2014-05-14T06:42:21-05:00 2013-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2012-07-01 460319070 Rapid City Regional Hospital Inc RAPI 6057559130 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 Mark Thompson 6057559130 2014-05-08 1 Kim Hunwardsen CPA P00484560 6122536500 2014-05-08 2012 2015-11-30 17:44:51Z Charles E Hart MD M 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 490836789 0 X www.regionalhealth.com X 1973 SD To provide and support health care excellence in partnership with the communities we serve. 15 8 3973 410 4994983 824758 4749192 5089909 380122755 464768579 20801982 18133397 57130874 1899254 462804803 489891139 0 0 0 0 195882187 206764787 0 0 386275 205734979 233148788 401617166 439913575 61187637 49977564 862197416 923907347 268087313 246708870 594110103 677198477 X To provide and support health care excellence in partnership with the communities we serve. 0 0 21776494 103122499 Pharmacy - provide pharmaceuticals in support of acute care hospital patients. 20540680 92309580 Surgical services - provide in and out patient surgical services to acute care patients. 12216325 76468425 Laboratory - provide laboratory testing in support of acute care patients. 242871934 192953797 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. 242871934 192953797 297405433 1 1 0 1 0 0 0 0 0 1 1 1 0 1 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 1 1 0 0 1 455 0 1 3973 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC CA X Mark Thompson 6057559130 353 Fairmont Blvd PO Box 6000 Rapid City SD 57701 Sharon I Lee 1.70 0.00 X X 0 0 0 Dennis Popp 1.90 0.00 X X 0 0 0 Tamara Riddle-Schumacher 2.00 0.00 X X 0 0 0 Jim Sorensen 1.70 0.00 X X 0 0 0 Roy Dishman 3.00 0.60 X 0 0 0 Gene Farrens 1.00 0.00 X 0 0 0 Timothy Frost MD 0.90 0.00 X 0 0 0 Stephen Kovarik MD 1.60 0.00 X 0 0 0 Jack Lynass 1.50 0.00 X 0 0 0 Tom Morrison 3.00 0.60 X 0 0 0 Lisa Seaman 2.10 0.40 X 0 0 0 Gregory Smith MD 41.10 0.00 X 262722 0 41631 Kyle D White 1.50 0.00 X 0 0 0 Charles E Hart MD 43.50 16.50 X X 0 994824 55181 Timothy H Sughrue 46.10 8.90 X X 742560 0 57208 Joseph C Sluka Jr 39.80 15.20 X 546963 0 62576 Mark A Thompson 39.80 15.20 X 489624 0 72816 James M Keegan MD 46.20 8.80 X 539101 0 22573 Robert G Allen Jr MD 55.00 0.00 X 358939 0 27572 Allan L Berreth 55.00 0.00 X 240772 0 40784 Mark F Brodin 39.80 15.20 X 244240 0 51837 Paul W Clemments 55.00 0.00 X 168702 0 28933 Shawn Y DeGroot 39.80 15.20 X 191663 0 30995 Jeanne A Galbraith 55.00 0.00 X 204928 0 33003 Dale E Gisi 39.80 15.20 X 155380 0 21543 Rita K Haxton 55.00 0.00 X 282684 0 65111 Jennifer D Horton 39.80 15.20 X 197112 0 35622 Suzanne P Koehler 55.00 0.00 X 181352 0 43238 Richard S Latuchie 39.80 15.20 X 333183 0 45241 Mary E Masten 39.80 15.20 X 420927 0 57426 Robert O McGlone 39.80 15.20 X 295324 0 51386 Michael P D'Urso MD 40.00 0.00 X 615849 0 75659 John K Heilman III MD 40.00 0.00 X 740406 0 79170 Jose M Teixeira MD 40.00 0.00 X 931483 0 36784 Joseph L Tuma MD 40.00 0.00 X 868670 0 79891 Amad Zineldine MD 40.00 0.00 X 674264 0 92159 9686848 994824 1208339 207 0 1 0 Rapid City Emergency Serv 353 Fairmont Blvd Rapid City SD 57701 ER Physician Coverage 9718967 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Temp Physician Staff 2947316 Avera McKennan Hospital 800 East 21st ST Sioux Falls SD 571175045 EICU Services Fees 1346800 H&R Accounts Inc 61265 Johndeere Parkway Moline IL 61262 Patient Self-Pay Billing 1207634 Cassling Diagnostic Imaging 13808 F Street Omaha NE 681371102 Equip Serv Agmt; Labor/Travel Reimb 1179444 88 754742 4335167 5089909 In Patient Pharmacy 446110 103122499 103122499 Surgical Services 622110 92309580 92309580 Laboratory 621500 80307753 76468425 3839328 Cath Lab 621500 37521351 37521351 Respiratory Therapy 622110 33827254 33827254 117680142 117680142 464768579 17823329 34494 17788835 76229 76229 898214 416592 481622 481622 481622 403024 169185 0 -169185 403024 233839 233839 379849 169100 210749 210749 276495 190773 85722 85722 Other UBI 900099 1121161 1121161 1121161 489891139 461014973 4994983 18791274 9373138 3777997 5595141 112745 112745 175689065 136395677 39078076 215312 4413573 3343672 1064769 5132 4958214 3762817 1189663 5734 12218052 9183346 3019302 15404 798561 798561 233000 233000 39427384 20817874 18609510 293256 15346 249717 28193 1661343 711382 940532 9429 9342841 2000450 7342391 6359522 484730 5874792 538072 357057 179748 1267 1338061 773934 559808 4319 4405958 146415 4259543 21311912 9437128 11872940 1844 1619887 331898 1287989 Medical Supplies 72988011 