2025-05-02T13:39:38-05:00 2024-06-30 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2023-07-01 460233030 CHILDREN'S CARE HOSPITAL AND SCHOOL CHIL 6054449500 2501 WEST 26TH STREET SIOUX FALLS SD 571052498 STEVE WILSON CFO 6054449500 2025-05-02 1 1 LAURIE HANSON CPA P00851848 6053391999 2025-05-02 2023 2025-03-06 01:10:19Z LIFESCAPE STEVE WATKINS 2501 WEST 26TH STREET SIOUX FALLS SD 571052498 46649467 0 X WWW.LIFESCAPESD.ORG X 1952 SD EMPOWERING PEOPLE TO LIVE THEIR BEST LIFE. 14 14 715 1089 0 0 4480887 7265000 36233693 38030959 258878 1278653 40699 40240 41014157 46614852 0 25000 0 0 27205697 28527038 0 0 0 10386785 11621287 37592482 40173325 3421675 6441527 35292129 43078734 7465120 8511628 27827009 34567106 X EMPOWERING PEOPLE TO LIVE THEIR BEST LIFE.VISION STATEMENT:LIFESCAPE WILL BE AN INNOVATIVE ORGANIZATION, PROVIDING EXCEPTIONAL SERVICES AND CREATIVE SOLUTIONS FOR PEOPLE WITH VARIED NEEDS AND COMPLEX CARE ACROSS THEIR LIFE SPAN. KEY FACTORS IN ACCOMPLISHING THIS ARE COLLABORATIVE PARTNERSHIPS, STRIVING TO BECOME A DESTINATION FOR RESEARCH, AS WELL AS DEVELOPING, IMPLEMENTING, AND TRAINING OF TECHNOLOGY-BASED SOLUTIONS TO IMPROVE THE LIVES OF PEOPLE WE SUPPORT. 0 0 32717764 25000 38030959 CHILDREN'S CARE HOSPITAL & SCHOOL (CCHS) IS ADDITIVE TO THE FABRIC OF CARE IN SOUTH DAKOTA BY BEING THE SOLE PROVIDER OF SPECIFIC MEDICAID BASED SERVICES AND SUPPORTS FOR THE CHILDREN OF SOUTH DAKOTA.IN FISCAL YEAR 2024, CCHS PROVIDED SERVICES FOR OVER 2,900 INDIVIDUALS FROM 6 STATES, FROM BIRTH THROUGH AGE 21 WITH DISABILITIES OR REHABILITATION NEEDS IN ALL OF ITS PROGRAMS. IN SOUTH DAKOTA ALONE, MORE THAN 2,580 CHILDREN SERVED WERE FROM 223 OF SOUTH DAKOTA'S TOWNS AND CITIES AND 65 OF 66 OF SOUTH DAKOTA'S COUNTIES. OUTPATIENT AND OUTREACH SERVICES, WHICH ARE COMMUNITY BASED, SERVED MORE THAN 2,600 OF THOSE CHILDREN IN SIOUX FALLS AND RAPID CITY, SD. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, THERAPIES RANGING FROM PHYSICAL AND OCCUPATIONAL TO SPEECH-LANGUAGE PATHOLOGY, BEHAVIORAL THERAPY, ASSISTIVE TECHNOLOGY, SEATING AND POSITIONING, AND POWERED MOBILITY SERVICES.IN SIOUX FALLS AND RAPID CITY OUTPATIENT CLINICS, 208 CHILDREN RECEIVED FREE AUTISM SCREENINGS AND 229 CHILDREN WERE EVALUATED FOR AUTISM. LIFESCAPE SAW A RESURGENCE IN NEED IN FY24 CAUSING THE WAITLIST TO INCREASE FROM 386 TO 583, LEADING TO A REEVALUATION IN HOW TO ADDRESS THE GROWING NEED FOR AUTISM SERVICES IN THE COMMUNITY. THE AUTISM SPECTRUM DISORDER STAR (SCREENING WITH THERAPUETIC ASSESSMENT AND RECOMMENDATIONS) CLINIC WAS CREATED IN LATE FY24 TO HELP REDUCE THE NUMBER OF CHILDREN ON THE WAITLIST. LIFESCAPE'S CHILDREN'S SPECIALTY HOSPITAL CONTINUES TO BE THE ONLY PEDIATRIC REHABILITATION HOSPITAL IN SOUTH DAKOTA. IN FY24, 41 CHILDREN WERE SERVED IN THE HOSPITAL. IN THE RESIDENTIAL PROGRAM AND INTERMEDIATE CARE FACILITY, 75 CHILDREN FROM THREE STATES WERE SERVED, MOST OF WHOM ALSO ATTENDED LIFESCAPE'S SPECIALTY SCHOOLS. IN ADDITION, THERE WERE 67 DAY STUDENTS AT THE 26TH STREET CAMPUS AND PATHWAYS TO LIFE SCHOOL.IN SOUTH DAKOTA, LIFESCAPE EMPLOYS 4 OUT OF 5 SEATING & MOBILITY SPECIALISTS, AND HAS THE 1ST AND ONLY SPEECH-LANGUAGE PATHOLOGIST IN SWALLOWING DISORDERS, WHICH HAS LED TO REFERRALS FROM OUT OF STATE. 