2025-08-13T09:35:59-05:00 2024-09-30 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2023-10-01 460255944 MOBRIDGE REGIONAL HOSPITAL MOBR 6058453692 1401 10TH AVE W MOBRIDGE SD 57601 JOHN AYOUB CEO 6058453692 2025-08-12 1 1 LAURIE HANSON CPA P00851848 6053391999 2025-08-12 2023 2025-03-06 01:10:19Z JOHN AYOUB 1401 10TH AVE W MOBRIDGE SD 57601 29978414 0 X WWW.MOBRIDGEHOSPITAL.ORG X 1959 SD PROVIDING HEALTHCARE TO PEOPLE THROUGHOUT THE REGION. 12 10 245 75 0 0 490204 826505 26498946 28869353 178161 282556 0 0 27167311 29978414 0 0 0 0 18156140 19165740 0 0 0 10028602 11453188 28184742 30618928 -1017431 -640514 47667918 58849065 20957382 32528581 26710536 26320484 X THE MISSION OF MOBRIDGE REGIONAL HOSPITAL IS TO PROVIDE HIGH QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE AND PROFESSIONAL MANNER FOR PEOPLE THROUGHOUT THE REGION. 0 0 25082424 28869353 MOBRIDGE REGIONAL HOSPITAL (MRH), A 25-BED CRITICAL ACCESS HOSPITAL, 16 BED ASSISTED LIVING CENTER, 8 BED SENIOR HOUSING CENTER, MEDICAL CLINICS, AND AMBULANCE SERVICE, PROVIDES HEALTHCARE SERVICES TO PERSONS THROUGHOUT THE REGION. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024, THE HOSPITAL PROVIDED CARE TO THE NORTH CENTRAL REGION OF SOUTH DAKOTA, AND THE SOUTH CENTRAL REGION OF NORTH DAKOTA. THE HOSPITAL HAD:1,530 PATIENT DAYS1,307 ACUTE CARE DAYS542 SWING BED CARE DAYS4,868 EMERGENCY ROOM VISITS941 AMBULANCE RUNS19,057 RURAL HEALTH CLINIC VISITS7,417 ASSISTED LIVING DAYS (PRAIRIE SUNSET VILLAGE)CONSTRUCTION IN THE NEW PATIENT WING INCLUDING OB, MED/SURG AND PHARMACY CONCLUDED IN JANUARY 2024. THIS WAS PHASE I OF IV TOTAL PHASES OF THE PROJECT. THIS PHASE INCLUDED THE NEW PATIENT WING AND OUR NEW OB DEPARTMENT WITH 4 NEW LABOR AND DELIVERY ROOMS. AN ADDED BENEFIT TO OUR RECENTLY CONSTRUCTED PATIENT WING IS THE WEST-MOST PORTION OF THE ADDED WING, INCLUDING ITS OWN WAITING ROOM, DONNING AND DOFFING ROOMS AND NURSES STATION ALLOWING FOR ADDED PRIVACY, SECURITY, AND THESE FOUR ROOMS ARE ON A SEPARATE AIR HANDLER THAT CAN BE USED FOR EMERGENCY INFECTION CONTROL PURPOSES. 25082424 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 245 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 10 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X RENAE KARST 6058458164 PO BOX 580 MOBRIDGE SD 57601 DR TRAVIS HENDERSON INTERNAL MEDICINE/DIRECTOR 40.00 X 390117 0 128670 DR ROBERT MARCIANO FAMILY MD/DIRECTOR 40.00 X 324291 0 31092 BILL BACHMEIER CHAIRMAN 1.00 X X 0 0 0 HEIDI ROSHAU TREASURER 1.00 X X 0 0 0 PATTI SCHMEICHEL SECRETARY 1.00 X X 0 0 0 LORI HEIL VICE CHAIR 1.00 X X 0 0 0 ADAM HAYES DIRECTOR 1.00 X 0 0 0 CHRISTOPHER BOHLANDER DIRECTOR 1.00 X 0 0 0 JAKE KRAFT DIRECTOR 1.00 X 0 0 0 RICHARD GROSS DIRECTOR 1.00 X 0 0 0 LAURIE BAUER DIRECTOR 1.00 X 0 0 0 JOSH WUDEL DIRECTOR 1.00 1.00 X 0 0 0 RENAE KARST CFO 40.00 X 133686 0 41414 JOHN AYOUB CEO 40.00 0.25 X 0 0 0 BROOKE SHERBECK CRNA 40.00 X 253138 0 36461 DR MATT SCHAFFER PHYSICIAN 40.00 X 372913 0 64660 DR EMILY BODEN PHYSICIAN 40.00 X 368302 0 40403 DR JOSH