ST ALEXIUS MEDICAL CENTER: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- ST ALEXIUS MEDICAL CENTER (EIN 45-0226711)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-12
- IRS object ID
- 201101329349302740
- Schema version
- 2009v1.7
- 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) |
|---|---|---|
| Timestamp | 2011-05-12T15:56:59-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4310 17TH AVE S PO BOX 2545 | AddressLine1 |
| City | FARGO | City |
| State | ND | State |
| ZIP Code | 581082545 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450226711 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Alexius Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAL | NameControl |
| Phone | 7015307000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 East Broadway Avenue | AddressLine1 |
| City | Bismarck | City |
| State | ND | State |
| ZIP Code | 585014520 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Gary Miller | Name |
| Title | Interim CEO | Title |
| Phone | 7015307000 | Phone |
| Date Signed | 2011-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LISA CHAFFEE CPA | Name |
| Phone | 7012398500 | Phone |
| Date Prepared | 2011-05-04 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Gary Miller | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 East Broadway Avenue | AddressLine1 |
| City | Bismarck | City |
| State | ND | State |
| ZIP Code | 585014520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 255788447 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c | X | Organization501c |
| Web Site | www.st.alexius.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1905 | YearFormation |
| State Legal Domicile | ND | StateLegalDomicile |
| Activity Or Mission Description | Providing Healthcare | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2491 | TotalNbrEmployees |
| Total Nbr Volunteers | 272 | TotalNbrVolunteers |
| Total Gross UBI | 9999184 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 481258 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 502924 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 228924634 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 246267321 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -3271782 | InvestmentIncomePriorYear |
| Investment Income Current Year | 567952 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 7783207 | OtherRevenuePriorYear |
| Other Revenue Current Year | 8393486 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 233917317 | TotalRevenuePriorYear |
| Total Revenue Current Year | 255731683 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 36314 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 95350115 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 100717797 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 418164 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 133007533 | OtherExpensePriorYear |
| Other Expenses Current Year | 144001746 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 228357648 | TotalExpensesPriorYear |
| Total Expenses Current Year | 244755857 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 5559669 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 10975826 | RevenuesLessExpensesCY |
| Total Assets BOY | 192777755 | TotalAssetsBOY |
| Total Assets EOY | 211958975 | TotalAssetsEOY |
| Total Liabilities BOY | 66495860 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 74459650 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 126281895 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 137499325 | NetAssetsOrFundBalancesEOY |
| Mission Description | Based on the Gospel values and our own heritage of healing, the mission of St. Alexius Medical Center is to use our community presence as a means of touching and healing people in a Christ-like manner, and to always exhibit the hospitality as reflected in the rule of St. Benedict: "Let all be received as Christ." | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 35732382 | Expense |
| Revenue | 120642013 | Revenue |
| Description | St. Alexius Medical Center began as a 20-bed hospital 125 years ago but has evolved into a 306-bed, full-service, certified Level II Trauma Acute Care Center that provides advanced healthcare services. St Alexius served 12,010 inpatients during the fiscal year ended June 30th, 2010. In 2006, St. Alexius was recognized as a Magnet Hospital being the first hospital to achieve this distinction. To be considered, the hospital must satisfy a set of criteria designed to measure the strength and quality of their nursing, which includes low employee turnover rates, a highly educated nursing staff, optimal nurse-to-patient ratios and high quality of care. Studies have shown that patients who are treated in Magnet facilities average a shorter length of stay and a higher rate of satisfaction. With over 1,200 births each year, two out of every three babies born in this region are born at St. Alexius Medical Center. Our family-focused care provides a wide range of services for mother and baby, and our specially trained nurses and physicians are prepared to handle every birthing experience with care. St. Alexius' 24-bed Level III NICU has served the region for more than 25 years, which is staffed by neonatal nurses, therapists, board-certified neonatologists, a pediatric neurologist and the regions only pediatric cardiologist. St. Alexius' Heart & Vascular Center provides comprehensive care to patients with cardiovascular, lung, and peripheral artery disease. We are comprised of an interventional radiologist, cardiologists, heart and vascular surgeons as well as other highly trained support personnel. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 29546362 | Expense |
| Revenue | 30171114 | Revenue |
