2018-04-16T19:11:37-05:00 2017-05-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2016-06-01 460391067 PRAIRIE LAKES HEALTH CARE SYSTEM INC PRAI 6058827000 PO BOX 1210 WATERTOWN SD 57201 ADAM POPP CFO 6058827000 2018-04-13 1 KURT BENNION P01469618 6123764500 67.137.57.251 2018-04-13 10:43:33 PD P 9484E6C550CEFEA19C9729386319D1474AD693AD 0C3B949DE0044FA10488A02C94FF2E706A60DCAB 2016 2021-01-29 14:40:06Z JILL FULLER PO BOX 1210 WATERTOWN SD 57201 315805862 0 X WWW.PRAIRIELAKES.COM X 1986 SD HEALTH CARE SERVICES 15 14 632 240 987771 242579 148957 102050 88106837 96483900 9486492 13723446 1899794 1591546 99642080 111900942 298013 2301132 0 0 42060895 45087234 0 0 0 41402836 47823644 83761744 95212010 15880336 16688932 246951179 308032192 26616175 63988101 220335004 244044091 X PRAIRIE LAKES HEALTH CARE SYSTEM THROUGH THE EFFORTS OF ITS DEDICATED EMPLOYEES AND PHYSICIANS, PROVIDES ACCESSIBLE, HIGH QUALITY, AFFORDABLE, AND COMPASSIONATE HEALTHCARE SERVICES FOR THE PEOPLE IN THE REGION. 0 0 84362789 2301132 96483900 PRAIRIE LAKES HEALTHCARE SYSTEM IS A RURAL, REGIONAL MEDICAL CENTER SERVING TEN COUNTIES IN NORTHEASTERN SOUTH DAKOTA AND WESTERN MINNESOTA. THE ORGANIZATION IS COMMITTED TO PROVIDING ACCESSIBLE, HIGH QUALITY, COST-EFFECTIVE HEALTHCARE WHILE EFFECTIVELY MANAGING THE TRANSITION TO NEW PAYMENT AND CARE DELIVERY MODELS. OVER THE PAST DECADE, PLHS SUCCESSFULLY RECRUITED TWENTY-THREE SPECIALTY PHYSICIANS IN ORDER TO BUILD NEW SERVICES THAT WERE NEEDED IN THE REGION. IN THE PAST YEAR, FOUR NEW PHYSICIANS WERE RECRUITED, INCLUDING A DERMATOLOGIST. IN THE NEXT FISCAL YEAR, WE ANTICIPATE TWO HOSPITALISTS, ANOTHER DERMATOLOGIST, A NON-INTERVENTIONAL CARDIOLOGIST, AN ENT PHYSICIAN, AND A PATHOLOGIST JOINING OUR STAFF. PLHS ALSO CONTINUED TO INCREASE THE NUMBER OF (CONTINUED IN SCHEDULE O)OUTREACH RURAL CLINICS TO NINETEEN. THESE CLINICS PROVIDE ACCESS TO SPECIALTY PHYSICIANS IN RURAL COMMUNITIES IN THE PLHS SERVICE AREA. DERMATOLOGY SERVICES WERE ADDED TO MEET THE NEEDS OF THE SERVICE AREA. THE FULL-TIME SERVICES SIGNIFICANTLY INCREASED ACCESSIBILITY TO NEEDED DERMATOLOGY CARE. A CLINICAL INTEGRATION INITIATIVE IS NOW IN ITS FOURTH YEAR. WORKING WITH COMMUNITY PRIMARY CARE PHYSICIANS, HOSPITAL-BASED PHYSICIANS, AND OTHER POST-ACUTE PROVIDERS, EFFORTS ARE FOCUSED ON IMPROVING PATIENT CARE TRANSITIONS FROM ONE SETTING TO ANOTHER AND BUILDING CARE MANAGEMENT PROTOCOLS TO ENSURE OPTIMAL CLINICAL OUTCOMES WHILE DECREASING THE TOTAL COST OF CARE. INCLUDED IN THESE CLINICAL INTEGRATION ACTIVITIES WERE THE FOLLOWING SPECIAL PROJECTS: 1. HOSPITAL-NURSING HOME CARE TRANSITIONS DESIGNED TO IMPROVE THE HANDOFF OF PATIENT INFORMATION DURING THE TRANSFER FROM ACUTE CARE TO SKILLED CARE TO DECREASE ERRORS AND TO DECREASE HOSPITAL READMISSIONS; 2. JOINT JOURNEY TO ENGAGE PATIENTS SCHEDULED FOR TOTAL JOINT REPLACEMENT