2017-05-10T07:16:23-05:00 2016-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2015-07-01 460360899 Regional Health Network Inc REGI 6057559130 2925 Regional Way PO Box 6000 Rapid City SD 57701 Mark Thompson CFO 6057559130 2017-05-08 1 Kim Hunwardsen CPA P00484560 6122536500 2017-05-08 2015 2021-01-29 14:40:06Z Brent Phillips 2925 Regional Way PO Box 6000 Rapid City SD 57701 164619034 0 X www.regionalhealth.com X 1981 SD Helping Patients and Communities Live Well 10 8 1392 314 1874084 -544501 274440 1497752 113012198 154371886 -141718 3077127 48110 78333 113193030 159025098 0 0 0 0 52989347 83859273 0 0 0 44870278 68987437 97859625 152846710 15333405 6178388 64461705 78958381 7711989 7681560 56749716 71276821 X Purpose: Helping Patients and Communities Live WellVision: We aspire to be the best healthcare system in AmericaValues: Courage, Integrity, Compassion, Innovation, Mutual RespectGoals: Patient & Family EXPERIENCE; Culture of Safety & Quality CARE; Physician & Caregiver ENGAGEMENT; Community & Financial STEWARDSHIP 1 1 6743360 6146753 Spearfish Regional Hospital's Queen City Medical Clinic is a hospital outpatient department providing primary care. It has a total of 47.44 full time equivalents that includes physicians (10.09) and advanced practice providers (5.31) provided by its related entity, Regional Health Physicians. This hospital outpatient department had 44,342 encounters throughout the year. 6233307 26266400 Spearfish Regional Hospital's surgery department offers surgical services provided by General Surgeons, Dermatology, ENT, OB/Gyns, Orthopedic Surgeons and Podiatrists. In FY16, a total of 1,813 surgeries were completed. The facility incurred additional volume during FYE16 and, as a result, incurred additional expense for staffing. 4302207 3806940 Spearfish Regional Hospital's Orthopedic Clinic is a hospital outpatient department providing orthopedic care. It has a total of 15.77 full time equivalents that includes orthopedic surgeons (3.27) and advanced practice providers (3.61) provided by its related entity, Regional Health Physicians. This hospital outpatient department experienced 14,045 encounters during the year. 100972980 118151793 The Regional Health Network, Inc. is a network of small hospitals, nursing homes, and assisted living facilities in western South Dakota. These hospitals and long-term care facilities are located in small rural towns and provide a very necessary rural healthcare safety net. 100972980 118151793 118251854 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1392 1 1 1 0 0 0 0 1 1 0 0 0 0 X 10 8 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Mark Thompson 6057559127 2925 Regional Way Rapid City SD 57701 Richard Tysdal Chairman 2.26 0.05 X X 0 0 0 David Thom Vice Chairman 0.63 0.00 X X 0 0 0 Dusty Pinske Secretary 2.35 0.05 X X 0 0 0 Robert Haivala Treasurer 0.81 0.00 X X 0 0 0 Lee B Bailey MD Director 40.95 0.00 X 382292 0 59933 Paul Bisson Director 0.92 0.00 X 0 0 0 Christopher Gasbarre DO Director 1.66 40.00 X 0 506011 65816 Ross Lamphere Director 0.73 0.00 X 629 0 0 Donovin Sprague Director 0.08 0.00 X 0 0 0 Pat Walker Director 0.68 0.00 X 0 0 0 Brent Phillips President and CEO 12.56 47.44 X 0 724743 62004 Mark A Thompson CFO 11.51 43.49 X 0 419639 67323 Maureen Henson VP Human Resources 11.51 43.49 X 0 242973 21876 Richard S Latuchie VP Info Technology/ CIO 11.51 43.49 X 0 297230 44951 Mary E Masten General Counsel 11.51 43.49 X 0 330753 42033 Kyle Richards President - Hills Mkt 55.00 0.00 X 279855 0 45763 Veronica Schmidt President - Custer 55.00 0.00 X 159301 0 39189 Mark Schulte President - Sturgis 55.00 0.00 X 173255 0 37036 Larry Veitz President - Spearfish 55.00 0.00 X 246797 0 43865 Krista Birkelo DO Physician - Emergency Services 40.00 0.00 X 301995 0 37703 Christopher Fromm MD Physician - Emergency Services 40.00 0.00 X 338101 0 56481 Jesse P Kurtenbach Nurse Anesthetist 40.00 0.00 X 169611 0 21839 M Donald Potts MD Physician - Emergency Services 40.00 0.00 X 177114 0 14211 Thomas Reid Nurse Anesthetist 40.00 0.00 X 186768 0 32860 Charles E Hart MD Former President Emeritus 12.56 47.44 X 0 210452 10516 Timothy H Sughrue Former CEO RCRH/RHN & COO RHI 11.55 43.45 X 0 595718 17808 2415718 3327519 721207 37 1 1 0 Alliance Recruiting Resources Inc PO Box 670416 Dallas TX 752670416 Temporary Physician Staffing Services 1507014 Athena Health Inc 311 Arsenal St Watertown MA 02472 Computer Software-Practice Management Bi 731197 Sentry Data Systems Inc 800 Fairway Dr Suite 400 Deerfield Beach FL 33441 Pharmacy Data Processing 412456 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Temporary Medical Staff Coverage 390367 MEDEFIS 10826 Old Mill Rd 101 Omaha NE 68105 Temporary Medical Staff Coverage 358701 21 56521 98986 1342245 1497752 Acute Care Hospital IP and OP 623000 90715000 90715000 Physician Clinics 621110 28975000 28975000 Long Term Care Facilities 623000 10310000 10310000 Home Care Services 621610 5725000 5725000 Assisted Living Facilities 623000 1735000 1735000 16911886 15037802 1874084 154371886 6449 6449 76597 34983 41614 41614 41614 8587181 5516503 3070678 3070678 3070678 79169 56521 42450 36719 36719 159025098 152497802 1874084 3155460 1299936 365556 934380 66121705 56065651 10056054 1153563 965520 188043 11138349 9322681 1815668 4145720 3411205 734515 14253 14253 13406 13406 11334727 8148134 3186593 27855 6229 21626 408483 219518 188965 885559 671304 214255 3219657 951131 2268526 297782 214571 83211 394652 343219 51433 3491 1166 2325 5327358 2808293 2519065 654678 525959 128719 Intercompany Supplies a 16911192 6915446 9995746 Medical Supplies 14156738 14090252 66486 Bad Debt Expense 8671184 8671184 6666422 4554835 2111587 152846710 118251854 34594856 0 23801 119100 18648439 21018316 1659813 1880769 509299 549402 100894029 51861186 41572393 49032843 255911 260005 1792049 6097946 64461705 78958381 6243589 7681560 1468400 0 7711989 7681560 X 55258991 68501806 1390725 2675015 100000 100000 56749716 71276821 64461705 78958381 X 6178388 -4055 8352772 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 13406 13406 0 Part II-B, Line 1: 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 2016 dues, which were paid in fiscal year 2016, in the amount of $97,420.99, 4.487% was used for lobbying purposes. In addition, annual dues were paid to the American Hospital Association, a portion of which is applicable to lobbying activities. For calendar year 2016 dues, which were paid in fiscal year 2016, in the amount of $40,843.00, 22.120% was used for lobbying purposes. 