WISHEK HOSPITAL CLINIC ASSOCIATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- WISHEK HOSPITAL CLINIC ASSOCIATION (EIN 45-0358986)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-07
- IRS object ID
- 201433119349300328
- Schema version
- 2013v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-07T08:48:49-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450310328 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRADY MARTZ & ASSOCIATES PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1297 | AddressLine1 |
| City | BISMARCK | City |
| State | ND | State |
| ZIP Code | 585021297 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450358986 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISHEK HOSPITAL CLINIC ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WISH | BusinessNameControlTxt |
| Phone | 7014522326 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 647 | AddressLine1 |
| City | WISHEK | City |
| State | ND | State |
| ZIP Code | 584950647 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK RINEHARDT | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7014522326 | PhoneNum |
| Signature | 2014-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PATRICK J BROWN | PreparerPersonNm |
| PTIN | P00149579 | PTIN |
| Phone | 7012231717 | PhoneNum |
| Preparation | 2014-10-31 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK RINEHARDT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 4TH AVE S | AddressLine1 |
| City | WISHEK | City |
| State | ND | State |
| ZIP Code | 58495 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,605,914 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WISHEKHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF WISHEK HOSPTIAL CLINIC ASSOCIATION IS TO PROVIDE THE HIGHEST POSSIBLE STANDARD OF HEALTH CARE IN A COMPASSIONATE AND PROFESSIONAL MANNER FOR THE PEOPLE IN OUR REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 115 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $208,034 | PYContributionsGrantsAmt |
| CY Contributions Grants | $126,120 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,937,353 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,271,561 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$6,710 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,056 | CYInvestmentIncomeAmt |
| PY Other Revenue | $406,796 | PYOtherRevenueAmt |
| CY Other Revenue | $188,341 | CYOtherRevenueAmt |
| PY Total Revenue | $6,545,473 | PYTotalRevenueAmt |
| CY Total Revenue | $6,594,078 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,270,117 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,375,794 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $4,598 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,783,926 | PYOtherExpensesAmt |
| CY Other Expenses | $3,363,239 | CYOtherExpensesAmt |
| PY Total Expenses | $6,054,043 | PYTotalExpensesAmt |
| CY Total Expenses | $6,739,033 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $491,430 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$144,955 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,755,538 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,530,130 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,630,238 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,557,096 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,125,300 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,973,034 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WISHEK HOSPITAL CLINIC ASSOCIATION IS A PROGRESSIVE AND INNOVATIVE HEALTHCARE LEADER PROVIDING PERSONALIZED SERVICES PROMOTING THE CREATION OF HEALTHIER COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,012,122 | ExpenseAmt |
| Revenue | $4,458,094 | RevenueAmt |
