MED Magazine, April/May 25 by MED- (Midwest Medical Edition)

Midwest Medical Edition

THE HIP DUO

Elevating Orthopedic Care in the Black Hills

National Distinction for Rural Hospitals

Discharging Against Medical Advice

Kenneth Milligan, MD and Eric Krohn, DO

JOINT PAIN

Our board-certified orthopedic specialists and surgeons use a team approach to care for your patients before, during and after joint replacement surgery. We use advanced techniques and technology to provide partial and total joint arthroplasty in a safe and efficient manner. This high level of care gives patients the ability to discharge on the same day or next so they can complete their recovery in the comfort of their own home.

Ryan Todhunter, MD Orthopedic Surgery

Joshua Johnson, MD Orthopedic Surgery

Mark Heidenreich, MD Orthopedic Surgery

Ryan Todhunter, MD Orthopedic Surgery

Joshua Johnson, MD Orthopedic Surgery

Mark Heidenreich, MD Orthopedic Surgery

A Legacy of Care Across Generations

Lionel and his family have an extraordinary bond with Children’s Nebraska’s Osteogenesis Imperfecta Clinic. Diagnosed before birth with the condition commonly known as brittle bone disease, Lionel’s family knew Children’s OI Clinic was the only place they would trust with his treatment because his father, José, was also a Children’s OI patient as a child. Lionel visits our clinic once a year for personalized treatment with Children’s expert multidisciplinary teams. By combining pediatric orthopedic expertise, advanced genetic research, medical management and leading-edge surgical techniques, our team is helping Lionel to a promising future just like his father.

We don’t just treat conditions — we uplift families, foster resilience and create brighter futures. Whether treating current patients or the next generation, our commitment to care runs deep.

Visit ChildrensNebraska.org/OI or scan the QR code to learn more about Children’s Osteogenesis Imperfecta Clinic.

THE HIP DUO

Elevating Orthopedic Care in the Black Hills

■ By Alex Strauss

Monument Health’s hip specialists bring university-level surgical expertise to the region, including complex procedures like periacetabular osteotomy that keep young patients active and pain-free without traveling hundreds of miles for care.

PAGE 6 | This Month Online Online exclusives: Sioux Falls makes the ‘happiest cities’ list again, USD prepares to host its second mental health summit, and a groundbreaking statewide healthcare referral network

PAGE 10 | LESSONS IN LIABILITY: Against Medical Advice

■ By Eric Zacharias

A 63-year-old’s refusal of hospital admission leads to emergency surgery at another facility. Here's how to protect your patients and yourself.

PAGE 12 | [Sponsored] History Meets Modern Charm at Preacher Smith’s Taproom

■ By Kim Lee

The Black Hills’ newest social hub serves up 20+ local brews and more in a distinctive space.

PAGE 14 | NEWS & NOTES

A $2M boost for Monument NICU, and three Good Sam leaders named Women of Distinction —plus dozens more headlines from across the region.

PAGE 18 | Area Rural Hospitals Achieve National Distinction

PAGE 19 | USD School of Health Sciences Success Spotlight: Lisa Varenhorst, DNP

PAGE 20 | BEYOND THE BORDER: News from MED’s Multi-state Coverage Area

CONTACT INFORMATION

STEFFANIE LISTON-HOLTROP

VP Sales & Marketing

Publisher / MED MAGAZINE, LLC

Sioux Falls, South Dakota

Vice President Sales & Marketing

STEFFANIE LISTON-HOLTROP

Editor in Chief / ALEX STRAUSS

Staff Writer / KIM LEE

Magazine Design / ANGELA CORBO GIER

Client Relationship Manager / BARBIE MUNOZ

605-366-1479

Steff@MidwestMedicalEdition.com

ALEX STRAUSS

Editor in Chief

605-759-3295

Alex@ MidwestMedicalEdition.com

WEBSITE

MidwestMedicalEdition.com

MAILING ADDRESS

16, NO. 3 ■ APRIL / MAY

elcome to the April/May issue of MED Magazine, where we continue our commitment to bringing you the most innovative healthcare developments from across our region.

In this issue, our cover story takes you inside Monument Health’s orthopedic program where two remarkable surgeons are transforming hip care for children, adolescents and young adults in the Black Hills. Dr. Kenneth Milligan and Dr. Eric Krohn have brought university-level expertise to the region, offering specialized procedures rarely available outside academic medical centers. Inside, you’ll also find Dr. Eric Zacharias’ insightful examination of the legal and ethical challenges of “against medical advice” discharges, as well as our comprehensive events calendar to help you plan your professional development for the spring and summer.

As always, we invite you to visit our website for exclusive online content and to share articles with colleagues through our enhanced sharing tools.

All the best, —Alex & Steff

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Digital Media Director / HYA AMURAO NEXT ISSUE

PO Box 90646, Sioux Falls, SD 57109

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THIS MONTH ONLINE

Exclusive Online Articles

NEXUS SD Strengthening Healthcare Connections Through Partnership

In today’s complex healthcare landscape, the best outcomes aren’t achieved in silos. Instead, they come from collaboration— healthcare, human services, and social support providers working together to address whole-person care. That’s exactly what Nexus SD is designed to do.

