Community Benefit Insight - Tax-exempt hospital

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Wagner Community Memorial Hospital

Wagner Community Memorial Hospital

513 Third Street
Wagner, SD 57380

Bed count	20	Medicare provider number	431315	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 460226283

Display data for year:

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

17.51%

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	$ 548,900 4.36 %
Medicaid as % of operating expenses	$ 49,524 0.39 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 2,000 0.02 %
Subsidized health services as % of operating expenses	$ 1,592,761 12.66 %
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.	$ 4,662 0.04 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 5,260 0.04 %
Community building* as % of operating expenses	$ 12,591 0.10 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	5
Physical improvements and housing	0
Economic development	1
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	2
Community health improvement advocacy	0
Workforce development	2
Other	0
Persons served (optional)	439
Physical improvements and housing	0
Economic development	2
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	2
Community health improvement advocacy	0
Workforce development	435
Other	0
Community building expense as % of operating expenses	$ 12,591 0.10 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 9,582 76.10 %
Community support as % of community building expenses	$ 0 0 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 749 5.95 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 2,260 17.95 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 2,500
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	$ 2,500
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	$ 257,012 2.04 %
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	$ 58,085 22.60 %

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 $ 10785278 including grants of $ 11949) (Revenue $ 12796940)
WCMH IS A 20 BED CRITICAL ACCESS HOSPITAL EQUIPPED WITH EXTENSIVE ADVANCED SERVICES, INCLUDING AREAS FOR MEDICAL/SURGICAL, PEDIATRIC, INTENSIVE/CORONARY CARE, AND SWING BED/LONG TERM CARE. THE CLINIC IS ADJACENT TO THE HOSPITAL MAKING IT CONVENIENT TO SEE HOSPITAL PATIENTS, AND SHARE LABORATORY SERVICES AND OTHER DIAGNOSTIC EQUIPMENT. OUTREACH SERVICES INCLUDE OB/GYN, PEDIATRICS, ORTHOPEDIC SURGERY, GENERAL SURGERY, UROLOGY, PODIATRY, ENT & AUDIOLOGY. THE PEOPLE OF THE COMMUNITY TRULY BELIEVE IN HAVING ACCESS TO CARE AND SUPPORT THEIR LOCAL MEDICAL PROVIDERS. THE FACILITY SERVES AS THE INPATIENT UNIT FOR THE LOCAL INDIAN HEALTH SERVICES CLINIC AND WORKS COLLABORATIVELY WITH THE IHS PHYSICIANS AND LEADERS TO CARE FOR THE NATIVE AMERICAN POPULATION. WCMH EXPERIENCED 549 INPATIENT DAYS, 606 SWING BED DAYS, 2,145 EMERGENCY DEPARTMENT VISITS, AND 3,189 CLINIC VISITS.

Facility Information

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

WAGNER COMMUNITY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: THE WAGNER COMMUNITY MEMORIAL HOSPITAL REPRESENTATIVES REACHED OUT TO LOCAL COMMUNITY MEMBERS AND LEADERS TO DEVELOP A COMMUNITY FOCUS GROUP. THE AMERICAN INDIAN POPULATION WAS IDENTIFIED AS AN UNDERSERVED POPULATION SPECIFIC TO THE HOSPITAL SERVICE AREA. THE FOCUS GROUP CONSISTED OF REPRESENTATIVES FROM THE FOLLOWING: WAGNER COMMUNITY MEMORIAL HOSPITAL BOARD MEMBERS, WAGNER INDIAN HEALTH SERVICE, YANKTON SIOUX TRIBAL POLICE, EMERGENCY MEDICAL TECHNICIAN, COMMUNITY HEALTH NURSE AND SDSU EXTENSION. THE HOSPITAL REPRESENTATIVES INCLUDED THE CEO/ADMINISTRATOR, DIRECTOR OF NURSING, AND CLINICAL COORDINATOR. THE CHNA COMMUNITY FOCUS GROUP MET FOR FOUR MEETINGS THROUGHOUT DECEMBER 2021 TO DISCUSS THE PURPOSE OF THE CHNA, THE GOALS OF THE FOCUS GROUP, AND THE IMPACT ON THE COMMUNITY.