32717764 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 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 1 1 1 0 0 1 40 0 1 715 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X X STEVE WILSON 6054449820 3803 N LOUISE AVE SIOUX FALLS SD 57107 STEVEN WATKINS CEO 23.00 27.00 X 0 345926 80906 STEVE WILSON CFO 22.00 28.00 X 0 198415 32603 CHARLENE CONNELLY RN 68.00 0.00 X 215469 0 5382 KRISTIN TUTTLE VP OF MED. & THERAPY SERVICE 40.00 5.00 X 150166 0 12256 REBECCA WEELDREYER DIRECTOR OF NURSING 45.00 0.00 X 120331 0 20951 VICKI ISLER DIRECTOR OF EDUCATION 40.00 0.00 X 114741 0 15070 KIMBERLY WINCKLER RN 46.00 0.00 X 113579 0 11144 MARLI SCHIPPERS CHAIR/PAST CHAIR FROM 01/2024 1.00 3.00 X X 0 0 0 LARRY FENTON VICE CHAIR 1.00 3.00 X X 0 0 0 BOB MCNANEY SECRETARY/CHAIR FROM 01/2024 1.50 3.00 X X 0 0 0 JAY SOUKUP TREASURER 1.00 3.00 X X 0 0 0 JASON HARRIS PAST CHAIR UNTIL 01/2024 1.00 3.00 X X 0 0 0 DR JOSH PAULI DIRECTOR/SECRETARY FROM 01/2024 1.00 3.00 X X 0 0 0 TERESA WARD DIRECTOR FROM 01/2024 1.00 3.00 X 0 0 0 DOUG BERKLAND DIRECTOR/MEMBER-AT-LARGE 1.00 3.00 X 0 0 0 TAMERA LARSEN-ENGELKES DIRECTOR FROM 01/2024 1.00 3.00 X 0 0 0 KIMBERLY NOONEY DIRECTOR 1.00 3.00 X 0 0 0 TYLER HAAHR FOUNDATION IMMEDIATE PAST CHAIR 0.50 3.00 X 0 0 0 ERICA DEBOER DIRECTOR 1.00 3.00 X 0 0 0 JASON HUBERS DIRECTOR 1.00 3.00 X 0 0 0 RICK KILEY DIRECTOR 1.00 3.00 X 0 0 0 ERIK NYBERG DIRECTOR 0.50 3.50 X 0 0 0 714286 544341 178312 14 0 1 0 LIFESCAPE 2501 W 26TH STREET SIOUX FALLS SD 57105 IT, MATERIALS MANAGEMENT, AND OTHER OVER 2372401 KOCH HAZARD ARCHITECTS 431 N PHILLIPS 200 SIOUX FALLS SD 57104 ARCHITECT SERVICES 1643798 INTERIM HEALTHCARE 3608 S SOUTHEASTERN AVE SIOUX FALLS SD 57103 CONTRACTED LABOR - NURSING 551838 SANFORD USD MEDICAL CENTER PO BOX 5064 SIOUX FALLS SD 571175064 RESP. THERAPY; IT SVCS 519499 SANFORD CHILDREN'S SPECIALTY CLINIC 1600 W 22ND ST SIOUX FALLS SD 57117 PHYSICIAN SERVICES 267516 8 683733 6540966 40301 679 7265000 PATIENT/RESIDENT FEES 623000 37634273 37634273 OTHER SERVICE REVENUE 900099 396686 396686 38030959 572977 572977 20894 0 20894 20894 20894 740291 0 34615 740291 -34615 705676 705676 INSURANCE PROCEEDS 900099 19346 19346 19346 46614852 38030959 0 1318893 X 25000 25000 23183180 21669301 1513879 474325 442138 32187 3166479 2599247 567232 1703054 1591964 111090 17081 17081 70200 70200 20735 20735 77995 77995 4172890 1437663 2735227 199320 179 199141 431461 336774 94687 3220 