A Member-Centered Approach to Healthcare Integration

As a public-private partnership led by the South Dakota Department of Health (SD DOH), Nexus SD provides a statewide referral and data-sharing network that connects providers across healthcare, human services, and social services. This technology-driven platform allows member organizations to coordinate care efficiently, reducing redundancy and ensuring people receive the right services at the right time.

Nexus SD is HIPAA compliant, ensuring that all patient information is securely handled and protected per federal privacy and security regulations. This compliance safeguards sensitive health data while enabling seamless collaboration between providers.

For members, Nexus SD is more than a database or referral system—it’s a tool that strengthens their ability to serve their communities. By participating, organizations gain access to:

• A comprehensive resource directory to find the best care options for patients

• Seamless electronic referrals with real-time status updates

• A shared seeker record, eliminating the need for individuals to repeat their health and social history at each provider

• Data insights to inform decision-making, identify gaps in services, and track outcomes

Addressing Social Drivers of Health (SDOH)

Research shows that up to 80% of a person’s health outcomes are influenced by factors outside of medical care—economic stability, education, transportation, housing, food security, and social support. These social drivers of health (SDOH) are critical to addressing health disparities in South Dakota, where rural barriers, poverty rates, and provider shortages impact access to care.

GO ONLINE TO READ THE FULL ARTICLE on Nexus SD and apply for a $10,000 Nexus SD Implementation Award.

USD Department of Social Work to Organize Mental Health Summit

The University of South Dakota Department of Social Work will host its second annual South Dakota Mental Health Services Conference May 14-15 in Rapid City at The Rushmore Hotel & Suites.

At this year’s conference, which will address behavioral health needs of children, adolescents and youth in rural and underserved areas, mental health professionals will hear from featured speaker Monique M. Apple of Oglala Lakota College, who will focus on “Supporting the Whole Child: Total Health and Wellness of South Dakota Youth.”

The Department of Social Work will also present the Inspiring Social Worker of the Year award at the conference. The honoree will receive a certificate of accomplishment and $2,500 in recognition of their dedication and inspiration to care.

GO ONLINE to nominate a social worker for the award or to register for the conference.

This year’s annual WalletHub report on America’s happiest cities ranks Sioux Falls at number #4 out of 180 of the U.S.’ largest cities. Only Fremont, San Jose, and Irvine, California rank higher.

To identify the happiest cities, WalletHub compared cities across 29 key indicators of happiness from the depression rate to the income-growth rate to the average leisure time spent per day.

Sioux Falls Once Again Ranked Among the Happiest Cities

Happiness in Sioux Falls (1=Happiest, 91=Avg.)

Overall Rank: 4th

17th Depression Rate

7th Adequate-Sleep Rate

67th Sports-Participation Rate

1st Unemployment Rate

43rd Separation & Divorce Rate

The only other city in South Dakota included in the analysis was Rapid City, which ranked 33rd overall. The personal finance site publishes the rankings each year around ‘International Day of Happiness’ on March 20th.

WE HAVE A LINK TO THE FULL LIST as well as in depth analysis on our website.

SHARING IS CARING

Want to share something you’ve read on the MED website? Our website share buttons make it easier than ever to send any article, event, announcement, etc., directly to your favorite social media platform, or even an email address. Pass it on!

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button in the navigation bar on our website and fill in the simple form. We’ll share on our website, in our bimonthly newsletter, and through our social media channels.

READ ANY BACK ISSUE OF MED MAGAZINE

It’s now easier than ever to find something you saw in a back Click on “MED Magazine” in the navigation bar for direct links to digital versions of the most Read on any device!

THE HIP DUO

E levating O rthopedic C are in the B lack Hills

BY ALEX STRAUSS

HIPS ARE TRICKY. Even a perfectly formed hip is likely to start showing signs of wear and tear—and may even need to be replaced— by the time its owner is in their 50s or 60s. For children born with hip dysplasia, or those whose hips are damaged by trauma or disease, that timeline can be even shorter. What is worse, these patients may spend decades in life-limiting pain without a definitive diagnosis.

“They may be told that the pain in their hips is a groin sprain and to treat it with NSAIDS or they may be told they have an abnormality but there is nothing they can do about it,” says orthopedic surgeon Kenneth Milligan, MD, of Monument Health Orthopedic & Specialty Hospital. “In the past, they would have no other option but to live with the pain until they get a hip replacement. If you are 12 or 14, that is a tough thing.”

Fortunately for children and adolescents with hip pain in the Black Hills region, Dr. Milligan and

his colleague, pediatric orthopedic surgeon Eric Krohn, DO, understand the hips of children and adolescents like few others do.

Rare Skills Benefit Young Patients

Dr. Milligan is a hip specialist who trained and conducted research alongside some of the top names in hip surgery at the University of Colorado and in Ottawa, Canada. He assisted on UC’s very first periacetabular osteotomy (PAO) procedure, a complex surgery to reposition the hip

socket for improved function and stability in people with hip dysplasia.

With Dr. Milligan’s arrival at Monument Health this past fall, Black Hills hip patients can now access this advanced treatment rarely available outside of a university setting.

As a pediatric orthopedic surgeon at Monument since 2022, it is Dr. Krohn’s job to find and fix problems in the hips and other joints before they are serious enough to need Dr. Milligan’s expertise.

