Community Benefit Insight - Tax-exempt hospital

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Freeman Regional Health Services

Freeman Regional Health Services

510 East 8th
Freeman, SD 57029

Bed count	25	Medicare provider number	431313	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 460232450

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

18.21%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 27,000 0.19 %
Medicaid as % of operating expenses	$ 380,294 2.70 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 2,155,268 15.32 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 355,126 2.52 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 34,199 9.63 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 11838874 including grants of $ 0) (Revenue $ 13985011)
FRHS IS COMPRISED OF A 49 BED NURSING HOME AND A 25 BED CRITICAL ACCESS HOSPITAL WITH A 24/7 EMERGENCY ROOM. THE EMERGENCY ROOM HAS LOCAL PROVIDERS ON CALL AND TELEMEDICINE CAPABILITIES WITH A REGIONAL TRAUMA CENTER. HOSPITAL ACUTE PATIENT DAYS = 621, SWING BED DAYS = 397, NURSING HOME RESIDENT DAYS = 14,404.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

FREEMAN REGIONAL HEALTH SERVICES
PART V, SECTION B, LINE 5: THE FOCUS GROUPS UTILIZED FOR THE CHNA WERE COMPRISED OF INVITED COMMUNITY/SERVICE AREA RESIDENTS WHO WERE SELECTED BASED ON OBTAINING AN ADEQUATE CROSS SECTION OF GENDER AND OCCUPATION. OTHER CRITERIA CONSIDERED DURING THE PROCESS WERE FINDING INDIVIDUALS THAT REPRESENTED TWO MAIN GROUPS: RETIRED SENIORS AND WORKING ADULTS, AND THE BROAD INTEREST OF OUR SERVICE AREA. THESE GROUPS WERE ALSO KEPT TO A REASONABLE NUMBER TO FACILITATE DISCUSSION. THIS PROCESS WAS FACILITATED WITH THE ASSISTANCE OF A COMMUNITY DEVELOPMENT SPECIALIST WITH THE SOUTH DAKOTA PLANNING AND DEVELOPMENT DISTRICT III.