WAGNER COMMUNITY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 7D: THE CHNA REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE AT HTTPS://WWW.AVERA.ORG/LOCATIONS/WAGNER-COMMUNITY-MEMORIAL-HOSPITAL-AVERA/

WAGNER COMMUNITY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 11: PURSUANT TO THE FY22 IMPLEMENTATION STRATEGY ADOPTED BY WAGNER COMMUNITY MEMORIAL HOSPITAL (WCMH), MENTAL HEALTH SERVICES, SUBSTANCE ABUSE, DIABETES, OBESITY AND HEART DISEASE WERE IDENTIFIED AS COMMUNITY NEEDS. THE FACILITY WILL ADDRESS THE IDENTIFIED NEEDS IN FUTURE YEARS, AS FOLLOWS.1. MENTAL HEALTH:A. HOSPITAL EMPLOYEES WILL BE KNOWLEDGEABLE OF BEHAVIORAL HEALTH RESOURCES.B. INCREASING UTILIZATION OF TELEMEDICINE SERVICES(EEMERGENCY AND ETRIAGE)C. THE HOSPITAL WILL CONTINUE TO EMPLOY OR CONTRACT A FULL TIME OR PART TIME PSYCHIATRIC (MEDICATION MANAGEMENT) AND/OR A PSYCHOLOGIC (COUNSELING) PROVIDER.2. SUBSTANCE ABUSE:A. WCMH EMPLOYEES WILL BE KNOWLEDGEABLE OF SUBSTANCE ABUSE RESOURCES AVAILABLE.B. WE WILL INCREASE UTILIZATION OF TELEMEDICINE SERVICES (EADDICTION, ETRIAGE ETC)3. DIABETES:A. PROVIDE DIABETIC EDUCATION OPPORTUNITIES WITHIN THE COMMUNITYB. INCREASE REFERRALS TO DIABETIC EDUCATION PROGRAMS AND RECOURSESC. EDUCATE DIABETIC PATIENTS OF THE AVAILABLE GLUCOSE MONITORS IN TOWN- JAMES DRUG FOR PURCHASE OR AT INDIAN HEALTH SERVICES TO THOSE WHO QUALIFY FOR BENEFITS.4. OBESITY:A. WCMH WILL INCREASE AWARENESS OF LOCAL EXERCISE OPPORTUNITIES WITHIN THE SURROUNDING AREA.B. WCMH WILL CONTINUE TO COLLABORATE WITH THE WAGNER HEALTH AND WELLNESS CONSORTIUM TO PROMOTE AREA EXERCISE PROGRAMSC. WCMH PROVIDERS WILL CONTINUE TO EDUCATE THEIR PATIENTS ON A HEALTHY DIET.5. HEART DISEASE:A. WCMH PROVIDERS WILL CONTINUE TO EDUCATE THEIR PATIENTS ON A HEALTHY DIET AND EXERCISE.B. WCMH WILL USE THE EXISTING PROGRAMS THAT ADDRESS OBESITY WHICH CAN BE CONNECTED MORE BROADLY TO HEART DISEASE.C. INCREASE PATIENT'S COMPLIANCE WITH MEDICATION MANAGEMENT.IN THE CURRENT YEAR THE FACILITY HAS TAKEN THE FOLLOWING ACTIONS TO ADDRESS NEEDS IDENTIFIED IN THE FY19 CHNA:1. EMPLOYED COUNSELOR AND CONTINUE TO EMPLOY PART-TIME PSYCHIATRIC PROVIDER2. STAFF IS AWARE OF SUBSTANCE ABUSE RESOURCES AVAILABLE, DECREASED TIME BETWEEN REFERRAL AND OUTPATIENT EVALUATION. 4. HAVE UTILIZED SOCIAL MEDIA TO INCREASE AWARENESS OF LOCAL EXERCISE OPPORTUNITIES WITH WAGNER HEALTH AND WELLNESS CONSORTIUM.ALL NEEDS IDENTIFIED IN THE FY22 COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE ADDRESSED.

