2025-03-24T08:45:07-05:00 2024-06-30 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2023-07-01 460239781 PLATTE COMMUNITY MEMORIAL HOSPITAL INC PLAT 6053373364 601 E 7TH STREET PLATTE SD 57369 MARK BURKET CEO 6053373364 2025-03-21 1 1 LAURIE HANSON CPA P00851848 6053391999 2025-03-21 2023 2025-03-06 01:10:19Z PLATTE HEALTH CENTER-AVERA MARK BURKET 601 E 7TH STREET PLATTE SD 57369 30652386 0 X WWW.PHCAVERA.ORG X 1947 SD PROVIDE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. 9 7 196 30 0 0 3047336 268134 18308559 19390028 339379 1493020 92497 69837 21787771 21221019 2921 23883 0 0 11430344 11352803 0 0 0 5257032 5893043 16690297 17269729 5097474 3951290 31733413 35260796 7309066 7211910 24424347 28048886 X PLATTE COMMUNITY MEMORIAL HOSPITAL, INC. IS A HEALTH MINISTRY ROOTED IN THE GOSPEL. OUR MISSION IS TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES. 0 0 14878218 23883 19390028 THE PURPOSE OF THE PLATTE COMMUNITY MEMORIAL HOSPITAL, INC. IS TO PROVIDE HEALTHCARE SERVICES TO THE COMMUNITY OF PLATTE AND THE SURROUNDING AREAS. THE FACILITY CONSISTS OF A 17-BED CRITICAL ACCESS HOSPITAL, A 39-BED LONG-TERM CARE FACILITY, AND THREE RURAL HEALTH CLINICS IN PLATTE, GEDDES, AND WHITE LAKE, SOUTH DAKOTA. SERVICES OFFERED INCLUDE PRIMARY CARE, EMERGENCY, SAME-DAY SURGERY, CARDIAC REHAB, PHARMACY, LABORATORY, IMAGING, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, TELEMEDICINE, SLEEP LAB, PSYCHIATRY, AND NUMEROUS SPECIALTIES VIA OUTREACH PROVIDERS. INPATIENT AND OUTPATIENT STATISTICAL DATA FOR THE YEAR WERE AS FOLLOWS: 409 INPATIENT DAYS; 490 SWING BED DAYS; 10,668 LONG-TERM CARE DAYS; 7,207 OUTPATIENT VISITS; AND 10,586 CLINIC VISITS.TO FULFILL ITS MISSION OF COMMUNITY SERVICE, THE PLATTE HEALTH CENTER PROVIDES CHARITY CARE TO PERSONS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE. CONSISTENT WITH ITS MISSION TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES, PHC STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE.PHC ATTESTED TO THE PROGRAM YEAR 2023 OF MEANINGFUL USE. THIS ATTESTATION TO CMS STATES PHC HAS MET AND WILL COMPLY WITH THE REQUIREMENTS FOR MEANINGFUL USE. WITH THIS, PHC HAS ENHANCED PATIENT CARE BY IMPLEMENTING AN ELECTRONIC HEALTH RECORD SYSTEM AS WELL AS THE MANY PATIENT SAFETY MEASURES THAT COMES WITH IT. 14878218 1 0 0 1 0 0 0 0 1 1 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 34 0 1 196 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X X VICKI JENSEN 6053373364 601 E 7TH STREET PLATTE SD 57369 DENNIS VANDERWERFF BOARD CHAIR 4.00 X X 0 0 0 JESSE BLOCK VICE CHAIR 1.00 X X 0 0 0 JILL GUSTAD SECRETARY 1.00 X X 0 0 0 BRANDI DELANGE TREASURER 1.00 X X 0 0 0 KAREN TURNIS DIRECTOR 1.00 X 0 0 0 ROBERT GRAVES DIRECTOR 1.00 X 0 0 0 ANN JOHNSON DIRECTOR 1.00 X 0 0 0 KIM EHLERS DIRECTOR 1.00 X 0 0 0 DENNIS SEVERSON DIRECTOR 1.00 X 0 0 0 MARK BURKET CEO 40.00 X 239854 0 77248 VICKI JENSEN CFO 40.00 X 106334 0 47671 DR NELSON BATOON PHYSICIAN 40.00 X 330439 0 58115 DR JEROME BENTZ PHYSICIAN 25.00 X 170803 0 37302 JEFFREY KONSTANZ PHYSICIAN ASSISTANT 40.00 X 208964 0 63751 HAU TRAN PHYSICIAN 40.00 X 357099 0 50629 APRIL VEURINK CNP 40.00 X 175302 0 9112 1588795 0 343828 13 0 1 0 SF CONSTRUCTIONJOURNEY PO BOX 2728 SIOUX FALLS SD 571012728 CONSTRUCTION 2305183 AVERA QUEEN OF PEACE 525 N FOSTER MITCHELL SD 57301 MGMT AGREEMENT/SERVICES 831919 PRIME TIME HEALTHCARE LLC PO BOX 3544 OMAHA NE 681033544 TEMP/CONTRACT CNAS AND RNS 408302 AVERA MCKENNAN HOSPITAL 1325 S CLIFF AVE SIOUX FALLS SD 571175045 PURCHASED SERVICES 271451 EIDE BAILLY LLP PO BOX 5125 SIOUX FALLS SD 571175125 ACCOUNTING SERVICES 208495 8 268134 268134 NET PATIENT SERVICE REVENUE 621110 12589658 12589658 NURSING HOME REVENUE 623000 3545250 3545250 CLINIC REVENUE 621110 1935452 1935452 PHARMACY REVENUE 623990 1157469 1157469 162199 162199 19390028 655479 655479 69837 0 69837 69837 69837 4073422 6195486 3259131 6172236 814291 23250 837541 837541 21221019 19390028 0 1562857 23883 23883 458340 458340 