3220 1339408 842244 497164 57367 41031 16336 44934 28845 16089 94938 94938 882614 845070 37544 655505 548015 107490 OTHER SUPPLIES 1834257 1632070 202187 MAINTENANCE AND REPAIR 457277 196691 260586 DUES AND SUBSCRIPTIONS 270719 69724 200995 991366 391073 600293 40173325 32717764 7455561 0 X 3068536 1282666 6347031 9484164 38379 32771 48228 45914 37852733 25438238 9140578 12414495 14829911 16901435 1819466 2917289 35292129 43078734 2810110 3557010 3281906 2794673 1373104 2159945 7465120 8511628 X 27504237 34212358 322772 354748 27827009 34567106 35292129 43078734 X 6441527 364153 -1831 -63752 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 8215 0 0 1 12520 0 0 20735 0 PART II-B, LINE 1: CHILDREN'S CARE HOSPITAL & SCHOOL (CCHS) CONTRACTS FOR LOBBYING SERVICES. THE LOBBYIST IS IN DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS AND GOVERNMENT OFFICIALS DURING THE STATE'S 30-40 DAY LEGISLATIVE SESSION. THE LOBBYIST HELPS CCHS DEFINE ISSUES AND MAKE CONTACT WITH APPROPRIATE LEGISLATIVE AND EXECUTIVE BRANCH PERSONNEL TO MAKE SURE THEY TRULY UNDERSTAND HOW ISSUES THAT MAY BE IN FRONT OF THEM WILL AFFECT CCHS. LOBBYING REVOLVES AROUND PROPOSED BUDGETARY ISSUES AS WELL AS ADVOCATING FOR THE WELFARE OF PEOPLE SERVED BY CCHS. 3294793 3294793 20834123 17763995 3070128 7232061 6322278 909783 6491756 1351965 5139791 12414495 INVESTMENT IN DAKOTA TRUCK UNDERWRITERS 485773 OPERATING LEASE RIGHT OF USE ASSET 2431516 2917289 ASSETS HELD IN TRUST 54156 OPERATING LEASE LIABILITY 2464641 DUE TO AFFILIATES -358852 2159945 X 46837258 364153 364153 46473105 77995 63752 141747 46614852 40095330 0 40095330 77995 77995 40173325 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 CONSOLIDATED 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 ARE INCURRED. PART XI, LINE 4B - OTHER ADJUSTMENTS: NET ASSET WITH DONOR RESTRICTIONS 63,752. 1 1 X 1 X 1 X 175.000000000000 1 0 0 25444611 24219001 1225610 0.03050 25444611 24219001 1225610 0.03050 25444611 24219001 1225610 0.03050 1 130044 0 38778 99475 -60697 X 1 1 1 1 CHILDREN'S CARE HOSPITAL & SCHOOL 2501 W 26TH 1020 W 18TH 7220 W 41ST SIOUX FALLS SD 57105 WWW.LIFESCAPESD.ORG 10562 X X CHILDREN'S CARE HOSPITAL & SCHOOL 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 7D 0 1 X 100.000000000000 175.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.LIFESCAPESD.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.LIFESCAPESD.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.LIFESCAPESD.