WITH A SUPPORT GROUP, PROVIDE PATIENT AND FAMILY EDUCATION, AND PROVIDE PRE-OPERATIVE EXERCISE TRAINING. SUCH PROGRAMS RESULT IN IMPROVED RECOVERY, BETTER POST-OPERATIVE PAIN CONTROL, AND DECREASE THE TOTAL COST OF CARE; 3. DIABETIC SUPPORT GROUPS WERE ESTABLISHED THROUGH FINANCIAL SUPPORT FROM PLHS. IMPROVING DIABETIC HEALTH WAS A PRIORITY IDENTIFIED IN THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT; AND, 4. THE HOME TRANSITION PROGRAM THAT PROVIDES HIGH-RISK, RECENTLY DISCHARGED PATIENTS WITH A COMPLIMENTARY POST-DISCHARGE VISIT BY A REGISTERED NURSE. THIS SERVICE FILLS A GAP IN THE CARE OF PEOPLE WITH HEART FAILURE AND OTHER DISEASES. THE ORGANIZATION'S COMMITMENT TO IMPROVING QUALITY AND PATIENT OUTCOMES WAS ACKNOWLEDGED BY THE RECEIPT OF AWARDS BASED ON REVIEW OF PUBLICALLY REPORTABLE DATA. FOR THE FOURTH CONSECUTIVE YEAR, PLHS RECEIVED THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION'S NCDR ACTION REGISTRY - PLATINUM PERFORMANCE ACHIEVEMENT AWARD. THE AWARD RECOGNIZED CONSISTENT ADHERENCE TO RECOMMENDED TREATMENT GUIDELINES FOR CARDIOLOGY PATIENTS AND PERFORMANCE AT THE 90TH PERCENTILE ON SELECTED PERFORMANCE MEASURES. IN JANUARY, 2017, PLHS WAS NAMED A RECIPIENT OF THE WOMEN'S CHOICE AWARD AS AMERICA'S BEST HOSPITALS FOR EMERGENCY CARE FOR THE THIRD YEAR IN A ROW. IN SUMMARY, PLHS ACHIEVES ITS HEALTHCARE MISSION IN THREE WAYS: FIRST, BY OPERATING A COMMUNITY HOSPITAL WITH ESSENTIAL SERVICES INCLUDING OBSTETRICS, CARDIOLOGY, EMERGENCY SERVICES, INPATIENT MEDICAL SERVICES AND OUTPATIENT SERVICES. SECOND, PLHS PROVIDES RURAL SPECIALTY OUTREACH WITH EMPHASIS ON DIALYSIS, HOME HEALTH, REHABILITATION SERVICES AND OUTREACH CLINICS THAT ALLOW PEOPLE TO SEE SPECIALISTS IN THEIR COMMUNITIES. THIRD, PLHS PROVIDES SPECIALTY MEDICAL AND SURGICAL CARE TO A TEN-COUNTY SERVICE AREA. 84362789 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 81 0 632 1 1 1 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X ADAM POPP 6058827000 401 9TH AVENUE NW WATERTOWN SD 57201 JIM REDLINGER CHAIR 1.00 0.00 X X 0 0 0 ROBB PETERSON VICE CHAIR 1.00 0.00 X X 0 0 0 TOM LABRIE SECRETARY 1.00 0.00 X X 0 0 0 DUSTIN FLATTEN TREASURER 1.00 1.00 X X 0 0 0 MARK ROBY PAST CHAIR 1.00 0.00 X 0 0 0 JOHN CALVIN BOARD MEMBER 1.00 0.00 X 0 0 0 ALAN CHRISTENSEN MD BOARD MEMBER 1.00 0.00 X 0 0 0 VINCE FOLEY BOARD MEMBER 1.00 0.00 X 0 0 0 CATHERINE GERRISH MD BOARD MEMBER 1.00 0.00 X 0 0 0 BERNIE HANSON MD BOARD MEMBER 1.00 0.00 X 0 0 0 MONTE HOPPER BOARD MEMBER 1.00 0.00 X 0 0 0 SHANNON KRUSE BOARD MEMBER 1.00 0.00 X 0 0 0 GERALD RIEBER MD BOARD MEMBER 1.00 0.00 X 0 0 0 DOUG SHARP BOARD MEMBER 1.00 1.00 X 0 0 0 LUANN STRAIT BOARD MEMBER 1.00 1.00 X 0 0 0 JILL FULLER CHIEF EXECUTIVE OFFICER 40.00 1.00 X 538276 0 44672 ADAM PAUL CHIEF FINANCIAL OFFICER 40.00 0.00 X 314884 0 32479 MICHAEL ANDERSON CHIEF INVESTMENT