2024-10-28T10:10:40-05:00 2023-12-31 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2023-01-01 460260288 PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICES PION 6053265161 315 N WASHINGTON ST PO BOX 368 VIBORG SD 570700368 ISAAC GERDES CEO 6053265161 2024-10-28 1 1 LAURIE HANSON CPA P00851848 6053391999 2024-10-28 2023 2024-10-15 13:58:12Z ISAAC GERDES 315 N WASHINGTON ST PO BOX 368 VIBORG SD 570700368 16446025 0 X WWW.PIONEERMEMORIAL.ORG X 1959 SD PROMOTION OF HEALTH 9 9 191 200 0 0 324058 2784864 12395783 13353217 47288 260939 42095 41718 12809224 16440738 0 0 0 0 7270636 7419718 0 0 86899 4916571 4851497 12187207 12271215 622017 4169523 15368923 19793954 1069584 1300042 14299339 18493912 COMMITTED TO HEALTH, HEALING AND COMMUNITY 0 0 4225011 5914594 PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES OPERATES A 12-BED CRITICAL ACCESS HOSPITAL. THE ORGANIZATION PROVIDES HEALTHCARE SERVICES TO VIBORG AND SURROUNDING RURAL COMMUNITIES. DURING THE CURRENT YEAR, THE HOSPITAL HAD 86 ACUTE AND SWING BED ADMISSIONS AND 644 PATIENT DAYS, 800 VISITS TO THE EMERGENCY ROOM AND PERFORMED 37 SURGERIES/SCOPE PROCEDURES. THE HOSPITAL HAD 10,112 OUTPATIENT VISITS DURING THE CURRENT YEAR. 4054646 4662439 PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES OPERATES A 46-BED SKILLED NURSING FACILITY, A 20-UNIT SENIOR HOUSING FACILITY, AND A 10-UNIT ASSISTED LIVING FACILITY. IN THE NURSING HOME, THERE WERE 32 ADMISSIONS AND 15,092 RESIDENT DAYS. THERE WERE 2,780 RESIDENT DAYS IN THE SENIOR HOUSING FACILITY, AND 3,130 RESIDENT DAYS IN THE ASSISTED LIVING FACILITY. 1913176 2776184 PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES OPERATES THREE MEDICARE-CERTIFIED RURAL HEALTH CLINICS LOCATED IN CENTERVILLE, PARKER AND VIBORG, SD. IN THE RURAL HEALTH CLINICS, THERE WERE 11,070 CLINIC VISITS. THE THREE RURAL HEALTH CLINICS ADMINISTERED 331 COVID VACCINATIONS IN FISCAL YEAR 2023. 10192833 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 15 0 1 191 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 1 1 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 0 1 0 X X ANNE CHRISTIANSEN 6053263004 315 N WASHINGTON ST VIBORG SD 57070 GABRIEL JOHNSON DO-FAMILY MEDICINE 45.00 0.00 X 255395 0 38741 KAYLA MEHLHAF CERTIFIED NURSE PRACTITIONER 45.00 0.00 X 140965 0 11622 ANNE CHRISTIANSEN CFO 45.00 2.00 X 106487 0 15637 SHARON JACOBSEN DIRECTOR OF NURSING - HOSPITAL 45.00 0.00 X 104550 0 17580 ALEX KALSBECK CERTIFIED NURSE PRACTITIONER 45.00 0.00 X 105543 0 13490 MELODY SHRACK MD-FAMILY MEDICINE 16.00 0.00 X 113860 0 1439 MELANIE PARSONS PRESIDENT 2.00 0.30 X X 0 0 0 PAUL CHRISTENSEN VICE PRESIDENT 1.00 0.30 X X 0 0 0 KIM LARSEN SECRETARY 1.00 0.00 X X 0 0 0 TROY LEE DIRECTOR 1.00 0.00 X 0 0 0 RYAN PENNING DIRECTOR 1.00 0.00 X 0 0 0 LINDA ANDAL DIRECTOR UNTIL 03/2023 1.00 0.00 X 0 0 0 CHRIS PONCELET DIRECTOR 1.00 0.00 X 0 0 0 MELISSA BUCKNEBERG DIRECTOR 1.00 0.00 X 0 0 0 JOANNE POWELL DIRECTOR 1.00 0.30 X 0 0 0 LISA STANAGE DIRECTOR FROM 04/2023 1.00 0.00 X 0 0 0 LINDSEY HAUGER CEO 45.00 2.00 X 0 0 0 826800 0 98509 5 0 1 0 SANFORD HEALTH NETWORK 1305 W 18TH STREET SIOUX FALLS SD 57117 CEO, IT AND MANAGEMENT SERVICES 330534 CONVERDIA HEALTH STAFFING 301 SHEYENNE ST WEST FARGO ND 58078 TEMP NURSING SERVICES 186020 ALLIANCE MEDICAL STAFFING 11510 BLONDO ST STE 200 OMAHA NE 68164 TEMP NURSING SERVICES 182871 INTERIM HEALTHCARE SIOUX FALLS 3608 S SOUTHEASTERN AVE SIOUX FALLS SD 57103 TEMP NURSING SERVICES 161846 EIDE BAILLY LLP PO BOX 2545 FARGO ND 58108 ACCOUNTING & AUDITING SERVICES 118786 6 32316 2734384 18164 2784864 NET PATIENT SERVICE REVENUE 621110 12788103 12788103 PHARMACY 456110 251561 251561 CONTRACT REVENUE 900099 183239 183239 OTHER REVENUE 900099 130314 130314 13353217 