HENDERSON INTERNAL MEDICINE 40.00 X 345820 0 40032 DR ALAN LAWRENCE SURGEON 40.00 X 433492 0 33907 2621759 0 416639 30 0 1 0 KRAUS-ANDERSON CONSTRUCTION COMPANY 501 SOUTH 8TH STREET MINNEAPOLIS MN 55404 CONSTRUCTION SERVICES 12895466 CERNER CORP CO ORACLE AM INC PO BOX 203448 DALLAS TX 75320 IT SERVICE 488065 HIGH POINT NETWORKS 728 E BEATON DRIVE SUITE 200 WEST FARGO ND 78078 IT SERVICE 212530 BEACON COMMUNICATIONS 7810 SHAFFER PARKWAY SUITE 120 LITTLETON CO 80127 NURSE CALL LIGHT EQUIPMENT AND INSTALL 120000 4 529300 294977 2228 826505 PATIENT SERVICE REVENUE 621400 26761249 26761249 PHARMACY REVENUE 621400 1889283 1889283 218821 218821 28869353 265919 265919 16637 0 16637 16637 16637 29978414 28869353 0 282556 1192809 790102 402707 13863219 11958974 1904245 466313 408344 57969 2637993 2531515 106478 1005406 850650 154756 68072 68072 7837 7837 104357 104357 1674151 1303151 371000 130135 4183 125952 235386 138084 97302 46704 6709 39995 434604 383435 51169 31380 25136 6244 33240 33240 543636 543636 2545438 1558596 986842 333638 273097 60541 MEDICAL SUPPLIES 3531932 3424826 107106 EQUIPMENT AND MAINTENAN 1513803 756977 756826 DUES AND SUBSCRIPTIONS 44861 12758 32103 174014 79011 95003 30618928 25082424 5536504 0 5254983 7209514 3764544 3890013 566794 587911 242598 165475 74533907 31930494 33181636 42603413 2359550 2104731 357898 553903 1939915 1734105 47667918 58849065 4842286 4371824 12253366 24212448 2993815 2893810 867915 1050499 20957382 32528581 X 25384707 24744193 1325829 1576291 26710536 26320484 47667918 58849065 X -640514 250462 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 104552 104552 37673603 12262661 25410942 23881487 18845941 5035546 12874265 821892 12052373 42603413 DEFERRED COMPENSATION PLAN PAYABLE 1050499 1050499 X 29978414 0 29978414 0 29978414 30618928 0 30618928 0 30618928 PART X, LINE 2: THE 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. THE 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. 1 1 X 1 X 1 X 1 1 1 0 0 84000 84000 0.00270 5500156 4205278 1294878 0.04230 5584156 4205278 1378878 0.04500 6762868 1741635 5021233 0.16400 6762868 1741635 5021233 0.16400 12347024 5946913 6400111 0.20900 1 1309289 256621 7333941 7369780 -35839 X 1 1 1 1 MOBRIDGE REGIONAL HOSPITAL 1401 10TH AVENUE W MOBRIDGE SD 57601 WWW.MOBRIDGEHOSPITAL.ORG 48404 X X X X 4 PROVIDER BASED CLINICS MOBRIDGE REGIONAL HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE 7D X X 1 21 1 SEE PART V, LINE 10A NARRATIVE. 0 1 X 100.000000000000 200.000000000000 X X X X X 1 1 X X X 1 X SEE NARRATIVE X SEE NARRATIVE X SEE NARRATIVE X X X X X X 1 X 0 X X X X 1 X 0 0 MOBRIDGE REGIONAL HOSPITAL PART V, SECTION B, LINE 5: THE MOBRIDGE REGIONAL HOSPITAL CONDUCTED AN ELECTRONIC COMMUNITY SURVEY TO UNDERSTAND IN GREAT DEPTH THE CURRENT PERCEPTION OF COMMUNITY HEALTH AND THE UNDERSTANDING OF HEALTH AND WELLNESS SERVICES AVAILABLE IN OUR AREA. THE SURVEY OF FORTY-FOUR QUESTIONS RECEIVED SEVENTY-NINE SUBMISSIONS AND ADDRESSED NINETEEN DIFFERENT TOPICS AND WHETHER EACH TOPIC WAS AN ISSUE