OFFICER 40.00 0.00 X 409150 0 40871 NATE LAKE VICE PRESIDENT 40.00 1.00 X 227227 0 33354 TRACI RABINE VICE PRESIDENT 40.00 0.00 X 230886 0 33347 MICHELE TURBAK CHIEF NURSING OFFICER 40.00 0.00 X 228426 0 33664 GRANT TILLETT CHIEF INFORMATION OFFICER 40.00 0.00 X 209912 0 32382 EVELIO GARCIA PHYSICIAN 40.00 0.00 X 1198946 0 29846 SALEM MAALIKI PHYSICIAN 40.00 0.00 X 1002753 0 29846 RICHARD HOWARD PHYSICIAN 40.00 0.00 X 538179 0 18217 JEFFREY BRINDLE PHYSICIAN 40.00 0.00 X 543697 0 29846 BIPIN AMIN PHYSICIAN 40.00 0.00 X 610000 0 24769 6052336 0 383293 38 0 1 0 COMPHEALTH PO BOX 972651 DALLAS TX 75397 LOCUM PHYSICIANS 1627771 WMG DAKOTA LLCSUMMIT STEGLITS 107 FLYNN DRIVE STE 600 MILBANK SD 57252 LOCUM ER PHYSICIANS 596634 FEKA HEMATOLOGY ONCOLOGY 300 WEST CENTURY AVE BISMARCK ND 58503 ONCOLOGY MD 427200 NAZIR DELAWAR MD 411 N 6TH ST EMERY SD 57332 HOSPITALIST LOCUM 375829 PRECISION DIAGNOSTIC SERVICE INC 4152 30TH AVE S STE 103 FARGO ND 58104 SLEEP STUDIES 361050 15 102050 102050 NET PATIENT SERVICE REVENUE 621400 95496129 95496129 RETAIL PHARMACY 446110 837580 837580 LAB SERVICE 621500 150191 150191 96483900 667620 667620 1008605 0 1008605 1008605 1008605 216913900 46846 203863064 41856 13050836 4990 13055826 13055826 CAFETERIA REVENUE 722210 321302 321302 OTHER INCOME 900099 257463 257463 VENDING MACHINES 722210 3093 3093 1083 1083 582941 111900942 95496129 987771 15314992 X 2301132 2301132 2334859 2334859 36069107 33034044 3035063 768157 756033 12124 3340344 3024331 316013 2574767 2264941 309826 51268 51268 10315915 9100233 1215682 430484 430484 1666904 1126763 540141 455785 41784 414001 880055 24679 855376 492643 355519 137124 239399 88721 150678 457579 457579 4873567 4476836 396731 378615 378615 UBI TAXES 77856 77856 MEDICAL SUPPLIES 11369405 11369405 DRUGS 8751255 8751255 PROVISION FOR BAD DEBT 4138557 4138557 3244357 2672362 571995 95212010 84362789 10849221 0 2026 2026 7546784 9786390 9327184 11019019 390523 378340 2026580 2678379 780324 759553 126702979 69214787 47053229 57488192 165900189 180771303 6255139 4504169 207890 2570154 7461311 38074667 246951179 308032192 12887305 14569467 9871073 43187520 1775890 3857797 4455224 26616175 63988101 X 216470980 239841138 3864024 4202953 220335004 244044091 246951179 308032192 X 16688932 6681227 338929 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3101762 3101762 48007445 23152764 24854681 2736874 1848899 887975 61736125 44213124 17523001 11120773 11120773 57488192 DUE FROM 457B 3779737 ACCRUED INTEREST RECEIVABLE 78975 TRUSTEE HELD FUNDS 29328959 ACCRUED REAL ESTATE 3761187 DUE FROM RELATED PARTY 1125809 38074667 457(B) PAYABLE 3779737 LONG-TERM PTO 583587 ASSET RETIREMENT OBLIGATION 91900 4455224 X PART X, LINE 2: THE 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 1821000 1821000 0.02000 3930802 2331126 1599676 0.01760 5751802 