120509 1194 121703 116730 3779 120509 100000 16730 116730 100000 100000 100000 100000 0.00000 0.82170 0.17830 0 0 9331968 9331968 52283518 25472047 26811471 35617302 24646163 10971139 3661241 1742976 1918265 49032843 Other Receivables 1871443 Other Long Term Assets 1705105 Due from Related Parties-Investment 2521398 6097946 X Part V, Line 4: Endowed funds are permanently restricted from use and are held in an interest bearing account. The interest earned may be used by the organization at its discretion. 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 and subsidiaries are organized as nonprofit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Regional Health and subsidiaries are annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). In addition, Regional Health and subsidiaries may be subject to income tax on income that is derived from business activities that are unrelated to its tax exempt purpose. 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 2012. Hospice Ball 64139 1475 62664 5576 17564 8615 579 Hospice Golf Tournament 26790 10285 16505 692 7386 1292 2 44761 44761 253 493 135690 56521 79169 6268 25203 8615 2364 42450 36719 1 1 X 1 X 1 X 1 1 1 0 0 4136909 4136909 0.02870 15267581 11449593 3817988 0.02650 19404490 11449593 7954897 0.05520 11 1134 52631 52631 0.00040 1111997 1046027 65970 0.00050 5 7818 7818 0.00010 16 1134 1172446 1046027 126419 0.00100 16 1134 20576936 12495620 8081316 0.05620 1 218 27690 27690 0.00020 1 218 27690 27690 0.00020 1 8671184 37734146 37804118 -69972 X 1 1 4 1 Spearfish Regional Hospital 1440 N Main Street Spearfish SD 57783 www.regionalhealth.com 10566 X X X 5 Provider-based clinics A 2 Custer Regional Hospital 1039 Montgomery Street Custer SD 57730 www.regionalhealth.com 47660 X X X X 2 Provider-based clinics A 3 Sturgis Regional Hospital 949 Harmon Street Sturgis SD 57785 www.regionalhealth.com 10567 X X X X A 4 Lead-Deadwood Regional Hospital 61 Charles Street Deadwood SD 57732 www.regionalhealth.com 10535 X X X X 1 Provider-based clinic A Facility Reporting Group - A 0 0 1 X X X X X X X X X 15 1 1 0 1 X See Part V, Line 7d X X 1 15 1 See Part V, Line 7d 0 0 1 X 200.000000000000 250.000000000000 X X X 1 1 X X X X 1 X http://www.regionalhealth.com/patients-and-families X See Part V line 16i X http://www.regionalhealth.com/patients-and-families X X X X X X 1 X 0 X X X 1 X 0 1 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Spearfish Regional Hospital, - Facility 2: Custer Regional Hospital, - Facility 3: Sturgis Regional Hospital, - Facility 4: Lead-Deadwood Regional Hospital Group A-Facility 1 -- Spearfish Regional Hospital 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. Group A-Facility 1 -- Spearfish Regional Hospital 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. Group A-Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 7d: http://www.regionalhealth.com/about-us/community-needs-assessment Group A-Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 11: In acknowledging the wide range of priority health issues revealed through the 2015-2016 CHNA process, Spearfish Regional Hospital (SPRH), Sturgis Regional Hospital (STRH), Lead/Deadwood Regional Hospital (LDRH), and Custer Regional Hospital (CRH) each determined it could only focus on those which it deemed most pressing, most under-addressed, and most within their ability to influence.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 the community. However, limited resources 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: Limited resources, services and expertise available to address oral health and access to oral health insurance excluded this as an area chosen for action. Other community organizations have infrastructure and programs in place to better meet this need. 8) Respiratory Diseases: 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.This most recent assessment identified the following three priority areas that three Regional Health workgroups are addressing:Access to Healthcare Services: Focus on developing strategies to support timely access to primary care, specialty care, diagnostics, and inpatient services. This area has four primary objectives:1. Improve Patient Access for Primary Care, Specialists, and Diagnostic Procedures2. Develop and implement a community-based population health program3. Investigate, Plan, Build and Launch First Phase of a Digital Health Strategy4. Support access to primary and preventive care for vulnerable populations.Strategies to meet these objectives are as follows:-Optimize scheduling rules, templates, and processes-Standardize scheduling practices-Develop specialist referral criteria-Build Population Health Infrastructure-Develop Primary Case Management program-Provide education and promotion concerning use of advanced directives-Determine organizational and community needs and solutions options-Develop business plan for the digital health strategy-Increase support of All Women Count SD programMental Health: Increase access and awareness of culturally appropriate mental health resources and education. This