WITHIN OUR COMMUNITY.A FOCUS GROUP OF COMMUNITY LEADERS, COMMUNITY HEALTHCARE PROVIDERS, COORDINATING AGENCIES, AND COMMUNITY MEMBERS REPRESENTING UNDERSERVED POPULATIONS ANALYZED THE DATA. MOBRIDGE REGIONAL HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA REPORT IS AVAILABLE AT HTTP://WWW.MOBRIDGEHOSPITAL.ORG/ABOUT-US/COMMUNITY-ASSESSMENT-REPORT-990/MOBRIDGE REGIONAL HOSPITAL:PART V, SECTION B, LINE 10ATHE HOSPITAL'S IMPLEMENTATION STRATEGY IS POSTED ON THE WEBSITE AT HTTP://WWW.MOBRIDGEHOSPITAL.ORG/ABOUT-US/COMMUNITY-ASSESSMENT-REPORT-990/THE IMPLEMENTATION STRATEGY BEGINS ON PAGE 8 OF THE CHNA. MOBRIDGE REGIONAL HOSPITAL PART V, SECTION B, LINE 11: IN THE CHNA AND IMPLEMENTATION STRATEGY COMPLETED DURING FY22, THE FOLLOWING PRIORITY ITEMS WERE IDENTIFIED: MENTAL AND BEHAVIORAL HEALTH AND ADDICTION COUNSELING, EDUCATION ABOUT EXISTING SERVICES, IMPROVING COMMUNITY PERCEPTION OF CONFIDENTIALITY, REVISITING THE NURSING HOME STUDY, IMPROVING YOUTH BEHAVIORS, PARTNERING WITH WEST RIVER SCHOOLS, AND INVESTIGATING OPPORTUNITIES TO INCREASE DAYCARE ACCESSIBILITY AND AFFORDABILITY. MRH WILL ADDRESS ALL OF THE IDENTIFIED PRIORITY NEEDS.DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024, THE ORGANIZATION MADE PROGRESS TOWARD MEETING THE IDENTIFIED NEEDS FROM THE FY22 CHNA AS FOLLOWS:MENTAL AND BEHAVIORAL HEALTH AND ADDICTION COUNSELING:MRH PARTNERED WITH IHC (INTEGRATED HEALTH CENTERS) TO PROVIDE BEHAVIORAL HEALTH SERVICES TO THE COMMUNITY. SERVICES ARE AVAILABLE IN ALL FOUR RURAL HEALTH CLINICS AND INCLUDE PROVIDING A CERTIFIED NURSE PRACTITIONER IN PSYCHIATRY FOR DIAGNOSIS AND MEDICATION MANAGEMENT AS WELL AS TWO LICENSED CLINICAL SOCIAL WORKERS FOR COUNSELING AND FOLLOW UP. MRH ALSO PARTNERS WITH EBEHAVIORAL HEALTH THROUGH AVEL FOR INPATIENTS WHO NEED BEHAVIORAL CARE UNTIL A SAFE TRANSFER OR DISCHARGE IS MADE. MRH CONTINUES TO FOCUS ON PROVIDER EDUCATION ALONG WITH DIRECT-TO-CONSUMER EDUCATION FOR ADDITIONAL REFERRALS AND SELF-REFERRALS TO SERVICES. THERE CONTINUES TO BE WORK DONE TO ADD ADDITIONAL STAFF SHOULD WE FIND THE DEMAND OUTPACES OUR CURRENT CAPACITY.EDUCATION ABOUT EXISTING SERVICES:MRH DISTRIBUTES A COMMUNITY NEWSLETTER THAT IS ISSUED FOUR TIMES PER YEAR TO PROMOTE OUR CURRENT AND NEW SERVICE OFFERINGS AND TO EDUCATE COMMUNITY MEMBERS. MRH HAS ALSO INCREASED THE PRODUCTION OF FACEBOOK POSTS, WEBSITE UPDATES, AND VIDEOS TO EDUCATE ABOUT CURRENT AND NEW SERVICE OFFERINGS. THERE HAVE BEEN A NUMBER OF EDUCATIONAL PIECES PRODUCED IN CONJUNCTION WITH OUR BUILDING PROJECT AND HEALTHY FUTURES CAPITAL CAMPAIGN TO HIGHLIGHT NEW AND EXISTING SERVICES. MRH HAS MADE A VERY CONCERTED EFFORT TO SHARE MORE INFORMATION ABOUT OUR SERVICES AND MISSION-DRIVEN WORK WITH THE PUBLIC. WE HAVE WORKED WITH THE MOBRIDGE TRIBUNE TO CREATE A RELATIONSHIP WHERE WE SHARE ARTICLES ABOUT NEW AND EXISTING SERVICES, LOCAL PHILANTHROPY, ETC., AS A GUEST COLUMNIST. WE ALSO HAVE STARTED BUILDING AN EMAIL LIST THROUGH THE MRHC FOUNDATION TO SEND OUT A PERIODIC NEWSLETTER, 'THE HEARTBEAT'. THIS NEWSLETTER