STRATEGY STUDIO / PUBLIC DATA EXPLORER

PHILIP HEALTH SERVICES INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
PHILIP HEALTH SERVICES INC (EIN 46-0361016)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-14
IRS object ID
202323189349312607
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-14T15:52:26-05:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN460393458PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WOHLENBERG RITZMAN & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1018AddressLine1Txt
CityYANKTONCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57078ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN460361016EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PHILIP HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPHILBusinessNameControlTxt
Phone6058592511PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1503 WEST PINE STREETAddressLine1Txt
CityPHILIPCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57567ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMAUREEN CADWELLPersonNm
Person TitleCHIEF EXECUTIVE OFFIPersonTitleTxt
Phone6058593908PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMAUREENPersonFirstNm
Person LastCADWELLPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKATHLEEN DOYLEPreparerPersonNm
PTINP01322431PTIN
Phone6056654401PhoneNum
Preparation2023-11-06PreparationDt
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMAUREEN CADWELLPrincipalOfficerNm
Gross Receipts$18,671,227GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PHILIPHEALTHSERVICES.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1953FormationYr
Legal Domicile StateSDLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH CARE TO PHILIP, SD & SURROUNDING AREASActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee190TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,964,988PYContributionsGrantsAmt
CY Contributions Grants$540,512CYContributionsGrantsAmt
PY Program Service Revenue$15,804,465PYProgramServiceRevenueAmt
CY Program Service Revenue$17,506,150CYProgramServiceRevenueAmt
PY Investment Income$25,567PYInvestmentIncomeAmt
CY Investment Income-$35,095CYInvestmentIncomeAmt
CY Other Revenue$443,873CYOtherRevenueAmt
PY Total Revenue$17,795,020PYTotalRevenueAmt
CY Total Revenue$18,455,440CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,985,444PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,080,127CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$12,205CYTotalFundraisingExpenseAmt
PY Other Expenses$5,917,430PYOtherExpensesAmt
CY Other Expenses$7,168,628CYOtherExpensesAmt
PY Total Expenses$14,902,874PYTotalExpensesAmt
CY Total Expenses$17,248,755CYTotalExpensesAmt
PY Revenues Less Expenses$2,892,146PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,206,685CYRevenuesLessExpensesAmt
Total Assets BOY$22,337,668TotalAssetsBOYAmt
Total Assets EOY$25,286,939TotalAssetsEOYAmt
Total Liabilities BOY$7,188,058TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,936,541TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,149,610NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,350,398NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH CARE TO PHILIP, SD & SURROUNDING AREASMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$12,670,201ExpenseAmt
Revenue$17,506,150RevenueAmt
DescTHE FACILITY OPERATES A CRITICAL ACCESS HOSPITAL IN PHILIP, SD PROVIDING SHORT TERM INPATIENT, OUTPATIENT AND EMERGENCY HEALTH CARE SERVICES. THE FACILITY ALSO OPERATES AN ASSISTED LIVING FACILITY PROVIDING RESIDENTIAL CARE SERVICES, A SKILLED NURSING FACILITY PROVIDING LONG TERM NURSING HOME CARE, AND CLINIC FACILITIES FOR PHYSICIAN SERVICES.Desc
Total Program Service Expenses$12,670,201TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee190EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonORGANIZATIONPersonNm
Phone6058592511PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 790AddressLine1Txt
CityPHILIPCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57567ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
DAVID HOLMAN MD
EMPLOYEE40.00Yes (X)$325,077$0$15,103
KERRY BLACKHAM
EMPLOYEE40.00$316,826$0$11,706Yes (X)
COENRAAD KLOPPER MD
EMPLOYEE40.00$264,010$0$11,705Yes (X)
JEREMY SCHULTES
CHIEF EXECUT40.00$0$186,218$27,680Yes (X)
TERRY HENRIE
EMPLOYEE40.00$177,501$0$0Yes (X)
DON BURNS
PRESIDENT1.00$0$0$0Yes (X)Yes (X)
LARRY GABRIEL
VICE PRESIDE1.00$0$0$0Yes (X)Yes (X)
KAREN KROETCH
DIRECTOR1.00$0$0$0Yes (X)
RITA O'CONNELL
DIRECTOR1.00$0$0$0Yes (X)
RUSTY OLNEY
DIRECTOR1.00$0$0$0Yes (X)
DJ RUSH
DIRECTOR1.00$0$0$0Yes (X)
RAY SMITH
DIRECTOR1.00$0$0$0Yes (X)
MAUREEN CADWELL
CHIEF EXECUT$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,083,414TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$186,218TotReportableCompRltdOrgAmt
Total Other Compensation$66,194TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K21IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
RANGEL CONSTRUCTION
2626 W MAIN STREETRAPID CITYSD57702CONTRACTOR$1,443,735
MONUMENT HEALTH
