PRAIRIE LAKES HEALTH CARE SYSTEM INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PRAIRIE LAKES HEALTH CARE SYSTEM INC (EIN 46-0391067)
- Tax period
- 2017-06-01 to 2018-05-31
- Filed
- 2019-04-15
- IRS object ID
- 201921059349301617
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-04-15T16:37:56-05:00 | ReturnTs |
| Tax Period End | 2018-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460391067 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE LAKES HEALTH CARE SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRAI | BusinessNameControlTxt |
| Phone | 6058827000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1210 | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ADAM POPP | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6058827000 | PhoneNum |
| Signature | 2019-04-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARTY LIENAU | PreparerPersonNm |
| PTIN | P00001025 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Preparation | 2019-04-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-04-15 | IPDt |
| IP Tm | 14:19:13 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0D02E0A3C8BE6705165B811C19B3E98A210D925A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 48DF7E18B51ED0D4ADE189227F60937B8E503023 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KC DEBOER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1210 | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $309,078,994 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PRAIRIELAKES.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | HEALTH CARE SERVICES | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 671 | TotalEmployeeCnt |
| Total Volunteers | 205 | TotalVolunteersCnt |
| Total Gross UBI | $1,064,159 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $271,409 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $102,050 | PYContributionsGrantsAmt |
| CY Contributions Grants | $395,556 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $96,483,900 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $95,150,271 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,723,446 | PYInvestmentIncomeAmt |
| CY Investment Income | $17,511,185 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,591,546 | PYOtherRevenueAmt |
| CY Other Revenue | $1,716,644 | CYOtherRevenueAmt |
| PY Total Revenue | $111,900,942 | PYTotalRevenueAmt |
| CY Total Revenue | $114,773,656 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,301,132 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $428,079 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $45,087,234 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $48,200,470 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $47,823,644 | PYOtherExpensesAmt |
| CY Other Expenses | $48,667,500 | CYOtherExpensesAmt |
| PY Total Expenses | $95,212,010 | PYTotalExpensesAmt |
| CY Total Expenses | $97,296,049 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $16,688,932 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $17,477,607 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $308,032,192 | TotalAssetsBOYAmt |
| Total Assets EOY | $329,183,316 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $63,988,101 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $60,880,353 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $244,044,091 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $268,302,963 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PRAIRIE LAKES HEALTH CARE SYSTEM THROUGH THE EFFORTS OF ITS DEDICATED EMPLOYEES AND PHYSICIANS, PROVIDES ACCESSIBLE, HIGH QUALITY, AFFORDABLE, AND COMPASSIONATE HEALTHCARE SERVICES FOR THE PEOPLE IN THE REGION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $84,574,102 | ExpenseAmt |
| Grant | $428,079 | GrantAmt |
| Revenue | $95,150,271 | RevenueAmt |
| Desc | PRAIRIE LAKES HEALTH CARE SYSTEM SERVES TEN COUNTIES IN NORTHEASTERN SOUTH DAKOTA AND WESTERN MINNESOTA AS A RURAL, REGIONAL MEDICAL CENTER. IT IS COMMITTED TO PROVIDING ACCESSIBLE, HIGH QUALITY, COST-EFFECTIVE HEALTHCARE SERVICES AS IT MANAGES EFFECTIVELY THE TRANSITION TO NEW PAYMENT AND CARE DELIVERY MODELS. TWENTY-THREE SPECIALTY PHYSICIANS HAVE BEEN RECRUITED OVER THE PAST DECADE TO BUILD NEW SERVICES AND BETTER SERVE THE NEEDS OF THE REGION. A NEW EAR, NOSE & THROAT PHYSICIAN JOINED THE STAFF IN 2018 AND A PULMONOLOGIST WILL BE JOINING IN 2019 AFTER COMPLETING RESIDENCY. | Desc |
