2018-05-15T09:01:32-05:00 2017-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2016-07-01 460319070 Rapid City Regional Hospital Inc RAPI 6057559130 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 Mark Thompson CFO 6057559130 2018-05-10 1 Kim Hunwardsen CPA P00484560 6122536500 2018-05-10 2016 2022-09-23 18:48:47Z Brent Phillips 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 691776957 0 X www.regionalhealth.com X 1973 SD Helping Patients and Communities Live Well 11 6 4809 345 6390045 983160 2503829 5580515 594165731 648592391 16754640 33161670 5211301 325810 618635501 687660386 0 0 0 0 252267378 274104003 0 0 889571 321433762 373459215 573701140 647563218 44934361 40097168 924629930 963416356 294479856 271456316 630150074 691960040 X PURPOSE: Helping Patients and Communities Live WellVISION: We aspire to be the best healthcare system in AmericaVALUES: Compassion, Innovation, Courage, Mutual Respect and IntegrityPRIORITIES: Patient & Family EXPERIENCE; Culture of Safety & Quality CARE; Physician & Caregiver EMPOWERMENT; Financial & Community STEWARDSHIP 0 0 446013654 642378788 Rapid City Regional Hospital, Inc. (RCRH) is a tertiary hospital serving Western South Dakota. The nearest larger hospital is in Sioux Falls, SD, more than 350 miles away. As such, the services provided by RCRH are truly a healthcare safety net for Western South Dakota. The Hospital provides comprehensive care, including Level II Trauma Care. 446013654 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 0 1 497 0 1 4809 1 1 1 0 0 0 0 1 1 0 0 0 0 X 11 6 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 NC CA X X Mark Thompson 6057559127 PO Box 6000 Rapid City SD 57701 Jack Lynass Chairman 1.15 0.00 X X 0 0 0 Lisa Seaman Vice Chairman 1.53 0.00 X X 0 0 0 Diedre Budahl Director 1.40 0.00 X 0 0 0 Sandra Burns Director 0.71 0.00 X 0 0 0 Bruce Eaton MD Director 1.25 40.00 X 0 539779 60264 Timothy Frost MD Director 0.74 0.00 X 0 0 0 Lia Green Director 2.84 0.02 X 0 0 0 Robert Mudge Director 0.82 0.00 X 0 0 0 Dennis Popp Director 1.28 0.00 X 0 0 0 Tamara Riddle-Schumacher Director 1.18 0.00 X 0 0 0 Brent Phillips President & CEO 47.17 12.83 X X 1002798 0 180200 Mark A Thompson CFO/Treasurer 43.24 11.76 X 486982 0 89668 Mary E Masten General Counsel/Secretary 43.24 11.76 X 382350 0 81638 Paul W Clemments VP Professional Services 55.00 0.00 X 223307 0 54205 Paulette R Davidson Chief Operating Officer 43.24 11.76 X 487508 0 91910 Michael Gibbs President Rapid City Marke 55.00 0.00 X 529919 0 28282 Maureen G Henson VP Human Resources 43.24 11.76 X 317431 0 43944 Michael E Latour VP Rapid City Market 55.00 0.00 X 200867 0 48509 Richard S Latuchie VP Info Technology CIO 43.24 11.76 X 403618 0 25252 John Pierce VP Rapid City Market 55.00 0.00 X 294997 0 64394 Laura C Wightman Chief Nursing Officer 43.24 11.80 X 280207 0 52803 Thomas S Worsley VP Rapid City Market 55.00 0.00 X 288249 0 56264 John Karl Heilman III MD Physician - Cardiology 40.00 0.00 X 729260 0 25644 Drew A Purdy MD Physician - Cardiology 40.00 0.00 X 833637 0 30098 Bhaskar Purushottam MD Physician - Cardiology 40.00 0.00 X 856933 0 72521 Joseph Tuma MD Physician - Cardiology 40.00 0.00 X 917674 0 85634 Michael O Robinson MD Physician - Oncology 40.00 0.00 X 737925 0 23117 Timothy Sughrue Former CEO RCRH & RHN; COO 0.00 0.00 X 151539 0 0 9125201 539779 1114347 257 1 1 0 MEDEFIS 10826 Old Mill Rd 101 Omaha NE 68105 Temporary Medical Staff Coverage 16367137 Healthsource Partners LLC 2134 Industrial Dr Suite B BOZEMAN MT 59715 Temporary Medical Staff Coverage 6536985 Comphealth Medical Staffing PO Box 972651 Dallas TX 753972651 Temporary Medical Staff Coverage 4021962 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Temporary Medical Staff Coverage 3487982 Athena Health 311 Arsenal St WATERTOWN MA 02472 Computer Software-Practice Management Bi 2462579 111 195722 5320 81503 5297970 5580515 In Patient Pharmacy 446110 152247286 152247286 Surgical Services 622110 119872063 119872063 Laboratory 621500 111346259 111346259 Cardiac Services 622110 80766342 80766342 MIS CT Scan 621500 61454882 61454882 122905559 116585910 6319649 648592391 9727579 9727579 27847 27847 577744 424970 152774 152774 152774 23624325 3115720 0 3333801 23624325 -218081 23406244 23406244 159783 195722 163189 -3406 -3406 300657 194611 106046 106046 UBI from Partnerships 900099 70396 70396 70396 687660386 642378788 6390045 33311038 X 3824361 3824361 308585 308585 242497265 187027821 54925662 543782 4777047 3628569 1137945 10533 6653131 5053613 1584849 14669 16043614 11557262 4458000 28352 593552 593552 226676 226676 80612 80612 66062156 44965542 21004782 91832 766890 21384 705063 40443 1765589 836703 904381 24505 14777129 2689866 12062833 24430 8228943 815238 7412964 741 825878 468587 352903 4388 1620454 924064 691599 4791 3217900 5311 3212589 27224538 10948167 16269089 7282 1666378 1509832 156546 Medical Supplies 115985083 115985083 Interco. Serv. & Suppl. 71058735 12444393 58614342 Bad Debt Expense 36141163 36141163 All other expenses 23217539 10682471 12441245 93823 647563218 446013654 200659993 889571 26148140 6955120 3928821 2729674 78213679 75237627 14101774 17071266 10771464 8568982 428977674 170014181 196318942 258963493 532129654 521106376 57268789 60346239 3580906 3580906 2167761 8856673 924629930 963416356 52261730 50762441 141481645 132708107 100736481 87985768 294479856 271456316 X 614095839 670667836 14391306 19629275 1662929 1662929 630150074 691960040 924629930 963416356 X 40097168 16426772 5286026 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 80612 80612 0 Part II-B, Line 1: Schedule C, Part II-B, Line 1i: Annual dues are paid to the South Dakota Association of Healthcare Organizations. A portion of the dues are applicable to lobbying activities. For calendar year 2017 dues, which were paid in fiscal year 2017, in the amount of $326,540, 6.42% was used for lobbying purposes. Annual dues were paid to the American Hospital Association, a portion of which is applicable to lobbying activities. For calendar year 2017 dues, which were paid in fiscal year 2017, in the amount of $61,947, 21.78% was used for lobbying purposes. Annual dues were paid to the American Medical Rehab Providers Association, a portion of which is applicable to lobbying activities. For calendar year 2017 dues, which were paid in fiscal year 2017, in the amount of $10,604, 39.00% was used for lobbying purposes. In fiscal year 2017, $27,021 of employee salary expense and $15,000 of consulting expense were incurred in regard to lobbying. 