72988011 Intercompany Services & 31294102 785005 30509097 Bad Debt Expense 23248559 23248559 18288319 8731390 9457288 99641 439913575 297405433 142121867 386275 7035183 4417092 64327994 70513535 9182870 10096684 8004963 7994310 470112211 301823969 150599711 168288242 472387635 487785884 2126511 150659060 172685089 862197416 923907347 45365022 42663804 174011840 166608616 48710451 37436450 268087313 246708870 X 582558987 663117309 9803137 12418239 1747979 1662929 594110103 677198477 862197416 923907347 X 49977564 24172486 8938324 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 262813 1 19134 0 1 30850 312797 0 Explanation of Lobbying Activities: Part II-B, Line 1: During fiscal year 2013, Rapid City Regional Hospital paid $262,813 to the South Dakota Association of Healthcare Organizations to further the efforts related to the healthy communities ballot question "Moving South Dakota Forward". Schedule C, Part II-B, Line 1g & 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 2012 dues, which were paid in fiscal year 2013, in the amount of $323,358, 4.98% 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 2012 dues, which were paid in fiscal year 2013, in the amount of $61,497, 23.98% was used for lobbying purposes. Expenditures of $19,134 were incurred related to lobbying efforts with the South Dakota Legislature on matters pertaining to healthcare. 1747979 10000 95050 1662929 1747979 1747979 1747979 1747979 1747979 1747979 1747979 1747979 1.00000 0 0 2443047 2443047 225778394 119302152 106476242 218048720 175341817 42706903 23842050 7180000 16662050 168288242 Current Funds Bond Indenture 23253517 F Designated By Board 444139218 F Designated By Donor 20393149 F 487785884 Intercompany Receivables 114242659 Other Receivables 4298349 Bond Issue Costs, Net 1837235 Other Long Term Assets 52306846 172685089 Payable Under Interest Rate Swap 10294715 Other Long Term Liabilities 13408210 Accrued Pension Liability 13733525 37436450 X Description of Intended Use of Endowment Funds: 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 temporarily 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. During the year, $95,050 of Board designated permanently restricted funds were released from their restrictions in support of radiology student tuition assistance. This assistance will be provided for those individuals currently enrolled in the radiology program. Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Rapid City Regional Hospital 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. Rapid City Regional Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). In addition, Rapid City Regional Hospital may be subject to income tax on income that is derived from business activities that are unrelated to its tax exempt purpose. Rapid City Regional Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. Rapid City Regional Hospital 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. Rapid City Regional Hospital's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2009. Duck Race 103504 103504 34203 Tough Enough to Wear Pink 147689 147689 80170 12 128656 128656 54727 379849 379849 169100 169100 210749 1 1 X 0 0 1 1 1 0 1 1 11835099 11835099 0.02840 42976100 32144143 10831957 0.02600 54811199 32144143 22667056 0.05440 11 5948 235346 235346 0.00060 5 238 5507463 3851169 1656294 0.00400 1982900 1904752 78148 0.00020 2299413 1976439 322974 0.00080 6 90 532918 532918 0.00130 22 6276 10558040 7732360 2825680 0.00690 22 6276 65369239 39876503 25492736 0.06130 3 7473 7473 0.00000 2 2116 2116 0.00000 2 4039 4039 0.00000 2 35 2897 2897 0.00000 1 276 151 151 0.00000 10 311 16676 16676 1 23248559 1710818 119950345 124081576 -4131231 X 1 1 1 Black Hills Medical Office BD LLC Office Building 0.67930 0.32070 2 Medical & Dental Building Office Building 0.71450 0.28500 3 The Imaging Center Medical Imaging 0.50000 0.50000 4 The MRI Center Medical Imaging 0.33330 0.66670 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

X X X X 2 Same Day Surgery Center

651 Cathedral Drive Rapid City SD 57701

X Rapid City Regional Hospital Inc 1 1 X X X X X X X X X 12 1 1 1 X X X X 0 0 1 0 0 1 X X 1 1 X X 1 0 X X X 1 X 0 1 Same Day Surgery Center 2 1 X X X X X X X X X 12 1 1 1 X X X X 0 0 1 0 0 1 X X 1 1 X X 1 0 X X X 0 X X 0 1 3 Regional Heart Doctors

4150 Fifth Street Rapid City SD 57701

Clinic Regional Med Clinic - Neurology & Rehab

2929 Fifth Street Rapid City SD 57701

Clinic Family Medicine Residency

502 E Monroe Suite 401 Rapid City SD 57701