58872 58872 8251338 7818305 433033 398535 377963 20572 1619710 1521542 98168 566008 512453 53555 35 35 92347 11479 80868 568 568 1409272 1114700 294572 30391 7501 22890 367609 282515 85094 466659 65476 401183 392146 379284 12862 37023 33629 3394 48094 40036 8058 127156 92388 34768 909599 761364 148235 148966 21788 127178 MEDICAL SUPPLIES 1342117 1340553 1564 REPAIRS AND MAINTENANCE 368536 364089 4447 DUES AND SUBSCRIPTIONS 44293 26523 17770 RECRUITMENT AND RECOGNI 28106 7193 20913 80126 16682 63444 17269729 14878218 2391511 0 8029245 2720413 1713626 1908145 252397 200302 126762 133306 26829319 14693108 6486348 12136211 1155408 3340558 9998287 10736981 270817 271262 3700523 3813618 31733413 35260796 1742652 1928458 425 425 5190486 4772891 375503 510136 7309066 7211910 X 21405720 24712605 3018627 3336281 24424347 28048886 31733413 35260796 X 3951290 -539701 -192527 405477 X 0 1 X 1 1 1 X 0 0 0 0 0 1 568 0 0 0 568 0 PART II-B, LINE 1F THE AMOUNT FOR GRANTS PAID TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES REPRESENTS THE PORTION OF DUES PAID TO SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATION (SDAHO) THAT ARE ATTRIBUTABLE TO LOBBYING. 0 1 X 2786086 1473 284242 3071801 2611416 1390 173280 2786086 2936661 962 -326207 2611416 2502516 1168 432977 2936661 2630519 6073 -18442 115634 2502516 0.00000 0.60830 0.39170 1 0 242952 242952 19663862 10033082 9630780 5549946 4284097 1265849 1372559 375929 996630 12136211 INTEREST IN AVERA HEALTH FOUNDATION 4030663 F UNDER LOAN AGREEMENT 249647 F ASSETS LIMITED AS TO USE - FUNDED DEPRECIATION 6456671 F 10736981 DEFERRED COMPENSATION 490136 OTHER RECEIVABLES 3282482 PROPERTY HELD FOR FUTURE USE 41000 3813618 DEFERRED COMPENSATION PAYABLE 490136 ESTIMATED THIRD-PARTY PAYOR SETTLEMENT 20000 510136 X 21086795 -539701 405477 -134224 21221019 0 21221019 17269729 0 17269729 0 17269729 PART IV, LINE 2B: THE NURSING HOME RESIDENTS ARE ALLOWED TO HAVE FUNDS IN THE RESIDENT TRUST ACCOUNT. THE MONEY CAN BE USED FOR ANY PERSONAL ITEMS THEY DESIRE: SNACKS, LUNCH, HAIRCUTS, ETC. THE RESIDENTS ARE NOT CHARGED ANY FEES FOR UTILIZING THE ACCOUNT. THE ACCOUNT IS RECONCILED MONTHLY BY THE BUSINESS OFFICE STAFF. INTEREST IS PAID TO ANY INDIVIDUAL RESIDENT WHO HAS OVER $50 IN THEIR ACCOUNT. PART V, LINE 4: THE INCOME WILL BE USED TOWARD EXPENDITURES FOR HEALTHCARE SERVICES. PART X, LINE 2: THE HEALTH CENTER 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 HEALTH CENTER 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 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 405,477. 1 1 X 1 X 1 X 1 1 1 0 0 1 43 313000 313000 0.01810 1 43 313000 313000 0.01810 4 293 18570 11615 6955 0.00040 8886442 6963127 1923315 0.11140 4 490 490 0.00000 8 293 8905502 6974742 1930760 0.11180 9 336 9218502 6974742 2243760 0.12990 1 0 0 5122294 5143600 -21306 X 1 1 1 1 PLATTE HEALTH CENTER-AVERA 601 E 7TH STREET PLATTE SD 57369 WWW.PHCAVERA.ORG 10557 X X X X X 3 PROVIDER-BASED CLINICS PLATTE HEALTH CENTER-AVERA 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V SECTION C X 1 21 1 SEE PART V SECTION C 0 1 X 150.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 PLATTE HEALTH CENTER-AVERA PART V, SECTION B, LINE 5: THE CHNA COORDINATOR COLLECTED QUALITATIVE OR PRIMARY REVIEW DATA THROUGH THE USE OF A COMMUNITY-WIDE SURVEY AS WELL AS TWO FOCUS GROUPS AND THREE KEY INFORMANT INTERVIEWS.THE GREATEST PORTION OF THE ORGANIZATION'S PATIENTS AND CUSTOMERS RESIDE IN THE COUNTY OF CHARLES MIX AND THE TOWNS OR PLATTE, GEDDES, AND WHITE LAKE. ONLINE AND PAPER SURVEYS WERE UTILIZED TO SOLICIT BROADER INPUT FROM THE COMMUNITY REGARDING POTENTIAL HEALTH NEEDS. PAPER COPIES WERE AVAILABLE UPON REQUEST FREE OF CHARGE. THE ORGANIZATION EVEN REACHED OUT ON SOCIAL MEDIA, UTILIZING THE FACILITY'S FACEBOOK PAGE AND AVERA'S WEBPAGE TO MAKE THE LINK AVAILABLE TO AS MANY PEOPLE AS POSSIBLE. THE SURVEY WAS OPENED ON SEPTEMBER 1, 2021, AND CLOSED ON NOVEMBER 1, 2021. A TOTAL OF 144 SURVEYS WERE COLLECTED. THE