2026-04-13T17:41:00-05:00 2025-05-31 410746749 CLIFTONLARSONALLEN LLP 10401 W INNOVATION DR STE 300 WAUWATOSA WI 53226 990 2024-06-01 460391067 PRAIRIE LAKES HEALTH CARE SYSTEM INC PRAI 6058827000 PO BOX 1210 WATERTOWN SD 57201 NICHOLAS OLSON EVP, CFO 6058827000 2026-04-03 1 1 KRISTEN DONLEVY P01670215 4144761880 2026-04-03 2024 2025-03-06 01:10:19Z BILL GASSEN 2301 EAST 60TH ST SIOUX FALLS SD 57104 769468271 0 X WWW.PRAIRIELAKES.COM X 1986 SD PROVIDE HIGH QUALITY, AFFORDABLE & COMPASSIONATE HEALTHCARE SERVICES FOR THE PEOPLE IN THE REGION. 13 12 938 48 1560283 743892 509238 75046 137807185 162495977 21347993 38124376 2232731 2213053 161897147 202908452 253200 235896 0 0 76077199 85433144 0 0 0 70694096 84039949 147024495 169708989 14872652 33199463 441055297 461671217 54198135 50801968 386857162 410869249 WE MAKE A POSITIVE DIFFERENCE IN THE HEALTH OF THE PATIENTS AND COMMUNITIES WE SERVE. 0 0 149482123 298746 160935694 PRAIRIE LAKES HEALTH CARE SYSTEM SERVES TEN COUNTIES IN NORTHEASTERN SOUTH DAKOTA AND WESTERN MINNESOTA. IT IS COMMITTED TO PROVIDING ACCESSIBLE, HIGH QUALITY, COST-EFFECTIVE HEALTHCARE SERVICES. 34 PHYSICIANS HAVE BEEN RECRUITED OVER THE PAST DECADE TO BUILD NEW SERVICES AND BETTER SERVE THE COMMUNITY. IN 2025, A NEW CLINIC OPENED IN CASTLEWOOD, SOUTH DAKOTA FOCUSING ON PRIMARY CARE AND PHYSICAL THERAPY. 149482123 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 116 0 1 938 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X BONNIE CORDELL 6058827000 401 9TH AVENUE NW WATERTOWN SD 57201 CASEY JOHNSTON MD DIRECTOR/PHYSICIAN 40.00 X 1297767 0 80279 ROB PETERSON PAST CHAIR 1.00 X X 0 0 0 VINCE FOLEY CHAIR 1.00 X X 0 0 0 CHRIS CARTER VICE CHAIR 1.00 X X 0 0 0 SCOTT MUNGER SECRETARY 1.00 X X 0 0 0 MIKE LUKEN TREASURER 1.00 X X 0 0 0 ALAN CHRISTENSEN MD DIRECTOR 1.00 X 0 0 0 DON ROBY DIRECTOR 1.00 X 0 0 0 TAMMY DAVIS DIRECTOR 1.00 X 0 0 0 JONATHAN OVIATT DIRECTOR 1.00 X 0 0 0 KRISTEN HENDERSON DIRECTOR 1.00 X 0 0 0 JESSE PETERSON DIRECTOR 1.00 X 0 0 0 DOUG SHARP DIRECTOR 1.00 X 0 0 0 JOHN ALLEN PRESIDENT/CEO 40.00 X 601671 0 102697 LYNN SEVERSON CFO 40.00 X 334391 0 68328 TIM PUGSLEY CIO 40.00 X 304717 0 101327 ALISON GILBERTSON VP OF HUMAN RESOURCES 40.00 X 238268 0 47066 LAURIE FIEBER VP OF CLINIC OPERATIONS 40.00 X 240548 0 59538 SHELLY TURBAK CNO 40.00 X 272111 0 86496 RAVISHANKAR KALAGA MD PHYSICIAN 40.00 X 1414016 0 49058 JEFFREY SMITH MD PHYSICIAN 40.00 X 1466218 0 80279 GERALD RIEBER MD PHYSICIAN 40.00 X 1175212 0 87779 SVIEN SENNE PHYSICIAN 40.00 X 609090 0 80279 JACOB SCHAEFFER MD PHYSICIAN 40.00 X 1098681 0 80279 9052690 0 923405 131 0 1 0 CONSULTING RADIOLOGISTS LTD 7595 ANAGRAM DR EDEN PRAIRIE MN 55344 LOCUM COVERAGE 1403851 DMS HEALTH TECHNOLOGIES PO BOX 670747 DALLAS TX 75267 