| Description | Specialty Clinics: The Clinics of St. Alexius is a unique multi-specialty group practice located mainly inside St. Alexius Medical Center. Over 40 providers in 14 different specialties work together to care for patients. Specialists must complete seven or more years of medical school and post-graduate training and then complete fellowships in their chosen specialties. All physicians are board eligible or board certified in one or more specialties. The providers see approximately 62,000 encounters a year. We provide clinic services in many off site satellite clinics and bring specialty services to the region. The Clinics of St. Alexius include Center for Family Medicine Mandan, Minot Medical Clinic, Infectious Disease, Neonatology, Nephrology, Nephrology, Neurosurgery, Pain, Pediatric Cardiology, Pediatric Neurology, Adult Physical Medicine, Primary Care, Rheumatology, Sleep Medicine, and Urology. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 153948288 | Expense |
| Revenue | 93272110 | Revenue |
| Description | Outpatient:1. St. Alexius operates an outpatient family service program called Archway Family Services. This program offers sensitive and responsive services for individual, marital and family problems.This program is keeping with St. Alexius Medical Center's philosophy of being a leader in progressive and quality services to the people of North Dakota. Archway services are also provided in Hazen, Garrison and Linton, ND.2. Great Plains Rehabilitation Services is a division of St. Alexius Medical Center that provides Home Medical Equipment, Orthotic & Prosthetic, Home Respiratory Care, ADA Environmental, and Rehabilitation Technology services. Great Plains provides needed medical equipment and supplies to help individuals lead active and independent lives. Great Plains services all of North Dakota, Central and Eastern Montana, and Northern South Dakota.OTHER:-St. Alexius Medical Center served 12,010 inpatients, 105,014 outpatients, 27,182 emergency patients, and 16,332 Home Health Care patients during the fiscal year ended June 30, 2010.-St. Alexius Medical Center provided community activities and services at reduced or no cost. Those included:1. EMPLOYEE ASSISTANCE - Two hundred and three employer contracts servicing 38,140 employees by providing problem assessment, short term counseling and referral to appropriate resources for follow-up care. 2. EMPLOYEE ACTIVITIES - In keeping with the Medical Center's commitment to its employees:-Actively participated in the United Way fund campaign.-Journey Beyond Excellence program with a new rewards and recognition program.-Nursing Education Council develops and implements a preceptor reward and recognition program.-The vacation donation program assisted employees who used 663.25 hours of donated vacation. Employees have donated 630 vacation hours.-The Employee Emergency Fund is for any St. Alexius employee who experiences a crisis or is directly affected by a crisis involving a family member. The funds are available to employees who are facing personal tragedies or hardships for reasons such as a loss of a spouse or child, catastrophic illness, loss of home by fire or flood, or other calamities. Since its inception, $157,570.34 has been raised with a total of 138 employee gifts awarded.3. ACUTE CARE FACILITY - St. Alexius is a partner with another acute care facility to operate a radiation therapy facility known as The Cancer Center. The Cancer Center helps to ensure that patients with cancer receive quality care and management of their disease without having to drive a long distance to receive the same type of care. 4. AWARDS/ACCOMPLISHMENTS--St. Alexius ranked among the top 5 percent in the nation and #1 in North Dakota for cardiac care. The ranking is based on the Tenth Annual HealthGrades Hospital Quality in America Study. HealthGrades is the leading healthcare ratings organization. Other outcomes from this study:-Ranked among the Top 5% in the Nation for Overall Cardiac Services-Ranked among the Top 5% in the Nation for Cardiac Surgery-Ranked among the Top 5% in the Nation for Coronary Interventional Procedures-Ranked among the Top 10% in the Nation for Cardiology Services-Ranked #1 in ND for Cardiac Care, Cardiac Surgery, Cardiology Services and Coronary Interventional Services-Five-Star Rated for Overall Cardiac Care, Cardiac Surgery, Cardiology Services, Coronary Bypass Surgery, Valve Replacement Surgery, Coronary Interventional Procedure, and Treatment for Heart Attack -St. Alexius fulfilled the requirements to become North Dakota's first Magnet(TM) Hospital. Magnet is considered to be the gold standard in patient care. Achieving Magnet designation helps consumers locate health care organizations that have a proven level of excellence in nursing care. -Great Plains Rehab Services Orthotics & Prosthetics area received unconditional accreditation for 3 years from The American Board of Certification in Orthotics & Prosthetics. Surveyor comments included having the best patient record and performance improvement practices that the surveyor had seen in the industry.-St. Alexius Medical Center has met the criteria necessary to be designated a Blue Distinction Center for bariatric surgery, knee and hip replacement, and spine surgery. This designation means that St. Alexius has met or exceeded certain criteria that demonstrate reliability in delivering bariatric surgical care and better overall outcomes for patients. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 219227032 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 226 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 2491 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gary Miller | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7015308888 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 East Broadway Avenue | AddressLine1 |
| City | Bismarck | City |
| State | ND | State |
| ZIP Code | 585014520 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| John Castleberry | ||||||||
| Chair | 3.00 | X | X | 9575 | 0 | 0 | ||
| Sr Nancy Miller | ||||||||
| President | 3.00 | X | X | 0 | 0 | 0 | ||
| Sr Thomas Welder | ||||||||
| Vice President | 3.00 | X | X | 0 | 0 | 0 | ||
| Sr Gerard Wald | ||||||||
| Secretary | 3.00 | X | X | 0 | 0 | 0 | ||
| Sr Rosanne Zastoupil | ||||||||
| Treasurer | 3.00 | X | X | 0 | 0 | 0 | ||
| Sr Mariah Dietz | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Kenneth Ziegler | ||||||||