2331126 3420676 0.03760 13833299 6297967 7535332 0.08270 13833299 6297967 7535332 0.08270 19585101 8629093 10956008 0.12030 1 4138557 0 33864503 32096214 1768289 X 1 1 1 1 PRAIRIE LAKES HOSPITAL 401 9TH AVE NW WATERTOWN SD 57201 WWW.PRAIRIELAKES.COM 10572 460391067 X X X PRAIRIE LAKES HEALTH CARE SYSTEM 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X WWW.PRAIRIELAKES.COM/IMAGES/PDFS/2016_COMMUNITY_NEEDS_ASSESSMENT_-_FINAL.PD X 1 15 1 WWW.PRAIRIELAKES.COM/IMAGES/PDFS/2016_COMMUNITY_NEEDS_ASSESSMENT_-_FINAL.PD 0 1 X 150.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X SEE LINE 16J X SEE LINE 16J X SEE LINE 16J X X X X X X 1 X 0 X X X 1 X 0 0 PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 5: A COMPREHENSIVE, DATA DRIVEN ASSESSMENT WAS USED TO IDENTIFY COMMUNITY HEALTH NEEDS. PLHS UTILIZED A TWO-STEP PROCESS TO COLLECT PRIMARY AND SECONDARY DATA. IN STEP ONE, PLHS SOLICITED INPUT FROM COMMUNITY HEALTH STAKEHOLDERS INCLUDING PUBLIC HEALTH PROFESSIONALS; SERVICE AGENCIES ASSISTING VULNERABLE, LOW-INCOME, AND MINORITY POPULATIONS; HEALTHCARE PROVIDERS; AND, GOVERNMENT AND PUBLIC SAFETY OFFICIALS. IN ORDER TO ADDRESS NEEDS OF THE ENTIRE "COMMUNITY," STAKEHOLDERS INCLUDED INDIVIDUALS FROM OUTSIDE THE PRIMARY SERVICE AREA OF PLHS. INPUT WAS OBTAINED THROUGH TWO FOCUS GROUP SESSIONS AND KEY INFORMANT INTERVIEWS. STEP TWO CONSISTED OF EVALUATION OF DATA RELATED TO DEMOGRAPHICS AND HEALTH FROM THE UNITED STATES CENSUS BUREAU, SOUTH DAKOTA DEPARTMENT OF HEALTH, SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS, MINNESOTA DEPARTMENT OF HEALTH AND OTHER SOURCES. PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 11: 1. MENTAL HEALTHOBJECTIVE:IMPROVE ACCESS TO MENTAL HEALTH SERVICES THROUGH PARTNERSHIPS WITH OTHER HEALTHCARE PROVIDERS TO FACILITATE IMPROVED ACCESS TO CARE.KEY INITIATIVES:A. DEVELOP THE INFRASTRUCTURE NEEDED TO IDENTIFY SPECIFIC NEEDS AND SOLUTIONSB. SEEK OUT COLLABORATION OPPORTUNITIES TO INCREASE ACCESS2. ACCESS TO HEALTHCARE - TRANSPORTATIONOBJECTIVES:DECREASES BARRIERS TO HEALTH CARE ACCESS RELATED TO TRANSPORTATION. KEY INITIATIVES:A. SUSTAIN PARTNERSHIP WITH WATERTOWN AREA TRANSIT PROVIDING FREE RIDE SERVICE TO MEDICAL APPOINTMENTSB. EXPLORE OPTIONS FOR INCREASED MARKETING AND DISSEMINATION OF INFORMATION TO INCREASE AWARENESS OF PUBLIC TRANSPORTATION OPTIONS3. CHRONIC DISEASE MANAGEMENTOBJECTIVE:IMPROVE QUALITY OF LIFE AND CLINICAL OUTCOMES FOR PEOPLE WITH CHRONIC DISEASE.KEY INITIATIVES:A. CARDIOVASCULAR DISEASE: - CONTINUE TO ENHANCE HOME TRANSITIONS PROGRAM 34 - ENHANCE PATIENT EDUCATIONB. DIABETES: - CONTINUE TO ENHANCE HOME TRANSITIONS PROGRAM - EXPLORE THE NEED FOR DIABETIC SPECIFIC TRAINED STAFFC. RESPIRATORY DISEASE: - CONTINUE TO ENHANCE HOME TRANSITIONS PROGRAM - RECRUIT A PULMONOLOGIST - REINSTATE OUTREACH CLINICSD. CEREBROVASCULAR DISEASE (STROKE): - ENHANCE PATIENT EDUCATION - EVALUATE STROKE PROTOCOLS4. HEALTH LITERACYOBJECTIVE:IMPROVE MEDICATION SAFETY FOR THE COMMUNITY.KEY INITIATIVES:A. DEVELOP THE INFRASTRUCTURE NEEDED TO PROVIDE PUBLIC EDUCATIONB. EXPLORE THE DEVELOPMENT OF MEDICATION PROTOCOLS FOR SELECT HEALTH CONDITIONS PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 16J: HTTPS://WWW.PRAIRIELAKES.