Dr. Krohn is from Washington state and did his pediatric orthopedic training at the University of Michigan. Hip dysplasia is one of the most common childhood conditions he treats, occurring in about 1 in 1,000 newborns.

“Our goal is to find these as early as possible when there are more treatment options,” says Dr. Krohn. “For instance, I can do a Salter osteotomy which realigns the acetabulum so that it better covers the femoral head. I can also do femoral osteotomy which addresses deformities in the femur.

“In the adult world, you’re often looking at trying to make a bad situation a little less bad, but in my population, you can hopefully make it so their situation is much, much better than it would have been otherwise.”

Kenneth Milligan, MD, attended the Monument Health Community Health Summit at the Black Hills Stock Show and Rodeo, where he showcased the advanced ROSA robotics system, a cutting-edge technology available at Monument Health Orthopedics.

Early Intervention for Better Outcomes

But if a child with dysplasia is asymptomatic or is incorrectly diagnosed, their real problem may not be found until their bones are more solid. That’s where the PAO procedure shines.

“A PAO is a very complex procedure,” says Dr. Krohn. “While I do a lot of work around the pelvis, a PAO is not something I would do by myself without someone with the kind of training Dr Milligan has. We needed his technical skills to be able to offer this.”

In his training, Dr. Milligan saw career athletes return to professional level sports after a PAO. Now, his first local patients are seeing similar successes.

“We did a PAO back in November on a teenager that had been having pain in the hip for four years and had pretty much stopped participating in all sports,” says Dr. Milligan. Several rounds of therapy did not help and careful measurements showed significant dysplasia. Three months after a PAO procedure, the patient has returned to a normal gait and has even been out hiking.

Comprehensive Hip Care for All Ages

Although dysplasia is one of the most common hip problems Drs. Krohn and Milligan treat, they are quick to emphasize that there are many potential causes for hip pain.

“An example might be a child with slipped capital femoral epiphysis (SCFE) where part of the femoral head sloughs off and they can end up with severe deformities of the ball side of the hips,” says Dr. Milligan. “There can be people with avascular necrosis in the hips. Steroids, infection, trauma, and surgery in the hip can all do this, so PAO is not the only thing we do for hip pain.”

Both say the key to effective long-term relief is to work with providers who deeply understand the complexity of the hip joint.

“You don’t need a bigger hospital to do some of these procedures, you just need people with the right expertise,” says Dr. Krohn. “We want to see anyone, at any age, with hip pain. If we can’t figure it out, I’m betting no one else can.”

Kenneth Milligan, MD, and Eric Krohn, DO, are two of the 15 specialist physicians at Monument Health Orthopedic & Specialty Hospital

LESSONS IN LIABILITY: AGAINST MEDICAL ADVICE

BY DR. ERIC ZACHARIAS

CASE STUDY

A physician in the emergency department went into a room to assess a 63-year-old female with concerns about diffuse abdominal pain. The patient had a history of smoking, coronary disease, and intermittent claudication. On exam, vitals were normal and the abdomen was diffusely tender with mild guarding and no rebound. On workup, the patient’s labs were unremarkable except for a white blood cell count of 13,000 with a normal differentiation. An abdominal CT scan was read as normal.

The physician recommended that she be admitted for observation since her pain was not improving during the ER stay. The patient declined admission, citing the concern of having to care for her pets and her high-deductible insurance plan. After a long discussion, the patient signed an “against medical advice” form and left the ER. Two days later, the physician was informed that the patient had been admitted the following night at another hospital with acute ischemic colitis and infarction requiring emergency surgery.

DISCUSSION

Against medical advice discharges are when the patient chooses to leave the hospital or clinic even when the physician suggests against it. Medical providers may feel distressed when the patient makes this type of decision, both because of the health risks to the patient and the liability risks to the provider.

Patients who present with actual or potentially high-risk clinical conditions pose the greatest safety risk. Providers should be vigilant around patients who want to leave against medical advice who have complaints such as non-specific chest pain, abdominal pain, potential stroke symptoms, or evidence of systemic infection, among other issues.

In the case study, there is risk for a lawsuit due to a poor outcome. However, good contemporaneous documentation of the physician’s communication with the patient about his concerns around the patient’s desire to refuse admission (as we will outline later) ultimately make this situation very defensible in the event of a lawsuit.

Against medical advice discharges expose the patient to a potential undertreated or undiagnosed medical problem and the complications of that diagnosis. This also presents the provider with an ethical dilemma. The physician wants to honor the patient’s wishes (autonomy) but also wants to do what is best for the patient (beneficence). Understanding the risks and ethics in these situations is important when formulating a strategy to best address what is essentially an inevitable event in nearly every practice setting.

THE LEGAL ASPECTS TO CONSIDER

A signed informed consent or informed refusal form is the cornerstone of provider protection for a situation such as the one illustrated in the case study. Informed decision making means the patient has arrived at their decision with a thorough discussion, no coercion, and full understanding of the risks and benefits.

Important areas to address and document include:

• Is the patient competent? Do they have capacity to make such a decision? Although courts have found that intoxication can impair a patient’s competence and ability to refuse medical treatment, a patient who is intoxicated does not automatically lack the competence or capacity to make medical decisions. Similarly, patients with psychiatric complaints can also be difficult to assess but do not necessarily lack capacity to make an informed decision.