| Director | 3.00 | X | 5200 | 0 | 0 | |||
| Chuck Reichert | ||||||||
| Director | 3.00 | X | 7025 | 0 | 0 | |||
| Robert Gayton | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Vern Dosch | ||||||||
| Director | 3.00 | X | 4000 | 0 | 0 | |||
| Nicholas Neumann MD | ||||||||
| Director | 3.00 | X | 3975 | 0 | 0 | |||
| John Giese | ||||||||
| Director | 3.00 | X | 4450 | 0 | 0 | |||
| Andrew Wilson | ||||||||
| President / CEO | 50.00 | X | X | 540076 | 0 | 22333 | ||
| Ernest Godfread | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Gary Miller | ||||||||
| Interim CEO | 50.00 | X | 272069 | 0 | 10002 | |||
| Frank Kilzer | ||||||||
| VP Material & Facility Res | 40.00 | 184581 | 0 | 22447 | X | |||
| Wanda Pfaff | ||||||||
| VP Human Resources | 40.00 | 199706 | 0 | 22790 | X | |||
| Duwayne Schlittenhard | ||||||||
| VP Professional Services | 40.00 | 212446 | 0 | 14894 | X | |||
| Dr Syed Hyder | ||||||||
| VP Medical Affairs | 40.00 | 442317 | 0 | 26945 | X | |||
| Linda Knodel | ||||||||
| Sr VP / CNO | 40.00 | 247773 | 0 | 24683 | X | |||
| Rosanne Schmidt | ||||||||
| VP / CNO | 40.00 | 151800 | 0 | 13439 | X | |||
| Kurt Waldbillig | ||||||||
| VP Physician Services & Outreach | 40.00 | 158092 | 0 | 20271 | X | |||
| Michael Brown | ||||||||
| Cardiologist | 40.00 | 697020 | 0 | 16812 | X | |||
| Brent Herbel | ||||||||
| Radiologist | 40.00 | 739350 | 0 | 22403 | X | |||
| Eric Belanger | ||||||||
| Neurosurgeon | 40.00 | 1205386 | 0 | 21753 | X | |||
| Steve Kraljic | ||||||||
| Neurosurgeon | 40.00 | 1125929 | 0 | 22059 | X | |||
| Leslie Rainwater | ||||||||
| Urologist | 40.00 | 578246 | 0 | 22223 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 6789016 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 283054 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Bismarck Radiology Associates | |||||
| 810 E Rosser Ave Ste 201 | Bismarck | ND | 58501 | Radiology Services | 5410638 |
| Northern Plains Laboratory LLC | |||||
| PO Box 2036 | Bismarck | ND | 58502 | Pathology Services | 3539161 |
| DMS Health Technologies | |||||
| PO Box 86 | Minneapolis | MN | 554862208 | Radiology Services | 566602 |
| Dell Marketing | |||||
| PO Box 802816 | Chicago | IL | 606802816 | Computer Services | 313716 |
| Mayo Collaborative Services | |||||
| PO Box 9146 | Minneapolis | MN | 554809146 | Laboratory Services | 276504 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| All Other Contributions | 502924 | AllOtherContributions |
| Total Contributions | 502924 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Patient service revenu | 541900 | 237726086 | 235544002 | 2182084 |
| Other revenue | 900099 | 7244432 | 7244432 | |
| Cafeteria | 900099 | 1147176 | 1147176 | |
| Health and Education | 900099 | 149627 | 149627 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 246267321 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 333442 | TotalRevenueColumn |
| Exclusion | $333,442 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 576386 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 576386 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 576386 | TotalRevenueColumn |
| Exclusion | $576,386 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 291274 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 56764 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 291274 | Securities |
| Other | -56764 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 234510 | TotalRevenueColumn |
| Exclusion | $234,510 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|
| Community pharmacy | 446110 | 5668234 | 5668234 |
| Northern plains lab | 621500 | 926866 | 926866 |
| Outside lab | 621500 | 808983 | 808983 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 413017 | TotalRevenueColumn |
| Unrelated Business Revenue | 413017 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 7817100 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 255731683 | TotalRevenueColumn |
| Related Or Exempt Function Income | 244085237 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 9999184 | UnrelatedBusinessRevenue |
| Exclusion | $1,144,338 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36314 | Total |
| Program Services | 36314 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2597929 | Total |
| Management And General | 2597929 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77425948 | Total |
| Program Services | 66938551 | ProgramServices |
| Management And General | 10343115 | ManagementAndGeneral |
| Fundraising | 144282 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3273801 | Total |
| Program Services | 2803690 | ProgramServices |
| Management And General | 464523 | ManagementAndGeneral |
| Fundraising | 5588 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10921178 | Total |
| Program Services | 9347921 | ProgramServices |
| Management And General | 1552961 | ManagementAndGeneral |
| Fundraising | 20296 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6498941 | Total |
| Program Services | 5691694 | ProgramServices |
| Management And General | 797679 | ManagementAndGeneral |
| Fundraising | 9568 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 146216 | Total |
| Management And General | 146216 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58573 | Total |
| Management And General | 58573 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34054124 | Total |
| Program Services | 33224703 | ProgramServices |
| Management And General | 829421 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22410001 | Total |
| Program Services | 15658918 | ProgramServices |
| Management And General | 6514694 | ManagementAndGeneral |
| Fundraising | 236389 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2364426 | Total |
| Program Services | 1976478 | ProgramServices |
| Management And General | 387948 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 919528 | Total |
| Program Services | 847911 | ProgramServices |
| Management And General | 70066 | ManagementAndGeneral |
| Fundraising | 1551 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2492441 | Total |