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 0 X X 0 0 CHILDREN'S CARE HOSPITAL & SCHOOL PART V, SECTION B, LINE 5: KEY INFORMATIONAL INTERVIEWS/SURVEYS WERE CONDUCTED. THE LIFESCAPE ADVISORY COMMITTEE SELECTED INDIVIDUALS WITH A WIDE RANGE OF BACKGROUNDS IN HEALTH-RELATED AGENCIES AND WITH HEALTH-RELATED QUALIFICATIONS TO PARTICIPATE IN THE INTERVIEWS. THESE INDIVIDUALS REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY LIFESCAPE. INTERVIEWS AND SURVEYS WERE PROVIDED FEBRUARY 23RD-MARCH 15TH, 2022. UNDERSERVED POPULATIONS THAT WE REACHED OUT TO TO PROVIDE FEEDBACK INCLUDE: PEOPLE WITH AUTISM, NON-AUTISM RELATED MENTAL HEALTH DIAGNOSES AND CONCERNS, MEDICALLY COMPLEX NEEDS AND PARENTS OR CAREGIVERS OF THOSE WITH COMPLEX NEEDS. CHILDREN'S CARE HOSPITAL & SCHOOL PART V, SECTION B, LINE 7D: HTTPS://WWW.LIFESCAPESD.ORG/WP-CONTENT/UPLOADS/2023/09/CHNA-2022-FINAL.PDFTHE IMPLEMENTATION STRATEGY CAN BE FOUND ON PAGE 16 OF THE CHNA REPORT. CHILDREN'S CARE HOSPITAL & SCHOOL PART V, SECTION B, LINE 11: THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REVEALED THE FOLLOWING PRIORITY NEEDS:1. ACCESSING SPECIALTY HOSPITAL AND OUTPATIENT SERVICES.2. LACK OF COMMUNITY AND CAREGIVER EDUCATION ON LIFESCAPE SERVICES AND COMMUNITY RESOURCES.3. INADEQUATE AVAILABILITY OF APPROPRIATE MEDICAL AND COMMUNITY-BASED SERVICES IN IDENTIFIED AREAS: PEDIATRIC SKILLED NURSING/PEDIATRIC HOME HEALTH/RESPITE CARE; MENTAL HEALTH; AND AUTISM/AUTISM AND BEHAVIORAL RESOURCES (ABA).NEEDS IDENTIFIED BUT NOT ADDRESSED: TRANSPORTATION AND INSURANCE COVERAGE WILL NOT BE ADDRESSED AS WE DON'T HAVE THE ABILITY TO DIRECTLY IMPACT THESE AREAS. WE ALSO ARE NOT ABLE TO ADDRESS THE NEED FOR ADDITIONAL LOCATIONS FOR THOSE AGING OUT OF SERVICES WITH HIGH MEDICAL NEEDS DUE TO FINANCIAL CONSTRAINTS OF DEVELOPING A NEW LOCATION.IN THE CURRENT YEAR THE FACILITY HAS TAKEN THE FOLLOWING ACTIONS TO ADDRESS:1. LACK OF PARENT TRAINING AND EDUCATION OF SERVICES: INCREASED SOCIAL MEDIA POSTS TIED TO PROGRAMS AND PARENT EDUCATION. SENT A PROVIDER SURVEY OUT GATHERING FEEDBACK ON BEST WAY TO ASSIST IN EDUCATING PATIENTS AND FAMILIES ON SERVICES AND THERAPY RELATED TOPICS. 2. LACK OF COORDINATION OF CONNECTING FAMILIES WITH RESOURCES: OUR ABA SERVICES HAS UPDATED THE ABA FAMILY HANDBOOK PROVIDED AT OUR CLINIC TO THOSE FAMILIES WITHIN OUR ABA PROGRAM. OUR ADMISSIONS DEPARTMENT HIRED A FLOAT POSITION TO HELP WITH COVERAGE OF INTAKE STAFF TO ENSURE TIMELY COMMUNICATION WITH FAMILIES. 3. LACK OF MENTAL HEALTH SERVICES AND PROVIDERS: WE WERE ABLE TO IMPLEMENT A NEW CLINIC AND PROCESS TO ACCESS PSYCHOLOGIST FOR AUTISM EVALUATIONS. WHEN OUR STAR CLINIC WAS IMPLEMENTED ALONG WITH HIRING AN ASSESSMENT PSYCHOLOGIST, WE WERE ABLE TO INCREASE AUTISM EVALS FROM 1 EVAL/WEEK TO 4-5 EVALS/WEEK. WE ALSO HAVE BEEN ABLE TO INCREASE THE NUMBER OF SITUATION, TASK, ACTION, RESULT (STAR) CLINIC EVALS ACROSS BOTH OUTPATIENT CLINICS TO ALLOW FOR ACCESS TO EARLY INTERVENTION. IMPLEMENTED A NEW ABA PROGRAM MODEL TO INCREASE THE NUMBER OF ABA HOURS PROVIDED AT THE CLINIC. CHILDREN'S CARE HOSPITAL & SCHOOL PART V, SECTION B, LINE 13B: THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT THROUGH OTHER SOURCES, WHICH COULD PROVIDE SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH CHARITY CARE ASSISTANCE. IN THE EVENT THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR CHARITY CARE, CHILDREN'S CARE HOSPITAL AND SCHOOL COULD USE OUTSIDE AGENCIES IN DETERMINING ESTIMATED INCOME AMOUNTS FOR THE BASIS OF DETERMINING CHARITY CARE ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:1. STATE-FUNDED PRESCRIPTION PROGRAMS;2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC;3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);4. FOOD STAMP ELIGIBILITY;5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY;6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAM THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN);7. LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AT A VALID ADDRESS; AND,8. PATIENT IS DECEASED WITH NO KNOWN ESTATE. CHILDREN'S CARE HOSPITAL & SCHOOL PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE MAY BE USED IF NECESSARY. CHILDREN'S CARE HOSPITAL & SCHOOL PART V, SECTION B, LINE 24: THE POLICY DOES NOT COVER ELECTIVE PROCEDURES AND NO FAP-ELIGIBLE PATIENTS HAD ELECTIVE PROCEDURES. 1 1 - CHILDREN'S CARE HOSPITAL & SCHOOL 7110 JORDAN DRIVE RAPID CITY SD 57702 OUTPATIENT REHABILITATION CENTER PART I, LINE 3C: IN ADDITION TO FEDERAL POVERTY GUIDELINES TO DETERMINE FAP ELIGIBILITY, CCHS USES AN ASSET TEST, REVIEWS INSURANCE STATUS, CONSIDERS MEDICAL INDIGENCY, AND REVIEWS INFORMATION TO DETERMINE PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 7: LINE 7B UNREIMBURSED MEDICAID IS THE COST OF MEDICAID PROVIDED FOR INPATIENTS, PATIENTS AT THE RAPID CITY REHAB CENTER, RAPID CITY OUTREACH, SIOUX FALLS OUTREACH, AND SIOUX FALLS OUTPATIENT CLINICS. THE COST IS CALCULATED BY MULTIPLYING THE MEDICAID CHARGES TIMES THE COST-TO-CHARGE RATIO, AS DETERMINED THROUGH USE OF THE GENERAL LEDGER. PART III, LINE 3: NO PART OF THE AMOUNT ON LINE 2 WAS DETERMINED TO BE CHARITY CARE ELIGIBLE. PART III, LINE 4: THE FINANCIAL STATEMENT FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSION IS AT PAGES 15-16. PART III, LINE 8: NO PART OF THE SHORTFALL ON LINE 7 IS TREATED AS COMMUNITY BENEFIT. THE HOSPITAL HAS MEDICARE CERTIFICATION BECAUSE IT IS REQUIRED IN ORDER TO OPERATE. THE OVERALL COST-TO-CHARGE RATIO BASED ON AUDITED FINANCIAL STATEMENTS WAS USED TO CALCULATE COST. PART III, LINE 9B: PRIOR TO ENGAGING IN ECAS, LIFESCAPE'S REVENUE CYCLE STAFF WILL IDENTIFY WHETHER REASONABLE EFFORTS WERE MADE TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IF A PATIENT SUBMITS A COMPLETE HOSPITAL FINANCIAL ASSISTANCE APPLICATION DURING THE APPLICATION PERIOD, LIFESCAPE WILL SUSPEND ECAS AND MAKE AN ELIGIBILITY DETERMINATION BEFORE RESUMING ECA ACTIVITY. PART VI, LINE 2: CCHS RELIES ON ITS BOARD MEMBERS AND BOARD MEMBERS OF LIFESCAPE FOUNDATION WHO REPRESENT ALL REGIONS OF THE STATE, ITS MEDICAL