WAGNER COMMUNITY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 13H: THE HOSPITAL USES PRESUMPTIVE ELIGIBILITY TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY IF NEEDED.

WAGNER COMMUNITY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 16J: PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.AVERA.ORG/LOCATIONS/WAGNER-COMMUNITY-MEMORIAL-HOSPITAL-AVERA/PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.AVERA.ORG/LOCATIONS/WAGNER-COMMUNITY-MEMORIAL-HOSPITAL-AVERA/PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.AVERA.ORG/LOCATIONS/WAGNER-COMMUNITY-MEMORIAL-HOSPITAL-AVERA/PART V, LINE 16J: THE REFERENCE TO THE POLICY AND ITS LOCATION IS SENT WITH ALL STATEMENTS.

WAGNER COMMUNITY MEMORIAL 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.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
IN ADDITION TO UTILIZING FPG TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE, THE HOSPITAL REVIEWS INSURANCE STATUS AND USES PRESUMPTIVE ELIGIBILITY.

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 7E, 7F AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINE 7G WAS OBTAINED FROM THE MEDICARE COST REPORT.

PART I, LINE 7G:
SUBSIDIZED HEALTH SERVICES INCLUDED PROVIDER-BASED CLINIC REVENUE OF $941,442 LESS EXPENSE OF $1,584,059, FOR A NET BENEFIT OF $642,617.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE CEO IS INVOLVED IN THE ROTARY CLUB, WHICH IS MADE UP OF BUSINESS LEADERS WHO WORK WITH COMMUNITY SERVICE ORGANIZATION TO ENHANCE THE COMMUNITY. THE CEO IS ALSO ACTIVE IN THE CHAMBER OF COMMERCE.WCMH HOSTED AN 8TH GRADE CAREER FAIR FOR THE REGIONAL SCHOOLS. EIGHTH GRADERS MUST SELECT CAREER PATHWAYS FOR HIGH SCHOOL REGISTRATION; THUS, THE GOAL OF THE CAREER FAIR IS TO EXPOSE STUDENTS TO THE TECHNICAL SKILLS AND EDUCATION NEEDED TO BE SUCCESSFUL IN BUSINESS AND INDUSTRY. THE HOSPITAL ASSISTS IN ORGANIZING POINT OF DISTRIBUTION (POD) EVENTS, AS WELL AS ADMINISTERING THE INFLUENZA VACCINE TO STUDENTS AND POD VOLUNTEERS AT THE WAGNER COMMUNITY SCHOOL IN CONJUNCTION WITH THE CHARLES MIX POD MANAGER AND CHARLES MIX COMMUNITY HEALTH NURSE.STRENGTHENING OUR COMMUNITY (SOC) IS THE PROJECT AWARE ADVISORYCOMMITTEE THAT IS MADE UP OF A CROSS SECTION OF COMMUNITY MEMBERS WHOSE GOAL IS TO BUILD RELATIONSHIPS AND CREATE CAPACITY TO BECOME A SELF-HEALING COMMUNITY. THE FOCUS IS ON MENTAL HEALTH WELL-BEING. SOC INCLUDES A JOINT EFFORT WITH SEVERAL COMMUNITY ORGANIZATIONS CONCERNED WITH THE MENTAL WELL-BEING OF OUR COMMUNITY'S YOUTH.THE WAGNER COMMUNITY MEMORIAL HOSPITAL HAS PARTNERED WITH SEVERAL COMMUNITY ENTITIES TO FORM THE WAGNER AREA HEALTH & WELLNESS CONSORTIUM. THIS GROUP COMBINES RESOURCES TO EMPHASIZE HEALTH EDUCATION AND ACTIVITIES TO PROMOTE IMPROVED HEALTH AND WELLNESS.