1662929 1662929 1662929 1662929 1662929 1662929 1662929 1662929 1747979 10000 95050 1662929 1.00000 0 0 8346017 8346017 203009879 88564203 114445676 8143294 2604814 5538480 130846559 78845164 52001395 78631925 78631925 258963493 Mortgage-Backed Securities 460183 F Investment in Western Dakota Health Care/RHN 43000231 F Investment in Privately Held Companies 16885825 F 60346239 Payable Under Interest Rate Swap 7868275 Other Long Term Liabilities 18770404 Accrued Pension Liability 25535057 Intercompany Payable 35812032 87985768 X Part V, Line 4: Endowed funds are held in an interest bearing account subject to the terms as specified by the donor and Board of Directors. The earnings on the endowment funds become temporariliy restricted funds and therefore are not part of the endowment balance. Of the $1,662,929 endowment funds, $692,332 are restricted to be used for grants/scholarships to students in a healthcare program, $512,197 is restricted for use in the pediatrics unit, $100,000 for promotion of a healthy community, $197,400 for cardiac services, $100,000 for hospice patients, $36,000 for plants in public areas and $25,000 for cancer care. Part X, Line 2: References to "Regional Health" apply to all entities controlled or leased by Regional Health, Inc. and its subsidiaries. This includes the reporting entity. Regional Health is organized as a nonprofit corporation as described in Section 501(c)(3) of the Internal Revenue Code, and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Certain consolidated subsidiaries, including Regional Health Home Plus are not tax-exempt entities and are considered disregarded entities for tax purposes. Regional Health is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, Regional Health is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose (Form 990T). Regional Health believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. Regional Health would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Regional Health's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2013. Duck Race 107168 92812 14356 58251 Tough Enough to Wear Pink 102910 102910 48326 5 145427 145427 56612 355505 195722 159783 163189 163189 -3406 1 1 X 1 X 1 X 1 1 0 0 13612669 13612669 0.02230 58368948 39552226 18816722 0.03080 71981617 39552226 32429391 0.05310 10 932 4415548 5954 4409594 0.00720 1 103 6232874 3745958 2486916 0.00410 23259925 16413035 6846890 0.01120 1834654 1138582 696072 0.00110 3 60 369724 369724 0.00060 14 1095 36112725 21303529 14809196 0.02420 14 1095 108094342 60855755 47238587 0.07730 1 823 823 0.00000 1 4858 4858 0.00000 2 76 16273 16273 0.00000 1 116 116 0.00000 2 162 18697 18697 0.00000 7 238 40767 40767 0.00000 1 36141163 2279044 171169155 181024395 -9855240 X 1 1 1 Black Hills Medical Office BD LLC Office Building 0.67930 0.32070 2 Medical & Dental Building Office Building 0.71450 0.28550 3 The Imaging Center LLC Medical Imaging 0.50000 0.50000 5 Same Day Surgery Center Specialty and Ambulatory Srvcs 0.40000 0.60000 6 Western Providers Inc PHO 0.50000 0.50000 2 1 Rapid City Regional Hospital 353 Fairmont Blvd Rapid City SD 57701 www.regionalhealth.com 10558 X X X X 8 Provider-based clinics; 1 behavioral health facility 2 Same Day Surgery Center 651 Cathedral Drive Rapid City SD 57701 www.samedaysurgerycenter.org 10581 X Rapid City Regional Hospital Inc 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X See Section C, Line 7d X 1 15 1 See Section C, Line 7d 0 1 X 200.000000000000 250.000000000000 X X X 1 1 X X X X 1 X See Section C, Line 16a-c X See Section C, Line 16a-c X See Section C, Line 16a-c X X X X X X 1 X 0 X X X X 1 X 0 1 Same Day Surgery Center 2 0 0 1 X X X X X X X X X 15 1 1 0 1 X See Line 10a X http://www.regionalhealth.com/about-us/community-needs-assessment X 1 15 1 http://www.samedaysurgerycenter.org/community-health-needs-assessment/ 0 1 X 200.000000000000 250.000000000000 X X X 1 1 X X X X 1 X See Section C, Line 16a-c X See Section C, Line 16a-c X See Section C, Line 16a-c X X X X X 1 X 0 X X X X 0 X X 0 1 Rapid City Regional Hospital, Inc. Part V, Section B, Line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. A total of 294 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Regional Health service area. Same Day Surgery Center Part V, Section B, Line 5: As part of the community health needs assessment, an online key informant survey was conducted that solicited input from individuals who have a broad interest in the health of the community. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. A total of 294 community stakeholders comprised of physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders completed the key informant survey for the Regional Health service area. Rapid City Regional Hospital, Inc. Part V, Section B, Line 6a: The Community Health Needs Assessment was undertaken by Regional Health, including: Rapid City Regional Hospital, Same Day Surgery Center, Spearfish Regional Hospital, Sturgis Regional Hospital, Lead-Deadwood Regional Hospital, and Custer Regional Hospital. Under a management contract with Regional Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Same Day Surgery Center Part V, Section B, Line 6a: The Community Health Needs Assessment was undertaken by Regional Health, including: Rapid City Regional Hospital, Same Day Surgery Center, Spearfish Regional Hospital, Sturgis Regional Hospital, Lead-Deadwood Regional Hospital, and Custer Regional Hospital. Under a management contract with Regional Health, Hans P. Peterson Memorial Hospital in Philip, SD, also collaborated on the project. Hans P. Peterson Memorial Hospital provided funding for their portion of the assessment. Rapid City Regional Hospital, Inc. Part V, Section B, Line 7d: http://www.regionalhealth.com/about-us/community-needs-assessment Rapid City Regional Hospital, Inc. Part V, Section B, Line 11: In review of the needs identified in the 2015 CHNA, Rapid City Regional Hospital has identified the areas below that will not be addressed due to prioritization of health needs:1) Cancer: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. Awareness activities through the American Cancer Society also currently exist in the community and surrounding area. 2) Dementia, Including Alzheimer's Disease: This issue will not be addressed as a primary need, but will be impacted through the mental health priority. In addition, there are local licensed skilled nursing facilities providing services to the elderly of the community. 