FREEMAN REGIONAL HEALTH SERVICES
PART V, SECTION B, LINE 7D: WWW.FREEMANREGIONAL.COM/COMMUNITY-NEEDS

FREEMAN REGIONAL HEALTH SERVICES
"PART V, SECTION B, LINE 11: PURSUANT TO THE 2019 IMPLEMENTATION STRATEGY ADOPTED BY FRHS, THE FOLLOWING NEEDS WERE ADDRESSED AS OF THE END OF THE YEAR FOR THIS 990:FREEMAN REGIONAL HEALTH SERVICES REMAINS COMMITTED TO PROMOTING HEALTH AND WELLNESS AND WILL CONTINUE EFFORTS ON MEETING THE NEEDS OF THE COMMUNITY. THIS INCLUDES CONTINUING TO PROMOTE COMMUNITY-BASED EDUCATION PROGRAMS WHICH FOCUS ON HEALTH-RELATED TOPICS OF INTEREST, AND WHICH TARGET SPECIFIC COMMON INTEREST GROUPS AND THE COMMUNITY AS A WHOLE. TO THIS END, FRHS COMPLETED THE FOLLOWING:-FACILITY PROVIDED EDUCATION TO PATIENTS, RESIDENTS, AND FAMILIES ABOUT COVID-19 (I.E., SYMPTOMS, HOW TRANSMITTED, MINIMIZE SPREAD, ETC.). -PROVIDED COVID-19 VACCINE CLINICS. -COVID19 EDUCATION WAS PRESENTED TO HUTTERITE COLONIES ALONG WITH HISPANIC POPULATION. -PROMOTED THE IMPORTANCE OF ANNUAL CHECKUPS AND WELL CHILD CHECKS POST PANDEMIC.-IMPLEMENTED AVERA ECARE BEHAVIORAL HEALTH OUTPATIENT SERVICES. -BOOTH AT FARMER'S MARKET PROVIDED HEALTHY MEAL RECIPES AND FREE TOOTH CARE ITEMS FOR ALL POPULATIONS. FREEMAN REGIONAL HEALTH SERVICES RECOGNIZES THE IMPORTANCE OF COMMUNITY OUTREACH AND THE VALUE OUR ORGANIZATION AND ITS EMPLOYEES BRING TO THE COMMUNITY. TO PROMOTE COMMUNITY OUTREACH AND VOLUNTEERISM, FRHS COMPLETED THE FOLLOWING:-FRHS CONTINUED TO SUPPORT AND ADVOCATE TO ITS EMPLOYEES THE VALUE AND IMPORTANCE OF BEING INVOLVED WITH THEIR COMMUNITIES.-THE DIRECTOR OF NURSING SERVES ON THE BOARD OF THE GROWING DREAMS DAYCARE CENTER AND WORKS TO HELP SUPPORT ACTION STEPS TO HELP EXPAND THE DAYCARE.-FRHS LEADERSHIP TEAM WORKED TOGETHER WITH THE CITY OF FREEMAN ON DESIGN OF NEW MAIN STREET SIDEWALKS TO HELP PROMOTE SAFETY FOR THE RESIDENTS OF THE CITY.-THE CEO IS A CURRENT MEMBER OF THE FREEMAN COMMUNITY DEVELOPMENT CORPORATION, AN ORGANIZATION DEDICATED TO PROMOTING THE ECONOMIC VITALITY OF THE COMMUNITY AND PROMOTING THE HIGHEST QUALITY OF LIFE FOR RESIDENTS AND THOSE WHO VISIT THE FREEMAN COMMUNITY. -THE CEO IS A CURRENT MEMBER OF FREEMAN COMMUNITY FOUNDATION WHICH OFFERS GRANTS TO NON-PROFITS IN FREEMAN AND SCHOLARSHIPS TO LOCAL STUDENTS. -FRHS HAS BEEN INVOLVED IN LOCAL SCHOOL ACTIVITIES SUCH AS ""DIG PINK"", AN OPPORTUNITY TO SUPPORT BREAST CANCER AWARENESS WITH THE FREEMAN HIGHSCHOOL VOLLEYBALL TEAM. -FRHS SPONSORED A FAMILY FRIENDLY ROOM AT THE SD CHISLIC FESTIVAL IN THE PRAIRIE ARBORETUM INTERPRETIVE CENTER.-FRHS PARTICIPATED IN COMMUNITY EVENTS SUCH AS THE HALLOWEEN PASSPORT/COMMUNITY TRICK OR TREAT SCAVENGER HUNT. -COMMUNITY HEALTH PROVIDED DISCOUNTED POOL PASSES FOR LOW-INCOME FAMILIESFREEMAN REGIONAL HEALTH SERVICES RECOGNIZES THE CHANGING DYNAMICS OF THE DIVERSE POPULATION WITHIN OUR SERVICE AREA. WE REMAIN COMMITTED TO PROVIDING SERVICES AIMED DIRECTLY AT MEETING THE CHANGING NEEDS OF THE COMMUNITIES WE SERVE. OUR EFFORTS INCLUDED:-IMPLEMENTATION OF PROPRIO INTERPRETER SERVICES-CUSTOMER SERVICE EDUCATION INCLUDING CULTURAL AWARENESS FROM AVERA. -FREEMAN REGIONAL HEALTH SERVICES CONTINUED TO WORK WITH THE SALEM MENNONITE HOME ASSISTED LIVING CENTER ON A JOINT PROJECT TO PROVIDE THE AREA WITH A FULL CONTINUUM OF CARE. THE SALEM MENNONITE HOME CURRENTLY PROVIDES ASSISTED LIVING SERVICES. FREEMAN REGIONAL PROVIDES CLINIC, HOSPITAL, AND LONG-TERM CARE SERVICES. THE PLAN FOR THE FUTURE IS TO BUILD ON A NEW SITE TOGETHER TO PROVIDE EASIER ACCESS PHYSICALLY AND OFFER BROADER HEALTHCARE SERVICES FROM ONE LOCATION. TO PROVIDE ACCESS TO COMMUNITY-BASED QUALITY CARE. THE MISSION OF FRHS IS TO PROVIDE ACCESSIBLE, COMMUNITY-BASED QUALITY CARE THAT IS COMPETENT, CREATIVE, AND COMPASSIONATE. TO MEET THESE NEEDS, FRHS COMPLETED THE FOLLOWING:-CONTINUED TO RECRUIT AND EMPLOY QUALITY PROVIDERS WHO ARE COMPETENT AND COMPASSIONATE TO MEET THE HEALTH CARE NEEDS OF THOSE WITHIN OUR SERVICE AREA.-FREEMAN REGIONAL HEALTH SERVICES CONTINUED TO EMPLOY THREE PHYSICIANS, ONE PHYSICIAN ASSISTANT, AND FOUR CERTIFIED NURSE PRACTITIONERS TO SERVE THE GREATER FREEMAN AREA AND OUR SATELLITE CLINIC LOCATIONS. THESE PROVIDERS MEET REGULARLY TO REVIEW THE SERVICES THEY PROVIDE TO THE AREAS AND ADJUST SERVICES AS NEEDED TO MEET THE NEEDS OF THE FREEMAN AREA RURAL COMMUNITIES. -OFFERED FREE BLOOD PRESSURE SCREENINGS IN RURAL CLINICS-FOOT CLINIC OFFERED IN BOTH FREEMAN AND MARION-DENTAL SERVICES OFFERED WITHIN THE NURSING HOME -PROVIDE PRIMARY SERVICES AND OUTREACH PROVIDERS THAT ARE APPROPRIATE FOR OUR RURAL SETTING.FRHS RECOGNIZES THE INCREASING DIFFICULTY IN FINDING THE RESOURCES REQUIRED TO STAFF THE VARIOUS DEPARTMENTS OF THE HOSPITAL, CLINIC, AND NURSING HOME. TO MEET THESE NEEDS FRHS COMPLETED THE FOLLOWING: -CONTINUED TO WORK WITH LOCAL SCHOOLS AND CHURCHES TO PROMOTE AN INTEREST IN HEALTHCARE CAREERS. -FRHS PARTNERED WITH LAKE AREA TECHNICAL INSTITUTE, DEPARTMENT OF LABOR, AND FREEMAN HIGH SCHOOL TO PROMOTE AN APPRENTICESHIP PROGRAM FOR STUDENTS. -ATTENDED JOB FAIRS TO HELP RECRUIT NEW NURSING GRADUATES AND ASSIST WITH UTILIZING THE RURAL HEALTH GRANT OR BUILD DAKOTA TO HELP THEM RETURN TO SCHOOL FOR FURTHER EDUCATION. -PARTICIPATED IN CAREER FAIRS FOR NURSING AT MITCHELL TECHNICAL INSTITUTE-WORKED WITH THE BOARD OF NURSING ON THE NURSE INTERN PROGRAM TO ALLOW STUDENTS TO EXPERIENCE RURAL HEALTH CARE IN FREEMAN. -ADVERTISED JOB OPPORTUNITIES TO LOCAL PAPERS, SOCIAL MEDIA, AND UTILIZE EXISTING STAFF TO PROMOTE FRHS IN THE PUBLIC. -FRHS PROMOTED SERVICES THROUGH AVERA HEALTH, LOCAL NEWSPAPERS, AND SOCIAL MEDIA, AS WELL AS WITHIN THE OUTREACH PROVIDERS THAT VISIT FRHS."