GOAL WAS TO OBTAIN AT LEAST 100 SURVEYS.FOCUS GROUPS CONSISTED OF DEPARTMENT DIRECTORS WITHIN THE HOSPITAL AND BOARD MEMBERS FROM WITHIN THE COMMUNITY. INTERVIEWS WERE CONDUCTED WITH THE FOLLOWING KEY COMMUNITY MEMBERS: CHARLES MIX COUNTY COMMUNITY HEALTH NURSE, THE PLATTE-GEDDES SCHOOL COUNSELOR, AND RIVER COUNSELING LICENSED COUNSELORS. PLATTE HEALTH CENTER-AVERA PART V, SECTION B, LINE 11: AS PART OF THE CHNA, THE COMMITTEE DISCUSSED THE DATA GATHERED AND CAME TO A CONSENSUS, RANKING THE HEALTH NEEDS OF THE COMMUNITY AS FOLLOWS:1. PROVIDING ACCESS TO PREVENTATIVE AND SCREENING PROGRAMS INCLUDING HEALTH PROMOTION AND EDUCATION TO DECREASE THE RATE OF OBESITY, CARDIOVASCULAR DISEASE, AND DIABETES.2. IMPROVE ACCESS TO MENTAL HEALTH SERVICES.3. ADDRESS SOCIAL DETERMINANTS OF HEALTH TO INCLUDE HOUSING/DAYCARE AS A WORKFORCE ISSUE.OTHER COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED WERE AFTER SCHOOL PROGRAM/ACTIVITIES, ACCESS TO INFORMATION ABOUT COMMUNITY RESOURCES, ADDICTION/SUBSTANCE ABUSE, AND ACCESS TO MEDICAL CARE DUE TO COST. DUE TO LIMITED FINANCIAL RESOURCES, THE HOSPITAL IS NOT ABLE TO ADDRESS ALL OF THE IDENTIFIED NEEDS. INFORMATION AROUND THE NEED FOR AFTERSCHOOL ACTIVITIES WILL BE SHARED WITH THE PLATTE CHAMBER OF COMMERCE AND DEVELOPMENT CORPORATION AND PLATTE-GEDDES SCHOOL DISTRICT AS THESE NEEDS ARE BEYOND THE SCOPE OF THE HOSPITAL'S SERVICES. ADDICTION AND SUBSTANCE ABUSE PROGRAM IS OUTSIDE OF THE FACILITY'S CURRENT SCOPE OF PRACTICE TO ADDRESS. IT IS POSSIBLE THIS CAN BE INCLUDED AS A PART OF THE MENTAL HEALTH SERVICES INITIATIVE. ACCESS TO MEDICAL SERVICE CONCERNS DUE TO COST IS ADDRESSED BY THE ORGANIZATION VIA PATIENT ASSISTANCE PROGRAMS. THE FOLLOWING ACTIONS WERE TAKEN DURING THE TAX YEAR TO ACHIEVE THE GOALS OF THE MOST RECENT CHNA. PLATTE HEALTH CENTER CONTINUES TO COLLABORATE WITH AVERA HEART HOSPITAL AND PROVIDE THE STAFFING AND RESOURCES FOR THE PROVISION OF PLANET HEART SCREENING SERVICES IN THE COMMUNITY. THE FACILITY COLLABORATES WITH LOCAL BUSINESSES AND THE COMMUNITY TO PROVIDE THE STAFFING AND RESOURCES TO PROMOTE SCREENING ACTIVITIES FOR MAMMOGRAPHY, COLO-RECTAL CANCER AND PROSTATE CANCER AND ENCOURAGE ANNUAL HEALTH/WELLNESS ASSESSMENTS. PLATTE HEALTH CENTER PROVIDES STAFFING AND RESOURCES FOR DIABETIC EDUCATION PROGRAMS AND ACTIVITIES. A DIG PINK EVENT WAS HELD IN OCTOBER. FUNDS RAISED WILL BE DESIGNATED TO PROMOTE BREAST CANCER SCREENINGS FOR UNDER/UNINSURED PATIENTS. IN NOVEMBER 2023, A NEW PSYCHIATRIST OPENED HER PRACTICE AT THE PLATTE HEALTH CENTER. THIS WAS THE SINGLE MOST EXCITING MOMENT OF THE YEAR FOR THE FACILITY. THERE ARE VERY FEW LICENSED PSYCHIATRISTS IN THE STATE OF SD, SO THIS IS HUGE FOR A COMMUNITY THE SIZE OF PLATTE. NOT ONLY WILL PATIENTS FROM OUR COMMUNITY BENEFIT, BUT PATIENTS FROM ALL ACROSS THE STATE. PATIENTS CAN BE SEEN IN PERSON OR VIRTUALLY. THE FACILITY INVESTED IN TWO GOVERNOR HOMES TO ADDRESS AFFORDABLE HOUSING CONCERNS, WHICH IN TURN IMPACT WORKFORCE. THESE HOMES HAVE BEEN OFFERED TO FULL-TIME EMPLOYEES AT A PRICE THAT COVERS ONLY THE COST OF THE HOME. THE INTENT IS TO ASSIST YOUNG FAMILIES WITH THE PURCHASE OF THE FIRST HOME; AND CULTIVATE EMPLOYEE/EMPLOYER LOYALTY TO AIDE IN WORKFORCE RETENTION. PLATTE HEALTH CENTER-AVERA PART V, SECTION B, LINE 13H: PRESUMPTIVE CHARITY CARE IS A TOOL OF LAST RESORT AND APPLIES ONLY AFTER ALL OTHER AVENUES HAVE BEEN EXHAUSTED. THERE ARE OCCASIONS WHEN A PATIENT MAY APPEAR ELIGIBLE FOR A CHARITY CARE DISCOUNT, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE BECAUSE DOCUMENTATION WAS LACKING THAT WOULD SUPPORT THE PROVISION OF FINANCIAL AID. SUCH INSTANCES HAVE RESULTED IN A PATIENT'S BILL BEING ASSIGNED TO A COLLECTION AGENCY AND ULTIMATELY RECOGNIZED IN THE ACCOUNTING RECORDS AS A BAD DEBT EXPENSE, DUE TO A LACK OF PAYMENT. THIS APPROACH, HOWEVER, RESULTS NEITHER IN A FAIR SOLUTION FOR THE PATIENT NOR IN AN APPROPRIATE ACCOUNTING OF THE TRANSACTION. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER SOURCES, WHICH COULD PROVIDE PHC WITH SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH A CHARITY CARE DISCOUNT, WITHOUT NEEDING TO DETERMINE ELIGIBILITY FOR MEDICAL INDIGENCE. THIS PRESUMPTIVE ELIGIBILITY, WHEN PROPERLY DOCUMENTED INTERNALLY BY PHC STAFF, IS SUFFICIENT TO PROVIDE A CHARITY CARE DISCOUNT TO PATIENTS WHO QUALIFY. ONCE DETERMINED, DUE TO THE INHERENT NATURE OF THE PRESUMPTIVE CIRCUMSTANCES, THE ONLY DISCOUNT THAT CAN BE GRANTED TO THE PATIENT BY PHC IS A 100% WRITE-OFF OF THE ACCOUNT BALANCE. PLATTE HEALTH CENTER-AVERA PART V, SECTION B, LINE 24: THE POLICY DOES NOT COVER ELECTIVE PROCEDURES AND THE FACILITY HAS CONFIRMED NO FAP PATIENTS HAD ELECTIVE PROCEDURES. PART V SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST AND ATHTTPS://WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/#PLATTE PART V SECTION B, LINE 7A THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ATHTTPS://WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/#PLATTE PART V SECTION B, LINE 16A-C THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/451D4AF2-8881-4580-A3DF-82C5537E5EC8/PLATTE-FINANCIAL-ASSISTANCE.PDF THE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/33676278-79EE-48A4-8E87-5B9FAE74F85C/PLATTE-SUMMARY-OF-FINANCIAL-ASSISTANCE.PDF THE APPLICATION IS AVAILABLE AT:HTTPS://WWW.AVERA.ORG/APP/FILES/PUBLIC/4775520E-7935-4BB9-BCE4-CF940A4056AB/PLATTE-FINANCIAL-ASSISTANCE-APPLICATION.PDF 1 1 - PLATTE CARE CENTER 601 E 7TH STREET PLATTE SD 57369 NURSING HOME PART I, LINE 3C: IN ADDITION TO FPG, PLATTE HEALTH CENTER (PHC) UTILIZES OTHER FACTORS INCLUDING AN ASSET TEST, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PRESUMPTIVE CHARITY CARE MAY ALSO BE USED BASED ON INDIVIDUAL LIFE CIRCUMSTANCES (HOMELESSNESS, PATIENTS WITH NO INCOME, PATIENTS WHO HAVE QUALIFIED FOR OTHER FINANCIAL ASSISTANCE PROGRAMS SUCH AS FOOD STAMPS OR WIC). 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 7E AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM.LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE HEALTH CENTER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THE RESPECTIVE CLASS OF PATIENTS AND RESIDENTS. DURING THE YEAR ENDED JUNE 30, 2024, THE HEALTH CENTER ADJUSTED THE QUALIFYING CRITERIA UNDER THE CHARITY CARE POLICY, WHICH RESULTED IN A RECLASSIFICATION OF ACCOUNTS CONSIDERED BAD DEBT IN PREVIOUS YEARS THAT NOW QUALIFIED AS PRESUMPTIVE CHARITY CARE UNDER THE ADJUSTED POLICY. IMPLICIT PRICE CONCESSION FOR THE YEAR OF $139,000 WAS REDUCED FOR PRIOR YEAR RECLASSIFICATIONS OF $435,000 RESULTING IN A NET NEGATIVE IMPLICIT PRICE CONCESSION OF $296,000. DUE TO THE NEGATIVE IMPLICIT PRICE CONCESSION PER THE GENERAL LEDGER, AN AMOUNT OF $0 HAS BEEN REPORTED ON LINE 2. 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 IN CHARLES MIX COUNTY FOR 2023. THEREFORE, 22.8% OF IMPLICIT PRICE CONCESSIONS CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE. APPOXIMATELY $31,692 OF THE AMOUNT REPORTED IN THE NARRATIVE FOR PART III, LINE 2 CAN REASONBLY BE CONSIDERED CHARITY CARE. HOWEVER, AN AMOUNT OF $0 HAS BEEN REPORTED DUE TO THE ADJUSTMENT MADE TO IMPLICIT PRICE CONCESSION IN THE CURRENT YEAR. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS ON PAGES 14-15 OF THE ATTACHED AUDIT REPORT. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 6/30/24. 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: IF A PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED, OR UNDER-INSURED PATIENTS AND IS COOPERATING WITH THE ORGANIZATION WITH REGARD TO EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE ORGANIZATION OR ITS AGENT SHALL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE COLLECTION AGENCY. WHEN THE ORGANIZATION SENDS THE UNCOLLECTED ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY SHALL REFLECT THE REDUCED-PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS. IF AN UNCOLLECTED ACCOUNT IS IN COLLECTION AND IT'S DETERMINED THE