY MEMBERS. CEO AND DIRECTOR OF NURSING (DON) ARE MEMBERS OF THE FREEMAN COMMUNITY DEVELOPMENT CORPORATION WITH THE DON HOLDING THE OFFICE OF EDUCATION CO-CHAIR. FRHS EMPLOYEES ALSO PARTICIPATED IN HEALTHY HOMETOWN BY WELLMARK BLUE CROSS AND BLUE SHIELD. - FRHS WILL POSITION ITSELF TO MEET THE CHANGING NEEDS OF THE SURROUNDING POPULATION.THIS IS BEING DEMONSTRATED BY FRHS'S CONTINUED PLANNING TO UPDATE THE CURRENT FACILITY. FRHS IS CONSIDERING ENLARGING THE LONG-TERM CARE FACILITY'S RESIDENT ROOMS AND BATHROOMS. ALSO, FRHS IS LOOKING TO IMPROVE THE PATIENT FLOW INTO THE FACILITY BY HAVING ONE COMMUNITY/PATIENT ENTRANCE TO THE FACILITY TO IMPROVE THE PATIENT EXPERIENCE AND MANAGE PATIENT/VISITOR FLOW.FRHS CONDUCTED A TABLE TOP ACTIVE SHOOTER DRILL FOLLOWED BY AN EXTENSIVE COMMUNITY-WIDE DRILL IN OCTOBER 2018 EXPANDING UPON THE TABLE TOP EXERCISE COMPLETED IN PREVIOUS YEARS. IN ADDITION TO FRHS STAFF, THE DRILL INCLUDED HOMELAND SECURITY REPRESENTATIVES AS WELL AS THE LOCAL EMS, FIRE DEPARTMENT, LAW ENFORCEMENT, FREEMAN SCHOOL DISTRICTS, AND OTHER COMMUNITY MEMBERS. FREEMAN REGIONAL WAS PART OF A STREET DRUG AWARENESS PROGRAM FOR STUDENTS. THIS PROGRAM WAS PUT ON BY THE SOUTH DAKOTA DIVISION OF CRIMINAL INVESTIGATION.- FRHS WILL WORK TO ENSURE THE CONTINUED AVAILABILITY OF MENTAL HEALTH SERVICES IN THE AREA. THIS AREA OF SERVICE CONTINUES TO BE A CHALLENGE, BUT IS ADDRESSED BY FREEMAN REGIONAL'S SUPPORT OF THE EXISTING MENTAL HEALTH PROVIDERS SUCH AS WELLSPRING AND THE USE OF TELEHEALTH. OTHER OPTIONS CONTINUE TO BE PURSUED. -FRHS RECOGNIZES THE INCREASING DIFFICULTY AND THE NEED FOR WORKFORCE DEVELOPMENT. THIS IS BEING ADDRESSED BY WORKING WITH THE SCHOOLS TO PROMOTE THE HEALTH OCCUPATIONS STUDENTS OF AMERICA (HOSA) PROGRAM AND HOSTING A "SCRUBS CAMP" TO GET HIGH SCHOOL KIDS INTERESTED IN HEALTHCARE CAREERS. FORTY STUDENTS FROM FOUR TO FIVE DIFFERENT SCHOOLS ATTENDED SCRUBS CAMP. THE STUDENTS HAD A WIDE VARIETY OF HEALTHCARE CAREERS TO CONSIDER AS EIGHT DIFFERENT HEALTH SPECIALTIES WERE AVAILABLE AT THE CAMP. CONVERSATIONS ABOUT HOSA WERE INITIATED BY THE FREEMAN COMMUNITY DEVELOPMENT EDUCATION CO-CHAIRS. FRHS MADE PLANS TO IMPLEMENT A HOSA PROGRAM AT FREEMAN JR. SR. HIGH SCHOOL AND FREEMAN ACADEMY IN 2019. FRHS STARTED PLANNING FOR FUTURE CAREER FAIRS. DON JOINED CAREER/TECHNICAL EDUCATION COMMITTEE AT FREEMAN JR. SR. HIGH SCHOOL. 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. 4 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 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. PRESUMPTIVE ELIGIBILITY MAY BE USED 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): BAD DEBT EXPENSE OF $302,565 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: WE SUBSIDIZED THE MEALS ON WHEELS PROGRAM TO PROVIDE AT LEAST ONE GOOD NUTRITIOUS MEAL PER DAY TO SENIORS IN NEED OF THAT SERVICE. PART III, LINE 2: BEFORE AN ACCOUNT IS WRITTEN OFF TO BAD DEBT ALL DISCOUNTS AND PAYMENTS ARE APPLIED, INCLUDING CONTRACTUAL ALLOWANCES. AFTER EVERY ATTEMPT IS MADE TO COLLECT THE UNPAID BALANCE, THE ACCOUNT IS WRITTEN OFF TO BAD DEBT. PAYMENTS ON ACCOUNTS THAT WERE WRITTEN OFF AS BAD DEBT REDUCES BAD DEBT EXPENSE.BAD DEBT EXPENSE IS REPORTED BASED ON CHARGES FOR THE YEAR ENDING 12/31/18 AS STATED IN THE AUDITED FINANCIAL STATEMENT. PART III, LINE 3: THE ESTIMATE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN 2018. 12.97% CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE.HTTP://WORLDPOPULATIONREVIEW.COM/US-COUNTIES/SD/HUTCHINSON-COUNTY-POPULATION/#POVERTY PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS ON PAGE 5 NOTE 1 - ORGANIZATION AND SIGNIFICANT ACCOUNTING POLICIES UNDER PATIENT AND RESIDENT RECEIVABLES FROM THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COSTS OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2018. 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 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 2016. 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 (2010 CENSUS) 7,343 5,618 8,347HOUSEHOLDS 3,351 2,491 3,939AVERAGE HOUSEHOLD SIZE (PEOPLE) 2.33 2.48 2.40MEDIAN HOUSEHOLD INCOME $42,386 $46,964 $50,143MEDIAN AGE 46.8 42.7 43.7% OF POPULATION UNDER 18 24% 26% 24%% OF POPULATION 19-64 51% 55% 57%% OF POPULATION 65+ 25% 19% 19%% OF POPULATION BELOW POVERTY INCOME LEVEL 11.8% 7.1% 7.3%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 56 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 X X 0 0 0 0 0 0 0 0 0 NICHOLAS BRANDNER CEO 152938 0 0 0 0 0 4717 0 6292 0 163947 0 0 0 A CITY OF FREEMAN 466000164 2006-09-29 750000 TO HELP FINANCE CONGREGATE LIVING UNITS. 0 0 0 A 368794 750000 750000 2006 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 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 4,460. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,460. PURCHASE OTHER CLINIC: PROGRAM SERVICE EXPENSES 1,262,556. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,262,556. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 561,798. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 561,798. PURCHASE COURIER: PROGRAM SERVICE EXPENSES 15,705. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,705. CONSULTING FEES: PROGRAM SERVICE EXPENSES 2,596. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,596. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 707,378. MANAGEMENT AND GENERAL EXPENSES 2,776. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 710,154. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 84,422. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,422. ULTRASOUND AND MRI CONTRACTS: PROGRAM SERVICE EXPENSES 73,124. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,124. PT FINANCIAL SVC COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 38,757. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,757. ADMINISTRATION CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 99,080. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,080.