MEDICAL IMAGING 727065 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 LOCUM COVERAGE 715335 SIGHTPATH MEDICAL LLC PO BOX 204253 DALLAS TX 75320 LOCUM COVERAGE 620604 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 55480 SPECIALTY LABORATORY SERVICES 409828 28 75046 75046 NET PATIENT SERVICE REVENUE 621400 160935694 160935694 LAB SERVICE 621500 1339176 1339176 RETAIL PHARMACY 456110 221107 221107 162495977 8155617 8155617 1111621 0 1111621 1111621 1111621 596528395 183 566559819 0 29968576 183 29968759 29968759 OTHER INCOME 624100 472886 472886 REBATE REVENUE 900099 326509 326509 CAFETERIA REVENUE 624210 300133 300133 1904 1904 1101432 202908452 160935694 1560283 40337429 235896 235896 72723760 64646938 8076822 1931842 1931842 6122251 5239820 882431 4655291 4129469 525822 27341 27341 1228548 1228548 16120581 11868026 4252555 864701 55692 809009 2345815 1687467 658348 2714941 512191 2202750 1190300 1190300 711300 526805 184495 215077 151449 63628 932223 932223 8751068 8136913 614155 582987 582987 PRESCRIPTIONS 23352462 23352462 MEDICAL SUPPLIES 14896388 14896388 PROVISION FOR BAD DEBT 5234764 5234764 EQUIP RENT/MAINTENANCE 2921121 2800904 120217 1950332 1369587 580745 169708989 149482123 20226866 0 3485 3836 7269492 8360396 13995210 19786888 1289614 1173947 3800328 4820866 1722903 2265389 197832208 114945343 77008762 82886865 289116838 297275798 5201970 5524467 7525080 7138203 34121615 32434562 441055297 461671217 16273851 15688261 362752 209953 21070074 18710000 16491458 16193754 54198135 50801968 X 381714479 405406924 5142683 5462325 386857162 410869249 441055297 461671217 X 33199463 -9507019 319643 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 13144 13144 0 PART II-B, LINE 1: THE LOBBYING EXPENDITURES ARE THE PORTION OF DUES PAID TO AMERICAN HOSPITAL ASSOCIATION WITH 39% AND SOUTH DAKOTA HOSPITAL ASSOCIATION 4% THAT ARE USED FOR LOBBYING. 4423423 4423423 98378602 45146616 53231986 3063215 2638664 424551 86940483 67160063 19780420 5026485 5026485 82886865 DUE FROM 457(B) PLAN 8380881 REAL ESTATE INVESTMENT 18784898 ROU ASSETS 5227938 ABATEMENTS 40845 32434562 457(B) PAYABLE 8380881 LONG-TERM PTO 968498 ASSET RETIREMENT OBLIGATION 139322 NAMING RIGHTS PAYABLE 500000 LEASE OBLIGATIONS 725000 DUE TO/FROM RELATED PARTY 10354 ROU LEASE LIABILITIES 5469699 16193754 X 186639375 -9507019 -9507019 196146394 1228548 5533510 6762058 202908452 162946931 0 162946931 1228548 5533510 6762058 169708989 PART X, LINE 2: THE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT PRAIRIE LAKES IS A TAX-EXEMPT, NONPROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE HEALTH SYSTEM FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE HEALTH SYSTEM'S FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,234,764. DONATION EXPENSE 298,746. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,234,764. DONATION EXPENSE 298,746. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 18784898 0 0 0 0 0 0 18784898 0 18784898 1 0 0 1 1 0 1 1 X 1 X 1 X 1 1 1 0 0 5510160 5510160 0.03350 20929686 5449153 15480533 0.09410 26439846 5449153 20990693 0.12760 8286 8286 0.00010 21738364 15813834 5924530 0.03600 21746650 15813834 5932816 0.03610 48186496 21262987 26923509 0.16370 1 5234764 0 38696905 40109233 -1412328 X 1 1 1 1 PRAIRIE LAKES HOSPITAL 401 9TH AVE NW WATERTOWN SD 57201 WWW.PRAIRIELAKES.COM 10572 460391067 X X X PRAIRIE LAKES HEALTH CARE SYSTEM 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE PART V, SECTION B X 1 25 1 SEE PART V, SECTION B 0 1 X 150.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X SEE LINE 16J X SEE LINE 16J X SEE LINE 16J X X X X X X X 1 X 0 X X X 1 X 0 0 PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 5: PLHS UTILIZED COUNTY HEALTH RANKINGS TO EVALUATE HEALTH OUTCOMES AND HEALTH FACTORS FOR BOTH THE PRIMARY AND SECONDARY SERVICE AREA. THE COUNTY HEALTH RANKINGS ALLOWED COMPARISON BETWEEN THE COUNTY'S VALUES AND STATE OR NATIONAL AVERAGE. RESULTS WERE COMPARED WITH DATA FROM THE COMMUNITY. IN ORDER TO ADDRESS THE NEEDS OF THE ENTIRE "COMMUNITY," STAKEHOLDERS INCLUDED INDIVIDUALS FROM OUTSIDE THE PRIMARY SERVICE AREA OF PLHS. INPUT WAS OBTAINED THROUGH TWO FOCUS GROUP SESSIONS. SESSIONS WERE HELD OVER 2 DAYS AND APPROXIMATELY 25 ORGANIZATIONS WERE REPRESENTED. IN ADDITION TO FOCUS GROUPS THE HUMAN SERVICE AGENCY, IN COLLABORATION WITH A GRADUATE STUDENT PROJECT, PERFORMED A COMMUNITY SURVEY FOR RESEARCH AND ANALYSIS. THE CODINGTON COUNTY WELFARE COMMISSIONER'S ASSET MAP WAS INCORPORATED TO ESTABLISH AND VALIDATE SYSTEMS OF CARE TO IMPROVE COMMUNITY SERVICES. THE DATA FROM FOCUS GROUPS, THE COMMUNITY SURVEY, AND ASSET MAP WERE COMPILED. AREAS OF OVERLAP BETWEEN THE COUNTY HEATH RANKINGS AND THE FOCUS GROUPS WERE REVIEWED BY THE CHNA WORK GROUP AND NEEDS WERE IDENTIFIED AND PRIORITIZED. PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 7D: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT HTTPS://WWW.PRAIRIELAKES.COM/ABOUT-US/COMMUNITY-SUPPORT/.CHNA DIRECT LINK:HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/PRAIRIE-LAKES-V10-SITE-502/MEDIA BD8DC93B9A484456BFF87CF767B6C3E5/PLHS-CHNA_ASSESSMENT_2025_FINAL.PDFIMPLEMENTATION DIRECT LINK:HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/PRAIRIE-LAKES-V10-SITE-502/MEDIA/4306AA7F82AD474A83779AD822F474E1/CHNA-IMPLEMENTATION-2025-FINAL.PDFIF A READER USES THIS INFORMATION TO ACCESS THE FORM ONLINE, BE SURE TO FORMAT THE URL WITH LOWERCASE LETTERS WHEN COPYING AND PASTING THE DIRECT LINKS. PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 