| Total Program Service Expenses | $84,574,102 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 117 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 671 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADAM POPP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6058827000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 9TH AVENUE NW | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JIM REDLINGER | |||||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROBB PETERSON | |||||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DOUG SHARP | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| VINCE FOLEY | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| MARK ROBY | |||||||||
| PAST CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN CALVIN | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALAN CHRISTENSEN MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CATHERINE GERRISH MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| BERNIE HANSON MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MONTE HOPPER | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| SHANNON KRUSE | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GERALD RIEBER MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JILL FULLER | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $538,710 | $0 | $29,949 | 1.00 | |||
| D ADAM POPP | |||||||||
| CHIEF FINANCIAL OFFICER (FROM JANUARY 2018) | 40.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| ADAM PAUL | |||||||||
| CHIEF FINANCIAL OFFICER (THROUGH NOVEMBER 2017) | 40.00 | Yes (X) | $305,127 | $0 | $30,089 | 1.00 | |||
| MICHAEL ANDERSON | |||||||||
| CHIEF INVESTMENT OFFICER | 40.00 | $396,986 | $0 | $24,525 | Yes (X) | ||||
| NATE LAKE | |||||||||
| VICE PRESIDENT | 40.00 | $228,506 | $0 | $37,523 | 1.00 | Yes (X) | |||
| TRACI RABINE | |||||||||
| VICE PRESIDENT | 40.00 | $228,452 | $0 | $36,061 | Yes (X) | ||||
| MICHELE TURBAK | |||||||||
| CHIEF NURSING OFFICER | 40.00 | $234,010 | $0 | $30,192 | Yes (X) | ||||
| GRANT TILLETT | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | $211,984 | $0 | $32,797 | Yes (X) | ||||
| EVELIO GARCIA MD | |||||||||
| PHYSICIAN | 40.00 | $1,203,394 | $0 | $31,632 | Yes (X) | ||||
| SALEM MAALIKI MD | |||||||||
| PHYSICIAN | 40.00 | $1,081,060 | $0 | $31,632 | Yes (X) | ||||
| RICHARD HOWARD MD | |||||||||
| PHYSICIAN | 40.00 | $758,310 | $0 | $31,632 | Yes (X) | ||||
| JEFFREY SMITH MD | |||||||||
| PHYSICIAN | 40.00 | $700,000 | $0 | $31,632 | Yes (X) | ||||
| BIPIN AMIN MD | |||||||||
| PHYSICIAN | 40.00 | $610,000 | $0 | $25,425 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,496,539 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $373,089 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 45 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | LOCUM PHYSICIANS | $978,751 |
| WAPTIT MEDICAL GROUP | |||||
| 107 FLYNN DRIVE STE 600 | MILBANK | SD | 57252 | LOCUM ER PHYSICIANS | $679,858 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | LOCUM PHYSICIANS | $572,678 |
| NATIONAL MEDICAL RESOURCES INC | |||||
| 2792 E BROADWAY AVE | BISMARCK | ND | 58501 | LOCUM HOSPITAL/PHYSICIANS | $520,201 |
| ALI CHAUDHRY MD | |||||
| 5981 MONTERRA CLUB DRIVE | LAKE WORTH | FL | 33463 | HOSPITALS LOCUM | $487,230 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $395,556 | AllOtherContributionsAmt |
| Total Contributions | $395,556 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621400 | $94,086,112 | $94,086,112 | |
| RETAIL PHARMACY | 446110 | $894,792 | $894,792 | |
| LAB SERVICE | 621500 | $169,367 | $169,367 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $95,150,271 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $719,232 | TotalRevenueColumnAmt |
| Exclusion | $719,232 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,015,097 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,015,097 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,015,097 | TotalRevenueColumnAmt |
| Exclusion | $1,015,097 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $211,095,662 | SecuritiesAmt |