FREEMAN REGIONAL HEALTH SERVICES
PART V, SECTION B, LINE 13H: THE FACILITY MAY USE PRESUMPTIVE ELIGIBILITY IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED.

FREEMAN REGIONAL HEALTH SERVICES
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.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
FREEMAN REGIONAL HEALTH SERVICES (FRHS) REQUIRES THAT THE PATIENT COMPLETE A FINANCIAL ASSISTANCE APPLICATION SHOWING HIS/HER INCOME AND EXPENSES. THE APPLICATION IS REVIEWED TO SEE WHAT FUNDS AND ASSETS THE PATIENT HAS AND WHETHER THE PATIENT HAS THE RESOURCES TO PAY HIS/HER MEDICAL BILLS. FOR SOME PATIENTS, FRHS USES DOCUMENTATION FROM OTHER GOVERNMENT BASED AGENCIES OF THE PATIENT'S FINANCIAL SITUATION AND RESOURCES AS A WAY TO HELP DETERMINE THE PATIENT'S FINANCIAL SITUATION. THE CHIEF FINANCIAL OFFICER REVIEWS ALL APPLICATIONS AND MAKES THE DETERMINATION OF ASSISTANCE OFFERED.THE FACILITY MAY USE PRESUMPTIVE ELIGIBILITY IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED.

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. LINES 7B AND 7G WERE OBTAINED FROM THE MEDICAID AND MEDICARE COST REPORTS, RESPECTIVELY.

PART I, LINE 7G:
SUBSIDIZED HEALTH SERVICES INCLUDES CLINIC REVENUE OF $1,744,720 AND EXPENSE OF $2,739,928, FOR A NET LOSS FROM CLINIC OPERATIONS OF $995,208.

PART III, LINE 2:
THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS.

PART III, LINE 3:
THE ESTIMATE AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSION ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL. 9.63% CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE.

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 12-13.

PART III, LINE 8:
MEDICARE ALLOWABLE COSTS OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2021. 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:
30-DAY NOTICE: OUR STATEMENTS, INCLUDING THE FIRST STATEMENT, HAVE A CHARITY CARE/FINANCIAL ASSISTANCE WEB SITE LISTED AT THE BOTTOM. THE SITE PROVIDES THE FINANCIAL ASSISTANCE POLICY AND FOLLOWS THE 30-DAY NOTICE GUIDELINES. 120 DAY NOTICE: FREEMAN REGIONAL DOES NOT INITIATE ANY ECA'S UNTIL AFTER THE 4TH MONTHLY STATEMENT. 240 DAY NOTICE: IF THE APPLICATION IS COMPLETE WE MAKE A DETERMINATION BY 240 DAYS. IF THE DETERMINATION IS AVERSE ANOTHER 30-DAY NOTICE IS AGAIN GIVEN OUT.