11: 1. MENTAL AND BEHAVIORAL HEALTH- PLHS PROVIDES STAFF MEMBERS WITH RESOURCES THAT CAN BE UTILIZED SUCH AS ASSISTANCE PROGRAMS FOR MENTAL HEALTH SERVICES AND A RESPITE LOUNGE- PLHS COLLABORATES WITH THE FOLLOWING ORGANIZATIONS WATERTOWN BOYS AND GIRLS CLUB TO SUPPORT THEIR EFFORTS, H.S.A TO SUPPORT THEIR SUICIDE PREVENTION SERVICES AND ANNUAL AWARENESS WALK. SERENITY HILLS- A FACILITY AND SAFE HOUSE FOR THOSE SUFFERING FROM MENTAL ILLNESS OR SUBSTANCE ABUSE ISSUESCOMMUNITY TRANSIT WATERTOWN/SISSETON-TRANSPORT INDIVIDUALS TO MEDICAL AND MENTAL HEALTH APPOINTMENTS.2. HEALTH EDUCATION, LITERACY, AND PREVENTION-VIDEOS AND EDUCATION ARE DISPLAYED ON THE WEBSITE FOR EASE OF ACCESS TO EDUCATE THE PUBLIC. IN ADDITION, MONTHLY PRIORITY HEALTH ARTICLES ARE POSTED TO THE WEBSITE AND SHARED ON SOCIAL MEDIA. PLHS ALSO DOES EDUCATION RADIO INTERVIEWS ON LOCAL STATIONS AND OFFERS LARGE IN PERSON AND ONLINE EVENTS. HEALTH SCREENINGS ARE BEING PROMOTED TO ASSIST WITH PREVENTION.3. SMOKING/DRUGS/ALCOHOL- VIDEOS AND EDUCATION ARE DISPLAYED ON THE WEBSITE WHICH FOCUS ON DISEASES CAUSED BY USING THE SUBSTANCES. A FULL-TIME ADVANCED PRACTICE PROVIDER WAS ADDED TO WORK ALONGSIDE A FULL-TIME PULMONOLOGIST TO SUPPORT PATIENT ACCESS. PLHS ALSO HAS A SERVICE LINE FOR PAIN THERAPY.- PLHS COLLABORATES WITH THE FOLLOWING ORGANIZATIONS BY PROVIDING FINANCIAL SUPPORT FOR THEIR SERVICES:SERENITY HILLSDASH (DRUG FREE, ALCOHOL FREE, SAFE AND HEALTHY LIFESTYLE)WATERTOWN HEALTHY YOUTHWATERTOWN AREA UNITED WAYBOYS AND GIRLS CLUB OF WATERTOWNFAMILY PLANNING CLINICSIGNIFICANT NEEDS TO BE ASSESSEDMANY ISSUES EMERGED THAT WERE BEYOND THE SCOPE OR CONTROL OF PLHS. ISSUES SUCH AS AFFORDABILITY OF CARE/UNDERINSURED, ECONOMY & WORKFORCE SHORTAGE, UNEMPLOYMENT, SEX EDUCATION/TEEN PREGNANCY, AND PRIMARY CARE PHYSICIANS WERE DEFERRED TO THE APPROPRIATE COMMUNITY ORGANIZATIONS. PRAIRIE LAKES HEALTH CARE SYSTEM PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT:WWW.PRAIRIELAKES.COM/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL ASSISTANCE POLICY DIRECT LINK:HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/PRAIRIE-LAKES-V10-SITE-502/MEDIA/B453FDA6C86541719B4AB9E878F4C085/PLHS_FINANCIAL_ASSISTANCE_POLICY-2020.PDFFINANCIAL ASSISTANCE APPLICATION DIRECT LINK:HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/PRAIRIE-LAKES-V10-SITE-502/MEDIA/EA0B3EF7896842E48D2948D7324EA65A/CHARITY_APPLICATION_WITH_COVER.PDFDIRECT LINK:IF A READER USES THIS INFORMATION TO ACCESS THE FORM ONLINE, BE SURE TO FORMAT THE URL WITH LOWERCASE LETTERS WHEN COPYING AND PASTING THE DIRECT LINKS. 