2024-04-12T12:43:54-05:00 2023-05-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-06-01 460391067 PRAIRIE LAKES HEALTH CARE SYSTEM INC PRAI 6058827000 PO BOX 1210 WATERTOWN SD 57201 LYNN SEVERSON CFO 6058827000 2024-04-08 1 LYNN SEVERSON 999009999 1 MACKENZIE MCNAUGHTON P02025805 6123764500 2024-04-05 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOHN ALLEN PO BOX 1210 WATERTOWN SD 57201 224753833 0 X WWW.PRAIRIELAKES.COM X 1986 SD PROVIDE HIGH QUALITY, AFFORDABLE & COMPASSIONATE HEALTHCARE SERVICES FOR THE PEOPLE IN THE REGION. 15 14 751 51 1538832 426731 3089804 3442618 115911149 123860971 19570123 14834473 1872492 1674509 140443568 143812571 4265261 3182921 0 0 59475377 66340068 0 0 0 61849878 68119743 125590516 137642732 14853052 6169839 432088879 404656079 52046490 48253764 380042389 356402315 WE MAKE A POSITIVE DIFFERENCE IN THE HEALTH OF THE PATIENTS AND COMMUNITIES WE SERVE. 0 0 117420704 3182921 140201445 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. 33 SPECIALTY PHYSICIANS HAVE BEEN RECRUITED OVER THE PAST DECADE TO BUILD NEW SERVICES AND BETTER SERVE THE COMMUNITY. THIS TOTAL INCLUDES THE RECENT ADDITION OF 3 ORTHOPEDIC PHYSICIANS. ORTHOPEDICS WAS ADDED AS A SERVICE LINE IN AUGUST OF 2022. JANUARY OF 2023 A PAIN SCIENCE CENTER WAS ADDED AS ANOTHER SERVICE AVAILABLE TO THE COMMUNITY. 117420704 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 1 114 0 1 751 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X LYNN SEVERSON 6058827000 401 9TH AVENUE NW WATERTOWN SD 57201 RICHARD HOWARD MD PHYSICIAN 40.00 X 1142455 0 28019 GREG GERRISH MD PHYSICIAN 40.00 X 1056309 0 33709 JACOB SCHAEFFER MD PHYSICIAN/DIRECTOR 40.00 X 1031477 0 33709 JEFFREY SMITH MD PHYSICIAN 40.00 X 909759 0 33709 SALEM MAALIKI MD PHYSICIAN 40.00 X 764874 0 19679 D ADAM POPP CFO 40.00 X 295305 0 27987 KC DEBOER FORMER CEO (THROUGH SEPT 2021) 40.00 X 279961 0 37624 MICHELE TURBAK CNO 40.00 X 268511 0 32380 LAURIE FIEBER VP OF CLINIC OPERATIONS 40.00 X 157833 0 24195 JOHN ALLEN PRESIDENT/CEO 40.00 X 0 0 0 ROBB PETERSON CHAIR 1.00 X X 0 0 0 VINCE FOLEY VICE CHAIR 1.00 X X 0 0 0 MIKE LUKEN SECRETARY 1.00 X X 0 0 0 CHRIS CARTER TREASURER 1.00 X X 0 0 0 JIM REDLINGER PAST CHAIR 1.00 X 0 0 0 ALAN CHRISTENSEN MD DIRECTOR 1.00 X 0 0 0 SVIEN SENNE DIRECTOR 1.00 X 0 0 0 SCOTT MUNGER DIRECTOR 1.00 X 0 0 0 MICHAEL ANDERSON DIRECTOR 1.00 X 0 0 0 MARK 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 DIANE STILES DIRECTOR 1.00 X 0 0 0 JESSE PETERSON DIRECTOR 1.00 X 0 0 0 5906484 0 271011 82 1 1 0 MEDICAL SOLUCTIONS PO BOX 310737 DES MOINES IA 50331 LOCUM COVERAGE 1645652 PEM ADVISORS LLC 2214 MERRIMAC LANE N PLYMOUTH MN 55447 INTERIM CEO COVERAGE 690467 FOXHIRE LLC 4883 DRESSLER RD NW SUITE 103 CANTON OH 44718 LOCUM COVERAGE 654776 GHAITH ABOUD MD 920 3RD ST NW APT C WATERTOWN SD 57201 LOCUM PHYSICIAN 481600 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 LOCUM COVERAGE 388877 34 3439393 3225 3442618 NET PATIENT SERVICE REVENUE 621400 122487203 122487203 RETAIL PHARMACY 456110 1098741 1098741 LAB SERVICE 621500 275027 275027 123860971 6336350 165064 6171286 1069642 0 1069642 1069642 1069642 89439385 