3) Diabetes: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.4) Heart Disease & Stroke: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.5) Infant health and Family Planning: Data from the CHNA revealed that infant mortality and teen births were of greatest concern in this area in the community. However, limited resources excluded this as an area chosen for action. 6) Injury & violence: RCRH has partnered with Kohl's Cares, Safe & Sound South Dakota, Farm Bureau of South Dakota, and Community Organized Resources in Educating Youth in order to address this area of opportunity. With these partnerships, Rapid City Regional Hospital determined that progress is being made in this area and that other areas of opportunity required more immediate and focused attention. 7) Oral Health: RCRH has limited resources, services and expertise available to address oral health and access to oral health insurance. Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action.8) Respiratory Diseases: RCRH believes this priority area falls more within the purview of other community resources, including outpatient clinical settings.9) Sexually Transmitted Diseases: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. 10) Substance Abuse: This issue will not be addressed as a primary need, but will be impacted through the mental health priority.11) Tobacco Use: Rapid City Regional Hospital is a tobacco-free facility. The facility provides smoking cessation screening to patients and provides reference to the South Dakota Quit Line as applicable. Limited resources and lower priority excluded this as an area chosen for action.During FY17, Regional Health focused on the following three priority areas identified through the most recent CHNA: Access to Healthcare Services, Mental Health, and Wellness (Physical Activity, Nutrition, and Weight). A workgroup for each priority was formed comprised of representatives from Rapid City Regional Hospital, Same Day Surgery Center, Regional Health Network, and the community. Workgroups met on a monthly basis to work on the strategies outlined in the Community Health Improvement Plan (CHIP) for the selected priority area. Oversight for the workgroups was provided by a Community Health Steering Team which includes leadership representing Rapid City Regional Hospital, Same Day Surgery Center, and Regional Health Network. In FY17, the Access to Healthcare Services workgroup focused on strategies to support access to primary and preventive care for vulnerable populations. This included increasing support for the All Women Count SD program which provides free breast and cervical cancer screenings for low income women. The team worked to identify methods of identifying and reaching out to patients that would qualify for the program. The other three objectives identified on the Access portion of the CHIP were addressed through the work of strategic objective teams formed at a system level.These include the following:Improve Patient Access for Primary Care, Specialists, and Diagnostic ProceduresDevelop and implement a community-based population health programInvestigate, Plan, Build and Launch First Phase of a Digital Health StrategyThe goal of the Mental Health priority is to increase access and awareness of culturally appropriate mental health resources and education using the following three objectives:Reduce stigma of mental health and increase public and provider awareness of mental health resources available in their community.Improve mental health screening process across the Black Hills region (starting with Regional Health system)Explore adding mental health access into primary care clinicsIn FY17, the Mental Health workgroup worked on the following strategies to meet these objectives: Review and create process for updating 211 Helpline's Behavioral Health Guide to ensure accuracy of the list of mental health resources in the service area Standardize mental health screening tool - review current mental health screening tools used across the Regional Health system and provide recommendations to the Epic implementation team on which tool to include in the new electronic health record going live in October 2017Develop publicity campaign in partnership with community to reduce stigma of mental health - exploring collaboration with statewide youth suicide grantThe goal of the Wellness priority is to explore, develop, and support opportunities that will positively impact the health of our community in the areas of physical activity, nutrition, and weight management. There are two objectives under this priority area: Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices Enhance access to organized well-being programs and activities in the community In FY17, the Wellness workgroup worked on the following strategies to meet these objectives: Enhance access to the Regional Health Diabetes Prevention Program - developed and sent surveys to current DPP participants to help identify future locations and times of classes and need for additional trainersDevelop pediatric diabetes prevention program - grant development for CATCH (Coordinated Approach to Child Health) Program to be piloted in Spearfish and Rapid City communitiesEnhance access to the Better Choices Better Health (BCBH) Program - Regional Health's Community Health Specialist served on BCBH steering team and the Senior Director for Community Case Management from Rapid City Regional Hospital selected as a fellow for the programLive Well Black Hills resource support - 3 members of workgroup serving on Live Well Black Hills. Same Day Surgery Center Part V, Section B, Line 11: In review of the needs identified in the 2015 CHNA, Same Day Surgery Center has identified the areas below that will not be addressed due to prioritization of health needs:1) Cancer: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. Awareness activities through the American Cancer Society also currently exist in the community and surrounding area. 2) Dementia, Including Alzheimer's Disease: This issue will not be addressed as a primary need, but will be impacted through the mental health priority. In addition, there are local licensed skilled nursing facilities providing services to the elderly of the community. 3) Diabetes: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.4) Heart Disease & Stroke: This issue will not be addressed as a primary need, but will be impacted through the Nutrition, Physical Activity and Weight priority.5) Infant health and Family Planning: Data from the CHNA revealed that infant mortality and teen births were of greatest concern in this area in the community. However, limited resources and lower priority excluded this as an area chosen for action. 