| Other | $1,629 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $194,279,807 | SecuritiesAmt |
| Other | $25,531 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,815,855 | SecuritiesAmt |
| Other | -$23,902 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,791,953 | TotalRevenueColumnAmt |
| Exclusion | $16,791,953 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER INCOME | 900099 | $378,968 | $378,968 |
| CAFETERIA REVENUE | 722210 | $307,303 | $307,303 |
| CASUALTY LOSS | 900000 | $12,219 | $12,219 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,057 | TotalRevenueColumnAmt |
| Exclusion | $3,057 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $701,547 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $114,773,656 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $94,086,112 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,064,159 | UnrelatedBusinessRevenueAmt |
| Exclusion | $19,227,829 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428,079 | TotalAmt |
| Program Services | $428,079 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,606,499 | TotalAmt |
| Management And General | $2,606,499 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,351,300 | TotalAmt |
| Program Services | $35,183,731 | ProgramServicesAmt |
| Management And General | $4,167,569 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $823,672 | TotalAmt |
| Program Services | $787,042 | ProgramServicesAmt |
| Management And General | $36,630 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,597,926 | TotalAmt |
| Program Services | $2,325,563 | ProgramServicesAmt |
| Management And General | $272,363 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,821,073 | TotalAmt |
| Program Services | $2,464,758 | ProgramServicesAmt |
| Management And General | $356,315 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,582 | TotalAmt |
| Management And General | $53,582 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,226 | TotalAmt |
| Management And General | $118,226 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,638,328 | TotalAmt |
| Program Services | $7,470,951 | ProgramServicesAmt |
| Management And General | $1,167,377 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $481,763 | TotalAmt |
| Management And General | $481,763 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,556,981 | TotalAmt |
| Program Services | $1,089,453 | ProgramServicesAmt |
| Management And General | $467,528 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $622,095 | TotalAmt |
| Program Services | $52,426 | ProgramServicesAmt |
| Management And General | $569,669 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $875,297 | TotalAmt |
| Program Services | $14,665 | ProgramServicesAmt |
| Management And General | $860,632 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490,655 | TotalAmt |
| Program Services | $378,929 | ProgramServicesAmt |
| Management And General | $111,726 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,106 | TotalAmt |
| Program Services | $57,901 | ProgramServicesAmt |
| Management And General | $140,205 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,336 | TotalAmt |
| Program Services | $289,336 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,142,339 | TotalAmt |
| Program Services | $4,795,511 | ProgramServicesAmt |
| Management And General | $346,828 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,255 | TotalAmt |
| Program Services | $374,255 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| UBI TAXES | $77,856 | $77,856 | |
| MEDICAL SUPPLIES | $10,498,081 | $10,498,081 | |
| DRUGS | $10,450,665 | $10,450,665 | |
| PROVISION FOR BAD DEBT | $5,295,765 | $5,295,765 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,504,170 | TotalAmt |
| Program Services | $2,616,991 | ProgramServicesAmt |
| Management And General | $887,179 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,296,049 | TotalAmt |
| Program Services | $84,574,102 | ProgramServicesAmt |
| Management And General | $12,721,947 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,026 | BOYAmt |
| EOY | $1,573 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,786,390 | BOYAmt |