priority has three objectives:1. Reduce stigma of mental health and increase public and provider awareness of available mental health resources available in their community.2. Improve mental health screening process across the Black Hills region (starting with Regional Health system)3. Explore adding mental health access into primary care clinicsStrategies to meet these objectives are as follows:-Partner with 211 Helpline to develop a comprehensive list of mental health resources in the service area -Create a community mental health asset map-Develop publicity campaign in partnership with community to reduce stigma of mental health-Develop education for providers on importance of screening process-Standardize mental health screening tool -Standardize process for referrals of patients who screen positive -Develop case management program for mental health-Build business case -Explore other access solutions (telehealth, mobile)Wellness: 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:1. Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices 2. Enhance access to organized well-being programs and activities in the community Strategies to meet these objectives are as follows:-Marketing campaign for existing health promotion programs -Enhance access to the Regional Health Diabetes Prevention Program-Develop pediatric diabetes prevention program (pilot in Rapid City and Spearfish communities)-Enhance access to the Better Choices Better Health (BCBH) Program -Explore partnership with local Native American agency (non-healthcare)-Expand Regional Health Employee Well-being program to offer consulting to organizations in the Rapid City and Spearfish Communities by the end of 2017 and Lead/Deadwood, Custer, and Sturgis communities by end of 2018-Live Well Black Hills resource support-Develop toolkit of disease prevention and disease management resources for providers (including referral process) Group A-Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 13b: Must reside within 200 mile radius of the location where the service was received. Group A-Facility 1 -- Spearfish Regional Hospital Part V, Section B, line 16i: The FAP application form is widely available on a the URL: http://www.regionalhealth.com/patients-and-familiesA 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. Group A-Facility 1 -- Spearfish Regional Hospital 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. Group A-Facility 2 -- Custer Regional Hospital 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. Group A-Facility 2 -- Custer Regional Hospital 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. Group A-Facility 2 -- Custer Regional Hospital Part V, Section B, line 7d: http://www.regionalhealth.com/about-us/community-needs-assessment Group A-Facility 2 -- Custer Regional Hospital Part V, Section B, line 11: In acknowledging the wide range of priority health issues revealed through the 2015-2016 CHNA process, Spearfish Regional Hospital (SPRH), Sturgis Regional Hospital (STRH), Lead/Deadwood Regional Hospital (LDRH), and Custer Regional Hospital (CRH) each determined it could only focus on those which it deemed most pressing, most under-addressed, and most within their ability to influence.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 the community. However, limited resources 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: Limited resources, services and expertise available to address oral health and access to oral health insurance excluded this as an area chosen for action. Other community organizations have infrastructure and programs in place to better meet this need. 8) Respiratory Diseases: 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) Potentially Disabling Conditions (CRH only): This issue will not be addressed as a primary need, but could be impacted through the Nutrition, Physical Activity and Weight and Access to Health Care Services priorities.12) Hearing & Vision (CRH only): Limited resources excluded this as an area chosen for action. Other community organizations have infrastructure and programs in place to better meet this need.This most recent assessment identified the following three priority areas that three Regional Health workgroups are addressing:Access to Healthcare Services: Focus on developing strategies to support timely access to primary care, specialty care, diagnostics, and inpatient services. This area has four primary objectives:1. Improve Patient Access for Primary Care, Specialists, and Diagnostic Procedures2. Develop and implement a community-based population health program3. Investigate, Plan, Build and Launch First Phase of a Digital Health Strategy4. Support access to primary and preventive care for vulnerable populations.Strategies to meet these objectives are as follows:-Optimize scheduling rules, templates, and processes-Standardize scheduling practices-Develop specialist referral criteria-Build Population Health Infrastructure-Develop Primary Case Management program-Provide education and promotion concerning use of advanced directives-Determine organizational and community needs and solutions options-Develop business plan for the digital health strategy-Increase support of All Women Count SD programMental Health: Increase access and awareness of culturally appropriate mental health resources and education. This priority has three objectives:1. Reduce stigma of mental health and increase public and provider awareness of available mental health resources available in their community.2. Improve mental health screening process across the Black Hills region (starting with Regional Health system)3. Explore adding mental health access into primary care clinicsStrategies to meet these objectives are as follows:-Partner with 211 Helpline to develop a comprehensive list of mental health resources in the service area -Create a community mental health asset map-Develop publicity campaign in partnership with community to reduce stigma of mental health-Develop education for providers on importance of screening process-Standardize mental health screening tool -Standardize process for referrals of patients who screen positive -Develop case management program for mental health-Build business case -Explore other access solutions (telehealth, mobile)Wellness: 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:1. Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices 2. Enhance access to organized well-being programs and activities in the community Strategies to meet these objectives are as follows:-Marketing campaign for existing health promotion programs -Enhance access to the Regional Health Diabetes Prevention Program-Develop pediatric diabetes prevention program (pilot in Rapid City and Spearfish communities)-Enhance access to the Better Choices Better Health (BCBH) Program -Explore partnership with local Native American agency (non-healthcare)-Expand Regional Health Employee Well-being program to offer consulting to organizations in the Rapid City and Spearfish Communities by the end of 2017 and Lead/Deadwood, Custer, and Sturgis communities by end of 2018-Live Well Black Hills resource support-Develop toolkit of disease prevention and disease management resources for providers (including referral process) Group A-Facility 2 -- Custer Regional Hospital Part V, Section B, line 13b: Must reside within 200 mile radius of the location where the service was received. Group A-Facility 2 -- Custer Regional Hospital Part V, Section B, line 16i: The FAP application form is widely available on a the URL: http://www.regionalhealth.com/patients-and-familiesA 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. Group A-Facility 2 -- Custer Regional Hospital 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. Group A-Facility 3 -- Sturgis Regional Hospital 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. Group A-Facility 3 -- Sturgis Regional Hospital 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, Spearfish Regional Surgery Center, 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. Group A-Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 7d: http://www.regionalhealth.com/about-us/community-needs-assessment Group A-Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 11: In acknowledging the wide range of priority health issues revealed through the 2015-2016 CHNA process, Spearfish Regional Hospital (SPRH), Sturgis Regional Hospital (STRH), Lead/Deadwood Regional Hospital (LDRH), and Custer Regional Hospital (CRH) each determined it could only focus on those which it deemed most pressing, most under-addressed, and most within their ability to influence.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 the community. However, limited resources 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: Limited resources, services and expertise available to address oral health and access to oral health insurance excluded this as an area chosen for action. Other community organizations have infrastructure and programs in place to better meet this need. 8) Respiratory Diseases: 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 (STRH only): Limited resources and lower priority excluded this as an area chosen for action. Sturgis Regional Hospital does provide smoking/tobacco cessation information to patients.This most recent assessment identified the following three priority areas that three Regional Health workgroups are addressing:Access to Healthcare Services: Focus on developing strategies to support timely access to primary care, specialty care, diagnostics, and inpatient services. This area has four primary objectives:1. Improve Patient Access for Primary Care, Specialists, and Diagnostic Procedures2. Develop and implement a community-based population health program3. Investigate, Plan, Build and Launch First Phase of a Digital Health Strategy4. Support access to primary and preventive care for vulnerable populations.Strategies to meet these objectives are as follows:-Optimize scheduling rules, templates, and processes-Standardize scheduling practices-Develop specialist referral criteria-Build Population Health Infrastructure-Develop Primary Case Management program-Provide education and promotion concerning use of advanced directives-Determine organizational and community needs and solutions options-Develop business plan for the digital health strategy-Increase support of All Women Count SD programMental Health: Increase access and awareness of culturally appropriate mental health resources and education. This priority has three objectives:1. Reduce stigma of mental health and increase public and provider awareness of available mental health resources available in their community.2. Improve mental health screening process across the Black Hills region (starting with Regional Health system)3. Explore adding mental health access into primary care clinicsStrategies to meet these objectives are as follows:-Partner with 211 Helpline to develop a comprehensive list of mental health resources in the service area -Create a community mental health asset map-Develop publicity campaign in partnership with community to reduce stigma of mental health-Develop education for providers on importance of screening process-Standardize mental health screening tool -Standardize process for referrals of patients who screen positive -Develop case management program for mental health-Build business case -Explore other access solutions (telehealth, mobile)Wellness: 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:1. Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices 2. Enhance access to organized well-being programs and activities in the community Strategies to meet these objectives are as follows:-Marketing campaign for existing health promotion programs -Enhance access to the Regional Health Diabetes Prevention Program-Develop pediatric diabetes prevention program (pilot in Rapid City and Spearfish communities)-Enhance access to the Better Choices Better Health (BCBH) Program -Explore partnership with local Native American agency (non-healthcare)-Expand Regional Health Employee Well-being program to offer consulting to organizations in the Rapid City and Spearfish Communities by the end of 2017 and Lead/Deadwood, Custer, and Sturgis communities by end of 2018-Live Well Black Hills resource support-Develop toolkit of disease prevention and disease management resources for providers (including referral process) Group A-Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 13b: Must reside within 200 mile radius of the location where the service was received. Group A-Facility 3 -- Sturgis Regional Hospital Part V, Section B, line 16i: The FAP application form is widely available on a the URL: http://www.regionalhealth.com/patients-and-familiesA 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. Group A-Facility 3 -- Sturgis Regional Hospital 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. Group A-Facility 4 -- Lead-Deadwood Regional Hospital 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. Group A-Facility 4 -- Lead-Deadwood Regional Hospital 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. Group A-Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 7d: http://www.regionalhealth.com/about-us/community-needs-assessment Group A-Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 11: In acknowledging the wide range of priority health issues revealed through the 2015-2016 CHNA process, Spearfish Regional Hospital (SPRH), Sturgis Regional Hospital (STRH), Lead/Deadwood Regional Hospital (LDRH), and Custer Regional Hospital (CRH) each determined it could only focus on those which it deemed most pressing, most under-addressed, and most within their ability to influence.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 the community. However, limited resources 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: Limited resources, services and expertise available to address oral health and access to oral health insurance excluded this as an area chosen for action. Other community organizations have infrastructure and programs in place to better meet this need. 8) Respiratory Diseases: 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.This most recent assessment identified the following three priority areas that three Regional Health workgroups are addressing:Access to Healthcare Services: Focus on developing strategies to support timely access to primary care, specialty care, diagnostics, and inpatient services. This area has four primary objectives:1. Improve Patient Access for Primary Care, Specialists, and Diagnostic Procedures2. Develop and implement a community-based population health program3. Investigate, Plan, Build and Launch First Phase of a Digital Health Strategy4. Support access to primary and preventive care for vulnerable populations.Strategies to meet these objectives are as follows:-Optimize scheduling rules, templates, and processes-Standardize scheduling practices-Develop specialist referral criteria-Build Population Health Infrastructure-Develop Primary Case Management program-Provide education and promotion concerning use of advanced directives-Determine organizational and community needs and solutions options-Develop business plan for the digital health strategy-Increase support of All Women Count SD programMental Health: Increase access and awareness of culturally appropriate mental health resources and education. This priority has three objectives:1. Reduce stigma of mental health and increase public and provider awareness of available mental health resources available in their community.2. Improve mental health screening process across the Black Hills region (starting with Regional Health system)3. Explore adding mental health access into primary care clinicsStrategies to meet these objectives are as follows:-Partner with 211 Helpline to develop a comprehensive list of mental health resources in the service area -Create a community mental health asset map-Develop publicity campaign in partnership with community to reduce stigma of mental health-Develop education for providers on importance of screening process-Standardize mental health screening tool -Standardize process for referrals of patients who screen positive -Develop case management program for mental health-Build business case -Explore other access solutions (telehealth, mobile)Wellness: 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:1. Increase community awareness of chronic disease prevention and management programs that promote healthy lifestyle choices 2. Enhance access to organized well-being programs and activities in the community Strategies to meet these objectives are as follows:-Marketing campaign for existing health promotion programs -Enhance access to the Regional Health Diabetes Prevention Program-Develop pediatric diabetes prevention program (pilot in Rapid City and Spearfish communities)-Enhance access to the Better Choices Better Health (BCBH) Program -Explore partnership with local Native American agency (non-healthcare)-Expand Regional Health Employee Well-being program to offer consulting to organizations in the Rapid City and Spearfish Communities by the end of 2017 and Lead/Deadwood, Custer, and Sturgis communities by end of 2018-Live Well Black Hills resource support-Develop toolkit of disease prevention and disease management resources for providers (including referral process) Group A-Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 13b: Must reside within 200 mile radius of the location where the service was received. Group A-Facility 4 -- Lead-Deadwood Regional Hospital Part V, Section B, line 16i: The FAP application form is widely available on a the URL: http://www.regionalhealth.com/patients-and-familiesA 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. Group A-Facility 4 -- Lead-Deadwood Regional Hospital 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. 