| Desc | ACUTE HEALTHCARE/OUTPATIENT SERVICES/EMERGENCY DEPARTMENT. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $918,800 | ExpenseAmt |
| Revenue | $1,677,897 | RevenueAmt |
| Desc | HEALTHCARE SERVICES PROVIDED TO FOUR COMMUNITIES WITHIN OUR SERVICE AREA OF RURAL ND. FOUR RURAL HEALTH CLINICS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $177,789 | ExpenseAmt |
| Revenue | $135,570 | RevenueAmt |
| Desc | HOME HEALTH/HOSPICE/EXTENDED CARE HEALTHCARE SERVICES PROVIDED TO HOME BOUND PATIENTS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $805,429 | ExpenseAmt |
| Revenue | $118,626 | RevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $805,429 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $118,626 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $5,914,140 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 115 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | 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 | BEV VILHAUER CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7014522326 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 4TH AVE S | AddressLine1 |
| City | WISHEK | City |
| State | ND | State |
| ZIP Code | 58495 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| NATHAN PINKE | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TODD SCHNABEL | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GREG SALWEI | |||||||
| EXECUTIVE SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CRIS TURMAN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| REBECCA SCHNABEL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARLA BERNTSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEE AIPPERSPACH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CARMEN RATH-WALD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRYAN SCHUMACHER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK RINEHARDT | |||||||
| CEO-CONTRACTED | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| SAHLENIA BRAUN | |||||||
| CFO | 40.00 | Yes (X) | $57,720 | $0 | $3,405 | ||
| KAY RAU | |||||||
| PA | 40.00 | $119,840 | $0 | $5,855 | Yes (X) | ||
| PAULETTE BENSON-EISEMAN | |||||||
| PA | 40.00 | $109,512 | $0 | $15,678 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $287,072 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $24,938 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD | |||||
| 1415 MAPLETON AVE | BISMARCK | ND | 58501 | HEALTH INSURANCE | $567,887 |
| ST ALEXIUS MEDICAL CENTER | |||||
| 900 E BROADWAY | BISMARCK | ND | 58501 | HEALTHCARE EQUIPMENT/CONTRACT LABOR | $404,115 |
| HEALTHLAND INC | |||||
| 1600 UTICA AVE S SUITE 300 | MINNEAPOLIS | MN | 55416 | HEATHCARE SUPPLIES | $326,261 |
| DAKOTA DRUG INC | |||||
| 1101 LUND BOULEVARD | ANOKA | MN | 55303 | PHARMACY | $208,017 |
| AMERICAN UNITED LIFE INSURANCE | |||||
| 2110 E THAYER AVE | BISMARCK | ND | 58501 | INSURANCE | $202,543 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $106,665 | GovernmentGrantsAmt |
| All Other Contributions | $19,455 | AllOtherContributionsAmt |
| Total Contributions | $126,120 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL PATIENT REV | 624100 | $4,458,094 | $4,458,094 |
| CLINIC PATIENT REV | 621400 | $1,677,897 | $1,677,897 |
| HOME HEALTH PATIENT RE | 621610 | $135,570 | $135,570 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,271,561 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,149 | TotalRevenueColumnAmt |
| Exclusion | $3,149 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,255 | 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 | $10,255 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,255 | TotalRevenueColumnAmt |