| EOY | $7,533,318 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,019,019 | BOYAmt |
| EOY | $10,794,983 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $378,340 | BOYAmt |
| EOY | $481,528 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,678,379 | BOYAmt |
| EOY | $3,155,497 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $759,553 | BOYAmt |
| EOY | $807,293 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $155,724,949 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $73,758,726 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,488,192 | BOYAmt |
| EOY | $81,966,223 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,771,303 | BOYAmt |
| EOY | $199,971,967 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,504,169 | BOYAmt |
| EOY | $4,820,482 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,570,154 | BOYAmt |
| EOY | $2,481,359 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,074,667 | BOYAmt |
| EOY | $17,169,093 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $308,032,192 | BOYAmt |
| EOY | $329,183,316 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,569,467 | BOYAmt |
| EOY | $15,519,382 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,187,520 | BOYAmt |
| EOY | $38,874,579 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,775,890 | BOYAmt |
| EOY | $1,331,918 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,455,224 | BOYAmt |
| EOY | $5,154,474 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,988,101 | BOYAmt |
| EOY | $60,880,353 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $239,841,138 | BOYAmt |
| EOY | $263,785,014 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,202,953 | BOYAmt |
| EOY | $4,517,949 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,044,091 | BOYAmt |
| EOY | $268,302,963 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $308,032,192 | BOYAmt |
| EOY | $329,183,316 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $17,477,607 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,466,268 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $314,996 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,421,875 | OtherCostOrOtherBasisAmt |
| Book Value | $3,421,875 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,336,235 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,560,050 | DepreciationAmt |
| Book Value | $23,776,185 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,761,353 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,947,051 | DepreciationAmt |
| Book Value | $814,302 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $66,690,785 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,251,625 | DepreciationAmt |
| Book Value | $19,439,160 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,514,701 | OtherCostOrOtherBasisAmt |
| Book Value | $34,514,701 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $81,966,223 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM 457B | $4,457,043 |
| ACCRUED INTEREST RECEIVABLE | $78,342 |
| TRUSTEE HELD FUNDS | $6,661,020 |
| ACCRUED REAL ESTATE | $4,409,860 |
| DUE FROM RELATED PARTY | $1,562,828 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $17,169,093 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| 457(B) PAYABLE | $4,457,043 |
| LONG-TERM PTO | $605,531 |
| ASSET RETIREMENT OBLIGATION | $91,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,154,474 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT PRAIRIE LAKES IS A TAX-EXEMPT, NOT-FOR-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE HEALTH SYSTEM FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE HEALTH SYSTEM'S FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,100,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,100,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02280 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,374,931 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,460,837 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,914,094 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02080 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,474,931 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,460,837 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,014,094 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04360 