10 1 - Custer Regional Senior Care 1065 Montgomery Street Custer SD 57730 Skilled Long Term Nursing Home 2 - Massa Berry Regional Medical Clinic 890 Lazelle Street Sturgis SD 57785 Clinic 3 - Sturgis Regional Senior Care 949 Harmon Street Sturgis SD 57785 Skilled Long Term Nursing Home 4 - Newcastle Regional Medical Clinic 1121 Washington Blvd Newcastle WY 82701 Clinic 5 - Fairmont Grand Regional Senior Care 409 east Fairlane Drive Rapid Ctiy SD 57701 Assisted Living 6 - Golden Ridge Regional Senior Care 200 Montana Ave Lead SD 57754 Assisted Living 7 - Wedgewood Regional Senior Care 423 N 10th Street Custer SD 57730 Assisted Living 8 - Hot Springs Regional Medical Clinic 130 North 15th St Hot Springs SD 57747 Clinic 9 - Buffalo Regional Medical Clinic 209 Ramsland Street Buffalo SD 57720 Clinic 10 - Upton Regional Medical Clinic 717 Pine Street Upton WY 82730 Clinic 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 and 7i. Part I, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $8,671,184. Part II, Community Building Activities: Regional Health provides numerous community benefit health events and screenings throughout the Black Hills Region. 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 heath 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 4: The footnote to the financial statements that describes bad debt expense is located on page nine and ten of the audited financials. Part III, Line 8: The Medicare shortfall is derived from the actual payments received from the Medicare program for services provided to patients with Medicare coverage. The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. The result is a shortfall with costs exceeding the reimbursement.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. Schedule H Part V In prior information returns a Schedule H was submitted for Spearfish Regional Surgery Center because it was a separately licensed hospital. Commencing with the reporting organization's fiscal year 2015 (July 1, 2014), Spearfish Regional Surgery Center (then operated by Regional Health Physicians, Inc.) became a department of Spearfish Regional Hospital (operated by Regional Health Network, Inc.). The Surgery Center and the Hospital were and are located in the same community but were operated by different, but related, entities. With the transfer of the Surgery Center to the Hospital, the Surgery Center was no longer a separately licensed hospital, and a separate Schedule H is no longer provided for it. The transfer of the Surgery Center to the Hospital did not change its financial assistance policies or identified community health needs which were and remain the same as those reflected in the Schedule H for Spearfish Regional Hospital. Part VI, Line 2: In Tax Year 2015, Regional Health conducted a Community Health Needs Assessment (CHNA) that included Rapid City Regional Hospital, Same Day Surgery Center, Spearfish Regional Hospital, Sturgis Regional Hospital, Lead-Deadwood Regional Hospital, Custer Regional Hospital, and Hans P. Peterson Memorial Hospital. Regional Health contracted with Professional Research Consultants, Inc. (PRC) to conduct the needs assessment. PRC is a nationally recognized health care consulting firm with extensive experience conducting Community Health Needs Assessments in hundreds of communities across the United States since 1994. PRC conducted Regional Health's previous CHNA in Tax Year 2012.The assessment incorporated data from both quantitative and qualitative sources. Quantitative data input included primary research (the PRC Community Health Survey) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for trending and comparison to benchmark data at the state and national levels. Qualitative data input included primary research gathered through an Online Key informant Survey.A variety of existing (secondary) data sources was consulted to complement the research quality of this Community Health Needs Assessment. Data for the service area was obtained from the following sources:* Center for Applied Research and Environmental Systems (CARES)* Centers for Disease Control & Prevention, Office of Infectious Disease, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention* Centers for Disease Control & Prevention, Office of Public Health Science Services, Center for Surveillance, Epidemiology and Laboratory Services, Division of Health Informatics and Surveillance (DHIS)* Centers for Disease Control & Prevention, Office of Public Health Science Services, National Center for Health Statistics* Community Commons* ESRI ArcGIS Map Gallery* National Cancer Institute, State Cancer Profiles* OpenStreetMap (OSM)* US Census Bureau, American Community Survey* US Census Bureau, County Business Patterns* US Census Bureau, Decennial Census* US Department of Agriculture, Economic Research Service* US Department of Health & Human Services* US Department of Health & Human Services, Health Resources and Services Administration (HRSA)* US Department of Justice, Federal Bureau of Investigation* US Department of Labor, Bureau of Labor StatisticsThe needs assessment report was completed in November 2015 (Tax Year 2015). Each network hospital's Advisory Council reviewed the areas of opportunity from the 2015 CHNA report, completed in Tax Year 2015. Utilizing input from the Councils, the Regional Health Network Board of Directors approved the following priority areas as the focus of the community-based efforts and resources for FY2017-FY2019: Access to Healthcare Services, Mental Health, and Wellness (Nutrition, Physical Activity, and Weight). Workgroups comprised of caregivers representing each of the communities served by Regional Health developed the goals, objectives, and strategies for each of the selected priority areas from across the system. A proposed Community Health Implementation Strategy was then written to address the community's health needs. In September, 2016, the Regional Health Network Board reviewed, discussed and approved the implementation strategies for addressing the community health priorities identified through the Community Health Needs Assessment. 