STAFF, AND SCHOOL DISTRICTS WHOSE STUDENTS IT SERVES TO HELP ADVISE OF HEALTH CARE NEEDS IN THEIR RESPECTIVE COMMUNITIES. CCHS ALSO CONDUCTS REGULAR MEETINGS WITH PARENTS AND PATIENTS TO HELP ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. PART VI, LINE 3: RESIDENTIAL AND INPATIENT SERVICES ARE ALWAYS PRE-AUTHORIZED BY A THIRD PARTY PAYER AND ANY PATIENT RESPONSIBILITY IS DISCUSSED WITH THE RESIDENT'S GUARANTOR UPON ADMISSION. FINANCIAL COUNSELING IS AVAILABLE FOR OUTPATIENT SERVICES. THIS STARTS WITH CCHS VERIFYING THAT THE PATIENT'S INSURANCE IS EFFECTIVE AND CONTACTING INSURANCE WITH DIAGNOSIS AND PROCEDURE CODES TO CHECK COVERAGE. NEXT, THE PARENT/GUARANTOR IS CONTACTED TO INFORM THEM OF THE APPROXIMATE AMOUNT FOR WHICH THEY'LL BE FINANCIALLY RESPONSIBLE. THEY ARE ASKED TO SIGN A PRIVATE PAY AGREEMENT BEFORE SERVICES ARE PROVIDED. BECAUSE CCHS DOES NOT PROVIDE EMERGENCY SERVICES, THERE IS ALWAYS TIME TO GET FORMS SIGNED BEFORE SERVICES ARE RENDERED. PART VI, LINE 4: CCHS SERVES APPROXIMATELY 3,000 CHILDREN AND THEIR FAMILIES IN 65 COUNTIES THROUGHOUT SOUTH DAKOTA EVERY YEAR. ADDITIONAL CHILDREN AND FAMILIES ARE SERVED THROUGHOUT MINNESOTA, IOWA AND NORTH DAKOTA. APPROXIMATELY 65 SOUTH DAKOTA PUBLIC AND TRIBAL SCHOOL DISTRICTS ALSO RELY ON CCHS AND CHILDREN FROM SEVERAL PUBLIC OR PRIVATE AGENCIES AND PROGRAMS ARE ALSO SERVED. NO OTHER HOSPITALS IN THE AREA PROVIDE SIMILAR SERVICES. PART VI, LINE 5: - ALL CCHS GOVERNING BODY MEMBERS RESIDE IN DIFFERENT PARTS OF ITS PRIMARY SERVICE AREA IN SOUTH DAKOTA. ALL BOARD MEMBERS ARE INDEPENDENT OF CCHS AND SERVE IN A VOLUNTEER CAPACITY.- CCHS EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES.- CCHS USES SURPLUS FUNDS TO ENHANCE SERVICES TO PATIENTS, FUND BUILDING IMPROVEMENTS OR EXPANSIONS, AND IMPROVE CARE BY PROVIDING ADDITIONAL TRAINING TO STAFF.- CCHS IS THE ONLY PROVIDER IN SOUTH DAKOTA OFFERING 24-HOUR, INTEGRATED MEDICAL, BEHAVIORAL, AND SPECIAL EDUCATION SERVICES FOR CHILDREN AGES BIRTH TO 21. CCHS SERVES FAMILIES AND SCHOOLS WHO ARE UNABLE TO SUPPORT CHILDREN WITH SEVERE BEHAVIORS WHO MAY HARM THEMSELVES OR OTHERS. MEDICAL PROGRAMMING IS PROVIDED TO FILL THE GAP BETWEEN SERVICES PROVIDED IN THE HOME AND SCHOOL DISTRICT AND SERVICES PROVIDED AT ACUTE CARE HOSPITALS.- CCHS HAS SEVERAL CLINICAL AFFILIATION AGREEMENTS WITH SURROUNDING AREA SCHOOLS TO PROVIDE TRAINING EXPERIENCE FOR PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS, NURSES AND PSYCHOLOGY STUDENTS.- CCHS PARTICIPATES IN THE MEDICARE PROGRAM, SEVERAL STATE MEDICAID PROGRAMS, AND THE BIRTH TO 3 PROGRAM.- 1,089 VOLUNTEERS ASSISTED WITH ALL ASPECTS OF CCHS OPERATIONS. VOLUNTEERS ASSIST CCHS STAFF WITH ADMINISTRATIVE TASKS IN RECEPTION, MEDICAL RECORDS AND FUNDRAISING, AND PROVIDE SUPPORT TO PROFESSIONALS IN RESIDENTIAL AREAS. 