126587 126587 41718 0 41718 41718 41718 139639 0 5287 139639 -5287 134352 134352 16440738 13353217 0 302657 X 122352 122352 6106240 5445244 605032 55964 108280 96102 11632 546 644079 561732 79156 3191 438767 377824 58797 2146 53442 53442 295489 295489 644 644 15894 15894 2204298 1857900 343809 2589 11669 1630 10039 518697 386159 122696 9842 289655 233323 55799 533 15263 11765 1642 1856 27123 21260 5863 502491 409110 93381 118711 5596 113115 MEDICAL SUPPLIES 785467 785467 MISCELLANEOUS 12654 1351 11110 193 12271215 10192833 1991483 86899 6294726 2033410 9452 2694 1247455 4070555 214988 219839 113034 204883 18269063 13505874 4545088 4763189 2661703 8361501 282477 137883 15368923 19793954 943997 1013202 8468 8645 117119 278195 1069584 1300042 X 14249543 18455813 49796 38099 14299339 18493912 15368923 19793954 4169523 25050 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 644 644 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS A PERCENTAGE OF THE DUES THAT WERE USED FOR LOBBYING. 0 1 X 388422 31843 420265 440681 -52259 388422 415394 25287 440681 391581 23813 415394 346850 44731 391581 0.00000 0.65500 0.34500 0 1 1 482015 482015 9614470 7614905 1999565 7560692 5402878 2157814 611886 488091 123795 4763189 SECURITY DEPOSITS 11500 OPEARATING LEASE LIABILITY 134695 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 132000 278195 X 16498260 25050 32703 57753 16440507 231 231 16440738 12296461 41140 41140 12255321 15894 15894 12271215 PART IV, LINE 2B: THE ORGANIZATION DOES REPORT ON ITS BALANCE SHEET THE FUNDS MAINTAINED FOR RESIDENT TRUST FUNDS. THE RESIDENT TRUST FUNDS FOR THE NURSING HOME AND ASSISTED LIVING ARE MAINTAINED IN SEPARATE CHECKING ACCOUNTS THAT ARE NOT CO-MINGLED WITH THE FUNDS OF THE ORGANIZATION. PART V, LINE 4: THE PRINCIPAL OF THE ENDOWMENT IS PERMANENT AND WILL BE HELD IN PERPETUITY. THE INTEREST INCOME MAY BE USED FOR CURRENT PROJECTS. PART X, LINE 2: THE ORGANIZATION 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. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES WERE INCURRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION INCOME INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS 48,597. INVESTMENT FEE -15,894. PART XI, LINE 4B - OTHER ADJUSTMENTS: DONOR RESTRICTED DONATION 231. PART XII, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION EXPENSES INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS 41,140. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEE 15,894. 1 1 X 1 X 1 X 1 1 0 1 1 16578 16578 0.00140 16578 16578 0.00140 10237 10237 0.00080 203563 7860 195703 0.01590 6193128 5024485 1168643 0.09520 15523 5175 10348 0.00080 6422451 5037520 1384931 0.11270 6439029 5037520 1401509 0.11410 6115 3043 3072 0.00030 6115 3043 3072 0.00030 1 441691 51678 2470177 2483112 -12935 X 1 1 1 1 PIONEER MEMORIAL HOSPITAL & HEALTH SERV 315 N WASHINGTON ST VIBORG SD 57070 PIONEERMEMORIAL.ORG 48451 X X X 3 PROVIDER BASED RURAL HEALTH CLINICS PIONEER MEMORIAL HOSPITAL AND HEALTH SER 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V, SECTION B, LINE 7D X X 1 22 1 SEE PART V, SECTION B, LINE 7D 0 1 X 200.000000000000 350.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, LINE 16J NARRATIVE X SEE PART V, LINE 16J NARRATIVE X SEE PART V, LINE 16J NARR X X X X X X X 1 X 0 X X X 1 X 0 0 PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICE PART V, SECTION B, LINE 5: PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES WORKED WITH SANFORD HEALTH TO UTILIZE A PROCESS DEVELOPED IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS WITHIN THE LOCAL COMMUNITY AND ACROSS SOUTH DAKOTA, NORTH DAKOTA, AND MINNESOTA TO DEVELOP A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. A SURVEY WAS SENT TO COMMUNITY STAKEHOLDERS, HEALTH