| Exclusion | $10,255 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,510 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,603 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,907 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,907 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,907 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $73,600 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $9,233 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,367 | TotalRevenueColumnAmt |
| Exclusion | $64,367 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACTIVITIES/MISC | Desc |
| Business | 624200 | BusinessCd |
| Total Revenue Column | $113,719 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $113,719 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $113,719 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,594,078 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,390,187 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $77,771 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,072 | TotalAmt |
| Program Services | $229,352 | ProgramServicesAmt |
| Management And General | $57,720 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,363,319 | TotalAmt |
| Program Services | $2,238,926 | ProgramServicesAmt |
| Management And General | $124,393 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,909 | TotalAmt |
| Program Services | $83,731 | ProgramServicesAmt |
| Management And General | $6,178 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $635,494 | TotalAmt |
| Program Services | $592,180 | ProgramServicesAmt |
| Management And General | $43,314 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,315 | TotalAmt |
| Management And General | $3,315 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,206 | TotalAmt |
| Management And General | $27,206 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,410 | TotalAmt |
| Management And General | $16,410 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,731 | TotalAmt |
| Program Services | $1,014 | ProgramServicesAmt |
| Management And General | $14,781 | ManagementAndGeneralAmt |
| Fundraising | $936 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,364 | TotalAmt |
| Program Services | $24,678 | ProgramServicesAmt |
| Management And General | $142,686 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,978 | TotalAmt |
| Management And General | $123,978 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $577,720 | TotalAmt |
| Program Services | $548,730 | ProgramServicesAmt |
| Management And General | $28,990 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,315 | TotalAmt |
| Program Services | $48,621 | ProgramServicesAmt |
| Management And General | $4,694 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,884 | TotalAmt |
| Management And General | $8,884 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,408 | TotalAmt |
| Program Services | $277,056 | ProgramServicesAmt |
| Management And General | $5,352 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,588 | TotalAmt |
| Management And General | $36,588 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT SERVICES | $1,150,926 | $973,591 | $173,673 | $3,662 |
| SUPPLIES | $740,688 | $740,688 | ||
| PROVISION FOR BAD DEBTS | $71,356 | $71,356 | ||
| PATIENT FOOD/LAUNDRY | $57,515 | $57,515 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,835 | TotalAmt |
| Program Services | $26,702 | ProgramServicesAmt |
| Management And General | $2,133 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,739,033 | TotalAmt |
| Program Services | $5,914,140 | ProgramServicesAmt |
| Management And General | $820,295 | ManagementAndGeneralAmt |
| Fundraising | $4,598 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $223,714 | BOYAmt |
| EOY | $14,753 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $960,316 | BOYAmt |