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

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 2021. THEREFORE, 22.6% 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 CONCESSIONS IS ON PAGES 10 AND 11 OF THE AUDITED FINANCIAL STATEMENTS.

PART III, LINE 8:
MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR THE FISCAL YEAR ENDING 6/30/2022.MANY PATIENTS IN OUR SERVICE AREA QUALIFY FOR MEDICARE. THE FACILITY PROVIDES SERVICES TO THESE PATIENTS REGARDLESS OF IF THERE IS A SHORTFALL OR SURPLUS. PROVIDING SERVICES TO THIS POPULATION PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE NEEDED IN OUR COMMUNITY, THEREBY PROVIDING A BENEFIT TO OUR COMMUNITY.TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICAID AND MEDICARE SERVICES.

PART III, LINE 9B:
THE COLLECTION PRACTICES AS SET FORTH IN THE POLICY REQUIRES THAT IF A PATIENT QUALIFIES FOR CHARITY CARE, NO BILL WILL BE SENT. INSTEAD, A LETTER INDICATING THAT THE PATIENT'S BILL HAS BEEN COMPLETELY FORGIVEN WILL BE SENT. WHEN SENDING A BILL TO ANY PATIENT, THE ORGANIZATION SHALL INCLUDE ON THE BILL A STATEMENT THAT INDICATES IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED PROGRAM OR FOR FINANCIAL ASSISTANCE FROM THE ORGANIZATION FOR HELP IN PAYING FOR THE SERVICES THAT WERE PROVIDED. IN ADDITION, A STATEMENT PROVIDES THE PATIENT WITH AN ORGANIZATION CONTACT RESOURCE WHOM THE PATIENT MAY OBTAIN INFORMATION ABOUT THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS AND HOW TO APPLY FOR SUCH ASSISTANCE FOR THE PAYMENT OF SERVICES THAT WERE PROVIDED.IF THE PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED 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. AT SUCH TIME AS 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 PAITENT WAS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS. WCMH DOES NOT REPORT ANY DATA TO ANY OF THE CREDIT AGENCIES, HOWEVER, THE COLLECTION AGENCIES WCMH UTILIZES MAY REPORT TO THE CREDIT AGENCIES.

PART VI, LINE 2:
IN ADDITION TO PREPARING A COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE FISCAL YEAR ENDED JUNE 30, 2022, WCMH DETERMINES PATIENT NEEDS THROUGH CONSTANT COMMUNICATION WITH PATIENTS, PRIMARY AND SPECIALTY PROVIDERS, AND STATE AND FEDERAL GOVERNMENTAL HEALTH AGENCIES. WCMH STRIVES TO CONSISTENTLY INVESTIGATE, ANALYZE, AND DETERMINE THE GREATEST NEEDS OF OUR COMMUNITY.

PART VI, LINE 3:
AT EACH POINT OF ADMISSION, NOTICES ARE POSTED STATING WCMH OFFERS FINANCIAL ASSISTANCE WITH CONTACT INFORMATION FOR ASSISTANCE. REFERENCE TO THE POLICY IS GIVEN TO THE PATIENT UPON ADMISSION AND AGAIN WITH THE NOTICE/STATEMENT FOR PAYMENT, INCLUDING CONTACT INFORMATION FOR ASSISTANCE. IF THE PATIENT EXPRESSES INTEREST IN FINANCIAL ASSISTANCE, A PATIENT ADVOCATE WILL ASSIST IN COMPLETING THE PROPER APPLICATION.

PART VI, LINE 5:
WCMH PROVIDES COMMUNITY HEALTH IMPROVEMENT SERVICES WHICH INCLUDE: COMMUNITY CPR CLASSES; BLOOD PRESSURE SCREENINGS AT AREA EVENTS; SCHOLARSHIPS TO LOCAL HIGH SCHOOL GRADUATES; DAKOTA SENIOR MEAL DELIVERY FOR LOCAL ELDERLY IN OUR COMMUNITY; OPERATING AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY EQUIPPED WITH THE LATEST TECHNOLOGY INCLUDING TELEMEDICINE.