6 1 - PRAIRIE LAKES BROWN CLINIC 506 1ST AVE SE WATERTOWN SD 57201 PRIMARY CARE 2 - PRAIRIE LAKES BROWN CLINIC-NORTHRIDGE 511 14TH AVE SE WATERTOWN SD 57201 PRIMARY CARE 3 - MALLARD POINTE SURGICAL CENTER 1425 MICKELSON DRIVE WATERTOWN SD 57201 OUTPATIENT SURGERY CENTER 4 - SISSETON SATELLITE DIALYSIS 5 EAST CHESTNUT SISSETON SD 57262 DIALYSIS UNIT 5 - ORTONVILLE SATELLITE DIALYSIS 450 EASTVOLD AVENUE ORTONVILLE MN 56278 DIALYSIS UNIT 6 - PRAIRIE LAKES CASTLEWOOD CLINIC 111 1ST AVE CASTLEWOOD SD 57223 PRIMARY CARE AND PT PART I, LINE 3C: IN ADDITION TO INCOME BASED CRITERIA FOR DETERMINING THE AMOUNT OF FINANCIAL ASSISTANCE SERVICES FOR WHICH A PATIENT IS ELIGIBLE AT THE TIME OF SERVICE OR DURING THE BILLING-AND-COLLECTION PROCESS, PLHS USES AN ASSET TEST. ASSET EXCLUSIONS THAT ARE CONSIDERED IN QUALIFYING FOR FINANCIAL ASSISTANCE ARE: (A) EQUITY IN PRIMARY RESIDENCE UP TO $15,000(B) EQUITY IN AUTOMOBILE UP TO $5,000(C) 70% OF VALUE OF ASSETS IN RETIRMENT ACCOUNTS(D) ASSETS IN CHECKING/SAVINGS/ETC. UP TO $15,000(E) OTHER ASSETS USED FOR INCOME PRODUCING PURPOSES. PART I, LINE 7: THE COSTS OF THE SUBSIDIZED SERVICES ARE BASED ON DIRECT COST PROVIDED BY THE DEPARTMENTS FOR THE SERVICES. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES INCLUDED IN SCHEDULE H, PART I, LINE 7G RELATE TO THE EMERGENCY ROOM, CARDIOLOGY CLINIC, ONCOLOGY CLINIC, NEPHROLOGY CLINIC, UROLOGY CLINIC, PULMONOLOGY CLINIC, AND ENT CLINIC. PART I, LN 7 COL(F): $5,234,764 OF BAD DEBT EXPENSE WAS ELIMINATED WHEN CALCULATING PART I, LINE 7, COLUMN F. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 3: THE ORGANIZATION DOES NOT HAVE A WAY TO IDENTIFY THE NUMBER OF PEOPLE WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE SO WE HAVE REPORTED $0 IN PART III, LINE 3. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE AND ALLOWANCE FOR CREDIT LOSSES" PARAGRAPH ON PAGE 10 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THERE WAS A SHORTFALL CALCULATED IN PART III, LINE 7. THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WAS DERIVED USING THE 2024 FILED MEDICARE COST REPORT. PART III, LINE 9B: BILLING STATEMENTS AND COLLECTION LETTERS WILL CONTAIN INFORMATION DIRECTING PATIENTS TO CONTACT THE HOSPITAL FOR INFORMATION ABOUT FINANCIAL ASSISTANCE OR PAYMENT PLANS IF THE PATIENTS ARE UNABLE TO PAY THE FULL OUTSTANDING ACCOUNT BALANCE BY THE DUE DATE. IF A COMPLETE ASSISTANCE APPLICATION IS RECEIVED, A DETERMINATION OF THE PATIENT'S ELIGIBILITY WILL BE DOCUMENTED APPROPRIATELY AND COMMUNICATED TO THE PATIENT IN WRITING. IF ELIGIBLE, THE HOSPITAL WILL ISSUE A BILLING STATEMENT WITH THE AMOUNT NOW OWED (ALONG WITH THE AMOUNT GENERALLY BILLED AND HOW IT WAS CALCULATED), REFUND ANY CREDIT BALANCES, AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS. IF AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION (FAA) IS RECEIVED BY THE HOSPITAL, THE HOSPITAL WILL CEASE COLLECTION ACTIONS