ACCOUNT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THEN ALL COLLECTION ACTIVITY IS STOPPED. PHC DOES NOT REPORT ANY DATA TO ANY OF THE CREDIT AGENCIES, HOWEVER, THE COLLECTION AGENCIES PHC UTILIZES MAY REPORT TO THE CREDIT AGENCIES. PART VI, LINE 2: THE PLATTE HEALTH CENTER IS CONSTANTLY EVALUATING THE NEEDS OF OUR PATIENTS AND THE COMMUNITIES WE SERVE. PATIENT SURVEYS ARE INSTRUMENTAL IN BOTH SHORT AND LONG-TERM STRATEGIC PLANNING. THE PLATTE, GEDDES, AND WHITE LAKE MEDICAL CLINICS PERFORM AN ANNUAL PATIENT SATISFACTION SURVEY. THE NURSING HOME ALSO PERFORMS ANNUAL SURVEYS. THE HOSPITAL SURVEYS ARE ONGOING. EMERGENCY AND INPATIENT SURVEYS ARE PERFORMED BY AN INDEPENDENT THIRD PARTY UPON DISCHARGE, WITH QUARTERLY SCORES BEING PROVIDED TO ADMINISTRATION. ALL OF THE SURVEY RESULTS ARE REVIEWED BY ADMINISTRATION AND THEN DISCUSSED AT THE BOARD LEVEL. THE BOARD AGENDA HAS A STANDING STRATEGIC PLANNING ITEM THAT DISCUSSES FACILITY GOALS AND COMMUNITY NEEDS; AND HOW EACH CAN BE ACHIEVED. MONTHLY PROVIDER MEETINGS ARE ALSO INSTRUMENTAL TO MEETING THE NEEDS OF OUR PATIENTS. ADMINISTRATION, PHYSICIANS, AND ADVANCED PRACTICE PROVIDERS MEET REGULARLY TO DISCUSS THE NEED FOR NEW SERVICES, EVALUATING CURRENT SERVICES, AND ESTABLISHING BEST PRACTICES TO ENSURE WE OFFER A TOP NOTCH PATIENT EXPERIENCE. PART VI, LINE 3: THE PATIENT ASSISTANCE POLICY IS POSTED ON OUR FACILITY'S WEBSITE AT WWW.PHCAVERA.ORG. SIGNAGE IS ALSO POSTED THROUGHOUT OUR FACILITY THAT EXPLAINS WHAT PATIENTS SHOULD DO IF THEY HAVE CONCERNS ABOUT PAYING THEIR BILL. DISCHARGE PACKETS INCLUDE THE SUMMARY FOR FINANCIAL ASSISTANCE DOCUMENT.UPON OUTPATIENT SERVICE REGISTRATIONS AND/OR ADMISSION, THE BUSINESS OFFICE STAFF WORKS TO EDUCATE ALL SELF-PAY PATIENTS ON OUR PATIENT ASSISTANCE POLICY. SELF-PAY PATIENTS WHO MAY BE ELIGIBLE FOR MEDICAID OR OTHER STATE/FEDERAL BENEFITS ARE INFORMED OF A THIRD PARTY VENDOR WHOM THE FACILITY HAS ENLISTED TO ASSIST PATIENTS IN EXPLORING BENEFITS THAT MAY BE AVAILABLE. THE THIRD PARTY VENDOR IS A PUBLIC INTEREST LAW FIRM THAT PROVIDES FREE LEGAL SERVICES TO THOSE WHO QUALIFY. A REPRESENTATIVE FROM THAT VENDOR WILL CONTACT PATIENTS TO DETERMINE WHETHER IT IS APPROPRIATE FOR THEM TO ASSIST IN AN APPLICATION FOR BENEFITS. WHEN THE GROUP ACCEPTS A CASE, THEY FOLLOW IT UNTIL APPLICATIONS HAVE BEEN APPROVED OR DENIED. ALL OF THIS IS DONE AT NO CHARGE TO THE PATIENT.THE SUMMARY OF FINANCIAL ASSISTANCE DOCUMENT AND THE PATIENT ASSISTANCE FORM ARE SENT OUT WITH THE INITIAL SELF-PAY BILL TO ALL SELF-PAY PATIENTS WITHIN 7-10 DAYS OF THE DATE OF SERVICE. SELF-PAY BALANCES THAT GO UNPAID FOR 60 DAYS WILL RECEIVE A SERIES OF TWO LETTERS WITH THEIR MONTHLY STATEMENT. THE LETTERS EXPLAIN THE FACILITY'S COLLECTION PROCESS, AND INCLUDE THE PLAIN LANGUAGE DOCUMENT, THE PATIENT ASSISTANCE FORM, AND POLICY FOR THE GUARANTOR TO COMPLETE. THE FORM IS REQUIRED TO BE COMPLETED AND RETURNED IN A TIMELY MANNER. UPON RECEIPT OF THE PATIENT ASSISTANCE FORM, THE FORM IS REVIEWED TO DETERMINE THE AMOUNT OF DISCOUNT THE PATIENT QUALIFIES FOR UNDER THE POLICY. A FOLLOW-UP LETTER IS MAILED TO THE PATIENT EXPLAINING THE AMOUNT OF DISCOUNT AND PAYMENT PLAN FOR THE REMAINING BALANCE. FAILURE TO RETURN THE COMPLETED PATIENT ASSISTANCE FORM OR CONTACTING THE FACILITY FOR PAYMENT ARRANGEMENTS WILL RESULT IN THE PATIENT ACCOUNT GOING TO THE FACILITY'S COLLECTION AGENCY PROVIDED AT LEAST 120 DAYS HAVE PASSED SINCE THE FIRST POST DISCHARGE BILLING STATEMENT WAS SENT TO THE PATIENT. IF THE PATIENT RETURNS THE COMPLETED ASSISTANCE FORM WITHIN 240 DAYS FROM THE FIRST POST DISCHARGE BILLING STATEMENT, PHC WILL HALT COLLECTION ACTIVITY UNTIL A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY CAN BE MADE. IF PHC APPROVES THE PATIENT FOR FINANCIAL ASSISTANCE, COLLECTION ACTIONS WILL CEASE. PART VI, LINE 4: PLATTE HEALTH CENTER IS A CRITICAL ACCESS HOSPITAL IN PLATTE, SD. PLATTE IS A RURAL COMMUNITY WITH ALMOST 1,400 RESIDENTS LOCATED IN SOUTH CENTRAL SOUTH DAKOTA. THE FACILITY