PO BOX 3450RAPID CITYSD57709STAFFING/IT$1,201,590
ROVE STAFFING LLC
PO BOX 31001PASADENACA91110NURSES$932,243
COUNTRY CARPET & FLOORING
414 EAST SIOUXPIERRESD57501CONTRACTOR$246,416
ONE STAFF MEDICAL
PO BOX 3544OMAHANE68103NURSES$213,255
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Government Grants$480,598GovernmentGrantsAmt
All Other Contributions$59,914AllOtherContributionsAmt
Total Contributions$540,512TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621990$17,371,195$17,371,195
OTHER OPERATING REVENUE621990$134,955$134,955
FieldValueIRS element (for citing)
Total Program Service Revenue$17,506,150TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$62,053TotalRevenueColumnAmt
Exclusion$62,053ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$118,639SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$215,787SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$97,148SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$97,148TotalRevenueColumnAmt
Related Or Exempt Func Income-$97,148RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAPITAL INSURANCE PROCEEDSDesc
Business621990BusinessCd
Total Revenue Column$443,873TotalRevenueColumnAmt
Related Or Exempt Func Income$443,873RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$443,873OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,455,440TotalRevenueColumnAmt
Related Or Exempt Func Income$17,852,875RelatedOrExemptFuncIncomeAmt
Exclusion$62,053ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$213,897TotalAmt
Management And General$213,897ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,254,516TotalAmt
Program Services$6,786,951ProgramServicesAmt
Management And General$1,467,565ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$179,532TotalAmt
Program Services$161,579ProgramServicesAmt
Management And General$17,953ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$889,104TotalAmt
Program Services$698,924ProgramServicesAmt
Management And General$190,180ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$543,078TotalAmt
Program Services$442,362ProgramServicesAmt
Management And General$100,716ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$15,720TotalAmt
Management And General$15,720ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,681TotalAmt
Management And General$37,681ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,738,228TotalAmt
Program Services$2,295,193ProgramServicesAmt
Management And General$430,830ManagementAndGeneralAmt
Fundraising$12,205FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$50,281TotalAmt
Program Services$3,332ProgramServicesAmt
Management And General$46,949ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$50,259TotalAmt
Program Services$6,868ProgramServicesAmt
Management And General$43,391ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$21,000TotalAmt
Program Services$21,000ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,927,750TotalAmt
Program Services$1,627,345ProgramServicesAmt
Management And General$1,300,405ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$123,704TotalAmt
Program Services$99,657ProgramServicesAmt
Management And General$24,047ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$122,702TotalAmt
Program Services$87,844ProgramServicesAmt
Management And General$34,858ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,081,303TotalAmt
Program Services$439,146ProgramServicesAmt
Management And General$642,157ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,248,755TotalAmt
Program Services$12,670,201ProgramServicesAmt
Management And General$4,566,349ManagementAndGeneralAmt
Fundraising$12,205FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,817,228BOYAmt
EOY$8,619,754EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$198,036BOYAmt
EOY$114,053EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,751,986BOYAmt
EOY$1,984,889EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$64,919BOYAmt
EOY$107,450EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$296,758BOYAmt
EOY$320,451EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$37,860BOYAmt
EOY$75,730EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$21,599,749LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,682,783LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,125,866BOYAmt
EOY$12,916,966EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$31,322BOYAmt
EOY$25,826EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,013,693BOYAmt
EOY$1,121,820EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$22,337,668BOYAmt
EOY$25,286,939EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,722,427BOYAmt
EOY$1,465,059EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$436,677BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,953,676BOYAmt
EOY$7,422,004EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$75,278BOYAmt
EOY$49,478EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,188,058BOYAmt
EOY$8,936,541EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,853,411BOYAmt