EXPERTS, PUBLIC HEALTH OFFICIALS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. A TOTAL OF 74 RESPONDENTS COMPLETED THE SURVEY. COUNTY HEALTH RANKINGS WERE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. SANFORD HEALTH'S OFFICE OF STRATEGIC PLANNING PROVIDED ANALYSIS TO IDENTIFY THE INITIAL COMMUNITY HEALTH NEEDS LIST. COMMUNITY ASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS. ONCE GAPS WERE DETERMINED, THE PRIORITIZATION EXERCISE FOLLOWED WITH KEY STAKEHOLDER GROUPS DETERMINING THE TOP NEEDS. COMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. HOSPITAL LEADERSHIP PROPOSED WHICH SPECIFIC HEALTH NEEDS WOULD BE ADDRESSED WITHIN THE IMPLEMENTATION PLAN, WITH INPUT AND SUPPORT FROM THE COMMUNITY MEMBERS. PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICE PART V, SECTION B, LINE 7D: LINES 7A AND 10A: HTTPS://WWW.PIONEERMEMORIAL.ORG/CUSTOM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICE PART V, SECTION B, LINE 11: IN THE MOST RECENT CHNA CONDUCTED, THE FOLLOWING NEEDS WERE IDENTIFIED: 1. AFFORDABLE HOUSING: 2. TRANSPORTATION3. ACCESS TO HEALTH CARE PROVIDERS4. HEALTHY LIVINGTHE ORGANIZATION WILL NOT ADDRESS THE FOLLOWING NEEDS IDENTIFIED:AFFORDABLE HOUSING: NOT INCLUDED IN THE IMPLEMENTATION PLAN AS THERE ARE OTHER COMMUNITY ENTITIES BETTER SUITED TO LEAD IN THIS SPACE. INFORMATION FROM THE CHNA SURVEY WAS SHARED WITH COMMUNITY MEMBERS AND LOCAL ORGANIZATIONS AS NEEDED AND AS AFFORDABLE HOUSING SOLUTIONS ARE DISCUSSED. PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES OFFERS FINANCIAL ASSISTANCE FOR HEALTH CARE COSTS FOR THOSE FACING FINANCIAL HARDSHIP.TRANSPORTATION: WHILE IMPORTANT, THIS WAS NOT INCLUDED IN THE PRIORITIZATION PLAN AS IT WILL REQUIRE BROAD COMMUNITY PARTNERSHIPS BEYOND THE HEALTH CARE SECTOR. THERE ARE CURRENTLY A FEW LOCAL OPTIONS, WHICH ARE OUTLINED IN THE ASSET MAP UNDER TRANSPORTATION. PIONEER MEMORIAL FACILITATES RIDES TO APPOINTMENTS WHEN NEEDED FOR PATIENTS IF OTHER OPTIONS ARE NOT AVAILABLE AND/OR FEASIBLE.IN THE CURRENT TAX YEAR, THE ORGANIZATION HAS TAKEN THE FOLLOWING ACTIONS TO ADDRESS THE NEED OF THE CHNA:ACCESS TO HEALTH CARE PROVIDERS: THE PROJECTED IMPACT IS THE COMMUNITY WILL BE BETTER INFORMED AS TO THE HEALTHCARE RESOURCES AND ACCESSIBILITY TO AVAILABLE HEATH CARE SERVICES. TWO GOALS WERE IDENTIFIED: (1) THE COMMUNITY WILL BECOME MORE AWARE OF PROVIDER AVAILABILITY AND ACCESS TO HEALTH CARE RESOURCES, AND (2) ENSURE CLINIC HOURS AND SPECIALTY AVAILABILITY VIA TELEMEDICINE MEET THE NEEDS OF THE SERVED POPULATION.- PROVIDED INFORMATION VIA PRINT AD AND SOCIAL MEDIA ON THE FOLLOWING: - RECOGNIZED OUR PROVIDER STAFF DURING NATIONAL DOCTOR DAY, NATIONAL CERTIFIED NURSE PRACTITIONER WEEK AND NATIONAL PHYSICIAN ASSISTANT WEEK. - WELCOME TO NEW PROVIDER, STACY WACHHOLTZ, CNP.- INTRODUCTION TO YOUR HOMETOWN MEDICAL TEAM- AT THE VIBORG CLINIC, YOU CAN SCHEDULE YOUR APPOINTMENT OVER THE NOON HOUR OR ON SATURDAY MORNINGS. - WELL CHILD EXAMS- TELEMED IS AVAILABLE IN VIBORG.- DRIVE-THRU FLU SHOT CLINICS- INVOLVED THE PROVIDERS WITH COMMUNITY INTERACTION AT LOCAL EVENTS THROUGHOUT THE YEAR. - REVIEWED HOURS OF CLINIC AVAILABILITY, AND BEGAN OFFERING APPOINTMENT TIMES FROM 12:00 PM TO 1:00 PM MONDAY THROUGH FRIDAY AT THE VIBORG MEDICAL CLINIC ON 05/01/2023. - ADDED ENDOCRINOLOGY TELEMED SERVICES ON 06/12/2023 IN VIBORG. - SUBMITTED A VIRTUAL CARE PROJECT REQUEST TO SANFORD IN OCTOBER 2023 ASKING TO ADD: PULMONOLOGY, UROLOGY, HEMATOLOGY/ONCOLOGY, AND NEUROLOGY AS SPECIALTIES TO BE OFFERED IN VIBORG.