| EOY | $822,058 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,198 | BOYAmt |
| EOY | $1,240,116 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,102 | BOYAmt |
| EOY | $63,754 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,355 | BOYAmt |
| EOY | $95,830 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,321,716 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,241,254 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,295 | BOYAmt |
| EOY | $1,080,462 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $287,558 | BOYAmt |
| EOY | $213,157 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,755,538 | BOYAmt |
| EOY | $3,530,130 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $765,832 | BOYAmt |
| EOY | $812,909 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $780,660 | BOYAmt |
| EOY | $684,067 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,746 | BOYAmt |
| EOY | $60,120 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,630,238 | BOYAmt |
| EOY | $1,557,096 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,041,641 | BOYAmt |
| EOY | $1,838,444 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,659 | BOYAmt |
| EOY | $134,590 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,125,300 | BOYAmt |
| EOY | $1,973,034 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,755,538 | BOYAmt |
| EOY | $3,530,130 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$144,955 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$7,311 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $69,975 | OtherCostOrOtherBasisAmt |
| Book Value | $69,975 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,469,003 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,161,361 | DepreciationAmt |
| Book Value | $307,642 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,782,738 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,079,893 | DepreciationAmt |
| Book Value | $702,845 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,080,462 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEPOSIT ON EQUIPMENT | $92,345 |
| RENTAL PROPERTY | $120,812 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $213,157 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAPITAL LEASE PAYABLE | Desc |
| Amt | $60,120 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $60,120 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,603,311 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,603,311 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$9,233 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$9,233 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,594,078 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,748,268 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,748,268 | ExpensesSubtotalAmt |
| Other Expenses Not Included | -$9,235 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | -$9,235 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,739,033 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | INCOME TAXES THE ASSOCIATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, THE ASSOCIATION IS NOT SUBJECT TO INCOME TAX. THE ASSOCIATION'S POLICY IS TO EVALUATE THE LIKELIHOOD THAT ITS UNCERTAIN TAX POSITIONS WILL PREVAIL UPON EXAMINATION BASED ON THE EXTENT TO WHICH THOSE POSITIONS HAVE SUBSTANTIAL SUPPORT WITHIN THE INTERNAL REVENUE CODE AND REGULATIONS, REVENUE RULINGS, COURT DECISIONS, AND OTHER EVIDENCE. ACCOUNTING FOR UNCERTAINTIES IN INCOME TAXES IT IS THE OPINION OF MANAGEMENT THAT THE ASSOCIATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION. THE FEDERAL INCOME TAX RETURNS OF THE ASSOCIATION ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES -9,233. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES -9,233. ROUNDING -2. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | NAPOLEON CLINIC FUNDRAISER | NameOfEvent1Amt |