AND ALLOW 30 DAYS FOR THE FAA TO BE FULLY COMPLETED. PART VI, LINE 2: THE FACILITY CONDUCTS NEEDS ASSESSMENT SURVEYS IN THE COMMUNITY AND SURROUNDING AREA TO DETERMINE WHAT HEALTH CARE SERVICES NEED TO BE ADDRESSED. PART VI, LINE 3: PLHS INFORMS AND EDUCATES PATIENTS ABOUT FINANCIAL ASSISTANCE THROUGH INFORMATION PROVIDED ON THE PLHS WEBSITE. FURTHERMORE, HOSPITAL STAFF PROVIDE INFORMATION REGARDING FINANCIAL ASSISTANCE ELIGIBILITY. PART VI, LINE 4: PRAIRIE LAKES HEALTH CARE SYSTEM'S PRIMARY SERVICE AREA CARES FOR 90,000 PEOPLE IN A 10-COUNTY REGION OF NORTHEAST SOUTH DAKOTA AND WESTERN MINNESOTA. PART VI, LINE 5: THE ORGANIZATION OFFERS HEALTH SEMINARS FREE TO COMMUNITY MEMBERS COVERING A VARIETY OF HEALTH TOPICS IN AN EFFORT TO EDUCATE PEOPLE ABOUT LEADING HEALTHY LIVES. COMMUNITY FORUMS ARE HELD TO UPDATE ATTENDEES ABOUT NEW EVENTS AND TECHNOLOGY AT THE FACILITY. THE ORGANIZATION WORKS WITH THE TECHNICAL COLLEGE AND TWO STATE UNIVERSITIES TO HELP TRAIN STUDENTS IN HEALTHCARE OCCUPATIONS. THE ORGANIZATION IS DEDICATED TO IMPLEMENTING AND MAINTAINING THE MOST CURRENT TECHNOLOGY IN PROVIDING CARE. PART VI, LINE 7, REPORTS FILED WITH STATES SD 1 BOYS AND GIRLS CLUB OF WATERTOWN PO BOX 833 WATERTOWN SD 57201 460311845 501(C)(3) 6200 0 GENERAL SUPPORT WATERTOWN AREA UNITED WAY PO BOX 283 WATERTOWN SD 57201 460359557 501(C)(3) 30000 0 SUPPORT OF UNITED WAY AGENCIES HUMAN SERVICE AGENCY PO BOX 1030 WATERTOWN SD 57201 460275247 501(C)(3) 30000 0 DETOX UNIT SUPPORT WATERTOWN CARES 7 W KEMP AVE WATERTOWN SD 57201 921696277 501(C)(3) 50000 0 HOUSING SUPPORT WATERTOWN DEVELOPMENT COMPANY 1 EAST KEMP AVE WATERTOWN SD 57201 466012194 501(C)(3) 100000 0 GENERAL SUPPORT NE TECHNICAL HIGH SCHOOL 1311 3RD AVE NE WATERTOWN SD 57201 460321361 501(C)(6) 10000 0 SPONSORED 11-12 KIDS TO ATTEND INTERNATIONAL LEADERSHIP CONFERENCE 5 1 PART I, LINE 2: FUNDS ARE GRANTED BASED ON ORGANIZATIONS AND INTERNAL REQUESTS. GRANT REQUESTS ARE REVIEWED AND APPROVED BY ADMINISTRATIVE LEADERSHIP TO BE USED FOR THE PURPOSES REQUESTED BY THE ORGANIZATION. FURTHER MONITORING IS NOT DONE ON A REGULAR BASIS. X X X X X 0 0 0 0 0 0 0 0 0 JEFFREY SMITH MD PHYSICIAN 853930 0 565748 0 46540 0 10350 0 69929 0 1546497 0 0 0 RAVISHANKAR KALAGA MD PHYSICIAN 1392815 0 0 0 21201 0 10350 0 38708 0 1463074 0 0 0 CASEY JOHNSTON MD DIRECTOR/PHYSICIAN 766412 0 484545 0 46810 0 10350 0 69929 0 1378046 0 0 0 GERALD RIEBER MD PHYSICIAN 745330 0 374060 0 55822 0 10350 0 77429 0 1262991 0 0 0 JACOB SCHAEFFER MD PHYSICIAN 404900 0 647241 0 46540 0 10350 0 69929 0 1178960 0 0 0 JOHN ALLEN PRESIDENT/CEO 443409 0 101250 0 57012 0 29532 0 73165 0 704368 0 0 0 SVIEN SENNE PHYSICIAN 562640 0 0 0 46450 0 10350 0 69929 0 689369 0 0 0 TIM PUGSLEY CIO 211395 0 37500 0 55822 0 19148 