6) Injury & violence: Limited resources and lower priority excluded this as an area chosen for action. 7) Oral Health: SDSC has limited resources, services and expertise available to address oral health and access to oral health insurance. Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action.8) Respiratory Diseases: SDSC believes this priority area falls more within the purview of other community resources, including outpatient clinical settings.9) Sexually Transmitted Diseases: This issue will not be addressed as a primary need, but will be impacted through the access to healthcare services priority. 10) Substance Abuse: This issue will not be addressed as a primary need, but will be impacted through the mental health priority.11) Tobacco Use: SDSC is a tobacco-free facility. The facility provides smoking cessation screening to patients and provides reference to the South Dakota Quit Line as applicable. Limited resources and lower priority excluded this as an area chosen for action.During FY17, Same Day Surgery Center focused on the following three priority areas identified through the most recent CHNA: Access to Healthcare Services, Mental Health, and Wellness (Physical Activity, Nutrition, and Weight). A workgroup for each priority was formed comprised of representatives from Same Day Surgery Center, Rapid City Regional Hospital, Regional Health Network, and the community. Workgroups met on a monthly basis to work on the strategies outlined in the Community Health Improvement Plan (CHIP) for the selected priority area. Oversight for the workgroups was provided by a Community Health Steering Team which includes leadership representing Same Day Surgery Center, Rapid City Regional Hospital, and Regional Health Network. In FY17, the Access to Healthcare Services workgroup focused on strategies to support access to primary and preventive care for vulnerable populations. This included increasing support for the All Women Count SD program which provides free breast and cervical cancer screenings for low income women. The team worked to identify methods of identifying and reaching out to patients that would qualify for the program. The other three objectives identified on the Access portion of the CHIP were addressed through the work of strategic objective teams formed at a system level. These include the following:Improve Patient Access for Primary Care, Specialists, and Diagnostic Procedures.Develop and implement a community-based population health program.Investigate, Plan, Build and Launch First Phase of a Digital Health Strategy.The goal of the Mental Health priority is to increase access and awareness of culturally appropriate mental health resources and education using the following three objectives:Reduce stigma of mental health and increase public and provider awareness of mental health resources available in their community.Improve mental health screening process across the Black Hills region (starting with Regional Health system).Explore adding mental health access into primary care clinicsIn FY17, the Mental Health workgroup worked on the following strategies to meet these objectives: Review and create process for updating 211 Helpline's Behavioral Health Guide to ensure accuracy of the list of mental health resources in the service area. Standardize mental health screening tool - review current mental health screening tools used across the Regional Health system and provide recommendations to the Epic implementation team on which tool to include in the new electronic health record going live in October 2017.Develop publicity campaign in partnership with community to reduce stigma of mental health - exploring collaboration with statewide youth suicide grant.The goal of the Wellness priority is to explore, develop, and support opportunities that will positively impact the health of our community in the areas of physical activity, nutrition, and weight management. There are two objectives under this priority area: Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices. Enhance access to organized well-being programs and activities in the community.In FY17, the Wellness workgroup worked on the following strategies to meet these objectives: Enhance access to the Regional Health Diabetes Prevention Program - developed and sent surveys to current DPP participants to help identify future locations and times of classes and need for additional trainers.Develop pediatric diabetes prevention program - grant development for CATCH (Coordinated Approach to Child Health) Program to be piloted in Spearfish and Rapid City communities.Enhance access to the Better Choices Better Health (BCBH) Program - Regional Health's Community Health Specialist served on BCBH steering team and the Senior Director for Community Case Management from Rapid City Regional Hospital selected as a fellow for the program.Live Well Black Hills resource support - 3 members of workgroup serving on Live Well Black Hills. Rapid City Regional Hospital, Inc. Part V, Section B, Line 16j: A summary of the hospital's financial assistance policy is posted for all patients at various points of entry, on the facility website, in waiting rooms, and in the admissions office. The policy in its entirety is also available upon request.The FAP application form was translated into the primary language spoken by LEP populations. This is posted on the website listed for line 16a. Same Day Surgery Center Part V, Section B, Line 16j: The FAP application and plain language summary were translated into the primary language spoken by LEP populations. These documents are posted on the website listed for line 16a. Rapid City Regional Hospital, Inc. Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for medically necessary care. The financial assistance policy does not apply to certain elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on certain elective procedures. Same Day Surgery Center Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for medically necessary care. The financial assistance policy does not apply to certain elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. Part V, Lines 16a-c Rapid City Regional Health The Financial Assistance Policy, Application form, and plain language summary are available at http://www.regionalhealth.com/patients-and-families Part V, Lines 16a-c Same Day Surgery Center The Financial Assistance Policy, Application form, and plain language summary are available at http://www.samedaysurgerycenter.org/financial-assistance 6 1 - Rapid City Regional Hospice House 224 Elk St Rapid Ctiy SD 57701 End of Life Care 2 - Regional Dialysis Center - Spearfish 132 Yankee St Spearfish SD 57783 Dialysis Center 3 - Wall Regional Medical Clinic 112 7th Ave Wall SD 57790 Clinic 4 - Pine Ridge Regional Medical Clinic East Highway 18 Pine Ridge SD 57702 Clinic 5 - Regional Health Dermatology 717 Meade Street 100 Rapid Ctiy SD 57701 Clinic 6 - Regional Health Home Hospice - Spearfis 1440 North Main Street Spearfish SD 57783 End of Life Care Part I, Line 3c: References to "Regional Health" apply to all entities controlled or leased by Regional Health, Inc. and its subsidiaries. This includes the reporting entity.Part I, Line 3c: Financial assistance debt reduction write-offs for free or discounted care are based on an income matrix utilizing the current Federal Poverty Level (FPL) income guidelines after satisfying applicable co-pay requirements. The income matrix may be updated annually as the FPL guidelines are released. Part I, Line 7: Ratio of patient care cost to charges is used for the calculation of cost of services provided for lines 7a, 7b, and 7g. Actual costs are used for the calculation of costs of services provided for lines 7e, 7f, 7h, and 7i. Part I, Ln 7 Col(f): The bad debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column, is $ 36,141,163. Part II, Community Building Activities: Regional Health collaborates with agencies and community-wide coalitions to address prioritized health needs within the communities we serve. Regional Health addresses its community's health needs by: 1) sustaining efforts operating within a targeted health priority area; 2) developing new programs and initiatives to address identified health needs: and 3) promoting an understanding of these health needs among other community organizations and within the public itself. Regional Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Regional Health provides in-kind support and employee volunteers to help support community health events and activities. Part III, Line 2: The bad debt reported on line 2 is at charges as reported on the financial statements. Part III, Line 3: The estimated amount of bad debt attributable to patients eligible under the financial assistance policy is determined through a review of the bad debt records to identify patient accounts that would be eligible for a discount under the financial assistance policy. The organization follows HFMA Statement 15, however the amount reported on Part III, Line 3 reflects amounts not previously determined to be charity care in prior years, however were determined in the current year to be charity care amounts. Part III, Line 4: The footnote to the Organization's financial statements can be found on page nine and ten of the attached audited financial statements. Part III, Line 8: The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. Part III, Line 9b: The collection policy requires invoking of the financial assistance policy at any time a patient expresses financial difficulty in meeting their debt obligation. Upon invoking the FAP, all collection activity is suspended. If the patient is approved for charity, then the account is closed out of the collection process and classified as charity. If a patient expresses financial concern but fails to complete the application process, additional notification is sent to the patient prior to re-instituting collection activity. We are following the 501(r) Final Regulations timelines for notifications and collections. Part V, Line 16i Financial Assistance Policy Description of failureType of failure: 501(r)(4) - The hospital is required to translate the financial assistance policy, plain language summary and financial assistance policy application into Spanish as more than the lesser of 1,000 individuals or 5% of the community served by the hospital speaks Spanish as a primary language. The hospital did not translate the financial assistance policy or plain language summary into Spanish. Cause of the failure: The hospital facility did not realize the FAP and plain language summary were required to be translated in addition to the application. The facility uses an interpreter telephone service that allows for interpretation in 170 languages, including Spanish. This service can be used by limited English proficiency (LEP) patients for questions related to the financial assistance policy.Facility or facilities where the failure occurred: The failure occurred in all facilities operated under Regional Health. However, it is possible that the service area of some of the individual facilities may not be subject to the translation requirements based on specific populations.The date(s) of the failure and its discovery: February 2, 2018 The number of occurrences: UnknownDescription of the correction of the failureMethod of correction: The financial assistance policy and plain language summary were translated into Spanish. The documents were made available at each facility and on the website.Date of correction: March 26, 2018Description of the practices or procedures put into placeThe financial assistance policy and plain language summary were translated into Spanish and posted on the website at https://www.regionalhealth.com/patients-and-families. The translated documents are also available at each facility. In addition, Regional Health continues to provide translation services to assist LEP patients with questions they may have regarding financial assistance. Part VI, Line 2: Providing patient and family centered care is essential for advancing the patient experience here at Regional Health. Currently, HealthStream, a third party CMS approved survey vendor, has partnered with Regional Health to conduct and analyze survey data from our Inpatient, Emergency Department, Urgent Care, Physician Clinics, Outpatient ancillary services, outpatient ambulatory surgical services, and Dialysis services. Recently, HealthStream has been acquired by Press Ganey so we will still conduct Patient Experience surveys with the same intention but on different survey platform. Regional Health currently meets all CAHPS requirements and adequately prepares for future regulatory programs related to patient experience metrics. Through our several patient experience surveys types, we focus on the patient perception of communication, coordination