PART VI, LINE 4:
WAGNER IS A RURAL COMMUNITY LOCATED IN SOUTHERN CHARLES MIX COUNTY IN SOUTH DAKOTA WHICH HAS MANY HEALTH DISPARITIES WITH UNMET NEEDS. IF ONE LOOKS AT SOUTHERN CHARLES MIX COUNTY, THE AVERAGE INDIVIDUAL INCOME IS $24,587 WITH THE MEDIAN FAMILY INCOME AT $52,981. THIS IS COMPARED TO THE NATIONAL AVERAGE OF $37,638 AND $69,021. SOUTHERN CHARLES MIX COUNTY HAS A FEDERAL POVERTY LEVEL OF 22.6% COMPARED TO 12.3% FOR SOUTH DAKOTA. COUNTY EDUCATION DEMOGRAPHICS INCLUDE 88.2% OF RESIDENTS HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 22.4% HOLDING A BACHELOR'S DEGREE OR HIGHER, COMPARED TO A NATIONAL LEVEL OF 88.9% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 33.7% HAVING A BACHELOR'S DEGREE OR HIGHER. ACCORDING TO THE US CENSUS BUREAU MOST RECENT DATA 33.6% OF SOUTHERN CHARLES MIX COUNTY ARE OF AMERICAN INDIAN DESCENT COMPARED TO 9.0% FOR SOUTH DAKOTA AND 1.3% NATIONALLY. THE WAGNER SERVICE AREA IS ALSO CONSIDERED A HEALTH PROFESSIONAL SHORTAGE AREA-LOW INCOME GEOGRAPHIC. THIS IS DUE TO ITS ACCESS TO FEW PROVIDERS AND LONG DISTANCES BETWEEN OTHER RURAL COMMUNITIES. OUR SERVICE AREA INCLUDES A COMMUNITY CLINIC IN ADDITION TO THE WAGNER INDIAN HEALTH SERVICES CLINIC AND THE VA CLINIC. MANY CLINICS PROVIDE ONLY PRIMARY CARE SERVICES AND ARE OFTEN STAFFED BY NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. IN CASES WHERE MORE SPECIALIZED CARE IS NEEDED, PATIENTS HAVE THE OPTION TO TRAVEL TO YANKTON, SOUTH DAKOTA, WHICH IS AN 110 MILE ROUND TRIP OR TRAVEL 222 MILES ROUND TRIP TO SIOUX FALLS, SOUTH DAKOTA, WHICH IS ALSO THE AREA'S TERTIARY CARE HUB FOR ALL TYPES OF SPECIALTY CARE. WE ALSO FIND CHARLES MIX COUNTY, SD IN AN AREA IN WHICH THERE IS A HIGH PERCENTAGE OF UNINSURED UNDER THE AGE OF 65. ACCORDING TO THE US CENSUS BUREAU, OUR COUNTY INCLUDES 18.5% UNINSURED AS COMPARED TO 9.8% NATIONALLY.*ALL STATISTICS FOR THIS REPORT WERE OBTAINED FROM CENSUS.GOV

PART VI, LINE 6:
"WCMH IS A MANAGED FACILITY OF AVERA HEALTH. AVERA HEALTH AND THE HOSPITAL WORK COOPERATIVELY TO ENHANCE HEALTHCARE THROUGHOUT THE COMMUNITY SERVED BY THE HOSPITAL. WCMH ALSO 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 AND MANY OTHER SERVICES. AVERA HEALTH IS ABLE TO PROVIDE THESE SERVICES TO WCMH AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT AND RESIDENT CARE. AVERA HEALTH AND WCMH DEDICATE RESOURCES TO ENDEAVORS THAT MAKE A POSITIVE DIFFERENCE TO 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, COMMUNITY HEALTH EDUCATION AND VARIOUS OTHER ACTIVITIES."

Operating expenses	$ 12,578,618
Total amount spent on community benefits as % of operating expenses	$ 2,203,107 17.51 %