| Gross Receipts Event1 | $27,765 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $27,765 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $101 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | TACO FEED & BIKE-A-THON | NameOfEvent2Amt |
| Gross Receipts Event2 | $27,723 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $27,723 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $1,401 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $18,112 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $18,112 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $7,731 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $73,600 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $73,600 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $9,233 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $9,233 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $64,367 | NetIncomeSummaryAmt |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 100.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,866 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,866 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $177,046 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,034 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $153,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02270 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $198,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,034 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $174,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02590 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $198,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,034 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $174,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02590 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $71,356 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $17,839 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,739,053 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,923,579 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$184,526 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NONE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 5 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (5 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Licensed HospitalLicensedHospitalInd | Critical Access HospitalCriticalAccessHospitalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc |
|---|---|---|---|---|---|---|---|---|
| WISHEK HOSPITAL | ||||||||
| 1 | 1007 4TH AVE S | WISHEK | ND | 58495 | Yes (X) | Yes (X) | Yes (X) | HOME HEALTH AND HOSPICE |
| WISHEK CLINIC | ||||||||
| 2 | 1015 4TH AVE S | WISHEK | ND | 58495 | RURAL HEALTH CLINIC | |||
| NAPOLEON CLINIC | ||||||||
| 3 | 420 MAIN STREET | NAPOLEON | ND | 58561 | RURAL HEALTH CLINIC | |||
| KULM COMMUNITY CLINIC | ||||||||
| 4 | 4TH 1ST AVE SE | KULM | ND | 58456 | CLINIC | |||
| GACKLE CLINIC | ||||||||
| 5 | 321 MAIN STREET | GACKLE | ND | 58442 | CLINIC | |||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISHEK HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 11 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WISHEK HOSPITAL | PART V, SECTION B, LINE 3: A TOTAL OF 24 COMMUNITY LEADERS WERE IDENTIFIED AND CONTACTED BY THE UND CENTER FOR RURAL HEALTH. EACH WAS ASKED TO PARTICIPATE IN AN INDIVIDUAL INTERVIEW AND/OR TO COMPLETE THE SURVEY. FOURTEEN PARTICIPANTS (58%) WERE AVAILABLE AND PARTICIPATED IN KEY INFORMANT INTERVIEWS WHICH WERE COMPLETED ON JUNE 13, 14 AND 15 IN NAPOLEON, WISHEK, KULM AND GACKLE. |
