Management Services

Provider Reimbursements and Audits

Hospital Statement of Cost for the Catastrophic County Poor Relief Program

Hospitals are required to complete the Hospital Statement of Costs at least annually to participate in the Catastrophic County Poor Relief Program.

If you have any questions about this form or need assistance, please contact Provider Reimbursement and Audits at 605-773-3643.

Statements of Cost are listed below by county:

 

Beadle

Facility City Current Next
Huron Regional Huron

Bennett

Facility City Current Next
Bennett County Community Hospital Martin

Bon Homme

Facility City Current Next
Landmann-Jungman Memorial Hospital Scotland
St. Micheals Hospital Tyndall

Brookings

Facility City Current Next
Brookings Hospital Brookings

Brown

Facility City Current Next
Avera St. Luke's Aberdeen
Dakota Plains Surgical Center Aberdeen

Brule

Facility City Current Next
Mid-Dakota Hospital Chamberlain

Charles Mix

Facility City Current Next
Platte Health Center, Inc. Platte
Wagner Community Memorial Hospital Wagner

Clay

Facility City Current Next
Sanford Hospital Vermillion Vermillion

Codington

Facility City Current Next
Prairie Lakes Hospital Watertown

Custer

Facility City Current Next
Custer Community Hospital Custer

Davison

Facility City Current Next
Avera Queen of Peace Mitchell

Day

Facility City Current Next
Lake Area Hospital Webster

Deuel

Facility City Current Next
Deuel County Memorial Hospital Clear Lake

Douglas

Facility City Current Next
Douglas County Memorial Hospital Armour

Edmunds

Facility City Current Next
Bowdle Hospital Bowdle

Fall River

Facility City Current Next
Fall River Health Services Hot Springs
VA of the Black Hills Hot Springs
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Faulk

Facility City Current Next
Faulk County Memorial Hospital Faulkton

Grant

Facility City Current Next
Milbank Area Hospital/Avera Milbank

Gregory

Facility City Current Next
Burke Community Memorial Hospital Burke
Avera Gregory Healthcare Gregory

Haakon

Facility City Current Next
Hans Peterson Memorial Hospital Philip
Philip Health Services Philip

Hand

Facility City Current Next
Hand County Memorial Hospital Miller

Hughes

Facility City Current Next
St. Mary's Pierre

Hutchinson

Facility City Current Next
Freeman Community Hospital Freeman
St. Benedict's Parkston

Jerauld

Facility City Current Next
Weskota Memorial Medical Center Wessinton Springs

Kingsbury

Facility City Current Next
Avera DeSmet Memorial Hospital DeSmet

Lake

Facility City Current Next
Madison Community Hospital Madison

Lawrence

Facility City Current Next
Lead/Deadwood Regional Hospital Deadwood
Spearfish Regional Hospital Spearfish

Lincoln

Facility City Current Next
Canton Inwood Memorial Hospital Canton

Marshall

Facility City Current Next
Marshall County Memorial Hospital Britton

McPherson

Facility City Current Next
Eureka Community Memorial Hospital Eureka

Meade

Facility City Current Next
Sturgis Regional Hospital Sturgis

Minnehaha

Facility City Current Next
Avera Dells Area Health Center Dell Rapids
Heart Hospital of SD Sioux Falls
Avera McKennan Sioux Falls
Sanford Health Sioux Falls
Sioux Falls Surgical Center Sioux Falls

Moody

Facility City Current Next
Avera Flandreau Medical Center Flandreau

Pennington

Facility City Current Next
Rapid City Regional Hospital Rapid City
Black Hills Surgical Hospital Rapid City
Rapid City Same Day Surgery Rapid City

Potter

Facility City Current Next
Gettysburg Medical Center Gettysburg

Roberts

Facility City Current Next
Coteau des Prairies Sisseton

Spink

Facility City Current Next
Community Memorial Hospital Redfield

Tripp

Facility City Current Next
Winner Regional Healthcare Center Winner

Turner

Facility City Current Next
Pioneer Memorial Hospital Viborg

Walworth

Facility City Current Next
Holy Infant Hospital Hoven
Mobridge Regional Hospital Mobridge

Yankton

Facility City Current Next
Avera Sacred Heart Yankton
Lewis and Clark Speciality Hospital Yankton