and compassion. Meeting with executives frequently to discuss current data, areas of opportunity and highlighting achievements. Physicians are held accountable for their individual performance as measured by patient experience surveys and are evaluated, supported, and coached on best practices by members of the Regional Health patient experience team. In our current process, HealthStream collects patient experience survey feedback through mail, phone and electronic survey options after discharge/or after visit. Part VI, Line 3: Financial Assistance Program brochures explaining the policy, a copy of the policy and Financial Assistance applications are available at each point of entry. Signs alerting patients to the availability of Financial Assistance are prominently displayed and a plain language summary describing the Financial Assistance program accompanies one billing statement for hospital services sent to the patient. The Financial Assistance policy, plain language summary and Financial Assistance application are provided free upon request and are also available on the hospital website at www.regionalhealth.com. Regional Health contracts with Midland Medical Group (an unrelated entity) to meet with uninsured patients to assist them with finding a funding source or applying for financial assistance; and our self-pay outsource partner also communicates any funding and financial assistance opportunities with our patients. Part VI, Line 4: Regional Health and its affiliates provide health care services to the 380,000 people who live in the Black Hills of South Dakota and the surrounding region, as well as thousands of visitors each year. Regional Health serves a 38-county region comprised of western South Dakota, southeastern Montana, northeastern Wyoming, southwestern North Dakota and northwestern Nebraska. Part VI, Line 5: Regional Health collaborates with agencies and community-wide coalitions to address prioritized health needs within the communities we serve. Regional Health addresses its community's health needs by: 1) sustaining efforts operating within a targeted health priority area; 2) developing new programs and initiatives to address identified health needs: and 3) promoting an understanding of these health needs among other community organizations and within the public itself. Regional Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Regional Health provides in-kind support and employee volunteers to help support community health events and activities. Part VI, Line 6: Regional Health is committed to partnering with the communities it serves to meet the needs of each respective community. Regional Health, Inc. is the parent organization of Rapid City Regional Hospital, Inc., Regional Health Network, Inc., and Regional Health Physicians, Inc. These corporations work together to meet the health care needs of the region. X 1 1 1 1 0 0 0 0 0 1 0 Bruce Eaton MD Director 0 497646 0 0 0 42133 0 35120 0 25144 0 600043 0 42133 Brent Phillips President & CEO 775117 0 222181 0 5500 0 161691 0 18509 0 1182998 0 0 0 Mark A Thompson CFO/Treasurer 407154 0 74136 0 5692 0 76949 0 12719 0 576650 0 5692 0 Mary E Masten General Counsel/Secretary 322717 0 59633 0 0 0 69302 0 12336 0 463988 0 0 0 Paul W Clemments VP Professional Services 200284 0 23023 0 0 0 31336 0 22869 0 277512 0 0 0 Paulette R Davidson Chief Operating Officer 406326 0 66221 0 14961 0 69824 0 22086 0 579418 0 0 0 Michael Gibbs President Rapid City Marke 297244 0 53963 0 178712 0 12388 0 15894 0 558201 0 48327 0 Maureen G Henson VP Human Resources 268475 0 48956 0 0 0 45908 0 -1965 0 361374 0 0 0 Michael E Latour VP Rapid City Market 179890 0 20977 0 0 0 32464 0 16045 0 249376 0 0 0 Richard S Latuchie VP Info Technology CIO 347006 0 56612 0 0 0 15017 0 10235 0 428870 0 0 0 John Pierce VP Rapid City Market 251445 0 29814 0 13738 0 39473 0 24921 0 359391 0 13738 0 Laura C Wightman Chief Nursing Officer 255718 0 24489 0 0 0 33950 0 18852 0 333009 0 0 0 Thomas S Worsley VP Rapid City Market 238027 0 50222 0 0 0 32151 0 24114 0 344514 0 0 0 John Karl Heilman III MD Physician - Cardiology 684499 0 44761 0 0 0 9447 0 16197 0 754904 0 0 0 Drew A Purdy MD Physician - Cardiology 614973 0 44761 0 173903 0 9447 0 20651 0 863735 0 172326 0 Bhaskar Purushottam MD Physician - Cardiology 812172 0 44761 0 0 0 46450 0 26071 0 929454 0 0 0 Joseph Tuma MD Physician - Cardiology 828761 0 47807 0 41106 0 53297 0 36939 0 1007910 0 41106 0 Michael O Robinson MD Physician - Oncology 729425 0 8500 0 0 0 9184 0 13933 0 761042 0 0 0 Timothy Sughrue Former CEO RCRH & RHN; COO 0 0 0 0 151539 0 0 0 0 0 151539 0 0 0 Part I, Line 3 The Executive Committee, which is a committee of the Regional Health (parent) Board, reviews and approves base salary and total compensation ranges for all executives within the Regional Health System. Part I, Lines 4a-b Severance payments were made to the following individuals: Timothy Sughrue 151,539 Michael E. Gibbs 115,386 Regional Health provides a supplemental nonqualified retirement plan and a flexible benefit plan that can include deferred compensation for its executives. The following individuals had amounts deferred into the account as reported in column c on Schedule J: Brent Phillips 153,500 Paulette R. Davidson 61,874 Maureen G. Henson 37,575 Mary E. Masten 44,401 Mark A. Thompson 57,787 Laura C. Wightman 26,000 Paul W. Clemments 20,200 Michael E. Latour 18,382 John Y. Pierce 25,898 Thomas S. Worsley 24,201 Bhaskar Purushottam, MD 38,500 Joseph L. Tuma, MD 43,850 Bruce Eaton, MD 25,673 The following individuals had supplemental non-qualified retirement plan amounts included in schedule J, column B(iii) that were previously reported as deferred compensation on Form 990. These amounts are identified in Schedule J, column f. Bruce Eaton, MD 42,133 Mark A. Thompson 5,692 Michael Gibbs 48,327 John Y. Pierce 13,738 Drew A. Purdy, MD 172,326 Joseph L. Tuma, MD 41,106 Part I, Line 7 Executives and Other Employees of System Entities will be eligible to receive annual incentive awards that are competitive with the incentives offered by the organizations in the System's Peer group(s) in accordance with the terms of the Regional Health, Inc. Annual Incentive Plan for Selected Executives and Other Employees (Incentive Plan). In accordance with this plan, the parent Board's Executive Committee will review and approve all incentive compensation performance measures and all awards, if any. A SD Health & Educational Facilities Authority 460315509 83755VQJ6 2010-08-17 