80929655 11607 8509730 -11607 8498123 8498123 OTHER INCOME 624100 309940 309940 CAFETERIA REVENUE 624210 292398 292398 VENDING MACHINES 722515 2529 2529 604867 143812571 122487203 1538832 16343918 3182921 3182921 963644 963644 796545 708226 88319 55383096 49722817 5660279 1326374 1216677 109697 4140094 3743018 397076 3730315 3344993 385322 101839 101839 243080 243080 1621531 1621531 13121900 9461206 3660694 618309 618309 2305656 1717542 588114 1497451 220908 1276543 1103672 45007 1058665 569596 569596 238426 146345 92081 765436 765436 6916466 4556655 2359811 543601 543601 DRUGS 15309645 15309645 MEDICAL SUPPLIES 13301839 13301839 PROVISION FOR BAD DEBT 5960477 5960477 EQUIP RENT/MAINTENANCE 2262416 2260953 1463 1638403 642842 995561 137642732 117420704 20222028 0 2186 2486 10718503 8597991 11136013 11608055 555577 1312712 4100386 3333167 1354351 1450914 172396552 100505143 72639519 71891409 301225629 268887742 5392483 5175128 3274649 6970926 21689583 25425549 432088879 404656079 16062301 15413280 3707082 179450 25528941 23332008 6748166 9329026 52046490 48253764 X 374705797 351283851 5336592 5118464 380042389 356402315 432088879 404656079 X 6169839 -29646785 -163128 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 10247 0 0 0 10247 0 PART II-B, LINE 1: THE LOBBYING EXPEDITURES ARE THE PORTION OF DUES TO VARIOUS HOSPITAL ASSOCATIONS THAT ARE USED FOR LOBBYING. 4423423 4423423 86716691 38475118 48241573 2936728 2451097 485631 75807551 59578928 16228623 2512159 2512159 71891409 DUE FROM 457(B) PLAN 5801030 ACCRUED REAL ESTATE 19624519 25425549 457(B) PAYABLE 5801030 LONG-TERM PTO 936096 ASSET RETIREMENT OBLIGATION 91900 NAMING RIGHTS PAYABLE 2500000 9329026 X 103455857 -29646785 -29646785 133102642 1621531 9088398 10709929 143812571 126877803 0 126877803 1621531 9143398 10764929 137642732 PART X, LINE 2: THE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT PRAIRIE LAKES IS A TAX-EXEMPT, NOT-FOR-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE HEALTH SYSTEM FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE HEALTH SYSTEM'S FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,960,477. DONATION EXPENSE 3,127,921. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,960,477. DONATION EXPENSE 3,127,921. GRANTS RETURNED 55,000. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 19624519 0 0 0 0 0 0 19624519 0 19624519 1 0 0 1 1 0 PART III ACCOUNTING METHOD: 1 1 X 1 X 1 X 1 1 1 0 1 1 3260480 3260480 0.02480 12092681 3383504 8709177 0.06610 15353161 3383504 11969657 0.09090 23701 23701 0.00020 21065098 15401933 5663165 0.04300 21088799 15401933 5686866 0.04320 36441960 18785437 17656523 0.13410 23701 23701 0.00020 23701 23701 0.00020 1 5960477 40488749 43984368 -3495619 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 22 1 0 0 1 X SEE PART V.C. X 1 22 1 SEE PART V, SECTION C 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 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 IN SPRING OF 2021. 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/COMMUNITY/COMMUNITY-BENEFIT-513.HTML. 