• Do they have the health literacy to understand their decision?

• Does the patient understand the diagnosis and the reason for treatment?

• Are they aware of alternatives?

• Can they communicate their choices?

• Is there an understanding of the effects of their refusal?

Dr. Eric Zacharias is Chief Medical Officer at COPIC.

❱ Dr. Zacharias explores three critical Medical Aspects to Consider when contemplating an Against Medical Advice discharge in the extended version of this article on our website.

History Meets Modern Charm at Preacher Smith’s Taproom

BY KIM LEE

WHEN YOU FIND YOURSELF in the Black Hills, a visit to The Lodge at Deadwood’s newest social hub is a must.

Preacher Smith’s Taproom & Commons, a new cocktail bar serving spirits, craft beers and perfectly crafted cocktails, is a cozy gathering spot where timeless nostalgia meets contemporary creativity.

Whiskey aficionados and beer connoisseurs will enjoy unwinding with Preacher Smith’s high-end bourbons and local brews on tap at the new late-night hangout. Preacher Smith’s has something to whet everyone’s whistle, with more than 20 local brews on tap and hundreds of bourbon and whiskey varieties.

“We have huge selection of whiskeys and taps,” said Anthony Galbraith, general manager of The Lodge at Deadwood. “Our staff crafts some truly exceptional cocktails. It’s a great place for before and after dinner drinks.”

The pub’s moniker honors the legacy of Deadwood’s Preacher Henry Weston Smith, the first

preacher to minister in the Black Hills Gold Rush camps.

“Deadwood is all about history and we wanted to name something after Preacher Smith to keep his memory alive,” Galbraith explained. “Our guests will love the speakeasy-church vibe and the distinctive whiskey barrel ceiling.”

In addition to Preacher Smith’s, The Lodge at Deadwood Gaming Resort offers something for everyone with its array of modern amenities. Perched atop a hill at the north end of Deadwood, The Lodge features breathtaking 300-degree views of the Black Hills, along with 185 guest suites, luxurious amenities and abundant entertainment options.

“We have everything under one roof here,” Galbraith said. “The whole lodge is a great place to relax and unwind. It’s an atmosphere that everyone can enjoy.” ❖

News & Notes

AVERA

BENSON S. HSU

Dr. Benson S. Hsu, pediatric critical care physician at Avera Children’s Hospital, has been elected to the Board of Regents of the American College of Critical Care Medicine. Dr. Hsu is one of only 10 Fellows selected nationally for this prestigious position. Previously, he served as Chair of the Executive Committee of the American Academy of Pediatrics Section on Critical Care and has authored over 10 national policy statements and clinical practice guidelines. In 2020, he became the only critical care physician in South or

and connecting families with ongoing community resources. According to Feeding South Dakota, 106,000 South Dakotans face food insecurity, with 65% not qualifying for federal assistance programs.

JARED FRIEDMAN

Dr. Jared Friedman has been appointed chief medical officer for the Avera McKennan region, effective March 2. In this position, Dr. Friedman will represent physician perspectives to administration, promote effective physician-system relationships, and partner with leadership to implement regional strategies focused on clinical quality and cost-effective care. Dr. Friedman, who joined Avera McKennan as an emergency medicine physician in 2005, received his medical degree from the University of South Dakota and completed his residency at HealthPartners Institute/Regions Hospital in St. Paul. He succeeds Dr. Michael Elliott.

MONUMENT

The Helmsley Charitable Trust has granted more than $2 million to Children’s Monument Health for neonatal intensive care unit equipment. The funding will purchase more than 20 medical devices, including a high-frequency oscillatory ventilator, transport incubators, and a 24-hour EEG machine. These additions will enhance neonatal care within a 250-mile radius of Rapid City, serving communities across South Dakota, Nebraska, and Wyoming. The investment aims to improve outcomes while allowing families to access specialized care closer to home.

Monument Health’s Heart and Vascular Unit at Rapid City Hospital has received the silver-level Beacon Award for Excellence from the American Association of Critical-Care Nurses. The recognition acknowledges units demonstrating effective approaches to policies, procedures, and processes with strong staff engagement and performance metrics above relevant benchmarks. The award evaluation focused on six key areas: leadership structures, appropriate staffing, effective communication, evidence-based practices, outcome measurement, and knowledge management. The unit was recognized for consistent enhancement of patient outcomes.

SIOUXLAND

Twelve nurses from MercyOne owned and managed medical centers have been recognized as 2025 Great Iowa Nurses. The honorees include nurses from MercyOne facilities in Davenport, Knoxville, Des Moines, Dubuque, and Siouxland, along with affiliated hospitals Franklin General, Manning Regional, and Palo Alto County. The Great Iowa Nurses program selects outstanding nurses based on their contributions to patient care, leadership qualities, and mentoring roles. The annual recognition also provides financial support to nursing students pursuing advanced degrees. A virtual ceremony will celebrate this year’s honorees.