1 UNIVERSITY OF SOUTH DAKOTA FOUNDATION 1110 N DAKOTA ST VERMILLION SD 57069 466018891 501(C)(3) 25000 0 GIFT TO THE SCHOOL OF HEALTH SCIENCES DEAN'S PROFESSORSHIP OF EXCELLENCE. 1 PART I, LINE 2: CHILDREN'S CARE HOSPITAL & SCHOOL D/B/A LIFESCAPE HAS A COLLABERATIVE RELATIONSHIP WITH THE UNIVERSITY OF SOUTH DAKOTA FOR THE BOARD CERTIFIED BEHAVIORAL ANALYST (BCBA) PROGRAM. CHILDREN'S CARE SERVES INDIVIDUALS WHO NEED BEHAVIORAL SUPPORT AND, AS A RESULT, REQUIRES CERTIFIED PROFESSIONALS WHO SPECIALIZE IN THIS FIELD. PROFESSIONALS FROM CHILDREN'S CARE FREQUENTLY SERVE AS INSTRUCTORS AND MENTORS FOR THIS PROGRAM. CHILDREN'S CARE IS AWARE OF HOW GRANT FUNDS ARE USED DUE TO THE CLOSE RELATIONSHIP TO THIS PROGRAM. 0 1 0 0 0 0 0 0 0 STEVEN WATKINS CEO 0 344533 0 0 0 1393 0 50651 0 30718 0 427295 0 0 STEVE WILSON CFO 0 197225 0 0 0 1190 0 5192 0 27875 0 231482 0 0 CHARLENE CONNELLY RN 215269 0 0 0 200 0 5382 0 183 0 221034 0 0 0 KRISTIN TUTTLE VP OF MED. & THERAPY SERVICE 149997 0 0 0 169 0 3052 0 9617 0 162835 0 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED PARTY, LIFESCAPE, TO DETERMINE COMPENSATION FOR THE CEO AND CFO. LIFESCAPE USES THE METHODS LISTED IN PART I, LINE 3 TO DETERMINE COMPENSATION. PART I, LINE 4B STEVE WATKINS HAS A NONQUALIFIED DEFERRED COMPENSATION AGREEMENT UNDER IRC 457(F). THE BALANCE IN THE FUND AS OF DECEMBER 31, 2023 IS $41,762, WHICH INCLUDES 2023 CONTRIBUTIONS OF $40,000 AND EARNINGS OF $1,762. A SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 480315509 83755VJ47 2017-11-01 5736456 REFINANCING OF 2007 BONDS 0 0 0 A 3081456 5736456 106780 597971 5031805 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 10/28/2022 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS COMPRISED OF THE CHAIR, VICE CHAIR, SECRETARY, TREASURER, IMMEDIATE PAST CHAIR, CHIEF EXECUTIVE OFFICER, AND ONE DIRECTOR. THE COMMITTEE CAN ACT ON BEHALF OF THE BOARD BETWEEN BOARD MEETINGS. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE MUST BE RATIFIED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 STEVE WATKINS HAS A BUSINESS RELATIONSHIP WITH JAY SOUKUP, JASON HARRIS, LARRY FENTON, KIMBERLY NOONEY, MARLI SCHIPPERS, JOSH PAULI, BOB MCNANEY, TYLER HAAHR, DOUG BERKLAND, ERICA DEBOER, JASON HUBERS, RICK KILEY, TERESA WARD, TAMERA LARSEN-ENGELKES, AND ERIK NYBERG. THE BUSINESS RELATIONSHIP EXISTS BECAUSE STEVE WATKINS WAS PAID BY LIFESCAPE. PERSONS LISTED AS HAVING A BUSINESS RELATIONSHIP WITH HIM SERVE ON THE BOARD OF LIFESCAPE. ADDITIONALLY, STEVE WATKINS AND STEVE WILSON HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS LIFESCAPE, A SOUTH DAKOTA NON-PROFIT, EXEMPT UNDER INTERNAL REVENUE CODE 501(C)(3). FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS SHALL BE ELECTED BY THE MEMBER AND SHALL BE THE SAME PERSONS WHO SERVE AS THE DIRECTORS OF THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND A FINAL