PART VI, LINE 2:
ANNUALLY, ON THE 4TH MONDAY OF FEBRUARY, FREEMAN REGIONAL HEALTH SERVICES (FRHS) HAS A COMMUNITY MEETING THAT IS ADVERTISED IN THE LOCAL NEWSPAPERS INVITING THE COMMUNITY TO ATTEND AND PROVIDE INPUT REGARDING ITS NEEDS AND IDEAS ON HOW FRHS CAN IMPROVE ITS SERVICES. ON A QUARTERLY BASIS, FRHS MEETS WITH THE MEDICAL STAFF TO DISCUSS OPERATIONS AND ANY SUGGESTIONS THEY MAY HAVE ON SERVICES PROVIDED BY FRHS AND THE NEEDS OF THE COMMUNITY. FRHS HAS A MONTHLY DEPARTMENT MANAGER MEETING WHERE THE NEEDS OF THE COMMUNITY AND OTHER ISSUES CAN BE DISCUSSED. COMMUNITY MEMBERS ARE ENCOURAGED TO COME TO THE FACILITY AT ANY TIME TO DISCUSS CONCERNS OR ISSUES WITH THE ADMINISTRATION. IN ADDITION, FRHS PREPARED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019. PLEASE SEE PART V, SECTION B, LINE 3 FOR MORE INFORMATION.

PART VI, LINE 3:
FRHS HAS POSTED SIGNAGE ABOUT CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. FRHS ADDRESSES THE FINANCIAL ASSISTANCE PROGRAM AND PROVIDES INFORMATION ON HOW TO APPLY FOR ASSISTANCE AT DISCHARGE AND IN PATIENT BILLS. THE BUSINESS OFFICE AND SOCIAL WORKERS ADVISE PATIENTS ON THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. A NOTICE RELATED TO AVAILABLE CHARITY CARE IS PRINTED AT THE BOTTOM OF ALL SERVICE STATEMENTS.

PART VI, LINE 4:
FRHS IS A HEALTHCARE FACILITY THAT PRIMARILY SERVES RESIDENTS IN RURAL HUTCHINSON, MCCOOK AND TURNER COUNTIES IN SOUTHEASTERN SOUTH DAKOTA. SERVICE AREA DEMOGRAPHICS HUTCHINSON MCCOOK TURNERPOPULATION (2019 DATA) 7,291 5,586 8,384HOUSEHOLDS 2,862 2,209 3,470AVERAGE HOUSEHOLD SIZE (PEOPLE) 2.43 2.38 2.33MEDIAN HOUSEHOLD INCOME $54,868 $62,234 $55,380MEDIAN AGE 43.8 40 43% OF POPULATION UNDER 18 25.3% 27.8% 24.4%% OF POPULATION 19-64 51.8% 53.3% 54.2%% OF POPULATION 65+ 22.9% 18.9% 21.4%% OF POPULATION BELOW POVERTY INCOME LEVEL 11.5% 9.6% 9.4%A MAJORITY OF THE EMPLOYERS IN THESE AREAS ARE SMALL EMPLOYERS WHO OFFER LITTLE TO NO EMPLOYEE BENEFITS. OF THE EMPLOYERS WHO DO OFFER HEALTH INSURANCE TO THEIR EMPLOYEES, DEDUCTIBLES AND CO-PAYS HAVE RISEN FROM 300-500% OVER THE PAST 10 YEARS. MANY EMPLOYERS HAVE PASSED THE INCREASE IN HEALTH INSURANCE PREMIUMS TO THEIR EMPLOYEES MAKING PAYING THE HIGHER DEDUCTIBLES AND CO-PAYS VERY DIFFICULT.

PART VI, LINE 5:
FRHS'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. FRHS EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN ITS COMMUNITY AND SURROUNDING AREA. FRHS REINVESTS SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, INCLUDING BUT NOT LIMITED TO EXPANSION OF SERVICES OFFERED, PATIENT EDUCATION, EMPLOYEE EDUCATION, AND EQUIPMENT AND FACILITY RENOVATIONS. FRHS IS COMPRISED OF A 49 BED NURSING HOME AND A 25 BED CRITICAL ACCESS HOSPITAL WITH A 24/7 EMERGENCY ROOM. THE EMERGENCY ROOM HAS LOCAL PROVIDERS ON CALL AND TELEMEDICINE CAPABILITIES WITH A REGIONAL TRAUMA CENTER.

Operating expenses	$ 14,070,608
Total amount spent on community benefits as % of operating expenses	$ 2,562,562 18.21 %