IS MEANT TO EDUCATE THE PUBLIC ABOUT SERVICES WE PROVIDE. IMPROVING COMMUNITY PERCEPTION OF CONFIDENTIALITY:MRH FOCUSES ON EMPLOYEE EDUCATION STRESSING THE IMPORTANCE OF CONFIDENTIALITY. THIS INCLUDES AUDITS OF THE EMR (ELECTRONIC MEDICAL RECORD) BEHAVIORS THAT IMPACT PATIENT CONFIDENTIALITY. THESE UPDATES AND METHODOLOGY OF AUDITS ARE BEING COMMUNICATED AT ALL-EMPLOYEE FORUMS. ALSO, WITH REGARD TO THESE AUDITS, WE FEEL IT IS IMPORTANT FOR THE PUBLIC TO KNOW THAT WE ARE KEEPING PATIENTS' INFORMATION CONFIDENTIAL AS WE RAISE AWARENESS OF EFFORTS TO DO SO. REVISITING THE NURSING HOME STUDY:MRH CONTINUES TO COLLABORATE WITH THE BOARD OF DIRECTORS OF THE WCCC (WALWORTH COUNTY CARE CENTER) TO REAFFIRM SUPPORT OF BOTH ENTITIES. RECENT COLLABORATIONS INCLUDE CNA CLASSES ENHANCING WORKFORCE FOR BOTH ENTITIES, ALONG WITH SOCIAL WORKERS WORKING TOGETHER FOR POSSIBLE ADMISSIONS THAT BEST MEET THE NEEDS OF PATIENTS AND RESIDENTS OF OUR SERVICE AREAS.IMPROVING YOUTH BEHAVIORS:THE IHC PARTNERSHIP INCLUDES ACCESS TO CHILDREN (LESS THAN 5 YEARS OLD) AND ADOLESCENT COUNSELING. MRH CONTINUES TO PROVIDE FREE SPORTS PHYSICALS TO ENSURE AS MANY STUDENTS AS POSSIBLE HAVE ACCESS TO SCHOOL SPORTS. THE MRH DIRECTOR OF DIAGNOSTIC IMAGING TEACHES THE HEALTHCARE CAREERS CLASSES AT THE MOBRIDGE POLLOCK HIGH SCHOOL TO ENGAGE STUDENTS IN HEALTH AWARENESS, EDUCATION, AND POTENTIAL INTEREST IN HEALTHCARE CAREERS; WE ALSO PROVIDE SCRUBS CAMP TO ENGAGE HIGH SCHOOL STUDENTS IN THE SURROUNDING COMMUNITIES. MRH ALSO COORDINATES THE MISYA WALK TO RAISE AWARENESS OF SUICIDE. MRH ALSO SPONSORS THE ANNUAL THINK & DRIVE EVENT TO ENCOURAGE HEALTHY YOUTH BEHAVIORS IN HIGH SCHOOL STUDENTS IN THE SURROUNDING COMMUNITIES.MRH PLAYED A PIVOTAL ROLE AS PART OF THE LEADERSHIP TEAM THAT WROTE A WINNING $500,000 GRANT THAT MOBRIDGE ECONOMIC DEVELOPMENT GROUP RECEIVED TO MERGE THE TIGER KIDS PROGRAM AND RIVER'S EDGE LEARNING CENTER INTO A NONPROFIT, COMMUNITY-OWNED AND STATE-LICENSED CHILDCARE CENTER FOR CHILDREN 0-10. MRH SUPPORTED THE TIGER KID'S PROGRAM IN ALLOWING THE FLEXIBILITY OF AN EMPLOYEE TO PROVIDE SERVICES AS VOLUNTEER DIRECTOR OF THE TIGER KIDS PROGRAM. THERE IS NO DOUBT THAT THE TIGER KID'S PROGRAM WOULD HAVE FAILED IN ITS FIRST YEAR AND THIS MERGER WOULDN'T HAVE HAPPENED AT ALL WITHOUT MRHS EMPLOYEE'S VISION. MRH IS REALLY THE UNSUNG BEHIND-THE-SCENES HERO IN ALL THIS WORK.PARTNERING WITH WEST RIVER SCHOOLSTHIS WAS NOT ADDRESSED AS OF FY24.INVESTIGATING OPPORTUNITIES TO INCREASE DAYCARE ACCESSIBILITY AND AFFORDABILITY:MRH CONTINUES TO PROVIDE SUPPORT TO LAKE OAHE LEARNING ACADEMY (LOLA) BY PROVIDING EMPLOYEE TIME AND ASSISTANCE GUIDING THEIR NEW BOARD OF DIRECTORS TO EXPAND CAPACITY AND FIND POTENTIAL GRANTS FOR CAPACITY GAINS INTO THE FUTURE. MOBRIDGE REGIONAL HOSPITAL PART V, SECTION B, LINE 13H: THE ORGANIZATION QUALIFIES FREE VERSUS DISCOUNTED CARE BASED ON PROFESSIONAL FEES VERSUS TECHNICAL FEES. WE OFFER 100% OF FREE CARE FOR PROFESSIONAL FEES AND UP TO AN 95% DISCOUNT FOR TECHNICAL FEES. BOTH ARE CALCULATED