- SPONSORED THE HEART AND VASCULAR SCREENING AT PARKER MEDICAL CLINIC ON 05/10/2023. HEALTHY LIVING: THE PROJECTED IMPACT IS TO INCREASE THE AWARENESS AND AVAILABILITY OF HEALTHY LIVING OPPORTUNITIES IN THE COMMUNITIES. TWO GOALS WERE IDENTIFIED: (1) ADD ADDITIONAL HEALTH PREVENTION SERVICES IN PARKER AND CENTERVILLE WHILE STILL OFFERING AT VIBORG, AND (2) EDUCATE, PROMOTE AND OFFER HEALTHY LIVING OPPORTUNITIES TO AREA COMMUNITIES. - SPONSORED HEART AND VASCULAR SCREENING AT PARKER MEDICAL CLINIC ON 05/10/2023. - ADDED MOBILE MAMMOGRAPHY SERVICES AT CENTERVILLE MEDICAL CLINIC AND PARKER MEDICAL CLINIC BEGINNING MARCH 2023. - PROVIDED EDUCATION VIA PRINT AND SOCIAL MEDIA ON THE FOLLOWING: - AWARENESS FOR CERVICAL CANCER, GLAUCOMA, PARKENSON'S, MENTAL HEALTH AND BREAST CANCER - SCREENINGS FOR: HEART AND VASCULAR; LUNG, AND SKIN CANCER- HEARTSAVER CPR TRAINING- HEART HEALTHY AT ANY AGE- VIBORG-HURLEY ELEMENTARY BIKE TO SCHOOL DAY- WELL-CHILD EXAMS- WHERE TO GO FOR CARE: CLINIC OR THE EMERGENCY ROOM- IMMUNIZATIONS AND VACCINATIONS- SYMPTOMS OF HEAT EXHAUSTION VS HEAT STROKE. HEAT INDEX AND HOW TO STAY SAFE.- THE AVAILABILITY OF MEALS ON WHEELS- COMMUNITY HEALTH FAIR: LEARN ABOUT WOUND CARE, DIABETIC EDUCATION, THERAPIES, CARDIAC REHAB AND SOCIAL SERVICES. HEALTHY SNACKS AND PREVENTATIVE SCREENINGS WERE PROVIDED. PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICE PART V, SECTION B, LINE 13B: FINANCIAL ASSISTANCE IS PROVIDED UP TO 100% FOR INDIVIDUALS WHO ARE AT 200% OR BELOW THE FEDERAL POVERTY GUIDELINES, AND A SLIDING SCALE DISCOUNT IS OFFERED TO INDIVIDUALS FROM 201% UP TO 350% OF THE FEDERAL POVERTY GUIDELINES. THE DETERMINATION OF FINANCIAL ASSISTANCE IS BASED ON THE FEDERAL POVERTY GUIDELINES, BUT WE ALSO TAKE INTO CONSIDERATION OTHER FACTORS SUCH AS SERIOUS ILLNESS, LOSS OF EMPLOYMENT, INSURANCE COVERAGE AND OTHER EXTENUATING CIRCUMSTANCES IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE OR DISCOUNTED CARE. PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICE PART V, SECTION B, LINE 16J: PART V, SECTION B, LINE 16A-C: THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE POSTED AT HTTPS://WWW.PIONEERMEMORIAL.ORG/CUSTOM/FINANCIAL-ASSISTANCEPART V, SECTION B, LINE 16J: SIGNS ARE POSTED IN THE ADMISSIONS OFFICES AND EMERGENCY ROOM THAT DISCOUNTED FEES ARE AVAILABLE FOR PATIENTS MEETING THE CRITERIA, AND PATIENTS ARE ENCOURAGED TO CONTACT PATIENT FINANCIAL SERVICES TO DISCUSS THEIR CHARGES. PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ON THE BILLING STATEMENT AND ARE GIVEN THE TELEPHONE NUMBER TO CONTACT PATIENT FINANCIAL SERVICES WITH QUESTIONS OR TO INQUIRE ABOUT FINANCIAL ASSISTANCE. INFORMATION ON FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS IN THE REMINDER LETTERS AND COLLECTION LETTERS SENT TO PATIENTS WITH DELINQUENT BALANCES. PATIENT FINANCIAL SERVICES VISIT WITH INPATIENTS THAT ARE ADMITTED TO THE HOSPITAL WITH NO INSURANCE TO DISCUSS PAYMENT OPTIONS AND THE AVAILABILITY OF FINANCIAL ASSISTANCE. PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICE PART V, SECTION B, LINE 20E: STATEMENT FOR PART V, SECTION B, LINE 20D REGARDING PRESUMPTIVE ELIBIGILITY DETERMINATIONS: ONCE A FINANCIAL ASSISTANCE APPLICATION IS COMPLETED AND APPROVED, IT WILL REMAIN IN EFFECT FOR SIX MONTHS FROM THE DATE OF APPROVAL. SERVICES PROVIDED DURING THE SIX MONTH PERIOD WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE AS DETERMINED DURING THE APPLICATION APPROVAL PROCESS.STATEMENT FOR PART V, SECTION B, LINE 20E - NOT APPLICABLE. PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICE PART V, SECTION B, LINE 24: THE HOSPITAL FINANCIAL ASSISTANCE POLICY DOES NOT COVER ELECTIVE PROCEDURES. THE HOSPITAL MAY HAVE CHARGED FAP ELIGIBLE PATIENTS GROSS CHARGES FOR SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY. 4 1 - PIONEER MEMORIAL NURSING HOME 315 N WASHINGTON ST VIBORG SD 57070 SKILLED NURSING 5 - PIONEER INN 315 N WASHINGTON ST VIBORG SD 57070 ASSISTED LIVING 6 - PIONEER