Family Medicine Residency Program References to "Regional Health" apply to all entities controlled or leased by Regional Health, Inc. This includes the reporting entity. Part I, Line 3c: Regional Health uses low income housing guidelines from Housing and Urban Development for determining financial assistance eligibility. The income guidelines, along with the number of dependents within the household, are used in a matrix to determine the percent discount applied to the outstanding balance. Discounts range from 100% to 10% of the balance. The financial assistance policy (i.e. charity policy) also has a catastrophic provision which limits a patient/guarantor's exposure to the lesser of the financial assistance reductions or 20% of the family's annual gross income. Part I, Line 6a: A community benefit report is completed by Regional Health, the parent organization, for all related organizations and made available to the public on its website at the following url:http://www.regionalhealth.com/About-Us/Community-Report.aspx. 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, L7 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 $23,248,559. Part II: 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 health events and activities. Part III, Line 4: The bad debt reported on line 2 is at charges.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.The footnote to the Organization's financial statements can be found on pages seven and eight of the attached audited financial statements. 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 expressed 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) Proposed Regulations timelines for notifications and collections. Rapid City Regional Hospital, Inc. Part V, Section B, Line 3: As part of the community health needs assessment, one focus group was held on September 24, 2012. The focus group participants were comprised of 13 key informants, including representatives from public health, Indian Health Services, other health professionals, social service providers, and other community leaders. 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. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. Same Day Surgery Center Part V, Section B, Line 3: As part of the community health needs assessment, one focus group was held on September 24, 2012. The focus group participants were comprised of 13 key informants, including representatives from public health, Indian Health Services, other health professionals, social service providers, and other community leaders. 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. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. Rapid City Regional Hospital, Inc. Part V, Section B, Line 4: 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. Same Day Surgery Center Part V, Section B, Line 4: 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. Rapid City Regional Hospital, Inc. Part V, Section B, Line 5c: The Community Health Needs Assessment is made widely available to the public at the following url: www.regionalhealth.com/chna. Same Day Surgery Center Part V, Section B, Line 5c: The Community Health Needs Assessment is made widely available to the public at the following url: www.regionalhealth.com/chna or http://www.samedaysurgerycenter.org/community-health-needs-assessment/. Rapid City Regional Hospital, Inc. Part V, Section B, Line 6i: Due to the timing of the adoption of the implementation strategy, Rapid City Regional Hospital has not had the time to execute the implementation strategy. The implementation strategy was made available upon request. Same Day Surgery Center Part V, Section B, Line 6i: Due to the timing of the adoption of the implementation strategy, Same Day Surgery Center has not had the time to execute the implementation strategy. The implementation strategy was made available upon request. Rapid City Regional Hospital, Inc. Part V, Section B, Line 7: In review of the needs identified in the CHNA, Rapid City Regional Hospital has identified the areas below that will not be addressed due to prioritization of health needs:1) Cancer: Rapid City Regional Hospital partners with All Women Count program promoting early detection for women who might have financial barriers to breast cancer screening. Awareness activities through the American Cancer Society currently exist in the community and surrounding area. 2) Conditions of Aging: In the area of Alzheimer's deaths, there are local licensed skilled nursing facilities providing services to the elderly of the community, including those with Alzheimer's Disease. Other organizations provide in-home services and case management to elders in the community with conditions of aging, such as difficulty seeing and hearing, assisting in obtaining adaptive equipment and transportation. 