| WISHEK HOSPITAL | PART V, SECTION B, LINE 14G: ON THE BACK OF THE PATIENT'S STATEMENTS, UNCOMPENSATED CARE IS OFFERED. THE BACK OF THE PATIENT'S STATEMENTS IS AS FOLLOWS "WISHEK HOSPITAL CLINIC ASSOCIATION OFFERS AN UNCOMPENSATED CARE PROGRAM FOR ANYONE UNABLE TO MEET OUR PAYMENT POLICY. IF YOU FEEL YOU WOULD QUALIFY FOR THIS PROGRAM, PLEASE CALL FOR THE NECESSARY PAPERS." |
| WISHEK HOSPITAL | PART V, SECTION B, LINE 20D: THE HOSPITAL USES THE SAME CHARGING METHOD AS THEY DO ALL OUR CLIENTS. CHARGES ARE ESTABLISHED WHEN WE GET THE BLUE CROSS BLUE SHIELD FEE SCHEDULE AT THE END OF THE END FOR UPCOMING YEAR AND OUR CHARGEMASTER IS CHANGED AT THAT TIME. ALL PAYERS ARE CHARGED THE SAME. |
| WISHEK HOSPITAL | PART V, SECTION B, LINE 22: ALL CHARGES ARE CHARGED AT GROSS BASED ON THE CHARGEMASTER RATES THAT WERE ESTABLISHED. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | WISHEK HOSPITAL CLINIC ASSOCIATION (WHCA) USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING FREE OR DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. WHCA USES 100% AS THE FAMILY INCOME LIMIT. |
| PART I, LINE 7: | A COST TO CHARGE RATIO WAS USED FOR THE FIGURES REPORTED IN THE TABLE USING WORKSHEET 2. |
| PART I, LINE 6A | WCHA COMPLETED A COMMUNITY BENEFIT REPORT AND MADE IT AVAILABLE TO PUBLIC UPON REQUEST. |
| PART III, LINE 4: | THE AMOUNTS WERE DETERMINED BASED UPON THE COST TO CHARGE RATIO USING WORKSHEET A. THE HOSPITAL ALSO HAS A POLICY FOR COLLECTIONS AND BAD DEBTS.WHCA FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. A PORTION CAN BE LOCATED IN PATIENT RECEIVABLES SECTION ON PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE AMOUNTS WERE DETERMINED BASED UPON THE COST TO CHARGE RATIO FROM THE COST REPORT THAT WAS FILED FOR THE YEAR. |
| PART III, LINE 9B: | ALL PATIENTS ARE NOTIFIED ON THEIR MONTHLY STATEMENT THAT THE ORGANIZATION OFFERS AN UNCOMPENSATED CARE PROGRAM FOR ANYONE UNABLE TO MEET THEIR PRIVATE PAY POLICY AND THAT THEY ARE TO CONTACT THE ACCOUNTS RECEIVABLE DEPARTMENT. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING WITH THE ORGANIZATION IN GOOD FAITH TO RESOLVE THEIR BILLS, THE ORGANIZATION WILL OFFER EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS, REDUCE THE BILL BY THE APPROPRIATE AMOUNTS, WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS. |
| PART VI, LINE 2: | THE MEDICAL STAFF TEAM MEETS MONTHLY TO DISCUSS CURRENT OR MOST RECENT CASES THAT THEY HAVE ENCOUNTERED. UNIQUE CASES, AS WELL AS THE ROUTINE CASES ARE DISCUSSED. EVERY OTHER MONTH, SUPPORT STAFF, WHICH INCLUDE THE DIRECTORS OF NURSING, HEALTH INFORMATION MANAGEMENT, LABORATORY/RADIOLOGY, PHARMACY, HOME HEALTH/HOSPICE, DISCHARGE PLANNING AND ADMINISTRATION, ARE INVITED TO THESE MEETINGS FOR SIMILAR DISCUSSIONS, IN ADDITION TO UNIFYING THE APPROACH IN VARIOUS MATTERS SUCH AS STANDARDS OF CARE, QUALITY ASSURANCE STUDY REVIEW, MEDICARE/MEDICAID OR 3RD PARTY GUIDELINES ON STANDARDS OF CARE AND/OR REIMBURSEMENT. THE ORGANIZATION HAS ALSO ESTABLISHED A CALL-BACK SYSTEM. ALL PATIENT DISCHARGED FROM THE HOSPITAL OR HOME HEALTH/HOSPICE PROGRAMS ARE FOLLOWED UP WITH A CALL AND/QUESTIONNAIRES ASKING ABOUT HOW THEY ARE DOING, IF THERE ARE ANY QUESTIONS, ADDITIONAL AREAS OF NEED OR SERVICES THAT WE MAY NEED TO GET IN PLACE FOR THEM. WE HAVE A SYSTEM IN OUR ORGANIZATION THAT ALSO ALLOWS FOR OUR STAFF TO REVIEW THE PATIENTS CHART PRIOR TO A CLINIC VISIT TO IDENTIFY ANY NEEDS SUCH AS MAMMOGRAMS, BONE DENSITY, PSA, CHOLESTEROL, PAP, COLONOSCOPE OR ANY OTHER IDENTIFIED FOLLOW-UP SCREENING OR TEST. A SHEET IS PLACED ON THE FRONT OF THE CHART TO ASSIST THE MEDICAL STAFF IN CUEING INTO THESE NEEDS. ONCE THE VISIT IS COMPLETE THE CHART IS THEN RE-ROUTED BACK INTO THE CALL-BACK OFFICE FOR PLACING INTO THE SYSTEM THE NEXT DATE OF SCREENING SERVICES OR TO SCHEDULE FOLLOW-UP OR REFERRAL APPOINTMENTS FOR THAT