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-PROGRAM-510.HTML 4 1 - SISSETON SATELLITE DIALYSIS 5 EAST CHESTNUT SISSETON SD 57262 DIALYSIS UNIT 2 - MALLARD POINTE SURGICAL CENTER 1425 MICKELSON DRIVE WATERTOWN SD 57201 OUTPATIENT SURGERY CENTER 3 - ORTONVILLE SATELLITE DIALYSIS 450 EASTVOLD AVENUE ORTONVILLE MN 56278 DIALYSIS UNIT 4 - PRAIRIE LAKE PULMONOLOGY CLINIC 600 4TH STREET NE WATERTOWN SD 57201 PULMONOLOGY CLINIC 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 CONIDERED 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 ARE CALCULATED USING A COST TO CHARGE RATIO DERIVED INTERNALLY USING THE HEALTH SYSTEM'S OVERALL COST TO CHARGE RATIO. 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): $4,138,557 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, 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 2017 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 STATES SD 1 BOYS & GIRLS CLUB OF WATERTOWN PO BOX 833 WATERTOWN SD 57201 460311845 501(C)(3) 125000 CAPITAL CAMPAIGN BUILDING PROJECT WATERTOWN UNITED WAY PO BOX 283 WATERTOWN SD 57201 460359557 501(C)(3) 24250 COMMUNITY ORGANIZATION FUNDING LAKE AREA KIDNEY ENDOWMENT 901 4TH AVE NW WATERTOWN SD 57201 474601728 501(C)(3) 11000 RESEARCH AND SCREENINGS LAKE AREA TECHNICAL INSTITUTE PO BOX 730 WATERTOWN SD 57201 460381673 501(C)(3) 2010123 CONSTRUCTING AND EQUIPPING A HEALTH EDUCATION CENTER; SCHOLARSHIPS HUMAN SERVICE AGENCY PO BOX 1030 WATERTOWN SD 57201 460275247 501(C)(3) 12833 DETOX FUNDING WATERTOWN DEVELOPMENT CORP PO BOX 1267 WATERTOWN SD 57201 466012194 501(C)(6) 35000 COMMUNITY DEVELOPMENT LUTHERAN OUTDOORS IN SD 2001 S SUMMIT AVE SIOUX FALLS SD 57197 460320561 501(C)(3) 25000 CAMP SPONSORSHIP 6 1 PART I, LINE 2: FUNDS 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. X X X X 0 0 0 0 0 0 0 0 0 JILL FULLER CHIEF EXECUTIVE OFFICER 398276 0 140000 0 0 0 22776 0 21896 0 582948 0 0 0 ADAM PAUL CHIEF FINANCIAL OFFICER 244024 0 70860 0 0 0 15660 0 16819 0 347363 0 0 0 MICHAEL ANDERSON CHIEF INVESTMENT OFFICER 284150 0 125000 0 0 0 18975 0 21896 0 450021 0 0 0 NATE LAKE VICE PRESIDENT 170229 0 56998 0 0 0 11458 0 21896 0 260581 0 0 0 TRACI RABINE VICE PRESIDENT 167499 0 56989 0 6398 0 11451 0 21896 0 264233 0 0 0 MICHELE TURBAK CHIEF NURSING OFFICER 170563 0 57863 0 0 0 11768 0 21896 0 262090 0 0 0 GRANT TILLETT CHIEF INFORMATION OFFICER 155792 0 54120 0 0 0 10486 0 21896 0 242294 0 0 0 EVELIO GARCIA PHYSICIAN 1073946 0 125000 0 0 0 7950 0 