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 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 IN THE LOCAL PAPER, 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 MIDLEVEL WAS ADDED TO WORK ALONGSIDE A FULL-TIME PULMONOLOGIST TO SUPPORT PATIENT ACCESS. PLHS WORKING TO START A SERVICE LINE FOR PAIN THERAPY. AS WELL AS OFFER FREE COMMUNITY PAIN EDUCATION CLASSES.-PLHS COLLABORATES WITH THE FOLLOWING ORGANIZATIONS BY PROVIDING FINANCIAL SUPPORTSERENITY HILLSDASH (DRUG FREE, ALCOHOL FREE, SAFE AND HEALTHY LIFESTYLE)WATERTOWN HEALTHY YOUTHWATERTOWN AREA UNITED WAYBOYS AND GIRLS CLUB OF WATERTOWNSIGNIFICANT NEEDS TO 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: HTTPS://WWW.PRAIRIELAKES.COM/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM-510.HTML 3 1 - SISSETON SATELLITE DIALYSIS 5 EAST CHESTNUT SISSETON SD 57262 DIALYSIS UNIT 2 - MALLARD POINTE SURGICAL CENTER 1425 MICKELSON DRIVE WATERTOWN SD 57201 OUTPATIENT SURGERY CENTER 3 - ORTONVILLE SATELLITE DIALYSIS 450 EASTVOLD AVENUE ORTONVILLE MN 56278 DIALYSIS UNIT 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): $5,960,477 OF BAD DEBT EXPENSE WAS ELIMINATED WHEN CALCULATING PART I, LINE 7, COLUMN F. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION SUPPORTS COMMUNITY BUILDING ACTIVITIES THROUGH DONATIONS TO COMMUNITY PROJECTS SUCH AS THE WATERTOWN COMMUNITY FOUNDATION WHICH WORKS TO BRING NEW BUSINESSES TO WATERTOWN, JOY RANCH WHICH PROVIDES CAMP EXPERIENCE TO DISABLED CHILDREN, LAKE AREA TECHNICAL COLLEGE WHICH PROVIDES EDUCATION AND TRAINING FOR HEALTH PROFESSIONALS, THE BOYS AND GIRLS CLUB WHICH PROVIDES RESOURCES FOR COMMUNITY YOUTH. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 3: THE ORGANIZATION DOES NOT HAVE A WAY TO IDENTIFY THE NUMBER OF PEOPLE WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE SO WE HAVE REPORTED $0 IN PART III, LINE 3. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE" PARAGRAPH ON PAGE 11 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 2023 FILED MEDICARE COST REPORT. PART III, LINE 9B: BILLING STATEMENTS AND COLLECTION LETTERS WILL CONTAIN INFORMATION DIRECTING PATIENTS TO CONTACT THE HOSPITAL FOR INFORMATION ABOUT FINANCIAL ASSISTANCE OR PAYMENT PLANS IF THE PATIENTS ARE UNABLE TO PAY THE FULL OUTSTANDING ACCOUNT BALANCE BY THE DUE DATE. IF A COMPLETE ASSISTANCE APPLICATION IS RECEIVED, A DETERMINATION OF THE PATIENT'S ELIGIBILITY WILL BE DOCUMENTED APPROPRIATELY AND COMMUNICATED TO THE PATIENT IN WRITING. IF ELIGIBLE, THE HOSPITAL WILL ISSUE A BILLING STATEMENT WITH THE AMOUNT NOW OWED (ALONG WITH THE AMOUNT GENERALLY BILLED AND HOW IT WAS CALCULATED), REFUND ANY CREDIT BALANCES, AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS. IF AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION (FAA) IS RECEIVED BY THE HOSPITAL, THE HOSPITAL WILL CEASE COLLECTION ACTIONS AND ALLOW 30 DAYS FOR THE FAA TO BE FULLY COMPLETED. PART VI, LINE 2: THE FACILITY CONDUCTS NEEDS ASSESSMENT SURVEYS IN THE COMMUNITY AND SURROUNDING AREA TO DETERMINE WHAT HEALTH CARE SERVICES NEED TO BE ADDRESSED. PART VI, LINE 3: PLHS INFORMS AND EDUCATES PATIENTS ABOUT FINANCIAL ASSISTANCE THROUGH INFORMATION PROVIDED ON THE PLHS WEBSITE. FURTHERMORE, HOSPITAL STAFF PROVIDE INFORMATION REGARDING FINANCIAL ASSISTANCE ELIGIBILITY. PART VI, LINE 4: PRAIRIE LAKES HEALTH CARE SYSTEM'S PRIMARY SERVICE AREA COVERS 3 COUNTIES IN SOUTH DAKOTA WITH A POPULATION OF APPROXIMATELY 38,000. IT'S SECONDARY SERVICE AREA COVERS 4 COUNTIES IN SOUTH DAKOTA AND 3 COUNTIES IN MINNESOTA WITH A POPULATION OF 49,000. 