The MercyOne Siouxland Foundation has appointed three new members to its board of directors: Dawn Prosser from the Diocese of Sioux City, Clinton Vos of GCC Ready Mix, and Angel Wallace from the City of Sioux City. The Foundation operates as a separate 501(c)3 organization governed by a volunteer board led by Chair Saul Gomez of Gomez Pallets. The Foundation supports MercyOne Siouxland Medical Center’s mission by generating resources, promoting community involvement, and funding programs, facilities, and equipment purchases that would otherwise be unavailable due to budget constraints.

UnityPoint Health–St. Luke’s has completed renovations to its Emergency Department, funded by a $200,000 grant from Missouri River Historical Development. The improvements include an expanded waiting room, new fast-track triage bays, modernization of seven infusion rooms, and enhanced patient flow systems. The Siouxland Miracle Riders also supported funding for a pediatric room in the department, which will be unveiled at the end of March. The renovations were designed to enhance patient experience and provide more efficient care.

UnityPoint Health–St. Luke’s Siouxland PACE has been renamed UnityPoint Health PACE Senior Care – Siouxland, aligning with other UnityPoint Health PACE programs statewide. The change is part of UnityPoint Health’s expansion plan, which includes new PACE Senior Care programs in Bettendorf (2024), Waterloo and Hiawatha (2025), and Des Moines (2026). The Program of All-Inclusive Care for the Elderly helps seniors live independently in their homes and communities. Despite the name change, the program will continue to provide the same comprehensive care with the same staff.

UnityPoint Health–St. Luke’s has acquired the Ion endoluminal system, a robotic-assisted platform for minimally invasive lung biopsies. The system features an ultra-thin, ultra-maneuverable catheter that allows navigation into the peripheral lung with unprecedented stability for precise biopsies. Manufactured by Intuitive, makers of the da Vinci surgical system, the technology enables earlier and less invasive detection of lung cancer. Dr. Sandeep Gupta, pulmonologist with UnityPoint Health–St. Luke’s, notes the system will help detect lung cancer earlier while allowing patients to receive advanced care locally.

INDEPENDENTS

LifeScape celebrated the opening of its fifth adult residential home in eastern Sioux Falls on March 14, completing a five-year strategic initiative. The organization has built one new residential duplex annually since 2020, opening Continuum (2020), Linden (2022), Magnolia (2023), and Kennedy (2024 in Harrisburg). The one-story, organization-owned homes improve accessibility and maintenance efficiency for residents. The project represents a partnership between LifeScape, the South Dakota Department of Human Services, and the South Dakota Housing Development Authority. LifeScape’s adult residential program serves over 250 adults.

Brookings Health System has been recognized as a five-year champion on Newsweek ’s World’s Best Hospitals list, ranking 224 out of 420 U.S. hospitals for 2025. The facility is the only South Dakota hospital outside Sioux Falls to receive this recognition. Brookings Health also earned Newsweek’s Patient Experience Award for outstanding performance on the CMS HCAHPS survey. The evaluation methodology incorporated multiple data sources: hospital recommendations from healthcare professionals across 30 countries, patient satisfaction surveys, hospital quality metrics, and Patient Reported Outcome Measures.

CVx cardiovascular ultrasound system, enabling photorealistic echocardiograms. The system features improved penetration and resolution, 3D imaging capabilities, and strain technology for measuring myocardial deformation. These advancements allow earlier diagnosis of cardiac conditions through myocardial strain measurement, speckle-tracking echocardiography, and global longitudinal strain assessment. The technology is particularly valuable for early detection of conditions like cardiomyopathy, chemotherapy-induced cardiotoxicity, and heart failure, enhancing diagnostic precision for patients with suspected or confirmed heart disease.

AMANDA SEDLACEK

Dr. Amanda Sedlacek, a Board-Certified Internal Medicine and Palliative Medicine physician at Yankton Medical Clinic, presented at the 2025 Annual Assembly of Hospice and Palliative Care in Denver. Her two presentations focused on developing interprofessional team skills through palliative care simulation and facilitating palliative conversations through virtual interdisciplinary seminars. Dr. Sedlacek provides palliative care throughout the region, including telehealth consultations to Gregory, South Dakota and O’Neill, Nebraska, contributing significantly to advancing palliative care practices nationally.

LINDA REESE

Linda Reese, MPAS, PA-C, of Yankton Medical Clinic has been named the 2025 South Dakota Quitline Referral Champion for referring the most patients to the state’s tobacco cessation program in 2024. As part of Yankton Medical Clinic’s Pulmonary Team, Reese is recognized for her expertise in smoking cessation. The team also emphasizes the importance of low-dose CT lung cancer screening for eligible patients, including those aged 50-77 who are current smokers or have quit within 15 years with at least a 20 pack-year history. Yankton Medical Clinic is the region’s only healthcare facility accredited as a centralized lung cancer screening center.

Huron Regional Medical Center partnered with three local fitness centers to promote heart health during American Heart Month in February through the HRMC Heart Hustle initiative. Each participating gym hosted a free class and tour designed to engage community members in heart-healthy activities. Prior to each class, HRMC offered free cardiac risk screenings, including cholesterol, blood glucose, and blood pressure checks, funded by the HRMC Foundation. Participants also received heart health education, and those who attended all three classes received a Heart Hustle t-shirt from HRMC.