21896 0 1228792 0 0 0 SALEM MAALIKI PHYSICIAN 1002753 0 0 0 0 0 7950 0 21896 0 1032599 0 0 0 RICHARD HOWARD PHYSICIAN 488179 0 50000 0 0 0 0 0 18217 0 556396 0 0 0 JEFFREY BRINDLE PHYSICIAN 543697 0 0 0 0 0 7950 0 21896 0 573543 0 0 0 BIPIN AMIN PHYSICIAN 610000 0 0 0 0 0 7950 0 16819 0 634769 0 0 0 A SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 460315509 83755VRN6 2010-12-08 21672812 CURRENT REFUNDING OF SERIES 1998 BONDS & ADVANCE REFUNDING OF SERIES 2002 0 0 0 B SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 460315509 2017-01-27 36000000 FUNDING OF THE NEW SPECIALTY CLINIC BUILDING 0 0 0 A 13285000 25166290 3303 431508 24731480 2010 1 1 1 1 B 36000000 397999 35602001 2017 0 0 1 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER 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. GREGORY GERRISH MD CATHERINE GERRISH IS A BOARD MEMBER AND THE MOTHER OF GREGORY GERRISH 408025 RESIDENCY STIPEND AND EMPLOYEE COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1 THE 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 11B EXECUTIVE 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 12C A CONFLICT OF INTEREST STATEMENT IS SIGNED BY ALL BOARD MEMBERS ON AN ANNUAL BASIS. THAT STATEMENT DISCLOSES ANY AREAS THAT MAY HAVE A POTENTIAL FOR CONFLICT OF INTEREST WITH THEMSELVES OR FAMILY MEMBERS. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO AND THE BOARD. AT BOARD MEETINGS, THE MEMBERS WILL EXCUSE THEMSELVES FROM ANY DISCUSSION OR VOTING ON AN ISSUE WHERE A CONFLICT MAY EXIST. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION COMPARABILITY STUDIES ARE REVIEWED EACH YEAR FOR ALL POSITIONS. THE COMPENSATION STUDIES ARE CONDUCTED INTERNALLY BY THE HUMAN RESOURCES DEPARTMENT. THE HUMAN RESOURCES DEPARTMENT HAS ACCESS TO VARIOUS COMPENSATION SURVEYS WHICH THEY REVIEW IN ORDER TO DETERMINE IF THE HOSPITAL'S COMPENSATION IS REASONABLE COMPARED TO OTHER FACILITIES. THE LAST COMPENSATION STUDY WAS PERFORMED IN 2017. THE BOARD APPROVES SALARY OF THE CEO THROUGH ITS EXECUTIVE COMMITTEE SERVING 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 BENCHMARKS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE THROUGH FILINGS WITH BONDING AUTHORITY. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED SERVICES / PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,100,233. MANAGEMENT AND GENERAL EXPENSES 1,215,682. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,315,915. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PRAIRIE LAKES FOUNDATION 338,929. PRAIRIE LAKES HOME CONNECTIONS INC 401 9TH AVE NW WATERTOWN SD 57201 460394984 HOMEMAKER & NURSING SERVICES SD 501(C)(3) LINE 10 PRAIRIE LAKES HEALTH CARE SYSTEM INC 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 PRAIRIE LAKES HOME CONNECTIONS INC L 80757 GAAP PRAIRIE LAKES HOME CONNECTIONS INC O 122249 GAAP