VILLA 315 N WASHINGTON ST VIBORG SD 57070 CONGREGATE HOUSING 7 - TURNER COUNTY PUBLIC HEALTH 315 N WASHINGTON ST VIBORG SD 57070 COMMUNITY PUBLIC HEALTH PART I, LINE 3C: FINANCIAL ASSISTANCE IS PROVIDED UP TO 100% FOR INDIVIDUALS WHO ARE AT 200% OR BELOW THE FEDERAL POVERTY GUIDELINES AND A SLIDING SCALE DISCOUNT IS OFFERED TO INDIVIDUALS FROM 201% UP TO 350% OF THE FEDERAL POVERTY GUIDELINES. THE DETERMINATION OF FINANCIAL ASSISTANCE IS BASED ON THE FEDERAL POVERTY GUIDELINES, BUT WE ALSO TAKE INTO CONSIDERATION OTHER FACTORS SUCH AS SERIOUS ILLNESS, LOSS OF EMPLOYMENT, INSURANCE COVERAGE AND OTHER EXTENUATING CIRCUMSTANCES IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE OR DISCOUNTED CARE.PART I, LINE 6B:THE ORGANIZATION'S COMMUNITY BENEFIT REPORT CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.PIONEERMEMORIAL.ORG/CUSTOM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART I, LINE 7: CHARITY CARE (LINE A) WAS CALCULATED USING THE OVERALL COST TO CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. COMMUNITY HEALTH IMPROVEMENT SERVICES (LINE E), HEALTH PROFESSIONS EDUCATION (LINE F) AND CASH AND IN-KIND CONTRIBUTIONS (LINE I) ARE BASED ON ACTUAL PROGRAM EXPENSES RECORDED IN THE GENERAL LEDGER. SUBSIDIZED HEALTH SERVICES(LINE G) IS REPORTED USING THE MEDICARE COST REPORTS. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES CLINIC REVENUE OF $1,908,642 AND EXPENSE OF $2,443,443, FOR A NET LOSS FROM CLINIC OPERATIONS OF $534,801. PART II, COMMUNITY BUILDING ACTIVITIES: PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES (PMHHS) PROVIDES FOR THE HEALTH AND SAFETY OF THE COMMUNITIES WE SERVE THROUGH FINANCIAL AND IN-KIND CONTRIBUTIONS TO THE LOCAL VOLUNTEER FIRE DEPARTMENTS, AMBULANCES AND FIRST RESPONDERS, SENIOR CITIZENS CENTERS, FOOD PANTRIES, DOMESTIC VIOLENCE SHELTERS, COMMUNITY AND SCHOOL EVENTS AND OTHER COMMUNITY ORGANIZATIONS THAT SERVE THE BETTERMENT OF THE COMMUNITIES WE SERVE. PMHHS IS ACTIVELY INVOLVED WITH THE TURNER COUNTY DISASTER PREPAREDNESS AND TURNER COUNTY CHILD PROTECTION TEAM. THE DESCRIBED ACTIVITY FURTHERS HEALTH IN THE COMMUNITY AS THE SUPPORT TO THESE ORGANIZATIONS PROVIDE SAFETY AND HEALTH SUPPORT TO INDIVIDUALS IN THE COMMUNITY. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THE RESPECTIVE CLASS OF PATIENTS AND RESIDENTS. PART III, LINE 3: THE METHODOLOGY USED WAS A PERCENTAGE OF DEMOGRAPHICS BELOW POVERTY LEVEL. THE POPULATION AND POVERTY RATES WERE OBTAINED FOR EACH OF THE COMMUNITIES IN OUR SERVICE AREA. THE PERCENTAGE OF POPULATION BY COMMUNITY TO THE TOTAL SERVICE AREA WAS CALCULATED, AND THIS PERCENTAGE WAS APPLIED TO THE COMMUNITY'S POVERTY RATE. THE AVERAGE WEIGHTED POVERTY RATE BY EACH COMMUNITY WAS TOTALED TO CALCULATE THE TOTAL AVERAGE WEIGHTED POVERTY RATE FOR OUR SERVICE AREA. THIS AVERAGE WEIGHTED POVERTY RATE WAS APPLIED TO THE AMOUNT OF THE IMPLICIT PRICE CONCESSION. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSION IS LOCATED IN THE AUDITED FINANCIAL STATEMENT REPORT ON PAGES 10-11. PART III, LINE 8: PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICES PROVIDES SERVICES TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THEY WILL NOT RECEIVE ALL THE COSTS ASSOCIATED WITH PROVIDING THESE SERVICES. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES. IN THE EVENT MEDICARE PRODUCES A SHORTFALL, IT IS CONSIDERED A COMMUNITY BENEFIT.MEDICARE ALLOWABLE COSTS OF CARE ARE BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES (PMHHS) IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO THOSE PATIENTS DEMONSTRATING AN INABILITY TO PAY FOR THE MEDICAL SERVICES PROVIDED. PMHHS WILL NOTIFY PATIENTS OF THEIR BALANCES BY BILLING STATEMENTS WHICH ARE MAILED APPROXIMATELY EVERY 28 DAYS FROM THE DATE THE ACCOUNT IS CONSIDERED SELF-PAY. THE BILLING STATEMENT PROVIDES INFORMATION REGARDING AVAILABILITY OF FINANCIAL ASSISTANCE. PMHHS WILL MAKE REASONABLE EFFORTS TO DETERMINE IF PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. IF THE PATIENT/GUARANTOR HAS PROVIDED AN ACCURATE MAILING ADDRESS TO PMHHS, THE PATIENT/GUARANTOR WILL BE PROVIDED A MINIMUM OF 4 BILLING STATEMENTS BEFORE AN UNPAID SELF-PAY BALANCE WOULD BE ASSIGNED TO AN OUTSIDE COLLECTION VENDOR. IF THE PATIENT HAS FAILED TO PROVIDE A CORRECT OR DELIVERABLE MAILING ADDRESS, THEN THEIR BALANCES MAY BE ASSIGNED TO A THIRD PARTY COLLECTION VENDOR PRIOR TO 4 STATEMENTS BEING PROVIDED. IF PMHHS IS REASONABLY ABLE TO DETERMINE THAT A PATIENT IS UNABLE TO PAY THEIR MEDICAL BILL, PMHHS MAY GRANT FINANCIAL ASSISTANCE PRIOR TO THE 4 STATEMENTS BEING PROVIDED. NEITHER PMHHS NOR ANY OF ITS THIRD PARTY COLLECTION VENDORS WILL TAKE ANY EXTRAORDINARY COLLECTION EFFORTS UNTIL PMHHS AND THE THIRD PARTY COLLECTION VENDOR HAVE MADE REASONABLE EFFORTS TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE PMHHS FINANCIAL ASSISTANCE POLICY. PMHHS DICTATES THAT ITS THIRD PARTY COLLECTION VENDORS CANNOT TAKE EXTRAORDINARY COLLECTION ACTIVITIES UNTIL A BALANCE IS AT LEAST 241 DAYS PAST THE FIRST SELF-PAY STATEMENT DATE PROVIDED TO THE PATIENT/GUARANTOR. THIS IS TO ENSURE THAT BOTH PMHHS AND ITS THIRD PARTY COLLECTION VENDORS ARE TAKING ANY AND ALL NECESSARY STEPS TO NOTIFY PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY AND ALLOWING THE APPROPRIATE TIME FOR A PATIENT/GUARANTOR TO FILL OUT A FINANCIAL ASSISTANCE APPLICATION. IF A PATIENT/GUARANTOR FILLS OUT A COMPLETED FINANCIAL ASSISTANCE APPLICATION, PMHHS WILL NOTIFY THE THIRD PARTY COLLECTION VENDOR TO SUSPEND ALL EXTRAORDINARY COLLECTION ACTIONS PENDING THE OUTCOME OF THE FINANCIAL ASSISTANCE DETERMINATION. IF REQUIRED BY REGULATION OR LAW AND THE PATIENT HAS FILLED OUT A FINANCIAL ASSISTANCE APPLICATION PRIOR TO 240 DAYS FORM THE FIRST SELF-PAY STATEMENT DATE, THEN THE THIRD PARTY COLLECTION VENDOR WILL TAKE STEPS TO REVERSE EXTRAORDINARY COLLECTION EFFORT FOR ANY PATIENT THAT QUALIFIES FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES (PMH&HS) ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES AS PART OF ITS ANNUAL STRATEGIC PLANNING PROCESS. INFORMATION IS ALSO OBTAINED THROUGHOUT THE YEAR FROM THE SATISFACTION SURVEYS COMPLETED BY PATIENTS OF THE HOSPITAL AND CLINICS AND THE RESIDENTS IN THE NURSING HOME IN ACCESSING HEALTH CARE NEEDS. PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES BASED OUT OF VIBORG, SD WORKED IN PARTNERSHIP WITH SANFORD HEALTH TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022, AND THE PMH&HS BOARD OF DIRECTORS APPROVED THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION STRATEGY 2023-2025 ON OCTOBER 27,2022. THE ASSESSMENT TARGETED THE SURROUNDING COMMUNITY, CONSIDERING THE NEEDS OF INDIVIDUALS AND HOUSEHOLDS WITHIN THE DEFINED RESEARCH AREA INCLUDING ADJACENT RURAL COMMUNITIES SUCH AS CENTERVILLE, DAVIS, HURLEY, PARKER, IRENE AND WAKONDA, AMONG OTHERS. AN IMPLEMENTATION STRATEGY WAS DEVELOPED THAT IDENTIFIES THE NEED AREAS AND THEIR RESPECTIVE GOALS AND ACTIVITIES THAT PMH&HS AIMS TO ACHIEVE IN THE COMING THREE-YEAR PERIOD. PART VI, LINE 3: PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES (1) POSTS CONTACT INFORMATION IN ADMISSIONS, EMERGENCY ROOM, AND OTHER AREAS OF THE ORGANIZATION FOR CONCERNS WITH CHARGES; (2) INCLUDES FINANCIAL ASSISTANT CONTACT INFORMATION ON PATIENT STATEMENTS AND COLLECTION LETTERS; (3) CONTACTS EMERGENCY ROOM PATIENTS WITH NO INSURANCE AND DISCUSSES PAYMENT OPTIONS AND FINANCIAL ASSISTANCE; (4) CONTACTS PATIENTS WITH NO INSURANCE WHO ARE SCHEDULED FOR PROCEDURES AND DISCUSSES PAYMENT OPTIONS