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 MEDICAL STUDENTS. THE ORGANIZATION IS DEDICATED TO IMPLEMENTING AND MAINTAINING THE MOST CURRENT TECHNOLOGY IN PROVIDING CARE. PART VI, LINE 7, REPORTS FILED WITH STATES SD 1 SANFORD CLINIC 901 4TH STREET NW WATERTOWN SD 57201 460447693 501(C)(3) 15000 0 SUPPORT OF FAMILY PLANNING CLINIC. WATERTOWN CARES 7 W KEMP AVE WATERTOWN SD 57201 921696277 501(C)(3) 15000 0 HOUSING SUPPORT WATERTOWN AREA UNITED WAY PO BOX 283 WATERTOWN SD 57201 460359557 501(C)(3) 17500 0 SUPPORT OF UNITED WAY AGENCIES HUMAN SERVICE AGENCY PO BOX 1030 WATERTOWN SD 57201 460275247 501(C)(3) 30000 0 DETOX UNIT SUPPORT LAKE AREA TECHNICAL INSTITUTE FOUNDATION PO BOX 730 WATERTOWN SD 57201 363860861 501(C)(3) 38500 0 SCHOLARSHIPS WATERTOWN DEVELOPMENT CORP PO BOX 1267 WATERTOWN SD 57201 466012194 501(C)(6) 40000 0 SUPPORT NEW BUSINESS DEVELOPMENT CITY OF WATERTOWN 23 2ND ST NE WATERTOWN SD 57201 466000515 GOVT 1000000 0 ICE AREA SUPPORT HUMAN SERVICE AGENCY FOUNDATION PO BOX 1030 WATERTOWN SD 57201 363287529 501(C)(3) 2000000 0 DETOX UNIT SUPPORT 7 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 1 0 0 0 0 0 0 0 0 RICHARD HOWARD MD PHYSICIAN 1142455 0 0 0 0 0 9150 0 18869 0 1170474 0 0 0 GREG GERRISH MD PHYSICIAN 604362 0 451947 0 0 0 9150 0 24559 0 1090018 0 0 0 JACOB SCHAEFFER MD PHYSICIAN/DIRECTOR 416795 0 614682 0 0 0 9150 0 24559 0 1065186 0 0 0 JEFFREY SMITH MD PHYSICIAN 858484 0 51275 0 0 0 9150 0 24559 0 943468 0 0 0 SALEM MAALIKI MD PHYSICIAN 764874 0 0 0 0 0 9150 0 10529 0 784553 0 0 0 D ADAM POPP CFO 191919 0 103386 0 0 0 10060 0 17927 0 323292 0 0 0 KC DEBOER FORMER CEO (THROUGH SEPT 2021) 0 0 25000 0 254961 0 19234 0 18390 0 317585 0 0 0 MICHELE TURBAK CNO 166808 0 101703 0 0 0 14453 0 17927 0 300891 0 0 0 LAURIE FIEBER VP OF CLINIC OPERATIONS 128407 0 29426 0 0 0 8902 0 15293 0 182028 0 0 0 PART I, LINE 4A K.C. DEBOER, FORMER CEO, RECEIVED SEVERANCE PAYMENTS OF $254,961 IN REGULAR COMPENSATION, $25,000 IN BONUS COMPENSATION AND $37,624 IN NON-TAXABLE COMPENSATION IN THE 2022 TAX YEAR. A SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 460315509 2017-01-27 36000000 FUNDING OF THE NEW SPECIALTY CLINIC BUILDING 0 0 0 A 12595000 36000000 397999 35602001 2017 0 0 1 1 A 0 1 0 0 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 FINANCE COMMITTEE CHAIR FOR FINAL REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST STATEMENT IS SIGNED BY ALL BOARD MEMBERS 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 BY THE HUMAN RESOURCES DEPARTMENT. 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. THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE SALARIES OF OTHER KEY EMPLOYEES. THIS PROCESS WAS LAST COMPLETED IN 2021 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 -218,128. RETURNED GRANT PAYMENTS 55,000.