PATIENT NEEDS. MESSAGES ARE ALSO SENT TO PATIENTS IN RELATION TO THE ROUTINE FOLLOW-UPS FOR MEDICATION REFILLS OR MONITORING OF CHRONIC MEDICAL CONDITIONS SUCH AS DIABETES, HEART DISEASE, KIDNEY OR LIVER DISEASE PROCESS, OSTEOPOROSIS OR ANY OTHER IDENTIFIED DISEASE PROCESS/ABNORMALITY.THE MANAGEMENT TEAM AND THE BOARD OF DIRECTORS ALSO MEETS MONTHLY TO BRING TO THE TABLE THE CURRENT OPERATIONS AND DISCUSSION OF CURRENT HAPPENINGS AND FEEDBACK. DUE TO THE FACT WE REPRESENT DIFFERENT AREAS THAT COME TOGETHER AS A TEAM TO ENSURE ACCESS TO HEALTHCARE AT A LOW COST HIGH QUALITY MANNER IS IN PLACE - THIS OPPORTUNITY ALLOWS VARIABLE DISCUSSION TO COMMUNITY NEEDS AND HOW WE CAN ADDRESS THEM IN AN INTERDISCIPLINARY TEAM APPROACH.UTILIZATION IS MONITORED IN RELATION TO THE CURRENT PROGRAMS IN PLACE. SUCH PROGRAMS INCLUDE THE CARDIAC REHAB PROGRAM, WOMENS WAY PROGRAM, CHARITY CARE OR UNCOMPENSATED CARE PROGRAM, HOME HEALTH AND EXTENDED CARE PROGRAMS.TO EXPAND A BIT ON HOW FAR OUR COMMUNITY REACHES AND ITS REPRESENTATION - WE HAVE ESTABLISHED FOUR RURAL HEALTH CLINICS IN SURROUNDING COMMUNITIES WHICH REACH AS FAR OUT AS 45 MILES FOR THE CLINIC LOCATION, HOWEVER COMMUNITY CITIZEN EXPANSION REACHES BEYOND THE 45 MILE RADIUS. REPRESENTATION ON THE MEDICAL STAFF AND BOARD OF DIRECTORS REACHES INTO THESE AREAS, AS WE HAVE BOTH DESIGNATED PROFESSIONALS FROM THOSE AREAS ON OUR TEAMS FOR ENSURING ACCESS TO HEALTHCARE AND ADDRESSING THOSE NEEDS OF THE POPULATION IN THE AREA. |
| PART VI, LINE 3: | AS PATIENTS ENTER INTO THE HOSPITAL THE SOCIAL WORKER PAYS CLOSE ATTENTION TO THE PATIENTS FINANCIAL CLASS (TYPE OF PAYOR). IF PATIENTS ARE PRIVATE PAY, WE GO EDUCATE AND SPEAK TO THAT PATIENT ABOUT PROGRAMS THEY WOULD BE ELIGIBLE FOR. IF PATIENTS HAVE LOW ASSETS/LOW INCOME, THEY COULD BE ELIGIBLE FOR MEDICAID THROUGH THE COUNTY SOCIAL SERVICES OR THEY ARE ELIGIBLE FOR THE HOSPITALS UNCOMPENSATED CARE. THE UNCOMPENSATED CARE (CHARITY CARE) FOLLOWS THE FEDERAL GUIDELINES REGARDING INCOME ASSET LEVELS. IF PATIENTS NEED ASSISTANCE WITH THE APPLICATION, WE WOULD ASSIST THEM. THE CHARITY CARE GUIDELINES ARE PRINTED ON THE BACK OF EVERY PATIENTS MONTHLY STATEMENT. THE SOCIAL WORKER AT OUR FACILITY IS THE RESPONSIBLE PARTY OF INFORMING PATIENTS WITH EDUCATION ABOUT PROGRAMS THEY MAY BE ELIGIBLE FOR WHETHER IT IS THE HOSPITALS CHARITY CARE OR OTHER STATE/FEDERAL FUNDED PROGRAMS. |
| PART VI, LINE 4: | WISHEK HOSPITAL CLINIC ASSOCIATION (WHCA) IS A 24-BED NON-PROFIT CRITICAL ACCESS HOSPITAL (CAH) LOCATED IN SOUTH CENTRAL NORTH DAKOTA. OUR ORGANIZATION PROVIDES SUCH SERVICES AS 24-HOUR EMERGENCY CARE, CLINIC, AMBULANCE, OUTPATIENT HOSPITAL AND ANCILLARY SERVICES, INPATIENT AND SWINGBED, OUTPATIENT SURGERY, HOME HEALTH, AND HOSPICE SERVICES. WHCA HAS FOUR RURAL HEALTH CLINICS LOCATED IN WISHEK, KULM, NAPOLEON, AND GACKLE AND OF THE FOUR; THREE ARE LOCATED MORE THAN 30 MILES AWAY. OUR AMBULANCE PROVIDES CPR TRAINING TO THOSE INTERESTED AND IS ON STANDBY CALL AT LOCAL FOOTBALL GAMES AS A COURTESY TO THE COMMUNITY. WHCA SERVES THE COUNTIES OF MCINTOSH, LOGAN, AND WESTERN LAMOURE, WHICH INCLUDES A GEOGRAPHIC AREA OF OVER 2,000 SQUARE MILES AND APPROXIMATELY 6,800 RESIDENTS ACCORDING TO THE U.S. CENSUS BUREAU, CENSUS 2010 REPORT. STATISTICS IN RELATION TO THIS POPULATION INCLUDE A MAJORITY OF THE POPULATION OF AGE 65 OR OLDER WITH MCINTOSH AT 37.2%, LOGAN 28.2%, AND LAMOURE 24.6%. THE CASE MIX FOR THE HOSPITAL IS 71% MEDICARE, 19% BCBS, 3% MEDICAID AND 7% OTHER. THE CASE MIX FOR OUR FOUR CLINICS IS 50% MEDICARE, 35% BCBS, 3% MEDICAID, AND 12% OTHER. THE MEDIAN AGE OF RESIDENTS OF MCINTOSH COUNTY IS 51 YEARS OF AGE. WITH THIS STATISTIC, THE MAIN AREA WHICH WHCA SERVES INDICATES MCINTOSH COUNTY IS THE OLDEST COUNTY OF THE 53 COUNTIES IN NORTH