BASED ON FEDERAL POVERTY GUIDELINES IN THE FAP.PRESUMPTIVE ELIGIBILITY MAY BE USED AS A LAST RESORT. MOBRIDGE REGIONAL HOSPITAL PART V, SECTION B, LINE 16J: PART V, LINE 16A, FAP WEBSITE:HTTPS://MOBRIDGEHOSPITAL.ORG/PATIENTS-AND-VISITORS/PAY-A-BILL/PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://MOBRIDGEHOSPITAL.ORG/PATIENTS-AND-VISITORS/PAY-A-BILL/PART V, LINE 16C, PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://MOBRIDGEHOSPITAL.ORG/PATIENTS-AND-VISITORS/PAY-A-BILL/PART V, LINE 16J: A FINANCIAL ASSISTANCE NOTICE IS MADE PART OF THE BILLING INVOICE. A FINANCIAL ASSISTANCE NOTICE IS POSTED IN THE EMERGENCY ROOM, WAITING ROOMS, AND ADMISSIONS OFFICE, AND THE FULL POLICY IS MADE AVAILABLE UPON REQUEST AND ON THE WEBSITE. MOBRIDGE REGIONAL HOSPITAL 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. 1 3 - PRAIRIE SUNSET VILLAGE 1320 W GRAND CROSSING MOBRIDGE SD 57601 24 BED ASSISTED LIVING & SENIOR HOUSING PART I, LINE 3C: THE ORGANIZATION QUALIFIES FREE VERSUS DISCOUNTED CARE BASED ON PROFESSIONAL FEES VERSUS TECHNICAL FEES. WE OFFER 100% OF FREE CARE FOR PROFESSIONAL FEES AND UP TO AN 95% DISCOUNT FOR TECHNICAL FEES. BOTH ARE CALCULATED BASED ON FEDERAL POVERTY GUIDELINES IN THE FAP.IN ADDITION TO FPG, THE HOSPITAL USES AN ASSET TEST, REVIEWS MEDICAL INDIGENCY, AND CONSIDERS INSURANCE STATUS IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. PRESUMPTIVE ELIGIBILITY MAY BE USED AS A LAST RESORT. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINE 7B WAS DETERMINED USING THE MEDICAID PS&R REPORT AND THE GENERAL LEDGER ACCOUNTING SYSTEM. LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 9/30/24. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE HOSPITAL 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 ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL. THE FPL OF 19.6% CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE. PART III, LINE 4: FOOTNOTE FROM FINANCIAL STATEMENTS: PLEASE SEE NOTE 1, FINANCIAL STATEMENT, PATIENT AND RESIDENT SERVICE REVENUE ON PAGES 13-14. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR THE FISCAL YEAR ENDING 9/30/2024. 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. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: THE PATIENT ACCOUNT SPECIALIST AT THE MOBRIDGE REGIONAL HOSPITAL KEEPS ON FILE ALL GUARANTORS WHO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE AND APPLIES THE FINANCIAL ASSISTANCE TO ALL ACCOUNTS WHEN THE GUARANTOR BALANCE BECOMES DUE. UPDATED FINANCIAL INFORMATION IS REQUESTED ANNUALLY FOR ANY CHANGES IN FINANCIAL ASSISTANCE THAT MAY APPLY. IF AN ACCOUNT GOES TO COLLECTIONS AND OUR COLLECTION AGENCY IDENTIFIES THAT A PATIENT IS MEETING FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA, THE PATIENT'S ACCOUNT MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE. COLLECTION ACTIVITY WILL BE SUSPENDED ON ACCOUNTS, AND THE FINANCIAL ASSISTANCE APPLICATION WILL BE REVIEWED. IF THE ENTIRE ACCOUNT BALANCE IS ADJUSTED, THE ACCOUNT WILL BE RETURNED. IF A PARTIAL ADJUSTMENT