0 82179 0 406044 0 0 0 LYNN SEVERSON CFO 283196 0 26250 0 24945 0 20696 0 47632 0 402719 0 0 0 SHELLY TURBAK CNO 171289 0 45000 0 55822 0 15423 0 71073 0 358607 0 0 0 LAURIE FIEBER VP OF CLINIC OPERATIONS 180691 0 45000 0 14857 0 14028 0 45510 0 300086 0 0 0 ALISON GILBERTSON VP OF HUMAN RESOURCES 180977 0 45000 0 12291 0 14366 0 32700 0 285334 0 0 0 A SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 460315509 2017-01-27 36000000 FUNDING OF THE NEW SPECIALTY CLINIC BUILDING 0 0 0 A 17290000 36000000 397999 35602001 2017 0 0 1 1 A 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL BE COMPRISED OF THE OFFICERS OF THE CORPORATION. EXCEPT AS MAY BE LIMITED BY THE BOARD, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL ACT IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD AND SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL ALSO SERVE AS THE CORPORATION'S COMPENSATION COMMITTEE, UNLESS IT OR THE BOARD DELEGATES THOSE RESPONSIBILITIES TO ANOTHER COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL NOT USURP THE FUNCTIONS OF THE OTHER STANDING COMMITTEES, ALTHOUGH IT WILL COORDINATE PROJECTS, TASKS AND COMMUNICATIONS AMONG SUCH COMMITTEES. A MAJORITY OF THE EXECUTIVE COMMITTEE SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF ANY BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B EXECUTIVE MANAGEMENT REVIEWS THE FORM 990 IN DETAIL. THE FORM 990 IS PRESENTED TO THE FULL BOARD BEFORE FILING WITH THE IRS. GIVEN THE AQUISTION OF PRAIRIE LAKES BY SANFORD HEALTH, THE 2024 FORM 990 WAS REVIEWED BY THE FULL SANFORD HEALTH BOARD. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST STATEMENT IS SIGNED BY ALL BOARD MEMBERS ANNUALLY. THIS STATEMENT DISCLOSES ANY AREAS THAT MAY POTENTIALLY PRESENT A CONFLICT OF INTEREST WITH THEMSELVES OR FAMILY MEMBERS. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO AND THE BOARD. MEMBERS WILL EXCUSE THEMSELVES DURING BOARD MEETING FROM ANY DISCUSSION OR VOTING ON AN ISSUE WHERE THERE MAY BE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION COMPARABILITY STUDIES ARE REVIEWED EACH YEAR FOR ALL POSITIONS. THE HUMAN RESOURCES DEPARTMENT HAS ACCESS TO VARIOUS COMPENSATION SURVEYS, WHICH ARE REVIEWED TO DETERMINE IF THE HOSPITAL'S COMPENSATION IS REASONABLE COMPARED TO OTHER FACILITIES. THE BOARD DELEGATES VICE PRESIDENT EXECUTIVE COMPENSATION APPROVAL TO THE CEO BASED ON THE ORGANIZATION'S COMPENSATION PHILOSOPHY IN CONJUCTION WITH MARKET BENCHMARKS. THIS PROCESS WAS LAST COMPLETED IN AUGUST 2025 AND IS ONGOING AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE THROUGH FILINGS WITH BONDING AUTHORITY. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PRAIRIE LAKES FOUNDATION 319,643. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.