DAKOTA. FURTHERMORE, MCINTOSH COUNTY IS THE FIFTH OLDEST MEDIAN AGE OF ALL COUNTIES IN THE NATION. THE STATE MEDIAN AGE IS 37 YEARS AND THE NATIONAL MEDIAN AGE IS 37.2. FIGURES ARE ACCORDING TO THE 2010 CENSUS. THE PERCENT OF NORTH DAKOTA RESIDENTS LIVING IN POVERTY WAS ESTIMATED IN 2009 TO BE 11.7%. MCINTOSH COUNTY WAS ESTIMATED TO BE 14%, LOGAN COUNTY 13.2%, AND LAMOURE COUNTY 10.9%.THE COMMUNITY OF WISHEK POSSESSES AN 86-BED NURSING HOME (WISHEK HOME FOR THE AGED), WHICH IS INDEPENDENT OF THE HOSPITAL. THE COMMUNITY OF NAPOLEON, WHICH IS LOCATED IN LOGAN COUNTY, HAS A 44-BED NURSING HOME (NAPOLEON CARE CENTER) AND WE PROVIDE THE MAJORITY OF HEALTH CARE IN THESE TWO SKILLED FACILITIES. WE ALSO PROVIDE HEALTH CARE SERVICES TO THE RESIDENTS OF THE GACKLE CARE CENTERS BASIC CARE RESIDENTS IN GACKLE, ND.WHCA IS LOCATED IN A DESIGNATED MEDICALLY UNDERSERVED AREA AND IN A HEALTH PROFESSIONAL SHORTAGE AREA IN NORTH DAKOTA. |
| PART VI, LINE 5: | THE WHCA GOVERNING BOARD IS COMPOSED OF MEMBERS FROM THE COMMUNITIES IT SERVES AND ARE NOT EMPLOYEES, CONTRACTORS, NOR FAMILY MEMBERS. THE SURPLUS OF FUNDS IS USED TO UPDATE THE AGING FACILITY AS WELL AS UPDATED TECHNOLOGICALLY MEDICAL EQUIPMENT TO SERVICE OUR PATIENT POPULATION. HAVING UPDATED MEDICAL EQUIPMENT NOT ONLY KEEPS THE SERVICES IN TO OUR RURAL AREA, BUT ALSO ALLOWS US TO PROVIDE FOR OUR PATIENTS |
| PART VI, LINE 7, REPORTS FILED WITH STATES | ND,ND |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK RINEHARDT | PersonNm |
| Title | CEO-CONTRACTED | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | MARK RINEHARDT IS AN EMPLOYEE OF ST. ALEXIUS MEDICAL CENTER, WHO THE ASSOCIATION HAS CONTRACTED WITH FOR MANAGEMENT SERVICES. ST. ALEXIUS IS AN UNRELATED ORGANIZATION. HIS COMPENSATION IS PAID DIRECTLY BY ST. ALEXIUS MEDICAL CENTER. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT SERVICES ARE PROVIDED BY A MANAGEMENT SERVICES AGREEMENT WITH ST. ALEXIUS MEDICAL CENTER. ST. ALEXIUS PROVIDES CEO SERVICES TO THE ASSOCIATION. THESE SERVICES INCLUDE HIRING EMPLOYEES, FIRING EMPLOYEES, SUPERVISING PERSONNEL AND SUPERVISING EXEMPT OPERATIONS. ALL DECISIONS OF THE CONTRACTED CEO ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP IS OPEN TO ANY INDIVIDUAL IN THE SERVICE AREA WHO CONTRIBUTES $10.00 TO THE ASSOCIATION AND REQUESTS MEMBERSHIP. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL ELIGIBLE MEMBERS MAY VOTE AT THE ANNUAL MEETING FOR THE ELECTION OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | AT THE ANNUAL MEETING THE MEMBERS MAY DISCUSS THE BUSINESS OF THE ASSOCIATION AND MAKE AND APPROVE MOTIONS CONCERNING THAT BUSINESS OR THE ACTIONS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS PROVIDED TO EACH BOARD MEMBER PRIOR TO THE FILING OF THE RETURN WITH THE IRS. ALL BOARD MEMBERS ARE GIVEN AN OPPORTUNITY TO REVIEW AND ASK ANY QUESTIONS CONCERNING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY THE BOARD MEMBERS MUST DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST TO THE BOARD AND MANAGEMENT AND MUST NOT PARTICIPATE IN ANY VOTE THAT INVOLVES A CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD RECEIVES AND REVIEWS A COPY OF THE ND HOSPITAL ASSOCIATION SALARY SURVEY, COMPARES THE SURVEY AMOUNTS TO THE SALARIES BEING PAID TO THE CEO, OTHER OFFICERS AND KEY EMPLOYEES, REVIEWS THE EVALUATION RESULTS FOR EACH INDIVIDUAL AND APPROVES APPROPRIATES SALARIES AND RAISES. |
| FORM 990, PART VI, SECTION C, LINE 19 | AUDITED FINANCIAL STATEMENTS ARE PRESENTED TO THE MEMBERS AT THE ANNUAL MEETING AND ARE AVAILABLE UPON REQUEST BY A MEMBER OF THE PUBLIC FOR REVIEW. |
| FORM 990, PART XI, LINE 2C: | THE FULL BOARD OF DIRECTORS APPROVE THE SELECTION OF THE AUDITORS AND MEET WITH THE AUDITORS TO REVIEW AND APPROVE THE AUDITED FINANCIAL STATEMENTS. |