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,480,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,306,388 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,173,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06710 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,480,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,306,388 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,173,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06710 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,955,307 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,767,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,188,082 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11070 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,295,765 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $34,343,460 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,634,576 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $708,884 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE LAKES HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 9TH AVE NW | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PRAIRIELAKES.COM | WebsiteAddressTxt |
| State License | 10572 | StateLicenseNum |
| Subordinate Hospital EIN | 460391067 | SubordinateHospitalEIN |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE LAKES HEALTH CARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.PRAIRIELAKES.COM/IMAGES/PDFS/2016_COMMUNITY_NEEDS_ASSESSMENT_-_FINAL.PD | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.PRAIRIELAKES.COM/IMAGES/PDFS/2016_COMMUNITY_NEEDS_ASSESSMENT_-_FINAL.PD | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE LINE 16J | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE LINE 16J | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE LINE 16J | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PRAIRIE LAKES HEALTH CARE SYSTEM | PART V, SECTION B, LINE 5: A COMPREHENSIVE, DATA DRIVEN ASSESSMENT WAS USED TO IDENTIFY COMMUNITY HEALTH NEEDS. PLHS UTILIZED A TWO-STEP PROCESS TO COLLECT PRIMARY AND SECONDARY DATA. IN STEP ONE, PLHS SOLICITED INPUT FROM COMMUNITY HEALTH STAKEHOLDERS INCLUDING PUBLIC HEALTH PROFESSIONALS; SERVICE AGENCIES ASSISTING VULNERABLE, LOW-INCOME, AND MINORITY POPULATIONS; HEALTHCARE PROVIDERS; AND, GOVERNMENT AND PUBLIC SAFETY OFFICIALS. IN ORDER TO ADDRESS NEEDS OF THE ENTIRE "COMMUNITY," STAKEHOLDERS INCLUDED INDIVIDUALS FROM OUTSIDE THE PRIMARY SERVICE AREA OF PLHS. INPUT WAS OBTAINED THROUGH TWO FOCUS GROUP SESSIONS AND KEY INFORMANT INTERVIEWS. STEP TWO CONSISTED OF EVALUATION OF DATA RELATED TO DEMOGRAPHICS AND HEALTH FROM THE UNITED STATES CENSUS BUREAU, SOUTH DAKOTA DEPARTMENT OF HEALTH, SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS, MINNESOTA DEPARTMENT OF HEALTH AND OTHER SOURCES. |
| PRAIRIE LAKES HEALTH CARE SYSTEM | PART V, SECTION B, LINE 11: 1. MENTAL HEALTHOBJECTIVE:IMPROVE ACCESS TO MENTAL HEALTH SERVICES THROUGH PARTNERSHIPS WITH OTHER HEALTHCARE PROVIDERS TO FACILITATE IMPROVED ACCESS TO CARE.KEY INITIATIVES:A. DEVELOP THE INFRASTRUCTURE NEEDED TO IDENTIFY SPECIFIC NEEDS AND SOLUTIONSB. SEEK OUT COLLABORATION OPPORTUNITIES TO INCREASE ACCESS2. ACCESS TO HEALTHCARE - TRANSPORTATIONOBJECTIVES:DECREASES BARRIERS TO HEALTH CARE ACCESS RELATED TO TRANSPORTATION. KEY INITIATIVES:A. SUSTAIN PARTNERSHIP WITH WATERTOWN AREA TRANSIT PROVIDING FREE RIDE SERVICE TO MEDICAL APPOINTMENTSB. EXPLORE OPTIONS FOR INCREASED MARKETING AND DISSEMINATION OF INFORMATION TO INCREASE AWARENESS OF PUBLIC TRANSPORTATION OPTIONS3. CHRONIC DISEASE MANAGEMENTOBJECTIVE:IMPROVE QUALITY OF LIFE AND CLINICAL OUTCOMES FOR PEOPLE WITH CHRONIC DISEASE.KEY INITIATIVES:A. CARDIOVASCULAR DISEASE: - CONTINUE TO ENHANCE HOME TRANSITIONS PROGRAM 34 - ENHANCE PATIENT EDUCATIONB. DIABETES: - CONTINUE TO ENHANCE HOME TRANSITIONS PROGRAM - EXPLORE THE NEED FOR DIABETIC SPECIFIC TRAINED STAFFC. RESPIRATORY DISEASE: - CONTINUE TO ENHANCE HOME TRANSITIONS PROGRAM - RECRUIT A PULMONOLOGIST - REINSTATE OUTREACH CLINICSD. CEREBROVASCULAR DISEASE (STROKE): - ENHANCE PATIENT EDUCATION - EVALUATE STROKE PROTOCOLS4. HEALTH LITERACYOBJECTIVE:IMPROVE MEDICATION SAFETY FOR THE COMMUNITY.KEY INITIATIVES:A. DEVELOP THE INFRASTRUCTURE NEEDED TO PROVIDE PUBLIC EDUCATIONB. EXPLORE THE DEVELOPMENT OF MEDICATION PROTOCOLS FOR SELECT HEALTH CONDITIONS |