EOY$16,180,518EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$296,199BOYAmt
EOY$169,880EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,149,610BOYAmt
EOY$16,350,398EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,337,668BOYAmt
EOY$25,286,939EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,206,685ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$5,897NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$123,035OtherCostOrOtherBasisAmt
Book Value$123,035BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,439,198OtherCostOrOtherBasisAmt
Depreciation$5,627,839DepreciationAmt
Book Value$9,811,359BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,396,338OtherCostOrOtherBasisAmt
Depreciation$2,630,119DepreciationAmt
Book Value$1,766,219BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,641,178OtherCostOrOtherBasisAmt
Depreciation$424,825DepreciationAmt
Book Value$1,216,353BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,916,966TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescCAPITAL LEASE OBLIGATIONDesc
Amt$49,478Amt
FieldValueIRS element (for citing)
Total Liability$49,478TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$18,449,543TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$5,897NetUnrealizedGainsInvstAmt
Revenue Not Reported-$5,897RevenueNotReportedAmt
Revenue Subtotal$18,455,440RevenueSubtotalAmt
Total Revenue Per Form990$18,455,440TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$17,248,755TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$17,248,755ExpensesSubtotalAmt
Total Expenses Per Form990$17,248,755TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationTHE FACILITY IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. HOWEVER, THE FACILITY CAN BE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE FACILITY HAS NO RESERVE FOR UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. ADDITIONALLY, THE FACILITY HAS NOT RECOGNIZED ANY INTEREST OR PENALTIES IN RELATION TO INCOME TAX FILINGS AS OF OR FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$46,169TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$46,169NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,626,731TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,063,194DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,672,900TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,063,194DirectOffsettingRevenueAmt
Net Community Benefit Expns$46,169NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,001,401TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$460,071DirectOffsettingRevenueAmt
Net Community Benefit Expns$541,330NetCommunityBenefitExpnsAmt
Total Expense0.03140TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,001,401TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$460,071DirectOffsettingRevenueAmt
Net Community Benefit Expns$541,330NetCommunityBenefitExpnsAmt
Total Expense0.03140TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,674,301TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,523,265DirectOffsettingRevenueAmt
Net Community Benefit Expns$587,499NetCommunityBenefitExpnsAmt
Total Expense0.03410TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$85,774TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$85,774NetCommunityBenefitExpnsAmt
Total Expense0.00500TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$85,774TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$85,774NetCommunityBenefitExpnsAmt
Total Expense0.00500TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$463,082BadDebtExpenseAmt
Reimbursed By Medicare$8,423,096ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$8,359,331CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$63,765MedicareSurplusOrShortfallAmt
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HANS P PETERSON MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1503 W PINE STAddressLine1Txt
CityPHILIPCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57567ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.PHILIPHEALTHSERVICES.COMWebsiteAddressTxt
State License10555StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HANS P PETERSON MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.PHILIPHEALTHSERVICES.COMOwnWebsiteURLTxt
Implementation Strategy AdoptfalseImplementationStrategyAdoptInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.PHILIPHEALTHSERVICES.COMFAPAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.PHILIPHEALTHSERVICES.COMFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, HANS P PETERSON MEMORIAL HOSPITAL - PART V, LINE 5AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THERE WERE KEY INFORMANT FOCUS GROUPS HELD IN THE REGION - THESE FOCUS GROUPS ALLOWED FOR INPUT FROM PERSONS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH, AS WELL AS OTHERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. TO OBTAIN ADDITIONAL INPUT FROM LOCAL RESIDENTS AND HEALTH CARE STAKEHOLDERS, THE HOSPITAL CONDUCTED AN ADDITIONAL SERIES OF FOCUS GROUPS IN 2021 WITH RESIDENTS FROM PHILIP, HAAKON COUNTY AND JACKSON COUNTY.