Huron Regional Medical Center recently recognized Koree Nowell, MLT, with the Beyond Exceptional Everyday (BEE) Award. Nowell, a medical laboratory technician at New Life Clinic, was nominated by a colleague for consistently demonstrating HRMC’s core values: being respectful, engaged, available, competent, and helpful. The quarterly award includes a meal certificate, employee store credit, professional photo session, $50, and a lapel pin.

Spencer Hospital recently welcomed over 350 first-grade students from the region for a Teddy Bear Clinic and hospital tour. The program familiarized children with the hospital environment through interactive stations in key departments, including a medical-surgical inpatient room, pre-op and recovery areas, rehabilitation services, laboratory, and diagnostic imaging. Each child received a teddy bear donated by the Build-A-Bear Foundation, accompanying their bear through wellness checks, laboratory tests, x-rays, and splint fittings. The event aimed to create positive associations with healthcare settings and reduce anxiety about potential future visits.

SANFORD

DEEANDRA SANDGREN TAMMI LEHTO CASSIE ZIELKE

Three Good Samaritan leaders have been recognized as 2025 McKnight’s Women of Distinction. DeeAndra Sandgren, Chief Nursing Officer in Sioux Falls, was named to the Hall of Honor for executives at vice president level or higher. Tammi Lehto, Administrator in Loveland, Colorado, received the Veteran VIP award recognizing leaders with over 15 years of experience. Cassie Zielke, Senior Director of Operations for Home-Based Services in Fargo, was recognized as a Rising Star for professionals with fewer than 15 years in the field or under age 40. The awards ceremony will be held May 13 in Chicago.

Five Sanford Health hospitals have been recognized by the American College of Cardiology in the ACC advertising insert in the 2025 U.S. News & World Report “Best Hospitals” Guidebook. The honored facilities include Sanford USD Medical Center and Sanford Aberdeen Medical Center in South Dakota, Sanford Medical Center Fargo and Sanford Medical Center Bismarck in North Dakota, and Sanford Bemidji Medical Center in Minnesota. The recognition highlights their participation in ACC quality programs, which use data-driven approaches to improve guideline adherence and overall cardiovascular care quality.

❱ Intrigued by something you’ve read here? Want to go deeper? Read the full versions of these and other recent news items on our website.

Helping Kids Reach Their Goals in a Shorter Amount of Time

LifeScape o ers a higher frequency of therapy services as part of our Intensify program.

Move and Groove: Improve strength and conditioning to improve developmental milestones and functional mobility skills. Power Mobility: Achieving increased mobility independence. Intensive Feeding: Team

Now scheduling evaluations for summer intensives. Refer your patients today!

Newsweek has named the Sanford USD Medical Center, located in Sioux Falls, South Dakota, to its list of World’s Best Hospitals for 2025. Sanford Health is ranked No. 54 out of 412 hospitals in the United States on the list. The Sanford USD Medical Center shares inclusion on the list’s top 100 hospitals with world-class health care organizations such as Mayo Clinic, Cleveland Clinic, Johns Hopkins Hospital and Massachusetts General Hospital. According to Newsweek, the ranking is based on an extensive evaluation process, including an online survey of thousands of medical experts (doctors, hospital managers and health care professionals), patient experience data, hospital quality metrics and a PROMs Implementation Survey.

AREA RURAL HOSPITALS ACHIEVE NATIONAL DISTINCTION

SEVERAL RURAL HOSPITALS

across South Dakota and Iowa have earned prestigious national recognition on the 2025 Chartis Center for Rural Health’s Top 100 lists, with some achieving the even more elite Top 20 status from the National Rural Health Association (NRHA).

Four area critical access hospitals in MED Magazine’s coverage area earned places on the Top 100 Critical Access Hospitals list. These facilities include Floyd Valley Healthcare (LeMars, IA), Avera Hand County Memorial Hospital (Miller, SD), Hans P Peterson Memorial Hospital (an Avera affiliate in Phillip, SD), and Madison Regional Health (Madison, SD).

“Being recognized for the 9th year in a row reflects something deeper than metrics,” says Matt Campion, Administrator at Avera Hand County Memorial Hospital. “It represents our team’s steadfast commitment to providing high-quality care close to home. In central South Dakota, where healthcare access can be limited by geography, this mission takes on profound significance.”

It’s a sentiment echoed by Madison Regional Health System CEO Teresa Mallett who attributes their Top 100 CAH designation to “remarkable employees whose commitment to excellence shapes every patient interaction.”

The region also finished strong in the Top 100 Rural & Community Hospitals category, with eight area facilities earning spots on this

Monument Health Spearfish Hospital, Spearfish, SD

Prairie Lakes Healthcare System, Watertown, SD

Brookings Health System, Brookings, SD

Madison Regional Hospital, Madison, SD

list. Iowa representatives in our coverage area include Lakes Regional Healthcare (Spirit Lake) and Spencer Hospital (Spencer). There were six honorees in South Dakota including Avera Sacred Heart Hospital (Yankton), Avera St. Luke’s Hospital (Aberdeen), Avera St. Mary’s Hospital (Pierre), Brookings Health System (Brookings), Monument Health Spearfish Hospital (Spearfish), and Prairie Lakes Healthcare System (Watertown).

Brookings Health System has maintained a presence on the Rural & Community Hospitals list since the program’s inception in 2016 but their performance in the 2025 assessment provided even more reason to celebrate. Their score of 99.9 percent ranks them as the highest-performing rural prospective payment system hospital nationwide.