54390000 Hospital Buildings & Equipment & Refund Series 1998 & 1999 Bonds 0 0 0 B SD Health & Educational Facilities Authority 460315509 83755VSW5 2011-11-22 50460000 Hospital Buildings & Equipment & Refund Series 2001 Bonds 0 0 0 C SD Health & Educational Facilities Authority 460315509 2015-01-27 67210000 Refund series 2008 bonds issued 8/14/08 0 0 0 A 23758083 57312811 785667 24925832 31601312 2013 1 0 1 1 B 18960500 54610462 709782 30161279 23739401 2013 1 0 1 1 C 6465000 67210000 250000 66960000 2015 1 0 1 1 A 0 1 1 0 1 0 0.00650 0.00060 0.00710 0 0 1 B 0 1 1 0 1 0 0.00060 0.00750 0.00810 0 0 1 C 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 0 1 1 US Bank NA 10.200000000000 0 0 0 0 1 A 1 B 1 C 1 Date Rebate Computation Performed Issuer Name: SD Health & Educational Facilities Authority Date the Rebate Computation was Performed: 10/22/2013 Issuer Name: SD Health & Educational Facilities Authority Date the Rebate Computation was Performed: 12/19/2013 Schedule K, Part II, Line 3, Bond A Part I issue price and Part II, line 3 Bond Proceeds differ due to interest earned on the proceeds and a net premium earned. Bond A: Issue Price 54,390,000 Plus Interest Earnings 25,040 Net Premium 2,897,771 Total Part II, Line 3 57,312,811 Bond B: Issue Price 50,460,000 Plus Interest Earnings 161,279 Net Premium 3,989,183 Total Part II, Line 3 54,610,462 Gregg Radtke Family member of Director Sandra Burns 33709 Employed by RCRH 0 Erika L Radtke Family member of Director Sandra Burns 58161 Employed by RCRH 0 Nadine E Radtke Family member of Director Sandra Burns 64633 Employed by RCRH 0 Caleb Hansen Family member of Director Lisa Seaman 48682 Employed by RCRH 0 Lindsey Hansen Family member of Director Lisa Seaman 48492 Employed by RCRH 0 Kelsey Olson Family member of Director Tamara Riddle-Schumacher 15890 Employed by RCRH 0 Form 990, Part IV, Line 24a: Bond Issues: The issue price of the bonds includes the filing organization's share of the entire bond issue, which was issued to Rapid City Regional Hospital on behalf of the Obligated Group. The Obligated Group consists of Rapid City Regional Hospital, Regional Health Inc, Regional Health Network Inc, and Regional Health Physicians Inc. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Rapid City Regional Hospital's tax return. Form 990, Part VI, Section A, line 1 The membership of the Executive Committee of the Corporation shall consist of the following: Chair of the Board of Directors, Vice Chair of the Board of Directors, two other Board members appointed by the Chair, and the Corporation's President. The Chair of the Board of Directors shall serve as the Chair of the Executive Committee. Directors on the Executive Committee shall serve during the term of office they hold which places them on the Executive Committee, or, for the two Chair-appointed members, for a term of one (1) year or until their successors are appointed. The Executive Committee, when the Board of Directors is not in session, shall have and may exercise all of the authority of the Board of Directors, except to the extent, if any, that such authority shall be limited by a motion or resolution of the Board of Directors or that is authority reserved to the Member. It is intended that the powers of the Executive Committee to act for the whole Board be confined to such urgent matters as reasonably should not be deferred until the next regularly-scheduled meeting of the full Board. Additionally, the Executive Committee is delegated the Board's final authority to act on individual applications for Medical Staff and Allied Health Professional Staff appointments, reappointments and privileges. Form 990, Part VI, Section A, line 2 Brent Phillips has a business relationship with Bruce Eaton, MD due to being the CEO of the supporting organization that exercises reserve powers over the supported organization that employs Dr. Eaton. Directors Sandra Burns and Jack Lynass are Directors of the Black Hills Community Bank Board. Form 990, Part VI, Section A, line 4 Amended the language regarding the composition of each Board of Directors to require "at least one" overlapping board member as between RH and RCRH and between RH and RHN. Previously, two overlapping members were required. (The board membership of RH and Regional Health Physicians, Inc. is identical - 100% overlap.) The overlapping membership is one way we assure that RH, as a Supporting Organization, remains responsive to its Supported Organizations. The reason for the change is that with the implementation of "System Committees" in 2016 (Governance, Clinical Quality, Finance and Investment, and Compliance Audit and Compensation) we are better assuring responsiveness by the supporting organization because the System Committee membership consists of at least one member from each Board (RH, RCRH and RHN). The System Committees, through representation from each corporation, not only assure RH responsiveness; they provide a means of shared decision-making. Also, by using the language "at least one", more than one overlapping member remains permitted. For FY17 two overlapping members remained in place as between RCRH and RH and three overlapping members remained in place as between RHN and RH. Amended the language regarding Board Officers. Each corporation's bylaws provide for four Board officers: Chair, Vice-Chair, Secretary and Treasurer. Previously all four offices were held by Board members elected by their respective boards. The bylaws were amended to designate the person (employee) holding the position of General Counsel as the Secretary and the person holding the position of Chief Financial Officer as Treasurer. The amended bylaw language makes clear the Secretary and Treasurer are not members of the Board; they simply fulfill the duties of the respective offices as described in the bylaws. Amended the composition of the Executive Committees of each Board. Because the Executive Committee membership previously consisted of all four Board Officers, but, per the above amendment, two of the Offices were now filled by non-board member employees, the bylaws were amended to delete the Secretary and Treasurer as members of each Executive Committee. Instead the amended language includes the Board Chair and Vice-Chair and two other Board members appointed by the Board Chair. Amended the language regarding Quorum to clarify that a quorum (majority of members) is required to start a meeting but that the meeting may continue even if a quorum is lost unless a Point of Order is