OCCURS, THE PATIENT FAILS TO COOPERATE WITH THE FINANCIAL ASSISTANCE PROCESS, OR IF THE PATIENT IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY WILL RESUME. PART VI, LINE 2: MOBRIDGE REGIONAL HOSPITAL (MRH) IS COMMITTED TO PROVIDING HIGH QUALITY HEALTHCARE SERVICES TO ALL PEOPLE THROUGHOUT THE REGION. THE FACILITY PROVIDES FAMILY MEDICINE, INTERNAL MEDICINE, OB, ICU, ALS, AMBULANCE SERVICE, EMERGENCY CARE, AND SURGICAL SERVICES TO ALL PEOPLE WHO ARE IN NEED OF THOSE SERVICES. MRH CURRENTLY IS WORKING IN COLLABORATION WITH WALWORTH COUNTY AND THE STATE OF SOUTH DAKOTA TO PROVIDE COMMUNITY HEALTH SERVICES, INCLUDING FAMILY PLANNING SERVICES, ADULT HEALTH, AND CHILD IMMUNIZATIONS. MRH'S MANAGEMENT STRIVES TO LISTEN TO THE COMMUNITY NEEDS. IF NEW HEALTHCARE NEEDS ARISE, ADMINISTRATION WILL COMPLETE AN ANALYSIS OF COST/BENEFIT FOR THE NEW SERVICE TO BE OFFERED. MRH'S ADMINISTRATION BELIEVES IN BEING OUT IN THE PUBLIC AT EVENTS TO ANSWER QUESTIONS THAT MAY SURFACE ABOUT THE FACILITY. PART VI, LINE 3: MRH POSTS ITS FINANCIAL ASSISTANCE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN THE ADMISSIONS AREAS AND CLINIC AREAS IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE FACILITY PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS WITH DISCHARGE MATERIALS. THE PATIENTS ACCOUNT MANAGER 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: MRH IS LOCATED IN A SMALL RURAL COMMUNITY IN WALWORTH COUNTY, SOUTH DAKOTA, KNOWN AS MOBRIDGE. WALWORTH COUNTY HAS A POPULATION OF 5,315 PEOPLE RACIALLY COMPRISED OF MAINLY CAUCASIAN (77.9%) AND NATIVE AMERICANS/ALASKAN NATIVE (15.2%). THE COMMUNITY BORDERS THE STANDING ROCK RESERVATION AND THE CHEYENNE RIVER RESERVATION WHICH ACCOUNTS FOR THE LARGER NATIVE AMERICAN POPULATION AND RELATIONS WITH INDIAN HEALTH SERVICES.WALWORTH COUNTY'S MEDIAN FAMILY INCOME IS $57,967. APPROXIMATELY 13.2% OF THE POPULATION OF WALWORTH COUNTY IS BELOW THE FEDERAL POVERTY LEVEL WITH APPROXIMATELY 11.7% OF THE POPULATION WITHOUT HEALTHCARE COVERAGE. CORSON COUNTY HAS A POPULATION OF 3,902 AND IS THE SECOND LARGEST COUNTY IN OUR SERVICE AREA. THE FPL OF CORSON COUNTY IS 43.4% WITH APPROXIMATELY 20.4% OF THE POPULATION WITHOUT HEALTHCARE COVERAGE. THE FACILITY OWNS AND OPERATES CLINICS IN MOBRIDGE, MCLAUGHLIN, TIMBER LAKE AND SELBY. THESE FACILITIES SERVE PATIENTS FROM A SIX-COUNTY AREA (WALWORTH, ZIEBACH, CORSON, DEWEY, CAMPBELL AND POTTER). MOBRIDGE REGIONAL HOSPITAL PROVIDES OBSTETRICS, FAMILY AND INTERNAL MEDICINE, AND SURGICAL SERVICES. IT IS APPROXIMATELY ONE HUNDRED MILES FROM ANOTHER HOSPITAL WITH A HIGHER LEVEL OF CARE OFFERED. PART VI, LINE 5: THE MOBRIDGE REGIONAL HOSPITAL IS COMMITTED TO THE PATIENTS WE SERVE, REGARDLESS OF RACE, COLOR, RELIGION, SEX, DISABILITY, OR ABILITY TO PAY. THE ORGANIZATION'S FINANCIAL ASSISTANCE ADJUSTMENTS HAVE CONTINUED TO TREND UP OVER THE PAST FEW YEARS, AND WE CONTINUE TO FOCUS BUDGET EFFORTS TO ADAPT TO THIS TREND. MRH IS 100 MILES FROM ANOTHER HEALTHCARE FACILITY WITH A HIGHER LEVEL OF CARE AND PARTICIPATES