| Program Services | 2492441 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13417459 | Total |
| Program Services | 13342630 | ProgramServices |
| Management And General | 74829 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1555809 | Total |
| Program Services | 1046807 | ProgramServices |
| Management And General | 509002 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 38074371 | 38074371 | ||
| Pharmacy | 15940948 | 15940948 | ||
| Bad debt | 8134880 | 8134880 | ||
| Equipment Rental/Mainte | 4432970 | 3668775 | 763705 | 490 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 244755857 | Total |
| Program Services | 219227032 | ProgramServices |
| Management And General | 25110661 | ManagementAndGeneral |
| Fundraising | 418164 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23439805 | BOY |
| EOY | 19918885 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34977849 | BOY |
| EOY | 36895675 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 434478 | BOY |
| EOY | 301511 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3340236 | BOY |
| EOY | 3593378 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2564806 | BOY |
| EOY | 1809174 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 261274856 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 157530339 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 95387407 | BOY |
| EOY | 103744517 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7055707 | BOY |
| EOY | 28084236 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23516089 | BOY |
| EOY | 15765845 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2061378 | BOY |
| EOY | 1845754 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192777755 | BOY |
| EOY | 211958975 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20626968 | BOY |
| EOY | 24524819 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36323557 | BOY |
| EOY | 42242200 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5089272 | BOY |
| EOY | 2824986 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4456063 | BOY |
| EOY | 4867645 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66495860 | BOY |
| EOY | 74459650 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125229541 | BOY |
| EOY | 136272278 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1052354 | BOY |
| EOY | 1227047 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 126281895 | BOY |
| EOY | 137499325 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192777755 | BOY |
| EOY | 211958975 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3228718 | BeginningOfYearBalance |
| Contributions | 347995 | Contributions |
| Investment Earnings Or Losses | 50166 | InvestmentEarningsOrLosses |
| Other Expenditures | 202661 | OtherExpenditures |
| Administrative Expenses | 4526 | AdministrativeExpenses |
| End Of Year Balance | 3419692 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3007949 | BeginningOfYearBalance |
| Contributions | 415278 | Contributions |
| Investment Earnings Or Losses | -7070 | InvestmentEarningsOrLosses |
| Other Expenditures | 176999 | OtherExpenditures |
| Administrative Expenses | 10440 | AdministrativeExpenses |
| End Of Year Balance | 3228718 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17177572 | OtherCostOrOtherBasis |
| Book Value | 17177572 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 151130592 | OtherCostOrOtherBasis |
| Depreciation | 85649977 | Depreciation |
| Book Value | 65480615 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 89346387 | OtherCostOrOtherBasis |
| Depreciation | 69485989 | Depreciation |
| Book Value | 19860398 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3620305 | OtherCostOrOtherBasis |
| Depreciation | 2394373 | Depreciation |
| Book Value | 1225932 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 103744517 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (11 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Cancer Center | 2664055 | C |
| Cancer Center Foundation | 47104 | C |
| Cash and Cash Equivalents | 4511971 | C |
| Central Dakota Laundry Coop | 43572 | C |
| HFIE Investment | 154183 | C |
| NCHCA - Primecare | 37500 | C |
| Northern Plains Lab | 3157914 | C |
| Real Estate and Specialty Assets | 213680 | C |
| SA Health Services, Inc. | 1263 | C |
| Under Bond Indenture Agreements | 4857840 | C |
| West River Coop | 76763 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 15765845 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Capital lease obligations | Description |
| Amount | $4,867,645 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4867645 | TotalOfAmounts |
| Total Revenue | 255731683 | TotalRevenue |
| Total Expenses | 244755857 | TotalExpenses |
| Excess Or Deficit For Year | 10975826 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 274263 | NetUnrealizedGLOnInvestments |
| Other | -$32,659 | OtherAmount |
| Total Adjustments | 241604 | TotalAdjustments |
| Excess Or Deficit Per FS | 11217430 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 239488399 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 274263 | NetUnrealizedGainsInvestments |
| Other Revenues | -4163159 | OtherRevenues |
| Revenue Not Rptd F990 | -3888896 | RevenueNotRptdF990 |
| Revenue Subtotal | 243377295 | RevenueSubtotal |
| Other Revenues Not Included | 12354388 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 12354388 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 255731683 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 228478789 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 228478789 | ExpensesSubtotal |
| Other Expenses Not Included | 16277068 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 16277068 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 244755857 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | The endowment is utilized to provide funding to continue to enhance patient care at St. Alexius Medical Center set forth in our mission, "Let all be received as Christ." |