3) Maternal, Infant, Child Health: As a provider of maternal, infant and child hospital care in the community, Rapid City Regional Hospital believes it fulfills its role in this area. It was therefore given a lower priority that excluded this as an area chosen for action. Rapid City Regional Hospital supports programs that address these issues, such as the Cribs for Kids program through the South Dakota Department of Health.4) Oral Health: Rapid City Regional Hospital has limited 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 expertise excluded this as an area chosen for action.5) Respiratory Diseases: Rapid City Regional Hospital believes this priority area falls within the purview of other available community resources, including outpatient clinical settings. 6) Substance Abuse: Rapid City Regional Hospital believes efforts outlined in its plan for mental health and mental health resources will also have a positive impact on substance abuse. A separate set of specific initiatives in this area is not justified at this time.7) Tobacco Use: Rapid City Regional Hospital is a tobacco-free facility. The facility provides smoking cessation screening to our patients and refers patients and employees to the South Dakota Quit Line for ongoing support. Lower priority excluded this as an area chosen for action.Due to the timing of the adoption of the implementation strategy, Rapid City Regional Hospital has not had the time to execute the implementation strategy during fiscal year 2013 to address the needs of the community that the Hospital has determined it will address. The needs that will be addressed in the future are as follows: 1) access to health services; 2) diabetes; 3) injury and violence prevention; 4) mental health and mental disorders; and 5) nutrition, physical activity and weight status. Same Day Surgery Center Part V, Section B, Line 7: In review of the needs identified in the CHNA, Same Day Surgery Center has identified the areas below that will not be addressed due to prioritization of health needs:1) Access to Health Services: Same Day Surgery Center felt that more pressing health needs existed. Lower priority excluded this as an area chosen for action.2) Conditions of Aging: Limited resources and population served excluded this as an area chosen for action.3) Maternal, Infant, Child Health: Same Day Surgery Center does not have an obstetrics program. Limited resources and lower priority excluded this as an area chosen for action.4) Mental Health & Mental Disorders: The community currently has several programs and services in place to assist in addressing mental health issues. Mental health issues are best addressed as a community as a whole and deemed out of the scope for a surgical hospital.5) Nutrition, Physical Activity & Weight Status: Same Day Surgery Center contracts dietary and physical therapy services through Rapid City Regional Hospital. Limited resources excluded this as an area chosen for action.6) Oral Health: Same Day Surgery Center provides general anesthesia dental service, however limited resources and lower priority excluded this as an area chosen for action.7) Respiratory Diseases: Same Day Surgery Center contracts respiratory therapy services through Rapid City Regional Hospital. Limited resources and lower priority excluded this as an area chosen for action.8) Substance Abuse: Same Day Surgery Center believes this priority area falls more within the purview of the county health department and other community organizations. Limited resources and lower priority excluded this as an area chosen for action.9) Tobacco Use: Same Day Surgery Center is a tobacco-free facility. The facility provides smoking cessation screening to our 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.Due to the timing of the adoption of the implementation strategy, Same Day Surgery Center has not had the time to execute the implementation strategy during fiscal year 2013 to address the needs of the community that the Same Day Surgery Center has determined it will address. The needs that will be addressed in the future are as follows: 1) cancer; and 2) injury and violence prevention. Rapid City Regional Hospital, Inc. Part V, Section B, Line 10: Housing and Urban Development (HUD) income