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 http://www.regionalhealth.com/patients-and-families. 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 Network is governed by a community board that provides leadership to the organization to meet the needs of the communities it serves. Regional Health partners with several educational institutions to provide numerous clinical training programs that would otherwise not exist in our region.Regional Health provides numerous community health education events and screenings throughout the Black Hills Region. 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 and other charitable programs. 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. and Regional Health Network, Inc. These corporations work together to meet the health care needs of the region. Financial Assistance Policy As required under the final treasury regulations issued under Section 501(r) of Internal Revenue Code, Regional Health's (parent organization) Board of Directors, adopted the current FAP for fiscal year ending June 30, 2016. Its approval is applicable to all of Regional Health's hospital facilities, including RHN's hospital facilities. On May 17, 2016, Regional Health's Finance and Investment Committee recommended that the current FAP be adopted by Regional Health's Board of Directors at its June 16, 2016 meeting. However, due to an inadvertent oversight, it was left off the agenda for that meeting. Once the error was discovered, an electronic vote of the Board was taken to adopt the FAP. Thus, the Board of Directors did not officially adopt the current FAP until August 2, 2016. The delay was slight, RHN immediately corrected the error once discovered, and RHN is not aware of any patient being harmed by this slight delay. Thus, because the error was not willful or egregious and RHN is disclosing such error on its Form 990 in accordance with Treasury Regulation Section 1.501(r)-2(c), the error should not be considered a failure to meet the requirements of Section 501(r) of the Code. X 0 0 1 1 0 0 0 0 0 1 0 Lee B Bailey MD Director 358659 0 0 0 23633 0 36132 0 25707 0 444131 0 23633 0 Christopher Gasbarre DO Director 0 506011 0 0 0 0 0 43250 0 22566 0 571827 0 0 Brent Phillips President and CEO 0 664243 0 54500 0 6000 0 47250 0 14754 0 786747 0 0 Mark A Thompson CFO 0 374676 0 37156 0 7807 0 50697 0 16626 0 486962 0 7807 Maureen Henson VP Human Resources 0 228049 0 14924 0 0 0 20269 0 1607 0 264849 0 0 Richard S Latuchie VP Info Technology/ CIO 0 278400 0 18830 0 0 0 14588 0 30363 0 342181 0 0 Mary E Masten General Counsel 0 310536 0 20217 0 0 0 24203 0 17830 0 372786 0 0 Kyle Richards President - Hills Mkt 251151 0 28704 0 0 0 21708 0 24055 0 325618 0 0 0 Veronica Schmidt President - Custer 149737 0 9564 0 0 0 14560 0 24629 0 198490 0 0 0 Mark Schulte President - Sturgis 162335 0 10920 0 0 0 14846 0 22190 0 210291 0 0 0 Larry Veitz President - Spearfish 219996 0 14441 0 12360 0 26715 0 17150 0 290662 0 12360 0 Krista Birkelo DO Physician - Emergency Services 301995 0 0 0 0 0 29741 0 7962 0 339698 0 0 0 Christopher Fromm MD Physician - Emergency Services 327788 0 0 0 10313 0 34092 0 22389 0 394582 0 10313 0 Jesse P Kurtenbach Nurse Anesthetist 169111 0 500 0 0 0 5517 0 16322 0 191450 0 0 0 M Donald Potts MD Physician - Emergency Services 175326 0 0 0 1788 0 6446 0 7765 0 191325 0 0 0 Thomas Reid Nurse Anesthetist 186068 0 700 0 0 0 9212 0 23648 0 219628 0 0 0 Charles E Hart MD Former President Emeritus 0 126523 0 83929 0 0 0 7605 0 2911 0 220968 0 0 Timothy H Sughrue Former CEO RCRH/RHN & COO RHI 0 254755 0 0 0 340963 0 9712 0 8096 0 613526 0 0 Part I, Line 1a The following individuals received "Tax Indemnification and gross-up payments" for the cost of life insurance in excess of $50,000: Lee Bailey 210 Krista Birkelo 169 Christopher Fromm 282 Christopher Gasbarre 265 Maureen G. Henson 1,778 Richard S. Latuchie 3,186 Mary E. Masten 3,215 Brent Phillips 2,731 Donald Potts 1,242 Kyle L. Richards 274 Veronica L. Schmidt 274 Mark D. Schulte 219 Mark A. Thompson 2,094 Larry W. Veitz 1,178 Part I, Line 3 The Compliance, Audit and Compensation 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. Please see Form 990, part VI, Lines 15a & 15b disclosure on Schedule O. Part I, Lines 4a-b 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: Henson, Maureen $12,792 Phillips, Brent $39,300 Thompson, Mark $32,081 Richards, Kyle $13,561 Schmidt, Veronica $9,085 Schulte, Mark $9,360 Veitz, Larry $13,717 Bailey MD, Lee $21,935 Birkelo DO, Krista $21,141 Fromm MD, Christopher $20,542 Gasbarre DO, Christopher $34,333 Severance payments were made to the following individual: Timothy Sughrue $340,963 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 Board's Compliance, Audit and Compensation Committee reviews and approves all incentive compensation performance measures and all awards, if any. The committee ensures that the total compensation, including incentive awards, is reasonable. Form 