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | Part X: St. Alexius undergoes an annual analysis of its various tax positions, assessing the likelihood of those positions being upheld upon examination with relevant tax authorities. St. Alexius has not identified any liability as a result of this analysis. |
| Part XI, Line 8 - Other Adjustments: | Fair Value of Interest Rate Swap: -32664. Rounding: 5. | |
| Part XII, Line 2d - Other Adjustments: | Income from subsidiary included in revenue for financial statements: -4163159. | |
| Part XII, Line 4b - Other Adjustments: | Temporily restricted contributions: 174691. Revenues of Disregarded Entity-St. Alexius Heart and Lung: 12113909. Contribution of Long-Lived Assets: 65788. | |
| Part XIII, Line 4b - Other Adjustments: | Expenses of Disregarded Entity-St. Alexius Heart and Lung: 16277068. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1269448 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1269448 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12250329 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9947964 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2302365 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13519777 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9947964 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3571813 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01460 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 469884 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 469884 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 231266 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 231266 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 50117266 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38625862 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11491404 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04710 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 50818416 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38625862 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12192554 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04990 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 64338193 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 48573826 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15764367 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06450 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 10000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 26314 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 26314 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 36314 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 36314 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,645,741 | BadDebtExpenseAmount |
| Amount Attributable To | 317489 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 53204999 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 61655212 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8450213 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Plains Lab | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | Labratory Services | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.50000 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.50000 | PhysicansProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV (8 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Teaching HospitalTeachingHospital | Er24 HoursEr24Hours | Critical Access HospitalCriticalAccessHospital |
|---|---|---|---|---|---|---|---|---|
| St Alexius Medical Center | ||||||||
| 900 East Broadway | Bismarck | ND | 585065510 | X | X | X | X | |
| St Alexius Mandan Clinic | ||||||||
| 403 Burlington Street SE | Mandan | ND | 58554 | X | ||||
| St Alexius Minot Clinic | ||||||||
| 1600 2nd Ave SW Ste 19 | Minot | ND | 58701 | X | ||||
| Great Plains Rehabilitation Services | ||||||||
| 1212 East Main | Bismarck | ND | 58501 | X | ||||
| St Alexius Same Day Surgery Center | ||||||||
| 810 East Rosser Ave | Bismarck | ND | 58501 | X | ||||
| St Alexius Heart & Lung Clinic | ||||||||
| 310 North 10th Street | Bismarck | ND | 58501 | X | ||||
| Great Plains Health Company | ||||||||
| 3222 28th Street South | Fargo | ND | 58104 | X | ||||
| Community Memorial Hospital | ||||||||
| 220 5th Ave | Turtle Lake | ND | 58575 | X | X | X | ||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | Part I, Line 7: The charity care included in Part I, Line 7a is based on the cost to charge ratio using Worksheet 1.The unreimbursed Medicaid in Part I, Line 7b is based on gross charges and claims from the Medicaid cost report.The community health services, education and contributions in Part I, Lines 7e and f are based on actual expenses.The subsidized health services in Part I, Line 7g are based on estimated costs from the internal cost accounting general ledger systems. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: Subsidized health services includes $48,740,701 in costs attributable to physician clinics.In addition, line 7g also includes $20,493 of costs that were associated with emergency ambulance and air medical services that were provided to patients with the understanding they would not be able to pay for these services. The Hospital identified four patients in the fiscal year that required transfers, of which the associated costs were directly recorded in their general and administrative ledger accounts and not billed to the patients. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: The amount of bad debt expense removed from the denominator of the calculation on Part 1, Line 7, column f was $8,305,407. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Footnote to the organization's financial statements that describes bad debt expense:The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients, residents, and third party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision.The bad debt expense was converted to cost using the cost to charge ratio calculated using Worksheet 2.The estimated amount of the organization's bad debt expense that is attributable to patients eligible under the organization's charity care policy is approximately $317,489. This was based off the most recent community needs assessment reported in March 2011, which indicated that 12% of the population is below the Federal Poverty Guidelines. The 12% was applied to the amount of bad debt expense at cost.Discounts and payments on accounts are applied directly to the principal of the account. The Hospital does not charge interest or fees related to the use of a collection agency to collect these payments. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: St. Alexius Medical Center provides medically necessary care to all regardless of the ability to pay. Therefore the shortfall should be treated as a community benefit.Medicare allowable cost is based on the Medicare cost report. The Medicare cost report is completed based on the rules & regulations set forth by CMS. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: Any individual who indicates the financial inability to pay a bill for a medically necessary service shall be evaluated for Charity Care assistance. The Financial Counselor along with the Social Work Department staff attempt to identify all inpatients prior to discharge and begin the discussion of available programs including, but not limited to, the charity care program. Determination of eligibility should be made prior to discharge or as close to the date of service as possible. However, retroactive determinations are also eligible. The Customer Service staff in Patient Financial Services discusses Charity Care options with patients after services are rendered, usually, after the patient has received their first statement and provided the necessary documentation.A patient's employment status and earning capacity is taken into consideration when evaluating a Charity Care request. The Charity Care application for a patient that is unemployed at the time of the application but is expected to return to work will be placed on hold for a short time period. Students, with less than two years remaining until graduation, will not be considered for Charity Care. Students, with more than two years to graduation, will be considered for deferment of payment or allowed to make minimal payments until graduation. Documented outstanding bills and expenses may be considered when the income is above the poverty guidelines. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: The Organization is in the process of assessing the health needs of the community through feedback from the physicians and from patients.The University of Mary, N.D. Department of Health, Centers for Disease Control & Prevention, John Goodman & Associates Study, and Minot Feasibility Study are together working on a community assessment for St. Alexius Medical Center. The results were presented to the Community Benefit Committee in March 2011. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Charity care is currently not posted but we are looking at changing this policy. Currently patients are contacted through pre-admissions and they meet with patient financial staff that go through information prior to procedures. Patient Financial Services also works with patients that need assistance with their billings. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: St. Alexius provides outreach services across its service area of central and western North Dakota. St. Alexius operates the Garrison Memorial Hospital in Garrison, North Dakota and manages the Community Memorial Hospital in Turtle Lake. St. Alexius owns and operates clinics in Mandan, Minot, Garrison, and Washburn. North Dakota's population is 646,844 of which 59,471 reside in the city of Bismarck. The population is 91.1% white, 5.6% Native American, and the remaining 5.6% being African American, Asian, and Hispanic. By the year 2020, 45 of the 53 counties will have more than 22% of their population age 65 or older. From 2000-2005 our state had a 15% decrease in the number of youth and a 13.8% increase in the minority population which was primarily Native American Reservations. North Dakota has 12% of their population living in poverty. The leading causes of death in Burleigh county ranked in order are Diseases of the Heart, Alzheimers, Respiratory Cancer, Accidental, Cerebrovascular Disease, COPD, Diabetes, Breast Cancer, and Colorectal Cancer. Health related behaviors influence cardiovascular diseases such as smoking, physical inactivity, poor nutrition, and unhealthy weight status. Hypertension is a chronic disease associated with aging that has a high risk factor for heart disease and stroke. In North Dakota, 26% adults have high blood pressure. North Dakota adults are a part of the national trend towards increased obesity. 63% of the adults here have an unhealthy weight/BMI. Some of the health screenings that St. Alexius is conducting throughout the service region are vascular, wellness, memory, sleep apnea, and chronic obstructive pulmonary disease. Those individuals that are being screened at no or minimal cost are being alerted of health risks that might go undetected. Through screenings, it is our hope that these individuals seek further treatment and are empowered to make healthier lifestyle choices. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: The Hospital donated to the United Way and Haiti Relief. The United Way donations impact the community to improve the health of children and adults, as well as helping children and youth achieve their potential. The Hospital encourages their employees to contribute by committing to matching contributions. The amount listed in Part II, Line 3 represents only the Organization's matching contributions.The Hospital also donated funds to the Bismarck State College in support of the National Energy Center of Excellence building project that was completed in 2008. This building is instrumental in the education and training of the energy workforce, as well as training of area energy companies. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: The governing body is comprised of people in the community who are knowledgeable to advise the organization and are compensated for their expertise and time (see Part VII of Form 990).The organization extends medical staff privileges to Primecare physicians. The organization applies surplus funds, if available, to their reinvestment in equipment and facilities to improve patient care.The Hospital provides serveral services at reduced or no costs. Those included are as follows:1. INTERACTIVE NETWORK - Consists of twenty five communities located in Montana, South and North Dakota covering 70,000 square miles are serviced by the St. Alexius Medical Center network. INTERACTIVE NETWORK provides electrocardiogram management, interactive cardiac management, remote cardiac monitoring, electroencephalogram monitoring, fetal monitoring, biomedical services, dialysis and infant pneumocardiograms to patients in western and central North Dakota. These services might not be provided if not for the Hospital servicing these areas.2. OTHER ACTIVITES INCLUDED ON PART 1, LINE 7E: - In keeping with the Hospital's commitment to serve all members of its community St. Alexius Medical Center: -participated in health fairs-provided patient educational materials and classes-provided patient support groups for different diseases-conducted health screenings-sponsored "Wellness" type programs ranging from Lamaze instruction and parenting to babysitting to diet and weight control to social issues.-maintained a tumor registry-operated a Hospice Program-has telemedicine capabilities set-up in several rural communities-provides PAC's (radiology) services and radiology reading to many rural communities 3. OTHER ACTIVITES INCLUDED ON PART 1, LINE 7E: - Standing Rock Sioux Indian Reservation network of services with emphasis focused on improving the quality of care in the area of maternal and child nursing and mental health with a goal to reduce infant mortality. The program consists of support from a OB trained physician to provide prenatal and ongoing care in the Fort Yates community. Also in that community a bi-monthly newsletter that addresses the following topics:-Pregnancy and prenatal care-Labor and delivery-Infant nutrition-Teen pregnancy-Self esteem-Suicide prevention-Drug and alcohol abuse 4. St. Alexius manages a non-profit critical access hospital in Turtle Lake North Dakota. St. Alexius offers administrative expertise and purchasing economies that it passes on to this facility. This allows the facility to continue to provide health care services and operate more efficiently. Turtle Lake also provides primary care providers to clinics in McClusky and Washburn, ND.5. St. Alexius manages a non-profit critical access hospital in Garrison North Dakota. Garrison Memorial Hospital operates a 22 bed acute care hospital and a 26 bed skilled nursing facility. They also operate a 24 hour, Level IV Certified Emergency Room.6. St. Alexius operates a Telemedicine network, known as The Telecare Network. It is a service St. Alexius Medical Center and affiliated physicians offer in cooperation with 27 healthcare providers throughout the Dakotas. The service features telemedicine consultations between rural physicians and specialists in Bismarck using real time video and audio telepresence equipment. Consultations of both urgent and routine nature are available.7. St. Alexius provides support to other rural communities like Hettinger, North Dakota to help maintain needed primary care physician coverage in rural communities. | OtherInformation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Bismarck State College | |||||||
| PO Box 5587 | Bismarck | ND | 585065587 | 450343495 | Government | 10000 | Center of Excellence Building |
| Catholic Relief Services | |||||||
| PO Box 17090 | Baltimore | MN | 212037090 | 135563422 | 501(c)(3) | 10000 | Haiti Relief |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: St. Alexius makes donations to entities with charitable missions to ensure that our donations are used for the purposes intended. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Andrew Wilson | |||||||||||||
| 396966 | 0 | 131152 | 0 | 11958 | 0 | 9939 | 0 | 16153 | 0 | 566168 | 0 | 0 | 0 |
| Gary Miller | |||||||||||||
| 206233 | 0 | 65836 | 0 | 0 | 0 | 9218 | 0 | 2297 | 0 | 283584 | 0 | 0 | 0 |
| Frank Kilzer | |||||||||||||
| 138576 | 0 | 46005 | 0 | 0 | 0 | 7468 | 0 | 16030 | 0 | 208079 | 0 | 0 | 0 |
| Wanda Pfaff | |||||||||||||
| 150549 | 0 | 49157 | 0 | 0 | 0 | 6822 | 0 | 17369 | 0 | 223897 | 0 | 0 | 0 |
| Duwayne Schlittenhard | |||||||||||||
| 160018 | 0 | 52428 | 0 | 0 | 0 | 8082 | 0 | 8008 | 0 | 228536 | 0 | 0 | 0 |
| Dr Syed Hyder | |||||||||||||
| 332140 | 0 | 110177 | 0 | 0 | 0 | 9551 | 0 | 19908 | 0 | 471776 | 0 | 0 | 0 |
| Linda Knodel | |||||||||||||
| 186079 | 0 | 61694 | 0 | 0 | 0 | 9335 | 0 | 16756 | 0 | 273864 | 0 | 0 | 0 |
| Rosanne Schmidt | |||||||||||||
| 114206 | 0 | 37594 | 0 | 0 | 0 | 5798 | 0 | 8503 | 0 | 166101 | 0 | 0 | 0 |
| Kurt Waldbillig | |||||||||||||
| 118171 | 0 | 39921 | 0 | 0 | 0 | 6081 | 0 | 15101 | 0 | 179274 | 0 | 0 | 0 |
| Michael Brown | |||||||||||||
| 576138 | 0 | 120882 | 0 | 0 | 0 | 9812 | 0 | 10755 | 0 | 717587 | 0 | 0 | 0 |
| Brent Herbel | |||||||||||||
| 739350 | 0 | 0 | 0 | 0 | 0 | 10009 | 0 | 17064 | 0 | 766423 | 0 | 0 | 0 |
| Eric Belanger | |||||||||||||
| 1124479 | 0 | 80907 | 0 | 0 | 0 | 9764 | 0 | 18694 | 0 | 1233844 | 0 | 0 | 0 |
| Steve Kraljic | |||||||||||||
| 744962 | 0 | 356613 | 0 | 24354 | 0 | 9665 | 0 | 16509 | 0 | 1152103 | 0 | 0 | 0 |
| Leslie Rainwater | |||||||||||||
| 409503 | 0 | 168743 | 0 | 0 | 0 | 9129 | 0 | 15966 | 0 | 603341 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | President/CEO is allowed up to annual maximum executive benefit allowance of $10,000 for expenses incurred for: airline, club memberships, wellness/fitness programs, financial planning and tax preparation services, membership in community club, and cell phone and wireless connectivity. The amount of benefit used is included in taxable income. |