COPY OF THE 990 IS SHARED WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C LIFESCAPE HAS A CONFLICT OF INTEREST POLICY THAT IS SIGNED ANNUALLY BY EACH MEMBER OF THE BOARD OF DIRECTORS. IN ADDITION, A CONFLICT LETTER IS SENT TO ALL BOARD MEMBERS AND SENIOR LEADERS OF LIFESCAPE TO COMPLETE AND TO DISCLOSE ANY POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND CFO OF CCHS ARE COMPENSATED BY LIFESCAPE, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,422,778. MANAGEMENT AND GENERAL EXPENSES 182,032. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,604,810. COLLECTION AGENCY: PROGRAM SERVICE EXPENSES 14,885. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,885. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,490,059. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,490,059. OUTSIDE SPEAKER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,738. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,738. OUTSIDE TRAINING SESSION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 54,398. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,398. FORM 990, PART X, LINE 20: THE ISSUE PRICE OF THE BONDS INCLUDES THE FILING ORGANIZATION'S SHARE OF THE ENTIRE BOND ISSUE, WHICH WAS ISSUED TO LIFESCAPE ON BEHALF OF THE LIFESCAPE OBLIGATED GROUP. THE LIFESCAPE OBLIGATED GROUP CONSISTS OF LIFESCAPE, CHILDREN'S CARE HOSPITAL AND SCHOOL D/B/A LIFESCAPE, SOUTH DAKOTA ACHIEVE D/B/A LIFESCAPE, AND LIFESCAPE FOUNDATION. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTION -63,752. LIFESCAPE 4100 S WESTERN AVE SIOUX FALLS SD 57105 465151247 ASSIST CHILDREN'S CARE HOSPITAL & SCHOOL AND SD ACHIEVE SD 501(C)(3) LINE 12A, I N/A 0 SOUTH DAKOTA ACHIEVE DBA LIFESCAPE 4100 S WESTERN AVE SIOUX FALLS SD 57105 237072116 PROVIDE SUPPORT SERVICES TO PEOPLE WITH DEVELOPMENTAL DISABILITIES SD 501(C)(3) LINE 2 LIFESCAPE 0 LIFESCAPE FOUNDATION 2501 WEST 26TH STREET SIOUX FALLS SD 57105 460353254 SUPPORT PROGRAMS & SERVICES OF LIFESCAPE ENTITIES SD 501(C)(3) LINE 12A, I LIFESCAPE 0 SIOUX RESIDENTIAL SERVICES INC - AKA HARVEST APARTMENTS 4100 S WESTERN AVE SIOUX FALLS SD 57105 460378935 HUD PROPERTY FOR INDIVIDUALS SUPPORTED BY SDA SD 501(C)(3) LINE 10 SOUTH DAKOTA ACHIEVE DBA LIFESCAPE 0 HAYWARD MEMORIAL TESTAMENTARY TRUST 100 S PHILIPS AVE SIOUX FALLS SD 57104 466010897 PROVIDE BENEFITS TO ORGANIZATIONS THAT PROMOTE CHARITABLE PURPOSES SD 501(C)(3) LINE 12A, I N/A 0 BEACON APARTMENTS LIMITED PARTNERSHIP 4100 S WESTERN AVE SIOUX FALLS SD 57105 471232136 LOW INCOME HOUSING SD N/A 0 0 REHABILITATION MEDICAL SUPPLY 1020 W 18TH ST SIOUX FALLS SD 57104 411936988 SALES & SERVICE OF DURABLE MEDICAL EQUIPMENT, ORTHOTICS, & PROSTHETICS SD CHILDREN'S CARE HOSPITAL AND SCHOOL C 2630861 1905498 1.00000 1 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 0 REHABILITATION MEDICAL SUPPLY Q 1909957 COST