FOUR AREA CRITICAL

ACCESS HOSPITALS IN MED

MAGAZINE’S COVERAGE AREA EARNED PLACES ON THE TOP 100 CRITICAL

ACCESS HOSPITALS LIST

“This recognition stems directly from our team’s dedication to providing world-class care with optimal outcomes for every patient, every time,” says Jason Merkley, President and CEO of Brookings Health System. Their approach has also earned Brookings Top 20 status from the National Rural Health Association for the eighth time since 2016—joining regional peers Avera Sacred Heart Hospital and Spencer Hospital in this elite category.

Similarly impressive is Prairie Lakes Healthcare System in Watertown, which has received Top 100 Rural & Community Hospital designation annually since the award’s creation. “Being one of only six South Dakota hospitals receiving this honor reflects our medical staff’s unwavering commitment to excellence,” says President and CEO John Allen.

Now in its 15th year, the Chartis Rural Hospital Performance INDEX provides comprehensive, objective evaluation across eight pillars of excellence, including quality, cost, and patient engagement. The INDEX utilizes publicly available data to assess performance metrics that serve as benchmarks for rural facilities nationwide. ❖

Lisa

Varenhorst, DNP

Degree: Doctor of Nursing Practice with focus on Systems Organizational Leadership

Current Position: Faculty Advisor/Instructor, USD BSN Undergraduate Program

For Lisa Varenhorst, the evolution from critical care nurse to educator was an entirely organic one. “I started my career at a critical access hospital in LeMars, Iowa and worked in NICU’s in Kansas City and at Sanford,” she recalls. “At one point, I had the opportunity to step into a nurse educator role in the NICU, so I did that.”

She quickly discovered her aptitude, not only for teaching others, but also for learning. Even while she was earning her master’s degree, Varenhorst was already setting her sights on her DNP. “I always knew that I was going to go on to get a doctorate,” she says.

But, as a mother of three children—one graduating high school and two in elementary school—finding a program that could accommodate her busy life was essential. USD’s Doctor of Nursing Practice program offered exactly what she needed.

“USD’s program was enticing for me largely because it was so flexible,” says Varenhorst. “Being able to say ‘I am only going halftime during the fall and spring semesters’ was huge for me.” The program’s individualized approach allowed her to create a study plan that respected her roles as both a professional and a parent.

Now, working as a faculty advisor and instructor in USD’s undergraduate nursing program, Varenhorst says USD’s rigorous DNP program shaped her own approach to education. “Previously, I would think, ‘This is how we do it because it’s how we do it.’ But now, I’m able to understand exactly why we do it the way we do it. And I can pass that on to students.”

Although she is not sure what direction her career will take next, Varenhorst says she is in a great position thanks to her USD education. “I think having a doctorate just sets a person up for the future. If something like a leadership role pops up, I have that leadership perspective. It gives you a leg up.”

This SUCCESS SPOTLIGHT brought to you by

BEYOND THE BORDER

In addition to MED Magazine in South Dakota, MED also curates and shares medical community news with 14,000+ digital subscribers in North Dakota, Nebraska, and Iowa. We periodically print some of the most notable news items from our wider coverage area.

NORTH DAKOTA

Virtual Reality Transforms Pediatric Care Experience

at Sanford Bismarck

The Sanford Health Foundation has announced a significant donation from K&L Homes and the Moldenhauer family that will bring virtual reality (VR) technology to pediatric patients at Sanford Bismarck. The VR headsets, now integrated into Sanford’s Child Life program, offer

immersive therapeutic experiences designed to help manage pain, reduce anxiety, and provide mental stimulation during medical procedures. Pediatric patients can access virtual experiences ranging from calming nature scenes to simulations of medical procedures like MRI scans.

“These VR headsets will offer pediatric patients an innovative tool to relax, escape and focus on healing, whether it’s through a calming meditation, an exciting virtual journey or therapeutic

simulations,” said Sara Haugen, Sanford Health Foundation Vice President.

Child Life specialists have received specialized training to utilize the technology during procedures such as blood draws and port access. The VR sessions can also help determine if children can undergo MRI procedures without sedation.

“It is important for me as both a member of this community and as a father, to be able to help children during a difficult time in their life,” says donor Chad Moldenhauer.

Innovative Scalp Cooling Technology Helps Cancer Patients Preserve Hair

Sanford Cancer Center is now offering the Paxman Scalp Cooling system to help reduce chemotherapy -induced hair loss—often cited as the most feared side effect of cancer treatment.

The technology, also known as “cold cap,” works by limiting damage to hair follicles during chemotherapy. Research shows the treatment is safe, relatively easy to tolerate, and does not interfere with

cancer treatment effectiveness. Success rates reach up to 70% for some chemotherapy regimens, with evidence suggesting faster and healthier hair regrowth even in cases where complete preservation isn’t achieved.

“Body image is a real struggle not only for the patient, but also for their family and friends,” says Sanford oncology nurse, Trisha James. “We are hoping to help

patients take back some control, to change how they feel when looking in the mirror, and to help their family and friends with a little bit more normalcy when cancer has tried to take everything away.”