made. Deleted the language included under the System Compliance, Audit and Compensation Committee regarding hire/fire/evaluation of the Compliance Officer. Amended the provision regarding composition of the Board to add the President of Medical Services as an ex-officio, non-voting member of the Board. Amended the Executive Committee composition to delete the Chief of Staff as a required member of the Committee. The Board Chair may still appoint the Chief of Staff but it is no longer mandatory. Form 990, Part VI, Section A, line 6 Regional Health, Inc. is the sole member of Rapid City Regional Hospital, Inc. Form 990, Part VI, Section A, line 7a The organization's sole member and supporting organization, Regional Health, Inc., appoints the members of Rapid City Regional Hospital's governing body. The bylaws require that at least one member of Rapid City Regional Hospital's board also serves as a voting member of the sole member's board to better assure the sole member's continued responsiveness to Rapid City Regional Hospital. Form 990, Part VI, Section A, line 7b Regional Health, Inc. provides compliance, governance, financial, and planning support to its Supported Organizations to best assure the functions and services of the Supported Organizations are coordinated and supported in a manner that furthers the shared charitable mission of the Supported Organizations and RHI, as a whole (the System). Regional Health, Inc. has final authority in significant business decisions affecting Supported Organizations. Form 990, Part VI, Section B, line 11b The 990 is prepared and reviewed by an independent accounting firm. It is then reviewed internally by finance and legal management. The Form 990 is further reviewed, prior to filing, by the organization's board of directors through a portal to the organization's internal information system, to which each board member has access. Educational sessions have been provided to each board member on how to access the portal. Form 990, Part VI, Section B, line 12c As part of the annual disclosure of potential conflicts process, all board members, officers, and management are required to complete an annual disclosure statement on financial interests and conflicting interests. At Board and Board Committee meetings, the meeting agenda includes an initial item "Conflicts of Interest" where the Chair asks members if they have any conflicting interests or financial interests related to an agenda item. If a conflicting or financial interest is disclosed, it is noted in the minutes and there is discussion or determination of whether the disclosure requires the board or committee member to be excused from discussion or action on that agenda item. Board or committee members whose disclosure is found to be a conflicting may be invited to speak on the matter by the Chair, but are not permitted to vote on the matter and may be required to leave the meeting during discussion, after they have made any comments invited by the Chair. Failure to comply with the Conflict of Interest policy constitutes grounds for removal from office or membership on the Board or Board Committee and, in the case of all employees, termination of employment. Form 990, Part VI, Section B, line 15a The Executive Committee of Regional Health Inc. (RHI; parent) engaged an independent third party compensation firm to conduct a review of all executives, Vice President level and above, to determine an appropriate compensation range in which their compensation would be established. The independent compensation consultant provided peer group market comparative data for base salary, total cash compensation, benefits and total compensation for executives. The CEO or his designee determines the actual base salary of the executives within the committee-approved base salary range based on experience and performance, providing the total compensation is within the targeted market percentile, e.g. 50th percentile. In May 2017, the independent consultant met with Committee members and presented 2017 data upon which the Committee determined all elements of compensation for the member's CEO (base salary, total cash compensation, benefits and total compensation) and reaffirmed the organization's executive compensation philosophy, which includes the targeted market percentile for all other executives. Actual compensation is paid by Rapid City Regional Hospital and charged to RHI. Form 990, Part VI, Section C, line 19 The Articles of Incorporation of the organization are filed in the office of the Secretary of State of South Dakota and are available to the public from the Office of the Secretary of State. Other documents (Bylaws, conflict of interest policy and financial statements) are not posted for the public but are available or described in other public documents or sites such as offering statements in bond issues or municipal securities rulemaking board's electronic municipal market access (EMMA) data port. Form 990, Part IX, line 11g Other Fees: Program service expenses 44,965,542. Management and general expenses 21,004,782. Fundraising expenses 91,832. Total expenses 66,062,156. Form 990, Part XI, line 9: Adj to the Funded Status of the Pension Plan 4,042,606. Medical Staff Net Income 13,161. Temporarily Restricted Net Asset Changes -741,945. Auxiliary Net Income -90,150. Amortized Bond Premium 463,224. Change in Interest Swap 1,599,130. Regional Health Home Plus LLC 2925 Regional Way PO Box 6000 Rapid City SD 57701 364841157 Healthcare Services SD 31322778 15431130 Rapid City Regional Hospital Inc Regional Health Inc 353 Fairmont Blvd Rapid City SD 57701 201487506 Healthcare SD 501(c)(3) Line 12c, III-FI N/A 0 Regional Health Network Inc 353 Fairmont Blvd Rapid City SD 57701 460360899 Healthcare SD 501(c)(3) Line 3 Regional Health Inc 0 Regional Health Physicians Inc 353 Fairmont Blvd Rapid City SD 57701 460372454 Healthcare SD 501(c)(3) Line 3 Regional Health Inc 0 Medical & Dental Building 2805 S 5th St Rapid City SD 57701 460339629 Medical Office Bldg SD Rapid City Regional Hospital Inc Investment -11503 970384 0 1 0.71450 Black Hills Medical Office BD LLC 353 Fairmont Blvd Rapid City SD 57701 411992146 Medical Office Bldg SD Rapid City Regional Hospital Inc Investment -6799 1575731 0 0 0.67930 Same Day Surgery Center 651 Cathedral Drive Rapid City SD 57701 411889892 Medical Services SD Rapid City Regional Hospital Inc RELATED 2896148 2358056 0 1 0.40000 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 Same day Surgery Center F 3240000