SERVES AN AREA OF ABOUT 5,000 PEOPLE IN CHARLES MIX, DOUGLAS, GREGORY, AURORA, AND BRULE COUNTIES. THE DOMINANT INDUSTRIES INCLUDE SMALL FAMILY BUSINESSES AND FAMILY FARMS. THE AREA IS VERY WELL KNOWN FOR RECREATIONAL HUNTING AND FISHING. WITH MORE THAN 1,950 PERMANENT CAMPSITES IN THE COUNTY, THE POPULATION RAPIDLY INCREASES BETWEEN MAY AND OCTOBER. THE PHC ALSO PROVIDES CARE FOR THREE DIFFERENT HUTTERITE COLONIES IN ITS GEOGRAPHIC SERVICE AREA: THE PLATTE COLONY, CEDAR GROVE COLONY, AND GRASS RANCH COLONY. THESE COLONIES MAKE UP A LARGE PORTION OF OUR POPULATION AND COMPRISE SOME UNIQUE CULTURAL DIFFERENCES. THE PLATTE HEALTH CENTER MAKES EXTRA EFFORT TO ENSURE WE ARE MEETING THE HEALTHCARE NEEDS OF THEIR COMMUNITIES. HUTTERITE COLONIES ARE NOT A PART OF THE REFERENCED CENSUS DATA.THE MAJORITY OF PEOPLE SERVED BY PHC ARE LIVING IN NORTHERN CHARLES MIX COUNTY. THE COUNTY IS AN ESTIMATED 1,100 SQUARE MILES AND HAS A POPULATION OF 9,373. CONSISTENTLY 80 PERCENT OF PLATTE HEALTH CENTER'S HOSPITAL DISCHARGES COME FROM CHARLES MIX COUNTY, AND ABOUT 74 PERCENT OF ALL SERVICES. ACCORDING TO THE U.S. CENSUS BUREAU QUICK FACTS DATA, CHARLES MIX COUNTY IS COMPRISED OF ABOUT 61 PERCENT CAUCASIAN PEOPLE, 33 PERCENT NATIVE AMERICAN, AND 6 PERCENT OTHER. PHC PREDOMINANTLY SERVES A CAUCASIAN POPULATION. THE ANNUAL MEDIAN HOUSEHOLD INCOME FOR CHARLES MIX COUNTY IN 2023 IS $64,850; HOWEVER, ALMOST 22.8 PERCENT OF THE POPULATION LIVES BELOW THE POVERTY LEVEL ($30,000/YEAR FOR A FAMILY OF FOUR). THERE ARE AN ESTIMATED 2,468 (OR 26%) PEOPLE ELIGIBLE FOR SOUTH DAKOTA MEDICAID; 1,061 ADULTS AND 1,407 CHILDREN, WHICH IS A STATISTIC THAT CONTINUES TO RISE EVERY YEAR. ABOUT 18 PERCENT OF THE COUNTY'S POPULATION REMAINS UNINSURED, WHICH IS ABOUT TEN PERCENT MORE THAN THE STATE AVERAGE. THE LOCAL PLATTE-GEDDES SCHOOL DISTRICT HAS APPROXIMATELY 16% OF THE STUDENTS ON FREE/REDUCED MEAL PLANS. PART VI, LINE 5: THE PLATTE HEALTH CENTER BOARD OF DIRECTORS CONSISTS OF NINE VOLUNTEER MEMBERS WHO REPRESENT ALL OF OUR SERVICE AREAS, INCLUDING PLATTE, GEDDES, WHITE LAKE, ACADEMY, NEW HOLLAND, AND HARRISON, SD. THE BOARD MEMBERS SHOW A SINCERE INTEREST IN UNDERSTANDING THE OPERATIONS OF THE FACILITY, ITS CONTINUED VIABILITY, AS WELL AS THE NEEDS OF THE COMMUNITY IT SERVES. THE BOARD HAS A STANDING ITEM FOR STRATEGIC PLANNING ON THEIR MONTHLY AGENDA. THIS IS FOR DISCUSSION ON THE NEED FOR NEW OR EXPANDED SERVICES, BUILDING PROJECTS, PROVIDERS, OUTREACH SERVICES, AND OTHER PATIENT RELATED TOPICS. AS A STANDING ITEM, THESE ITEMS BECOME GOALS AND STRATEGY FOR THE FACILITY'S FUTURE. THE BOARD HAS COMMITTED TO CONTRIBUTING FUNDS ANNUALLY TO THE AVERA POOLED INVESTMENTS. THESE FUNDS ARE INTENDED TO SUPPORT EQUIPMENT UPGRADES AND FUTURE BUILDING PROJECTS.MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PROVIDERS IN THE AREA. IN TOTAL WITH AVERA ESERVICES THE FACILITY HAS ABOUT 250 CREDENTIALLED PROVIDERS. THIS NUMBER INCLUDES THE THREE FULL-TIME EMPLOYED FAMILY PRACTICE PHYSICIANS, TWO CERTIFIED NURSE PRACTITIONERS, TWO PHYSICIAN ASSISTANTS, AND A CERTIFIED REGISTERED NURSE ANESTHETIST. PHC HAS NUMEROUS SPECIALTY PHYSICIANS VIA OUTREACH CLINICS AND ESERVICES.PHC IS THE ONLY HOSPITAL IN THE PLATTE COMMUNITY. THE NEXT CLOSEST CRITICAL ACCESS HOSPITAL IS 35 MILES TO THE EAST; AND THE CLOSEST REGIONAL HOSPITAL IS 66 MILES NORTHEAST. PHC WORKS VERY HARD TO PROVIDE QUALITY HEALTHCARE IN A RURAL SETTING. PHC PROVIDES INNOVATIVE TECHNOLOGY APPLICATIONS LEVERAGED BY HIGHLY TRAINED STAFF WITH ECARE SERVICES, WHICH INCLUDE EEMERGENCY, EICU, EPHARMACY, AND ECONSULT. THROUGH A GROWING TELECOMMUNICATIONS NETWORK, WE OFFER VIDEO TELECONFERENCING FOR EDUCATIONAL AND MEDICAL SERVICES. WE EXTEND OUR MISSION IN THE REGION THROUGH MOBILE OUTREACH PROGRAMS AND PROVIDE LOCAL HEALTH CARE SPECIALIST VISITS RIGHT HERE IN PLATTE SAVING OUR PATIENTS TIME AND TRAVEL EXPENSES. THE FACILITY IS CERTIFIED AS A TRAUMA RECEIVING FACILITY WITH FULLY INTEGRATED EEMERGENCY AND ESTROKE