| PRAIRIE LAKES HEALTH CARE SYSTEM | PART V, SECTION B, LINE 16J: HTTPS://WWW.PRAIRIELAKES.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-PROGRAM-510.HTML |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SISSETON SATELLITE DIALYSIS | ||||
| 5 EAST CHESTNUT | SISSETON | SD | 57262 | DIALYSIS UNIT |
| 2 - MALLARD POINTE SURGICAL CENTER | ||||
| 1425 MICKELSON DRIVE | WATERTOWN | SD | 57201 | OUTPATIENT SURGERY CENTER |
| 3 - ORTONVILLE SATELLITE DIALYSIS | ||||
| 450 EASTVOLD AVENUE | ORTONVILLE | MN | 56278 | DIALYSIS UNIT |
| 4 - PRAIRIE LAKE PULMONOLOGY CLINIC | ||||
| 600 4TH STREET NE | WATERTOWN | SD | 57201 | PULMONOLOGY CLINIC |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | IN ADDITION TO INCOME BASED CRITERIA FOR DETERMINING THE AMOUNT OF FINANCIAL ASSISTANCE SERVICES FOR WHICH A PATIENT IS ELIGIBLE AT THE TIME OF SERVICE OR DURING THE BILLING-AND-COLLECTION PROCESS, PLHS USES AN ASSET TEST. ASSET EXCLUSIONS THAT ARE CONIDERED IN QUALIFYING FOR FINANCIAL ASSISTANCE ARE: (A) EQUITY IN PRIMARY RESIDENCE UP TO $15,000(B) EQUITY IN AUTOMOBILE UP TO $5,000(C) 70% OF VALUE OF ASSETS IN RETIRMENT ACCOUNTS(D) ASSETS IN CHECKING/SAVINGS/ETC. UP TO $15,000(E) OTHER ASSETS USED FOR INCOME PRODUCING PURPOSES. |
| PART I, LINE 7: | THE COSTS OF THE SUBSIDIZED SERVICES ARE BASED ON DIRECT COST PROVIDED BY THE DEPARTMENTS FOR THE SERVICES. |
| PART I, LINE 7G: | THE SUBSIDIZED HEALTH SERVICES INCLUDED IN SCHEDULE H, PART I, LINE 7G RELATE TO THE EMERGENCY ROOM, CARDIOLOGY CLINIC, ONCOLOGY CLINIC, NEPHROLOGY CLINIC, UROLOGY CLINIC, PULMONOLOGY CLINIC, AND ENT CLINIC. |
| PART I, LN 7 COL(F): | $5,295,765 OF BAD DEBT EXPENSE WAS ELIMINATED WHEN CALCULATING PART I, LINE 7, COLUMN F. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE ORGANIZATION SUPPORTS COMMUNITY BUILDING ACTIVITIES THROUGH DONATIONS TO COMMUNITY PROJECTS SUCH AS THE WATERTOWN DEVELOPMENT COMPANY, WHICH WORKS TO BRING NEW BUSINESSES TO WATERTOWN; JOY RANCH, WHICH PROVIDES CAMP EXPERIENCE TO DISABLED CHILDREN; LAKE AREA TECHNICAL INSTITUTE, WHICH PROVIDES EDUCATION AND TRAINING FOR HEALTH PROFESSIONALS; AND THE BOYS AND GIRLS CLUB, WHICH PROVIDES RESOURCES FOR COMMUNITY YOUTH. |
| PART III, LINE 2: | IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. |
| PART III, LINE 3: | THE ORGANIZATION DOES NOT HAVE A WAY TO IDENTIFY THE NUMBER OF PEOPLE WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE SO WE HAVE REPORTED $0 IN PART III, LINE 3. |
| PART III, LINE 4: | SEE THE "PATIENT ACCOUNTS RECEIVABLE" PARAGRAPH ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THERE WAS NO SHORTFALL CALCULATED IN PART III, LINE 7.THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WAS DERIVED USING THE 2018 FILED MEDICARE COST REPORT. |
| PART III, LINE 9B: | BILLING STATEMENTS AND COLLECTION LETTERS WILL CONTAIN INFORMATION DIRECTING PATIENTS TO CONTACT THE HOSPITAL FOR INFORMATION ABOUT FINANCIAL ASSISTANCE OR PAYMENT PLANS IF THE PATIENTS ARE UNABLE TO PAY THE FULL OUTSTANDING ACCOUNT BALANCE BY THE DUE DATE. IF A COMPLETE ASSISTANCE APPLICATION IS RECEIVED, A DETERMINATION OF THE PATIENT'S ELIGIBILITY WILL BE DOCUMENTED APPROPRIATELY AND COMMUNICATED TO THE PATIENT IN WRITING. IF ELIGIBLE, THE HOSPITAL WILL ISSUE A BILLING STATEMENT WITH THE AMOUNT NOW OWED (ALONG WITH THE AMOUNT GENERALLY BILLED AND HOW IT WAS CALCULATED), REFUND ANY CREDIT BALANCES, AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS. IF AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION (FAA) IS RECEIVED BY THE HOSPITAL, THE HOSPITAL WILL CEASE COLLECTION ACTIONS AND ALLOW 30 DAYS FOR THE FAA TO BE FULLY COMPLETED. |
| PART VI, LINE 2: | THE FACILITY CONDUCTS NEEDS ASSESSMENT SURVEYS IN THE COMMUNITY AND SURROUNDING AREA TO DETERMINE WHAT HEALTH CARE SERVICES NEED TO BE ADDRESSED. |
| PART VI, LINE 3: | PLHS INFORMS AND EDUCATES PATIENTS ABOUT FINANCIAL ASSISTANCE THROUGH INFORMATION PROVIDED ON THE PLHS WEBSITE. FURTHERMORE, HOSPITAL STAFF PROVIDE INFORMATION REGARDING FINANCIAL ASSISTANCE ELIGIBILITY. |