990, Part III, line 2 Spearfish Regional Hospital started providing Chemotherapy services on 07/01/15. The Spearfish Regional Health Clinics all were designated as "Provider based clinics" to the Spearfish Hospital - Provider # 43-0048 as of 06/15/15. This includes Spearfish Regional Medical Clinic, Queen City Regional Medical Clinic, Spearfish Regional Orthopedics and Regional Dermatology. Also within this same time frame the Belle Fourche Rural Health Care Clinic - provider 43-3440 also became a provider based Rural Health Clinic. These clinics are now owned and operated under the Organization's EIN. The Spearfish REgional Hospital's Queen City Regional Medical Clinic did offer extended hours and same day appointments beginning in October 2015 in preparation for offering urgent care services. Form 990, Part III, line 3 RHN discontinued some of its assisted living services. 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 Inc. on behalf of the Obligated Group. The Obligated Group consists of Rapid City Regional Hospital Inc., 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 Inc.'s tax return. Form 990, Part V, Line 1a: All 1099's are issued centrally by Rapid City Regional Hospital, Inc., a related organization. Form 990, Part VI, Section A, line 1 The membership of the Executive Committee of the corporation shall consist of the following: Chairman of the Board of Directors, Vice Chairman of the Board of Directors, Secretary, Treasurer, the most recent past Chairman of the Board of Directors unless such person is otherwise a member of the Committee (and only if the person continues to be a member of the Board of Directors), and the Corporation's President. The Chairman of the Board of Directors shall serve as Chairman 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 as otherwise provided by the Board of Directors. 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. 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. Form 990, Part VI, Section A, line 2 Brent Phillips has a business relationship with the following individuals due to being the CEO of the supporting organization that exercises reserve powers over the supported organizations that employ each of these key employees: Maureen Henson; Richard Latuchie; Mary Masten; Kyle Richards; Veronica Schmidt; Mark Schulte; Mark Thompson; Larry Veitz and employed Board Members: Lee Bailey MD; Christopher Gasbarre DO. Form 990, Part VI, Section A, line 4 The bylaws of the Organization were amended with the following significant changes: -Following changes made to Regional Health, Inc., the President/CEO was changed to a non-voting member of the board, -System Committees were established to further increase responsiveness and gain more direct and efficient input from the supported organization's in Regional Health, Inc.'s decision-making. The amended bylaws require that at least one member of each supported entity's governing board be a member of the committee, along with members from the supporting organization's governing body. -Bylaw provisions were modernized to permit notices, meetings, etc. to be sent or attended and action to be taken through electronic means, -Added additional duties to the duties of the governing body related to accomplishment of strategic goals and Medical staff oversight. Form 990, Part VI, Section A, line 6 Regional Health, Inc. is the sole member of Regional Health Network, Inc. Form 990, Part VI, Section A, line 7a Regional Health, Inc., being the sole member of Regional Health Network, Inc., has the ability to appoint or remove all members of Regional Health Network, Inc.'s board. 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 the Supported Organizations. Form 990, Part VI, Section B, line 11 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 a part of the annual disclosure of potential conflicts process, all board members, officers, and management each required to complete a disclosure statement. Annually, a summary list of all conflicts disclosed by board members is prepared and provided to the full board so board members are aware of the conflicts/interests of other board members and are able to point out conflicts if an individual member with a conflict forgets. Additionally, the agenda for each board meeting and each board committee meeting includes an initial agenda item "Conflicts of Interest" where board members are asked if they have any conflicts related to the other items on the agenda. All employees are covered by the conflict of interest policy but completion of the annual disclosure statement is limited to board and board committee members, management, and certain physicians. When a proposed transaction involves a board member, the transaction is reviewed by the compliance and audit committee. At meetings, board members who have a conflict of interest may be invited to speak on the matter by the chairman, but are not permitted to vote on the matter and are required to leave the meeting during discussion, after they have made any comments invited by the chair. Failure to comply with this policy constitutes ground for removal from office or membership and in the case of all employees, termination of employment. 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 XI, line 9: Golden Ridge Facility Sale Net Asset Adjustment 1,198,469. Fairmont Grand Facility Sale Net Asset Adjustment 7,154,303. Regional Health Inc 353 Fairmont Blvd Rapid City SD 57701 201487506 Healthcare SD 501(c)(3) Line 11c, III-FI N/A 0 Rapid City Regional Hospital Inc 353 Fairmont Blvd Rapid City SD 57701 460319070 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 N/A Black Hills Medical Office BD LLC 353 Fairmont Blvd Rapid City SD 57701 411992146 Medical Office Bldg SD N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0