AND FINANCIAL ASSISTANCE; (5) DISCUSSES WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. PART VI, LINE 4: PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES SERVES THE RURAL COMMUNITIES OF VIBORG, CENTERVILLE, DAVIS, HURLEY, IRENE, PARKER AND WAKONDA. PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES IS A CRITICAL ACCESS HOSPITAL AND IS THE ONLY HOSPITAL LOCATED IN TURNER COUNTY. THERE ARE TWO TERTIARY HOSPITALS AND ONE HEART HOSPITAL LOCATED IN THE SIOUX FALLS METROPOLITAN AREA (45 MILES AWAY), AND ONE HOSPITAL LOCATED IN YANKTON (35 MILES AWAY). TURNER COUNTY IS A HEALTHCARE PROFESSIONAL SHORTAGE AREA. THE UNINSURED, MEDICAID AND MEDICARE PATIENTS REPRESENT RESPECTIVELY, 3%, 4% AND 61% OF TOTAL HOSPITAL PATIENTS.COMMUNITY POPULATION AVERAGE INCOME AVG HOUSEHOLD SIZE VIBORG 1,037 $ 45,179 2.3 CENTERVILLE 1,290 $ 59,125 2.4 DAVIS 172 $ 73,750 2.2 HURLEY 623 $ 63,021 2.4 IRENE 687 $ 66,652 2.3 PARKER 1,433 $ 86,699 2.7 WAKONDA 349 $ 73,971 2.2 PART VI, LINE 5: PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY.THE DIRECTOR OF SAFETY AT PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES IS A MEMBER OF THE TURNER COUNTY DISASTER PREPAREDNESS TEAM. THE TEAM HAS ALSO BEEN INVOLVED WITH STATEWIDE DRILLS FOR DIFFERENT DISASTER SCENARIOS (I.E. TORNADO, PANDEMIC OUTBREAK) SO THE HOSPITAL IS PREPARED TO RESPOND IF AN ACTUAL EVENT WERE TO OCCUR. THE PUBLIC HEALTH NURSE IS A MEMBER OF THE TURNER COUNTY CHILD PROTECTION TEAM AND IS TRAINED TO STEP INTO A SITUATION INVOLVING THE WELFARE OF A CHILD IF THE NEED SHOULD ARISE.THE GOVERNING BOARD OF PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE FACILITY HAS AN OPEN MEDICAL STAFF. THE USE OF SURPLUS FUNDS IS RE-INVESTED IN CAPITAL AND PLANT AND ALSO ALLOCATED FOR IMPROVING PATIENT CARE. X 0 0 0 0 0 1 0 0 0 GABRIEL JOHNSON DO-FAMILY MEDICINE 255335 0 0 0 60 0 8171 0 30798 0 294364 0 0 0 KAYLA MEHLHAF CERTIFIED NURSE PRACTITIONER 140911 0 0 0 54 0 4437 0 7413 0 152815 0 0 0 PART I, LINE 6 THE COMPENSATION PACKAGE FOR PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES INCLUDES A 0%-1% ONE-TIME BONUS BASED ON NET INCOME OF THE ORGANIZATION. ALL EMPLOYEES ARE ELIGIBLE FOR THE ONE-TIME BONUS EXCEPT THE CONTRACTED EMPLOYEES. SCHEDULE J, PART I, LINE 3: THE ORGANIZATION RELIES ON SANFORD HEALTH NETWORK, AN UNRELATED MANAGEMENT COMPANY, TO DETERMINE THE COMPENSATION PAID TO THE CEO. THE ORGANIZATION'S BOARD OF DIRECTORS APPROVES THE CONTRACT WITH SANFORD HEALTH NETWORK. COMPENSATION FOR LINDSEY HAUGER, CEO, IS REFLECTED AS PART OF THE MANAGEMENT FEE IN FORM 990, PART VII SECTION B FOR SERVICES RENDERED TO THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE WHICH CONSISTS OF THE PRESIDENT, VICE PRESIDENT, AND SECRETARY. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE ORGANIZATION DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE WILL BE REFERRED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 TROY LEE AND ANNE CHRISTIANSEN HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT SERVICES ARE PROVIDED TO THE ORGANIZATION BY SANFORD HEALTH NETWORK UNDER A MANAGEMENT SERVICES AGREEMENT. LINDSEY HAUGER IS THE CEO. AS THE CEO SHE IS RESPONSIBLE FOR LOCAL PLANNING AND MANAGEMENT OF ALL ACTIVITIES IN THE ORGANIZATION, CARRYING OUT THE MISSION AND GOALS OF THE FACILITY AND ENSURING THE HIGHEST POSSIBLE HEALTH STATUS OF THE COMMUNITY WITHIN THE LIMITS OF AVAILABLE RESOURCES. THE BASIC MANAGEMENT FUNCTIONS OF THE POSITION INCLUDE PLANNING, ORGANIZING, MANAGING HUMAN AND FINANCIAL RESOURCES, DIRECTING STAFF AND CONTROLLING THE OPERATIONS. SANFORD HEALTH NETWORK PAID LINDSEY HAUGER $159,650 IN COMPENSATION AND $38,691 IN BENEFITS. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP CERTIFICATES SHALL BE GIVEN TO EACH PERSON CONTRIBUTING TO THE ORGANIZATION, SUBJECT HOWEVER TO THE CONDITION THAT SUCH CONTRIBUTIONS SHALL BE NOT LESS THAN THE SUM OF $100. FORM 990, PART VI, SECTION A, LINE 7A ALL MEMBERS SHALL BE PRIVILEGED TO ATTEND AND PARTICIPATE IN ALL SESSIONS OF THE ANNUAL OR SPECIAL MEETINGS OF THE CORPORATION AND SHALL BE ELIGIBLE TO SERVE AS A DIRECTOR OR OFFICER, EXCEPT WHERE SPECIFICALLY PROHIBITED BY LAW. THEY ARE INVITED TO ANNUAL MEETINGS AND SPECIAL MEETINGS. AT SUCH MEETINGS, EACH MEMBER SHALL BE ENTITLED TO CAST ONE VOTE. MEMBERS DO ELECT THE BOARD OF DIRECTORS - NOMINATED BY THE NOMINATING COMMITTEE. MOTION IS PASSED BY THE MEMBERS AT THE ANNUAL MEETING TO ELECT BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DID NOT HAVE ANY MEETINGS HELD BY THE EXECUTIVE COMMITTEE DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT FORM 990 WILL BE REVIEWED BY THE CFO. IT WILL BE MAILED OR E-MAILED OUT TO THE BOARD OF DIRECTORS FOR A PERIOD OF TIME DURING WHICH IT WILL BE OPEN FOR COMMENT PRIOR TO FINALIZING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS COMPLETE AN ANNUAL CONFLICT OF INTEREST FORM AT EITHER THE APRIL OR MAY BOARD MEETING. THE FORM IS REVIEWED INITIALLY BY THE CEO, AND ANY ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS. CONFLICT OF INTEREST IS ENFORCED AT EVERY MEETING. BOARD MEMBERS WILL REFRAIN FROM VOTING IF A CONFLICT OF INTEREST IS PRESENT. FORM 990, PART VI, SECTION B, LINE 15B CEO: SANFORD PRESENTS A COMPARATIVE SCHEDULE ON CEO SALARIES WITH MEDIAN AND HIGH/LOW SALARIES, FOR COMPARABLE POSITIONS AND AREAS OF RESPONSIBILITIES. THE CURRENT MARKET AND LONGEVITY IS ALSO INCLUDED IN THE EVALUATION OF COMPENSATION. THE SANFORD NETWORK VICE PRESIDENT PRESENTS THE COMPENSATION SUBSTANTIATION TO THE BOARD OF DIRECTORS AT A MEETING THAT EXCLUDES THE CEO. PERFORMANCE EVALUATIONS ARE COMPLETED BY EACH BOARD MEMBER, THE VICE PRESIDENT AND CEO SELF EVALUATION. ADMINISTRATIVE STAFF (CFO, DIRECTOR OF HR/MATERIALS, DIRECTOR OF SUPPORT SERVICES, HOSPITAL DON, LTC DON): THE CEO COMPARES COMPENSATION TO SDAHO SALARY SURVEY AND ALSO CONTACTS SANFORD FOR COMPENSATION COMPARISON WITH LIKE-SIZED FACILITIES AND RESPONSIBILITIES. SALARY INCREASES ARE PRESENTED TO THE BOARD OF DIRECTORS AS PART OF THE BUDGET APPROVAL PROCESS. THIS PROCESS WAS LAST UNDERTAKEN IN THE CURRENT YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 18,777. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,777. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 404,355. MANAGEMENT AND GENERAL EXPENSES 100,352. FUNDRAISING EXPENSES 2,589. TOTAL EXPENSES 507,296. QUALITY CONTROL: PROGRAM SERVICE EXPENSES 6,330. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,330. PURCHASED STAFFING SERVICES: PROGRAM SERVICE EXPENSES 705,464. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 705,464. CONTRACT PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 818. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 818. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 181,261. MANAGEMENT AND GENERAL EXPENSES 230,275. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 411,536. OUTSIDE MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 289,291. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 289,291. PURCHASED SERVICES - SANDFORD HEALTH: PROGRAM SERVICE EXPENSES 251,604. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 251,604. COLLECTION AGENCY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 13,182. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,182. PIONEER MEMORIAL FOUNDATION 315 NORTH WASHINGTON STREET VIBORG SD 57070 261832061 FUNDRAISING SD 501(C)(3) LINE 7 PIONEER MEMORIAL HOSPITAL AND HEALTH SERVICES 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0