limits as designated for the State of South Dakota are used to determine eligibility for providing free or discounted care. Same Day Surgery Center Part V, Section B, Line 10: Housing and Urban Development (HUD) income limits as designated for the State of South Dakota are used to determine eligibility for providing free or discounted care. Rapid City Regional Hospital, Inc. Part V, Section B, Line 11: Housing and Urban Development (HUD) income limits as designated for the State of South Dakota are used to determine eligibility for providing free or discounted care. Same Day Surgery Center Part V, Section B, Line 11: Housing and Urban Development (HUD) income limits as designated for the State of South Dakota are used to determine eligibility for providing free or discounted care. Rapid City Regional Hospital, Inc. Part V, Section B, Line 12h: Means testing of net assets in excess of 200% of household income will be considered income for the purpose of the financial assistance program. Same Day Surgery Center Part V, Section B, Line 12h: Means testing of net assets in excess of 200% of household income will be considered income for the purpose of the financial assistance program. Rapid City Regional Hospital, Inc. Part V, Section B, Line 14g: A summary of the Hospital's financial assistance policy is posted for all patients at various points of entry, on the facility website, emergency and waiting rooms, and admissions office. The policy in its entirety is also available upon request. Same Day Surgery Center Part V, Section B, Line 14g: The policy in its entirety is available upon request. Rapid City Regional Hospital, Inc. Part V, Section B, Line 22: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. Same Day Surgery Center Part V, Section B, Line 22: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. Part VI, Line 2: The Community Health Needs Assessment was conducted in FY2013 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, Custer Regional Hospital, and Hans P. Peterson Memorial Hospital. In July 2012, we 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. The assessment incorporated data from both quantitative and qualitative sources. Quantitative data input included primary research (the PRC Community Health Survey, November 2012) and secondary research (vital statistics and other existing health-related data); these quantitative components allowed for trending and comparison to benchmark data at the state and national levels. Qualitative data input included primary research gathered through a Key Informant Focus Group.A variety of existing (secondary) data sources was consulted to complement the research quality of the Community Health Needs Assessment. Data for the service area were obtained from the following sources: * Centers for Disease Control & Prevention* National Center for Health Statistics* South Dakota Department of Public Health* US Census Bureau* US Department of Health and Human Services* US Department of Justice, Federal Bureau of InvestigationAs part of the needs assessment, one focus group was held on September 24, 2012. The focus group participants were comprised of 13 key informants, including representatives from public health, Indian Health Services, other health professionals, social service providers, and other community leaders. 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. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. The needs assessment report was completed in February 2013. After reviewing the findings, the Community Health Needs Assessment Steering Committee met regularly during the month of March, to determine the health needs to be prioritized for action in FY2014-FY2016. Following a detailed presentation of the Community Health Needs Assessment findings by PRC, steering committee members were led through a process of understanding key local data findings (Areas of Opportunity) and ranked identified health issues against the following established, uniform criteria: * Magnitude. The number of persons affected, also taking into account variance from benchmark data and Healthy People targets. * Impact/Seriousness. The degree to which the issue affects or exacerbates other quality of life and health-related issues. * Feasibility. The ability to reasonably impact the issue, given available resources. * Consequences of Inaction. The risk of not addressing the problem at the earliest opportunity. A proposed Implementation Strategy was then written to address the community's health needs. In