FACILITY 1, HANS P PETERSON MEMORIAL HOSPITAL - PART V, LINE 6ATHE COMMUNITY HEALTH NEEDS ASSESSMENT WAS SPONSORED BY A PARTNERSHIP BETWEEN HANS P PETERSON MEMORIAL HOSPITAL AND MONUMENT HEALTH
FACILITY 1, HANS P PETERSON MEMORIAL HOSPITAL - PART V, LINE 11AREAS OF OPPORTUNITY WERE PRIORITIZED AS FOLLOWS: 1.) MENTAL HEALTH; 2.) SUBSTANCE ABUSE; 3.) DIABETES; 4.) NUTRITION, PHYSICAL ACTIVITY & WEIGHT; 5.) TOBACCO USE; 6.) CANCER; 7.) INJURY & VIOLENCE PREVENTION; 8.) HEART DISEASE & STROKE; 9.) INFANT HEALTH & FAMILY PLANNING; 10.) ACCESS TO HEALTH CARE SERVICES; 11.) POTENTIALLY DISABLING CONDITIONS; 12.) SEXUAL HEALTH. IN ACKNOWLEDGING THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, THE HOSPITAL DETERMINED THAT IT COULD ONLY EFFECTIVELY FOCUS ON THOSE WHICH IT DEEMED MOST PRESSING, MOST UNDERADDRESSED, AND MOST WITHIN ITS ABILITY TO INFLUENCE. DUE TO LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS THESE HEALTH PRIORITIES, THE FOLLOWING WERE NOT CHOSEN FOR ACTION: SUBSTANCE ABUSE AND TOBACCO USE AND CANCER. REGARDING INJURY & VIOLENCE PREVENTION, THE HOSPITAL BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY AND LAW ENFORCEMENT ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA FOR ACTION.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
PHILIP NURSING HOME
503 WEST PINEPHILIPSD57567NURSING HOME
SILVERLEAF ASSISTED LIVING FACILTIY
519 WEST PINEPHILIPSD57567ASSISTED LIVING FACILITY
PHILIP CLINIC
507 WEST PINEPHILIPSD57567RURAL HEALTH CLINIC
KADOKA CLINIC
601 CHESTNUT STREETKADOKASD57543RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3CPATIENT COMPLETES AN APPLICATION WHICH GATHERS FINANCIAL INFORMATION RELATED TO THE PATIENT. NET WORTH IS CONSIDERED IN DETERMINING FREE OR DISCOUNTED CARE. DEBT OWED TO THE HOSPITAL MUST BE MORE THAN 20% OF THE PATIENT'S NET WORTH TO QUALIFY FOR FREE OR DISCOUNTED CARE. FAP ELIBIBLE INDIVIDUALS ARE NEVER CHARGED MORE THAN AGB.
SCHEDULE H, PART III, LINE 2THE FACILITY PROVIDES ALLOWANCES FOR DOUBTFUL RECEIVABLES EQUAL TO THE ESTIMATED COLLECTION LOSSES. THE ESTIMATED COLLECTION LOSSES ARE BASED ON HISTORICAL COLLECTION EXPERIENCE COUPLED WITH REVIEW OF THE CURRENT STATUS OF THE EXISTING RECEIVABLES.
SCHEDULE H, PART VI, LINE 2FACILITY MANAGEMENT, AS PART OF ITS OPERATIONAL PLANNING PROCESS, CONTINUALLY EVALUATES OPPORTUNITIES TO ADD NEW SERVICES TO THE CLINICAL SPECTRUM. SERVICES AVAILABLE IN THE REMOTE LOCATION ARE EVALUATED BASED ON THE CLINIAL CAPABILITIES OF THE AVAILABLE MEDICAL STAFF PROVIDERS AND SUPPORTIVE CLINICAL RESOURCES. THOSE FACTORS ARE BALANCED WITH THE NUMBER OF PEOPLE IN THE SERVICE AREA WHO DEMONSTRATE THE NEED FOR THOSE SERVICES. CLINICAL MODELS AND BUSINESS MODELS ARE MATCHED AND MONITORED OVER THE COURSE OF TIME TO DETERMINE THE FEASIBILITY OF NEW AND/OR EXISTING SERVICESS OFFERD IN THE COMMUNITY.
SCHEDULE H, PART VI, LINE 3SIGNS ARE POSTED AT ENTRANCES INFORMING THE PUBLIC OF THE COMMUNITY BENEFIT PROGRAM.
SCHEDULE H, PART VI, LINE 4THE ORGANIZATION SERVES THE SMALL TOWNS (POPULATIONS ARE LESS THAN 700) OF PHILIP, KADOKA, MIDLAND, WALL AND OTHERS, AS WELL AS THE RURAL RESIDENTS OF WESTERN SOUTH DAKOTA. THERE IS NO OTHER AVAILABLE HEALTH CARE WITHIN 90 MILES.
SCHEDULE H, PART VI, LINE 5PHILIP HEALTH SERVICES, INC, A NON-PROFIT COMMUNITY OWNED CORPORATION, HAS BEEN ABLE TO CONTINUE TO OFFER PRIMARY MEDICAL CARE TO THIS AREA IN LARGE PART DUE TO THE SUPPORT OF THE COMMUNITY AND THE LEARDERSHIP OF THE BOARD OF DIRECTORS. ALL NET GAINS ARE INVESTED BACK INTO THE ORGANIZATION TO MAINTAIN CURRENT SERVICES AND EXPAND SERVICES.