| PART VI, LINE 4: | PRAIRIE LAKES HEALTH CARE SYSTEM'S PRIMARY SERVICE AREA COVERS 3 COUNTIES IN SOUTH DAKOTA WITH A POPULATION OF APPROXIMATELY 36,000. IT'S SECONDARY SERVICE AREA COVERS 4 COUNTIES IN SOUTH DAKOTA AND 3 COUNTIES IN MINNESOTA WITH A POPULATION OF 54,000. |
| PART VI, LINE 5: | THE ORGANIZATION OFFERS FREE HEALTH SEMINARS TO COMMUNITY MEMBERS COVERING A VARIETY OF HEALTH TOPICS IN AN EFFORT TO EDUCATE PEOPLE ABOUT LEADING HEALTHY LIVES. COMMUNITY FORUMS ARE HELD TO UPDATE ATTENDEES ABOUT NEW EVENTS AND TECHNOLOGY AT THE FACILITY. THE ORGANIZATION WORKS WITH THE TECHNICAL INSTITUTE AND TWO STATE UNIVERSITIES TO HELP TRAIN MEDICAL STUDENTS. THE ORGANIZATION IS DEDICATED TO IMPLEMENTING AND MAINTAINING THE MOST CURRENT TECHNOLOGY IN PROVIDING CARE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | SD |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| BOYS & GIRLS CLUB OF WATERTOWN | |||||||
| PO BOX 833 | WATERTOWN | SD | 57201 | 460311845 | 501(C)(3) | $126,000 | CAPITAL CAMPAIGN BUILDING PROJECT |
| WATERTOWN UNITED WAY | |||||||
| PO BOX 283 | WATERTOWN | SD | 57201 | 460359557 | 501(C)(3) | $43,750 | COMMUNITY ORGANIZATION FUNDING |
| LAKE AREA TECHNICAL INSTITUTE | |||||||
| PO BOX 730 | WATERTOWN | SD | 57201 | 460381673 | 501(C)(3) | $14,600 | CONSTRUCTING AND EQUIPPING A HEALTH EDUCATION CENTER; SCHOLARSHIPS |
| HUMAN SERVICE AGENCY | |||||||
| PO BOX 1030 | WATERTOWN | SD | 57201 | 460275247 | 501(C)(3) | $10,000 | DETOX FUNDING |
| WATERTOWN DEVELOPMENT CORP | |||||||
| PO BOX 1267 | WATERTOWN | SD | 57201 | 466012194 | 501(C)(6) | $35,000 | COMMUNITY DEVELOPMENT |
| SANFORD CLINIC | |||||||
| 901 4TH STREET NW | WATERTOWN | SD | 57201 | 460447693 | 501(C)(3) | $15,000 | FAMILY PLANNING CLINIC |
| WATERTOWN FIRE RESCUE | |||||||
| 129 1ST AVE NW | WATERTOWN | SD | 57201 | 466000515 | GOVERNMENT | $7,500 | ASSIST NON-PROFITS AND SMALL BUSINESSES PLACE AED'S IN THEIR BUILDINGS |
| ARROW EDUCATION FOUNDATION | |||||||
| PO BOX 730 | WATERTOWN | SD | 57201 | 460453170 | 501(C)(3) | $10,000 | SCHOLARSHIPS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 7 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FUNDS ARE GRANTED BASED ON ORGANIZATIONS AND INTERNAL REQUESTS. GRANT REQUESTS ARE REVIEWED AND APPROVED BY ADMINISTRATIVE LEADERSHIP TO BE USED FOR THE PURPOSES REQUESTED BY THE ORGANIZATION. FURTHER MONITORING IS NOT DONE ON A REGULAR BASIS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JILL FULLER | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $418,710 | $0 | $120,000 | $0 | $0 | $0 | $18,288 | $0 | $11,661 | $0 | $568,659 | $0 | $0 | $0 |
| ADAM PAUL | ||||||||||||||
| CHIEF FINANCIAL OFFICER (THROUGH NOV | $232,432 | $0 | $72,695 | $0 | $0 | $0 | $15,072 | $0 | $15,017 | $0 | $335,216 | $0 | $0 | $0 |
| MICHAEL ANDERSON | ||||||||||||||
| CHIEF INVESTMENT OFFICER | $281,986 | $0 | $115,000 | $0 | $0 | $0 | $12,864 | $0 | $11,661 | $0 | $421,511 | $0 | $0 | $0 |
| NATE LAKE | ||||||||||||||
| VICE PRESIDENT | $170,229 | $0 | $58,277 | $0 | $0 | $0 | $13,841 | $0 | $23,682 | $0 | $266,029 | $0 | $0 | $0 |
| TRACI RABINE | ||||||||||||||
| VICE PRESIDENT | $170,184 | $0 | $58,268 | $0 | $0 | $0 | $12,379 | $0 | $23,682 | $0 | $264,513 | $0 | $0 | $0 |
| MICHELE TURBAK | ||||||||||||||
| CHIEF NURSING OFFICER | $174,833 | $0 | $59,177 | $0 | $0 | $0 | $12,717 | $0 | $17,475 | $0 | $264,202 | $0 | $0 | $0 |
| GRANT TILLETT | ||||||||||||||
| CHIEF INFORMATION OFFICER | $156,408 | $0 | $55,576 | $0 | $0 | $0 | $9,977 | $0 | $22,820 | $0 | $244,781 | $0 | $0 | $0 |
| EVELIO GARCIA MD | ||||||||||||||
| PHYSICIAN | $1,103,394 | $0 | $100,000 | $0 | $0 | $0 | $7,950 | $0 | $23,682 | $0 | $1,235,026 | $0 | $0 | $0 |
| SALEM MAALIKI MD | ||||||||||||||
| PHYSICIAN | $1,081,060 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $23,682 | $0 | $1,112,692 | $0 | $0 | $0 |
| RICHARD HOWARD MD | ||||||||||||||
| PHYSICIAN | $668,035 | $0 | $90,275 | $0 | $0 | $0 | $7,950 | $0 | $23,682 | $0 | $789,942 | $0 | $0 | $0 |
| JEFFREY SMITH MD | ||||||||||||||
| PHYSICIAN | $700,000 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $23,682 | $0 | $731,632 | $0 | $0 | $0 |
| BIPIN AMIN MD | ||||||||||||||
| PHYSICIAN | $610,000 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $17,475 | $0 | $635,425 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| A | 460315509 | 83755VRN6 | 2010-12-08 | $21,672,812 | CURRENT REFUNDING OF SERIES 1998 BONDS & ADVANCE REFUNDING OF SERIES 2002 | 0 | 0 | 0 |
| SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| B | 460315509 | 2017-01-27 | $36,000,000 | FUNDING OF THE NEW SPECIALTY CLINIC BUILDING | 0 | 0 | 0 | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $15,630,000 | $25,166,290 | $3,303 | $431,508 | $24,731,480 | 2010 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | |
| B | $1,955,000 | $36,000,000 | $397,999 | 2017 | 0 | 0 | Yes (1) | Yes (1) | $35,602,001 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | B | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DATE REBATE COMPUTATION PERFORMED | ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2013 |
| SCHEDULE K, PART II, LINE 3 | THE DIFFERENCE IN THE ISSUANCE PRICE INCLUDED IN PART I, LINE A, COLUMN E OF $21,672,812 IS DIFFERENT THAN THE TOTAL PROCEEDS OF ISSUANCE INCLUDED IN PART II, LINE 3 OF $25,166,290 BECAUSE OF THE TRUSTEE FUNDS UTILIZED DURING THE REFINANCING. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREGORY GERRISH MD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CATHERINE GERRISH IS A BOARD MEMBER AND THE MOTHER OF GREGORY GERRISH | RelationshipDescriptionTxt |
| Transaction | $444,885 | TransactionAmt |
| Transaction | RESIDENCY STIPEND AND EMPLOYEE COMPENSATION | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL BE COMPRISED OF THE OFFICERS OF THE CORPORATION. EXCEPT AS MAY BE LIMITED BY THE BOARD, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL ACT IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD AND SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL ALSO SERVE AS THE CORPORATION'S COMPENSATION COMMITTEE, UNLESS IT OR THE BOARD DELEGATES THOSE RESPONSIBILITIES TO ANOTHER COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL NOT USURP THE FUNCTIONS OF THE OTHER STANDING COMMITTEES, ALTHOUGH IT WILL COORDINATE PROJECTS, TASKS AND COMMUNICATIONS AMONG SUCH COMMITTEES. A MAJORITY OF THE EXECUTIVE COMMITTEE SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF ANY BUSINESS. |
| FORM 990, PART VI, SECTION B, LINE 11B | EXECUTIVE MANAGEMENT REVIEWED THE FORM 990 IN DETAIL. THEY THEN PRESENTED THE FORM 990 TO THE FINANCE COMMITTEE CHAIR FOR FINAL REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST STATEMENT IS SIGNED BY ALL BOARD MEMBERS ON AN ANNUAL BASIS. THAT STATEMENT DISCLOSES ANY AREAS THAT MAY HAVE A POTENTIAL FOR CONFLICT OF INTEREST WITH THEMSELVES OR FAMILY MEMBERS. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO AND THE BOARD. AT BOARD MEETINGS, THE MEMBERS WILL EXCUSE THEMSELVES FROM ANY DISCUSSION OR VOTING ON AN ISSUE WHERE A CONFLICT MAY EXIST. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION COMPARABILITY STUDIES ARE REVIEWED EACH YEAR FOR ALL POSITIONS. THE COMPENSATION STUDIES ARE CONDUCTED INTERNALLY BY THE HUMAN RESOURCES DEPARTMENT. THE HUMAN RESOURCES DEPARTMENT HAS ACCESS TO VARIOUS COMPENSATION SURVEYS WHICH THEY REVIEW IN ORDER TO DETERMINE IF THE HOSPITAL'S COMPENSATION IS REASONABLE COMPARED TO OTHER FACILITIES. THE LAST COMPENSATION STUDY WAS PERFORMED IN 2017. THE BOARD APPROVES SALARY OF THE CEO THROUGH ITS EXECUTIVE COMMITTEE SERVING AS THE COMPENSATION COMMITTEE. THE BOARD DELEGATES VICE PRESIDENT EXECUTIVE COMPENSATION APPROVAL TO THE CEO BASED ON THE ORGANIZATION'S COMPENSATION PHILOSOPHY IN CONJUNCTION WITH MARKET BENCHMARKS. THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE SALARIES OF OTHER KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE AVAILABLE THROUGH FILINGS WITH BONDING AUTHORITY. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN PRAIRIE LAKES FOUNDATION 314,996. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE LAKES HOME CONNECTIONS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 9TH AVE NW | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460394984 | EIN |
| Primary Activities | HOMEMAKER & NURSING SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 10 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE LAKES HEALTH CARE SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PRAIRIE LAKES HOME CONNECTIONS INC | ||
| L | $98,899 | GAAP |
| PRAIRIE LAKES HOME CONNECTIONS INC | ||
| O | $139,104 | GAAP |