The Sanford Health Foundation funded two Paxman Scalp Cooling machines, with financial assistance potentially available as the treatment is not typically covered by insurance.

NEBRASKA

Regional West Launches Community Paramedic Program to Bridge Rural Healthcare Gaps

Regional West Emergency Medical Services has introduced a community paramedic program designed to expand the role of their EMS team and address gaps in rural healthcare delivery.

This referral-based initiative connects paramedics with patients and families post-discharge to ensure understanding of care instructions and facilitate recovery at home. The program aims to reduce unnecessary Emergency Department visits and hospital readmissions while helping patients access appropriate community resources.

“When patients or their families are going through a healthcare event, they may not have questions immediately, but they might in the 36 hours post discharge when they’re home and going through their instructions or their new medications,” said community paramedic Robby Rhembrandt, NRP. “We’re there to help them through that.”

Regional West EMS Director Shawn Baumgartner, NRP, ASM, emphasized that the program complements existing services: “All of our community services have their niche, and they are all important niches. This program is a way for us to plug patients into these services so that they are getting the right care for them.”

IOWA

MercyOne Clinton Wound Care Center Earns Dual National Recognition

MercyOne Clinton Wound Care and Hyperbaric Center has received two prestigious achievement awards from RestorixHealth, recognizing exceptional patient care and outcomes.

The center earned the Clinical Distinction Award for exceeding national healing benchmarks with a 90% healing rate and median 32 days to heal. Additionally, the Excellence in Patient Satisfaction Award acknowledges the center’s success in surpassing the national patient satisfaction benchmark of 96%.

“This achievement reaffirms MercyOne’s commitment to patient experience and optimized outcomes,” says WCC Area Program Director, Adrienne Page, RN. “We can only accomplish this because of the effort and dedication of our tireless center staff, providers, and hospital support.”

April 1 – 2

8:00 am – 5:00 pm

UPCOMING 2025 EVENTS

2025 Public Health Conference of Iowa

Location: Airport Holiday Inn, Des Moines, IA

April 3

9:00 am – 4:00 pm

4th Annual Legal Workshop on Child Welfare Law

Location: USD MUC Ballroom, Vermillion, SD

April 4

6:30 pm – 10:00 pm

Pioneer Memorial Foundation Extravaganza

Location: Viborg Community Center, Viborg, SD

April 8 – 9

8:00 am – 5:00 pm

SDAHO Post-Acute Partners in Care Conference

Location: Sioux Falls, SD

April 23 – 24

2:00 pm

SDAHO Healthcare Leadership Essentials – Crucial Conversations

Location: Convention Center at Cedar Shore, Oacoma, SD

April 24

8:30 am – 4:00 pm

Castle of Care Symposium: Trauma, Emergency and Critical Care 2025

Location: Sanford Center, Sioux Falls, SD

April 24 – 25

8:00 am – 5:00 pm

Iowa Healthcare Leaders Association (IHLA) Spring Conference

Location: Renaissance Des Moines Savery Hotel, Des Moines, IA

May 13 – 14

8:00 am – 5:00 pm

2025 Avera PACE Conference and Tradeshow

Location:Sioux Falls Convention Center, Sioux Falls, SD

May 20

4:00 pm – 5:00 pm

2025 Avera Lung Conference

Location: Sioux Falls, SD

May 21

1:00 pm – 2:30 pm

SDAHO Healthcare Leadership Essentials -Principles of Health Care Finance

Location: Virtual

May 31

9:00 am – 1:00 pm

National Cancer Survivors Day

Location: Monument Health Cancer Institute

June 13

12:00 pm – 5:00 pm

Pioneer Memorial 18th Annual Golf Fundraiser

Location: Glenridge Golf Course, Irene, SD

June 17 – 19

8:00 am – 5:00 pm

2025 Dakota Conference on Rural and Public Health

Location: Bismarck Event Center, Bismarck, ND

June 18

1:00 pm – 2:30 pm

SDAHO Healthcare Leadership Essentials - Human Resources: Legal Aspects of Management

Location: Virtual

June 25 – 26

8:00 am – 5:00 pm

SDAHO Rural Health Leaders Conference

Location: Drifter’s Event Center, Fort Pierre, SD

September 11 – 12

8:00 am – 5:00 pm

Iowa Healthcare Leaders Association (IHLA) Fall Conference

Location: Hilton Garden Inn, West Des Moines, IA

September 19

8:00 am – 4:00 pm

CNOS Occupational Medicine Symposium

Location: Holiday Inn Express, Dakota Dunes, SD

September 24 – 26

8:00 am – 5:00 pm

99th Annual SDAHO Convention

Location: Sioux Falls, SD

October 16

8:00 am – 5:00 pm

11th Annual SD Health Link Fall Forum

Location: Sioux Falls Convention Center, Sioux Falls, SD

October 17

8:00 am – 4:00 pm

CNOS Orthopaedic Sports Medicine Symposium

Location: Holiday Inn Express, Dakota Dunes, SD

Matt Rushing Person in Recovery

Let’s be clear: as a caregiver, you play a vital role in reducing stigma and helping patients navigate the path to recovery. Suboxone is just one form of MOUD, but different options are available based on each treatment plan. Learn more about MOUD and other evidence-based treatment strategies at LetsBeClearSD.com