SCHEDULE H, PART VIPART III, SEC B, LINE 8 - COMMUNITY BENEFIT THE MEDICARE SHORT FALL IS ALL CONSIDERED COMMUNITY BENEFIT. THERE IS NO ADDITIONAL FUNDING SOURCE TO OFFSET THE MEDICARE SHORTFALL. SERVICES ARE PROVIDED TO MEDICARE BENEFICIARIES IN ALL AREAS OF THE HOSPITAL KNOWING THAT MEDICARE COSTS WILL NOT BE FULLY RECOVERED.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
DAVID HOLMAN MD
EMPLOYEE$325,077$15,103$340,180
KERRY BLACKHAM
EMPLOYEE$316,826$11,706$328,532
COENRAAD KLOPPER MD
EMPLOYEE$264,010$11,705$275,715
JEREMY SCHULTES
CHIEF EXECUTIVE OFFI$186,218$7,991$19,689$213,898
TERRY HENRIE
EMPLOYEE$177,501$177,501

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 1, PART I, LINE 6BOARD MEMBERS SERVE WITHOUT COMPENSATION VOLUNTEERS ENTERTAIN NURSING RESIDENTS
FORM 990, PAGE 6, PART VI, LINE 7AMEMBERS ELECT THE GOVERNING BOARD AT THE ANNUAL MEETING
FORM 990, PAGE 6, PART VI, LINE 7BBOARD DECISIONS ARE NOT SUBJECT TO APPROVAL OF MEMBERS
FORM 990, PAGE 6, PART VI, LINE 11BCHIEF EXECUTIVE REVIEWS 990 WHICH IS PREPARED BY AN AUDITING FIRM
FORM 990, PAGE 6, PART VI, LINE 12COFFICERS, DIRECTORS AND KEY EMPLOYEES REQUIRED TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS
FORM 990, PAGE 6, PART VI, LINE 15AANNUAL BOARD EVALUATION CONDUCTED WITH INPUT FROM REGIONAL HEALTH PERSONNEL
FORM 990, PAGE 6, PART VI, LINE 15BPHYSICIANS HAVE EMPLOYMENT CONTRACTS
FORM 990, PAGE 6, PART VI, LINE 18GUIDESTAR.COM
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS ARE MADE AVAILABLE ON REQUEST
FORM 990, PART IX, LINE 11GCONSULTANT & MGMT 145,116 393,270 0 EDUCATION/TRAINING 21,066 1,860 0 MAINTENANCE CONTRACT 96,095 34,242 0 PHYSICIAN FEES 54,841 0 0 PROFESSIONAL FEES-OTHER 0 0 12,205 RECRUITMENT 91,002 1,458 0 REFERENCE LAB 168,883 0 0 NURSING SERVICES-NON PHYS 1,718,190 0 0 TOTAL 2,295,193 430,830 12,205

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MONUMENT HEALTHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 6000AddressLine1Txt
CityRAPID CITYCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57709ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesREIMBURSEMPrimaryActivitiesTxt
Legal Domicile StateSDLegalDomicileStateCd
Exempt Code Section501ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MONUMENT HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypePTransactionTypeTxt
Involved$1,216,451InvolvedAmt
Method Of Amount DeterminationCASH EXPENDITURESMethodOfAmountDeterminationTxt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE RFormAndLineReferenceDesc
ExplanationON OCTOBER 1, 2011, THE FACILITY ENTERED INTO A MANAGEMENT AGREEMENT WITH MONUMENT HEALTH (MH) TO PROVIDE SERVICES TO THE HOSPITAL, CLINICS AND ASSISTED LIVING FACILITY. MH PROVIDES THE FOLLOWING SERVICES; ADMINISTRATOR, SUPPORTING SERVICES, OTHER SPECIFIC SERVICES, ATTENDANCE AT MEETINGS, REPORTS AND EDUCATION. IN CONSIDERATION FOR THESE SERVICES, THE FACILITY REIMBURSES MH 100% OF THE ADMINISTRATORS BASE SALARY AND BENEFITS, REIMBURSES MH 2,582 PER MONTH FOR OTHER SPECIFIC SERVICES AND REIMBURSES MH THE ACTUAL COST OF SUPPORTING SERVICES. THE AGREEMENT TERMINATED ON SEPTEMBER 30,2021. THE FACILITY ENTERED INTO A NEW MANAGEMENT AGREEMENT WITH MONUMENT HEALTH (MH) FOR THE SAME SERVICES AS THE PRIOR AGREEMENT ON OCTOBER 1, 2021. THE NEW AGREEMENT EXPIRES SEPTEMBER 30, 2031. EITHER PARTY MAY TERMINATE THE AGREEMENT SOONER, WITH OR WITHOUT CAUSE, BY GIVING 90 DAYS WRITTEN NOTICE OF TERMINATION.ExplanationTxt