SERVICES IN BOTH EMERGENCY ROOM (ER) BAYS. EMERGENCY ROOM SERVICES ARE A SUBSIDIZED SERVICE FOR THE ORGANIZATION. THIS SERVICE IS NOT ONLY PROVIDED TO COMPLY WITH REGULATORY REQUIREMENTS BUT HAS ALSO BEEN IDENTIFIED AS A CRITICAL SERVICE FOR THE COMMUNITY AND ORGANIZATION AS IT ENSURES ACCESS TO EMERGENCY SERVICES FOR OUR CUSTOMERS.PLATTE HEALTH CENTER IS A FARM (FRONTIER AND RURAL MEDICINE) SITE. THE FARM PROGRAM IS THE UNIVERSITY OF SOUTH DAKOTA SANFORD SCHOOL OF MEDICINE'S RURAL TRACK MEDICAL STUDENT PROGRAM. THIS IS A UNIQUE OPPORTUNITY FOR A SELECT GROUP OF MEDICAL STUDENTS TO OBTAIN NINE MONTHS OF THEIR CLINICAL TRAINING IN RURAL COMMUNITIES. THE PROGRAM EDUCATES MEDICAL STUDENTS ON THE NEED FOR PHYSICIANS IN RURAL FAMILY MEDICINE; AND THE FACILITY BUILDS ON RELATIONSHIPS THAT COULD RESULT IN THE RECRUITMENT OF FUTURE PHYSICIANS. THIS IS A COMPETITIVE PROGRAM IN WHICH BOTH THE HOSPITAL AND MEDICAL STUDENT MUST APPLY FOR THROUGH AN APPLICATION PROCESS.PLATTE HEALTH CENTER IS A HEALING MINISTRY FOR THE SICK, THE ELDERLY, AND THE OPPRESSED, AND PROVIDES HEALTHCARE SERVICES TO ALL PERSONS IN NEED, WITHOUT REGARD TO AGE, RACE, SEX, CREED, NATIONAL ORIGIN, OR ABILITY TO PAY.IN CONJUNCTION WITH THE FACILITY'S COMMUNITY HEALTH NEEDS ASSESSMENT, THE FACILITY MAKES OTHER CONTRIBUTIONS TO THE COMMUNITY IT SERVES. THE PLATTE HEALTH CENTER ENCOURAGES VOLUNTEERING AT ALL LEVELS OF THE FACILITY. FACILITY EMPLOYEES ROUTINELY DONATE TIME AND MONEY TO SOME VERY WORTHY CAUSES. THE FACILITY PARTICIPATED IN THE FOLLOWING VOLUNTEER PROJECTS DURING THE YEAR: PLATTE HEALTH CENTER STAFF VOLUNTEERS TO OPERATE THE PUBLIC MOVIE THEATER THE SECOND SATURDAY OF EVERY MONTH. STAFF CONDUCTED A FOOD DRIVE FOR THE HELPING HANDS FOOD PANTRY LOCATED IN PLATTE, SD. THE MEDICAL CLINICS HOSTED A COMMUNITY BAKE SALE. THE PROCEEDS WERE USED TO COVER THE EXPENSE OF MEDICAL LICENSES FOR TWO PHYSICIANS WHO ARE FULFILLING A MEDICAL MISSION IN NORTH AFRICA. OUR RADIOLOGY DEPARTMENT CONDUCTED GO PINK EVENTS IN OCTOBER FOR BREAST CANCER AWARENESS. FUNDS WERE RAISED TO SUPPORT THE LOCAL BREAST CANCER SURVIVOR SUPPORT GROUP; AND TO PROVIDE SCREENING MAMMOGRAMS FOR UNINSURED/UNDERINSURED WOMEN. SURPLUS MEDICAL SUPPLIES ARE SENT TO FOREIGN COUNTRIES IN NEED. BAKE SALES COVER THE COST OF MAILING THESE ITEMS. FACILITY PROVIDES MEDICAL, NURSING, AND OTHER HEALTHCARE PROFESSION STUDENTS THE OPPORTUNITY TO JOB SHADOW AND GAIN HANDS-ON LEARNING AT THE FACILITY. EMPLOYEES PARTICIPATED AND HELPED ORGANIZE NUMEROUS FUND RAISING ACTIVITIES FOR LOCAL RESIDENTS DEALING WITH SERIOUS HEALTH CONDITIONS. PART VI, LINE 6: THE PLATTE HEALTH CENTER IS AFFILIATED WITH THE AVERA HEALTH SYSTEM AND IS A MANAGED FACILITY OF AVERA QUEEN OF PEACE. AVERA QUEEN OF PEACE AND THE PHC WORK COOPERATIVELY TO ENHANCE HEALTHCARE. THEIR DEDICATED RESOURCES TO ENDEAVORS THAT MAKE A POSITIVE DIFFERENCE IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. THESE ACTIVITIES INCLUDE LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENTS IN THE COMMUNITY, CONTRIBUTIONS TO NONPROFIT COMMUNITY ORGANIZATIONS, NONPROFIT EVENT SPONSORSHIPS, DONATED MEDICAL SUPPLIES, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH SCREENINGS, FLU-SHOT CLINICS, AND VARIOUS OTHER ACTIVITIES.THROUGH THIS AFFILIATION, THE PLATTE HEALTH CENTER HAS ACCESS TO "BACK OFFICE" SUPPORT SERVICES, SUCH AS LEGAL CONSULTATION, QUALITY BENCHMARKING, CODING, COMPUTER SERVICES, CONTRACT NEGOTIATIONS, ADMINISTRATIVE CONSULTATION, GROUP PURCHASING, HUMAN RESOURCE ASSISTANCE, PHYSICIAN RECRUITING, AND MANY OTHER SERVICES. AVERA HEALTH CAN PROVIDE THESE SERVICES TO THE HOSPITAL AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE ON ITS OWN. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT AND RESIDENT CARE. 1 PANTHER CUB ACADEMY 504 E 2ND STREET PLATTE SD 57369 922092194 501(C)3 20000 0 START UP FOR NEW DAYCARE FACILITY 1 0 PART I, LINE 2: THE FACILITY DOES NOT LOOK FOR GRANTS TO AWARD; HOWEVER, THE FACILITY WILL CONSIDER GRANT REQUESTS. IN THE CURRENT YEAR, THE COMMUNITY OPENED A NEW NONPROFIT DAYCARE. THE NEW DAYCARE DID A FUNDRAISING CAMPAIGN; AND THE BOARD WAS WELL AWARE OF A NEED AS IT WAS PREVIOUSLY IDENTIFIED ON THE FACILITY'S CHNA. THE BOARD THEN APPROVED A DONATION IN THE AMOUNT OF $20,000 TO THE NEW DAYCARE. X 0 0 0 0 0 0 0 0 0 HAU TRAN PHYSICIAN 291373 0 0 0 65726 0 9714 0 41392 0 408205 0 0 0 DR NELSON BATOON PHYSICIAN 329639 0 0 0 800 0 16500 0 42092 0 389031 0 0 0 MARK BURKET CEO 238992 0 0 0 862 0 34883 0 42716 0 317453 0 0 0 JEFFREY KONSTANZ PHYSICIAN ASSISTANT 189664 0 19300 0 0 0 22020 0 42007 0 272991 0 0 0 DR JEROME BENTZ PHYSICIAN 170003 0 0 0 800 0 8645 0 29106 0 208554 0 0 0 APRIL VEURINK CNP 159079 0 7000 0 9223 0 8782 0 480 0 184564 0 0 0 VICKI JENSEN CFO 106334 0 0 0 0 0 6156 0 41748 0 154238 0 0 0 SCHEDULE J, PART I PHYSICIANS AND ADVANCED PRACTICE PROVIDERS CAN ACHIEVE INCENTIVE PAY AS OUTLINED IN THEIR RESPECTIVE EMPLOYMENT CONTRACTS. FOR THE YEAR END 06/30/24, THE FACILITY HAD TWO ADVANCED PRACTIVE PROVIDERS ACHIEVE THEIR INCENTIVE GOALS. ONE WAS A PHYSICIAN ASSISTANT WHO EARNED AN INCENTIVE BASED ON PRODUCTIVITY STANDARDS. THE OTHER WAS A CERTIFIED NURSE PRACTITIONER WHO ACHIEVED INCENTIVE BY MEETING THE FOLLOWING CRITERIA: PARTICIPATION/ATTENDANCE AT PROVIDER AND MEDICAL STAFF MEETINGS; ED RESPONSE TIME REQUIREMENTS; STAFF EDUCATION REQUIREMENTS; AND ANNUAL WELLNESS VISITS FOR NURSING HOME RESIDENTS. JULIE GUSTAD MOTHER-IN-LAW OF JILL GUSTAD, BOARD MEMBER 38375 COMPENSATION 0 JEANETTE PHEIFER MOTHER OF BRANDI DELANGE, BOARD MEMBER 20497 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL HAVE THE BOARD PRESIDENT AS ITS CHAIRMAN AND RESPONSIBLE PERSON. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE FACILITY DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF DIRECTORS AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF DIRECTORS. ALL OTHER COMMITTEES ARE ADVISORY TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 8B IF AND WHEN THE EXECUTIVE COMMITTEE MEETS, IT DOES NOT PREPARE MINUTES FOR THEIR MEETINGS. INSTEAD, IT REPORTS TO THE BOARD AND DISCUSSION OF EXECUTIVE COMMITTEE MEETINGS IS INCLUDED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND CFO REVIEW THE FORM 990. AFTER THEIR REVIEW, A COPY OF THE COMPLETED FORM 990 IS GIVEN TO ALL BOARD MEMBERS FOR THEIR FEEDBACK. THE CFO FILES THE TAX RETURN WITH THE IRS AFTER VERIFYING WITH THE BOARD THAT IT IS OKAY TO PROCEED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD IS REQUIRED ANNUALLY TO SIGN-OFF ON THE CONFLICT OF INTEREST POLICY. PER POLICY, BOARD MEMBERS ARE EXPECTED TO DISCLOSE CONFLICTS AS THEY ARISE. THE FULL BOARD REVIEWS THE POTENTIAL CONFLICTS OF INTEREST AND DETERMINES WHETHER A CONFLICT EXISTS. IF A CONFLICT EXISTS, THE AFFECTED PERSON IS REQUIRED TO ABSTAIN FROM VOTING ON THE ITEM THAT GIVES RISE TO THE CONFLICT. ALL EMPLOYEES ARE REQUIRED TO FOLLOW THE CONFLICT OF INTEREST POLICY. ADMINISTRATION REVIEWS AND RESOLVES ANY CONFLICTS AS THEY ARISE. IN MATTERS OF PATIENT CARE, ADMINISTRATION WOULD CONVENE AN ETHICS COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 PER THE CEO'S CONTRACT, THE CEO ANNUAL COMPENSATION SHALL BE AGREED UPON AT AN ANNUAL REVIEW OF THE CEO'S COMPENSATION AND PERFORMANCE BY THE BOARD. IF NO OTHER AMOUNT IS SET AT THE ANNUAL REVIEW, THE SALARY SHALL REMAIN THE SAME FOR THE NEXT CALENDAR YEAR, SUBJECT TO ANNUAL INFLATIONARY INCREASE. THIS ANNUAL REVIEW SHALL OCCUR THREE MONTHS PRIOR TO THE END OF EACH YEAR OF THE CONTRACT. THE COMPENSATION PACKAGE FOR THE CFO IS BASED ON A REVIEW OF THE SDAHO ANNUAL COMPENSATION SURVEY AND APPROVED BY THE CEO. THE ANNUAL SDAHO SURVEY IS BASED ON MARKET BY FACILITY SIZE AND LOCATION. ANY MARKET INCREASES ARE AWARDED ON JULY 1ST ANNUALLY. ANNUAL MERIT INCREASES (NOT TO EXCEED 2.5 PERCENT) ARE GIVEN BASED ON A PERFORMANCE REVIEW ON THE CFO'S ANNIVERSARY DATE OF EMPLOYMENT. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF 405,477.