the months of May and June, 2013, the organization's Board as well as the Board of Regional Health reviewed, discussed and approved the implementation strategies for addressing the community health priorities identified through the Community Health Needs Assessment. Part VI, Line 3: We provide information on all statements, on our website, we have information available at all admission areas, we contract with Midland Medical Group (an unrelated entity) to meet with all 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 serves the people of the Black Hills Region. The area is mostly rural in nature with only one city of over 50,000 people. Regional Health is the primary medical services provider for the region. Part VI, Line 5: Regional Health is governed by a community board that provides leadership to the organization to meet the community needs. Regional Health partners with the educational institutions to provide numerous clinical training programs, that if they were not provided by Regional Health would 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., Regional Health Network, Inc., and Regional Health Physicians, Inc. These corporations work together to meet the health care needs of the region. 0 1 0 0 0 0 0 0 0 Gregory Smith MD 243474 0 25 0 19223 0 36982 0 4649 0 304353 0 0 0 Charles E Hart MD 0 735994 0 252694 0 6136 0 47785 0 7396 0 1050005 0 0 Timothy H Sughrue 574517 0 165514 0 2529 0 49690 0 7518 0 799768 0 0 0 Joseph C Sluka Jr 396322 0 140393 0 10248 0 54920 0 7656 0 609539 0 0 0 Mark A Thompson 370699 0 118925 0 0 0 65653 0 7163 0 562440 0 0 0 James M Keegan MD 408704 0 130397 0 0 0 16417 0 6156 0 561674 0 0 0 Robert G Allen Jr MD 299848 0 59091 0 0 0 22676 0 4896 0 386511 0 0 0 Allan L Berreth 191624 0 49148 0 0 0 39223 0 1561 0 281556 0 0 0 Mark F Brodin 205381 0 38859 0 0 0 45606 0 6231 0 296077 0 0 0 Paul W Clemments 154610 0 14092 0 0 0 23368 0 5565 0 197635 0 0 0 Shawn Y DeGroot 146876 0 44787 0 0 0 26495 0 4500 0 222658 0 0 0 Jeanne A Galbraith 171899 0 33029 0 0 0 28368 0 4635 0 237931 0 0 0 Dale E Gisi 135184 0 20196 0 0 0 14296 0 7247 0 176923 0 0 0 Rita K Haxton 224434 0 58250 0 0 0 58130 0 6981 0 347795 0 0 0 Jennifer D Horton 159290 0 37822 0 0 0 28842 0 6780 0 232734 0 0 0 Suzanne P Koehler 141333 0 38158 0 1861 0 37186 0 6052 0 224590 0 0 0 Richard S Latuchie 272900 0 60283 0 0 0 39735 0 5506 0 378424 0 0 0 Mary E Masten 356206 0 64721 0 0 0 50247 0 7179 0 478353 0 0 0 Robert O McGlone 240711 0 54613 0 0 0 45846 0 5540 0 346710 0 0 0 Michael P D'Urso MD 566671 0 49178 0 0 0 67222 0 8437 0 691508 0 0 0 John K Heilman III MD 691228 0 49178 0 0 0 72714 0 6456 0 819576 0 0 0 Jose M Teixeira MD 882305 0 49178 0 0 0 32453 0 4331 0 968267 0 0 0 Joseph L Tuma MD 817979 0 49178 0 1513 0 74342 0 5549 0 948561 0 0 0 Amad Zineldine MD 625086 0 49178 0 0 0 86222 0 5937 0 766423 0 0 0 Part I, Line 3 The audit and compliance 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, Line 4b 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: Joseph C. Sluka Jr. $7,073 Mark A. Thompson $2,223 Rita K. Haxton $1,042 A SD Health & Educational Facilities Authority 460315509 83755VNL4 2008-08-14 67465000 Hospital Buildings & Equipment & Refund Series 2003 Bonds 0 0 0 B SD Health & Educational Facilities Authority 460315509 83755VQJ6 2010-08-17 54390000 Hospital Buildings & Equipment & Refund Series 1998 & 1999 Bonds 0 0 0 C SD Health & Educational Facilities Authority 460315509 83755VSW5 2011-11-22 50460000 Hospital Buildings & Equipment & Refund Series 2001 Bonds 0 0 0 A 505000 67538801 790000 45000 15073802 51125000 2011 1 0 1 1 B 8285000 57311279 785667 24107301 31601312 817000 2013 1 0 0 1 C 2730000 54585040 709782 15260120 23739401 14875736 2014 1 0 0 1 A 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 1 0.00750 1 1 B 0 1 1 0 1 0 0.00660 0.00000 0.00660 0 0 1 C 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 US Bank NA 16.200000000000 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 Schedule K Part IV, Arbitrage, Line 2c Date Rebate Computation Performed Issuer Name: SD Health & Educational Facilities Authority Date the Rebate Computation was Performed: 10/11/2011 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 67,465,000 Plus Interest Earnings 73,801 Total Part II, Line 3 67,538,801 Bond B: Issue Price 54,390,000 Plus Interest Earnings 23,508 Net Premium 2,897,771 Total Part II, Line 3 57,311,279 Bond C: Issue Price 50,460,000 Plus Interest Earnings 135,858 Net Premium 3,989,182 Total Part II, Line 3 54,585,040 