IN THE NORTH DAKOTA AND SOUTH DAKOTA TRAUMA SYSTEMS WITH LEVEL IV CERTIFICATION. MRH CONTINUES A BROAD LEVEL OF BOARD INVOLVEMENT FOR CORSON, DEWEY, AND WALWORTH COUNTIES TO MONITOR COMMUNITY NEEDS IN THOSE AREAS. MRH CONTINUES TO BE A POPULAR PLACE FOR MEDICAL STUDENTS TO COMPLETE CLINICAL ROTATIONS, AND WE CONTINUE TO OFFER A WIDE VARIETY OF CERTIFICATION CLASSES TO NURSES AND THE MEMBERS OF THE COMMUNITY INCLUDING EMT-B, PALS, ACLS, TNCC, ALSO, NALS, EMT-I, AND CPR. MRH HAS DEVELOPED A WORKSITE WELLNESS PROGRAM WITHIN THE ORGANIZATION AND HAS GOALS TO WORK WITH OTHER BUSINESSES IN THE COMMUNITY TO PROMOTE OVERALL HEALTHY LIFESTYLES.THE HOSPITAL HAS A BOARD OF DIRECTORS COMPRISED OF VOLUNTEERS WHO RESIDE IN THE SERVICE AREA. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE AREA. ALL QUALIFIED PHYSICIANS WHO SHOW AN INTEREST MUST GO THROUGH A CREDENTIAL REVIEW AND BOARD APPROVAL. SURPLUS FUNDS, IF AVAILABLE, ARE REINVESTED IN THE FACILITIES TO IMPROVE PATIENT CARE. 0 1 0 0 0 0 0 0 0 DR TRAVIS HENDERSON INTERNAL MEDICINE/DIRECTOR 390117 0 0 0 0 0 99414 0 29706 0 519237 0 0 0 DR ALAN LAWRENCE SURGEON 433492 0 0 0 0 0 16720 0 17637 0 467849 0 0 0 DR MATT SCHAFFER PHYSICIAN 365274 0 0 0 7639 0 38235 0 26875 0 438023 0 0 0 DR EMILY BODEN PHYSICIAN 354969 0 13333 0 0 0 13978 0 26875 0 409155 0 0 0 DR JOSH HENDERSON INTERNAL MEDICINE 345820 0 0 0 0 0 13607 0 26875 0 386302 0 0 0 DR ROBERT MARCIANO FAMILY MD/DIRECTOR 324291 0 0 0 0 0 12679 0 18608 0 355578 0 0 0 BROOKE SHERBECK CRNA 236471 0 0 0 16667 0 6986 0 29925 0 290049 0 0 0 RENAE KARST CFO 133686 0 0 0 0 0 5721 0 35945 0 175352 0 0 0 PART I, LINE 3 THE CEO WAS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH CHI ST. ALEXIUS MEDICAL CENTER IN BISMARCK, ND, IN CALENDAR YEAR 2023. THE EXECUTIVE COMMITTEE OF MOBRIDGE REGIONAL HOSPITAL REVIEWED THE MANAGEMENT AGREEMENT AND MADE A DETERMINATION AS TO WHETHER THE COMPENSATION FOR THE CEO'S SERVICES IS REASONABLE. THE CEO BECAME AN EMPLOYEE OF MRH EFFECTIVE 12/31/23. PART I, LINE 4B DEFERRALS WERE MADE TO THE 457(B) PLAN (NOT SUBSTANTIALLY VESTED) BY THE FOLLOWING PARTICIPANTS: DR. TRAVIS HENDERSON - $83,932 AND DR. MATTHEW SCHAFFER - $23,846. A CITY OF MOBRIDGE SOUTH DAKOTA 466000320 2021-12-27 41492000 CONSTRUCT A NEW INPATIENT WING, REMODEL SURGERY, RADIOLOGY, PHARMACY, & ER 0 0 0 A 24689770 24689770 16802230 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 0 A 1 FORM 990 SCHEDULE K, PART II, LINE 3 THE TAX-EXEMPT BOND FINANCING IS BASED ON A DRAW DOWN METHOD FOR INTERIM FINANCING WITH THE LENDER AFTER ALLOWABLE EXPENSES ARE PAID AND APPROVED. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN OF THE BOARD, WHO SHALL ACT AS CHAIRMAN OF SAID COMMITTEE, THE SECRETARY, VICE-CHAIRMAN, AND TREASURER. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES OF THE EXPRESSED WISHES OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 3 MRH HAS A MANAGEMENT AGREEMENT WITH CHI ST. ALEXIUS MEDICAL CENTER IN BISMARCK, ND. THE MANAGEMENT AGREEMENT PROVIDES THAT CHI ST. ALEXIUS HEALTH WILL PROVIDE MANAGEMENT AND ADMINISTRATIVE SERVICES. THE AGREEMENT REMAINS IN EFFECT IN PERPETUITY BUT MAY BE CANCELLED BY THE HOSPITAL FOLLOWING A 90-DAY NOTICE. THE MANAGEMENT AGREEMENT WAS AMENDED AS OF DECEMBER 31, 2023, TO REMOVE MANAGEMENT SERVICES. JOHN AYOUB, CEO, RECEIVED COMPENSATION OF $236,479 AND ESTIMATED BENEFITS OF $35,809 DURING CALENDAR YEAR 2023. THE CEO OVERSEES ALL DAILY OPERATIONAL ACTIVITIES AND REPORTS TO THE ORGANIZATION'S BOARD OF DIRECTORS. THE CEO WORKS VERY CLOSELY WITH ALL DEPARTMENT SUPERVISORS TO ENSURE THAT ALL AREAS OF THE HOSPITAL ARE RUNNING EFFICIENTLY AND SMOOTHLY. THE CEO IS RESPONSIBLE FOR PHYSICIAN CONTRACTING AND WORKS VERY CLOSELY WITH HUMAN RESOURCES FOR RECRUITMENT OF PROFESSIONAL MEDICAL STAFF. FOR CALENDAR YEAR 2023, THE CEO'S SALARY WAS DETERMINED USING A SALARY SURVEY AND DISCUSSIONS WITH THE MANAGEMENT COMPANY. THE EXECUTIVE COMMITTEE APPROVED THE SALARY OF THE CEO. FORM 990, PART VI, SECTION A, LINE 6 THERE IS ONLY ONE CLASS OF MEMBER; ALL MEMBERS HAVE ONE VOTE (SAME VOTING RIGHTS). EACH PERSON WHO DONATES $100 OR MORE IS A MEMBER ENTITLED TO ONE VOTE. FORM 990, PART VI, SECTION A, LINE 7A THE NOMINATING COMMITTEE NOMINATES CANDIDATES FOR ELECTION. THE MEMBERS VOTE ON CANDIDATES AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION B, LINE 11B THE CEO, CFO, AND BOARD OF DIRECTORS WILL REVIEW THE FORM 990 VIA ELECTRONIC TRANSMISSION PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS THE ENTIRE BOARD OF DIRECTORS. IF A CONFLICT SHOULD ARISE, IT WOULD FIRST GO TO THE CEO FOR EVALUATION, THEN TO THE BOARD OF DIRECTORS FOR FINAL EVALUATION. THE BOARD OF DIRECTORS IS RESPONSIBLE FOR MAKING THE FINAL DECISION IN DETERMINING IF A CONFLICT EXISTS. IF A CONFLICT IS FOUND, THE PERSON(S) INVOLVED WOULD BE REQUIRED TO ABSTAIN FROM DISCUSSIONS AND VOTING ON THE ITEM CAUSING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE CEO WAS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH CHI ST. ALEXIUS MEDICAL CENTER IN BISMARCK, ND, IN CALENDAR YEAR 2023. THE EXECUTIVE COMMITTEE OF MOBRIDGE REGIONAL HOSPITAL REVIEWED THE MANAGEMENT AGREEMENT AND MADE A DETERMINATION AS TO WHETHER THE COMPENSATION FOR THE CEO'S SERVICES IS REASONABLE. THE CEO BECAME AN EMPLOYEE OF MRH EFFECTIVE 12/31/23. THE CEO BECAME AN EMPLOYEE OF MRH EFFECTIVE 12/31/23. HIS COMPENSATION WAS DETERMINED BY INDEPENDENT COMMITTEE MEMBERS WHO USED COMPARABILITY DATA FROM VARIOUS SOURCES. THE FINANCE COMMITTEE DETERMINES AND APPROVES THE PHYSICIAN CONTRACTS, INCLUDING COMPENSATION. SALARIES FOR OTHER OFFICERS OR MEMBERS OF MANAGEMENT ARE DETERMINED BY THE CEO THROUGH THE USE OF SALARY SURVEY INFORMATION FROM SDAHO AND EMPLOYEE SERVICE AND EXPERIENCE FILES. THIS PROCESS IS UNDERTAKEN ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FOUNDATION INTEREST 250,462. MOBRIDGE REGIONAL HEALTHCARE FOUNDATION PO BOX 580 MOBRIDGE SD 57601 460416693 OUTREACH FOR MOBRIDGE REGIONAL HOSPITAL SD 501(C)(3) LINE 12C, III-FI N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0