West River Anesthesiology Associates Consultants PC (Steve Frost MD) Brother of board member Timothy Frost, MD is a greater than 5% owner 309643 Professional services agreement 0 Geib Elston Frost Professional Assoc (James Frost MD) Brother of board member Timothy Frost, MD is a greater than 5% owner 613561 Pathology and laboratory medical directorship services 0 Scott Eccarius MD Brother-in-law of key employee, Mary Masten 98794 Employed physician 0 Lindsey Seaman Daughter of board member, Lisa Seaman 13950 Employed by RCRH 0 Black Hills Power & Light Board member Kyle White is an officer of Black Hills Power & Light 2713162 Purchase of utility services 0 Premier Purchasing Partners LP President/CEO Charles Hart, MD is a board member of organization 367871 Operational benchmarking reporting services 0 Northern Plains Premier Collaborative President/CEO Charles Hart, MD is a board member of organization 151155 Purchasing collaborative 0 Black Hills Pediatrics & Neonatology Board member Stephen Kovarik, MD is greater than 5% owner 142995 Professional services agreement 0 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 Chief of the Medical Staff of Rapid City Regional Hospital, 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 CEO. 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 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 two members of Rapid City Regional Hospital's board also serve as voting members 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 business decisions made by 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 receive a copy of the conflict of interest policy and sign an acknowledgement they have read and understand it. Additionally, they are 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 B, line 15 The compliance and audit committee of the sole member's board, a committee that includes only board members deemed "independent", determines the appropriate base salary range of the CEO of the organization and its other executive staff. The CEO of the member or his designee then determines the actual base salary of the other executives within the committee-approved ranges based on a performance evaluation conducted by the CEO or designee. For determination of the base salary ranges, as well as incentive compensation, benefit plans and perquisites (total compensation), the compliance and audit committee retains an independent consultant, Sullivan and Cotter, to provide survey/comparability data for both base salary and total compensation at least every three years. The survey/compatability data was provided in February 2013 and new market ranges were approved by the compliance and audit committee in October 2013 based on this information. 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 at the Secretary of State's website. 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Adj to the Funded Status of the Pension Plan 6,537,185. Medical Staff Net Loss 25,677. Net Assets Released from Restriction 200,629. Gift Shop Net Income -85,721. Auxiliary Net Income -58,775. Amortized Bond Premium 463,224. Change in Interest Swap 1,562,816. Temporarily Restricted Net Asset Changes 378,339. Permanently Restricted Net Asset Changes -85,050. Form 990, Part XII, Line 2c Independent auditors are engaged by the compliance and audit committee of the Regional Health, Inc. (the parent organization) board of trustees. Final audit results, on a consolidated basis, are reported by the independent auditors directly to the compliance and audit committee. Regional Health Inc 353 Fairmont Blvd Rapid City SD 57701 201487506 Healthcare SD 501(c)(3) 11, Type III N/A 0 Regional Health Network Inc 353 Fairmont Blvd Rapid City SD 57701 460360899 Healthcare SD 501(c)(3) 3 Regional Health Inc 1 Regional Health Physicians Inc 353 Fairmont Blvd Rapid City SD 57701 460372454 Healthcare SD 501(c)(3) 3 Regional Health Inc 1 Medical & Dental Building 2805 S 5th St Rapid City SD 57701 460339629 Medical Office Bldg SD Rapid City Regional Hospital Inc Investment 23478 796415 0 0 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 -33920 1736768 0 0 0.67930 0 0 0 1 0 0 0 0 0 1 1 1 1 0 1 1 1 0 0 Regional Health Physicians Inc J 1056705 Cost Regional Health Network Inc L 7364327 Cost Regional Health Physicians Inc L 2587889 Cost Regional Health Network Inc M 1107681 Cost Regional Health Physicians Inc M 275684 Cost Regional Health Network Inc P 1626677 Cost Regional Health Physicians Inc P 1573224 Cost Regional Health Network Inc Q 123871 Cost