| Part I, Line 6 | At the beginning of each fiscal year, the Compensation Committee establishes a financial threshold which must be met before any awards are paid and establishes guidelines defining the size of any awards available to participants. At the end of the plan year, the Committee decides whether to make any awards to participants and how large any award shall be, in accordance with the guidelines established at the beginning of the plan year. Incentive compensation is earned as a percent of base salary. Base salary is defined as the annualized rate of pay (summation of monthly base salary for the plan year). |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (5 entries)
| Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|
| Burleigh County | |||||
| 456002204 | 2005-11-15 | 3059378 | 2005-Hospital Equipment | 0 | 0 |
| Burleigh County | |||||
| 456002204 | 2009-04-15 | 9160311 | 2009-Remodeling, Renovation and Expansion of Medical Center | 0 | 0 |
| City of Garrison | |||||
| 456002076 | 2007-12-20 | 3200000 | 2007-Improvements to the Infrastructor Relating to Energy Management | 0 | 0 |
| City of Bismarck | |||||
| 456002036 | 1998-12-01 | 24563857 | 1998-Building & Capital Equipment, Refund Prior Bonds | 0 | 0 |
| Burleigh County | |||||
| 456002204 | 2010-05-27 | 8156220 | Building Construction | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (5 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount DefeasedAmountDefeased |
|---|---|---|---|---|---|---|---|---|
| 3059378 | 59378 | 3000000 | 2006 | 0 | 0 | 1 | 1 | |
| 9160311 | 173311 | 8987000 | 2010 | 0 | 0 | 1 | 1 | |
| 3200000 | 3200000 | 2008 | 0 | 0 | 1 | 1 | ||
| 24563857 | 670200 | 19140564 | 1 | 0 | 1 | 1 | 4753093 | |
| 8156220 | 156220 | 8000000 | 2010 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (5 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (5 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate | Term Of HedgeTermOfHedge |
|---|---|---|---|---|---|---|
| (no name) | ||||||
| 0 | 0 | 0 | 0 | 0 | 0 | |
| (no name) | ||||||
| 0 | 0 | 0 | 0 | 0 | 0 | |
| US Bank NA | ||||||
| 0 | 0 | 1 | 0 | 0 | 0 | 10.000000000000 |
| (no name) | ||||||
| 1 | 0 | 0 | 0 | 0 | 0 | |
| (no name) | ||||||
| 0 | 0 | 0 | 0 | 0 | 0 | |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Steve Kraljic | NamePerson |
| Purpose Of Loan | Promissory Note | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $108,000 | OriginalPrincipalAmount |
| Balance Due | 23400 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 23400 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Blue Cross Blue Shield | |||
| Gary Miller BCBS board member | 1486319 | Insurance services | 0 |
| Wells Fargo | |||
| John Giese is Wells Fargo CEO | 263703 | Banking and insurance services | 0 |
| Lynn Dosch | |||
| Spouse of Board Member | 14701 | Employee | 0 |
| Martha Reichert | |||
| Daughter of Board Member | 33879 | Employee | 0 |
| David Gayton | |||
| Brother of Board Member | 375841 | Employee | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | Members: The corporation shall have one class of members, which shall consist of members of the monastic community known as the Benedictine Sisters of the Annunciation, BMV, who have made their perpetual monastic profession and who have been elected to or appointed to the Sponsorship Group of the Benedictine Sisters of the Annunciation, BMV. | |
| Form 990, Part VI, Section A, line 7a | Joint Powers of Members and Board of Directors: The following powers shall be reserved jointly to the members of the corporation and the board of directors: 1. Approve a new candidate appointed to serve as President/Chief Executive Officer of the corporation. 2. Approve any person to be elected to serve on the board of directors. 3. Remove any director if this action is indicated. The power of the board of directors to act on any of these matters is subject to the requirement that the members of the corporation shall approve such action prior to the submission of the matter to a vote of the board of directors. | |
| Form 990, Part VI, Section A, line 7b | Powers Reserved to Members: Exercise of the following powers shall be reserved exclusively to the members of the corporation to: 1. Change the sponsorship, reserved powers or mission of the corporation as an institution founded on Gospel values, the Benedictine heritage of healing and the healing ministry of Jesus. 2. Make any major policy change on ethical issues. 3. Authorize the sale or encumbrance of all or substantially all of the assets or property of the corporation. 4. Merge, liquidate or dissolve the corporation. S. Change the name of the corporation. 6. Change or amend the structure of the board of directors of the corporation. 7. Amend, alter or repeal the articles of incorporation and/or the bylaws of the corporation. 8. Approve or disapprove a proposed course of action which could reasonably be anticipated to adversely affect the sponsorship or mission of the corporation as an institution founded on Gospel values, the Benedictine heritage of healing and the healing ministry of Jesus. | |
| Form 990, Part VI, Section A, line 8b | There are no committees with the authority to act on behalf of the board of directors. | |
| Form 990, Part VI, Section B, line 11 | Internal staff will present to the audit and compliance committee and that committee recommends approval to the board. A draft is presented at a board meeting. | |
| Form 990, Part VI, Section B, line 12c | Annually all employees are asked conflict of interest questions at evaluation time. Employees are responsible for disclosing potential conflicts of interest by completing a disclosure form. Each year the compliance officer initiates a review of all conflicts of interests within the medical center. The following annually complete a disclosure form: board members, President/CEO, Vice Presidents, Directors/Managers, other employees with significant decision making authority or who are in a position to influence decisions. The forms are reviewed by the compliance officer and if a conflict is "new" or requires review, the CEO and the Audit & Compliance Committee discuss the conflict and determine appropriate course of action. | |
| Form 990, Part VI, Section B, line 15 | Compensation is reviewed annually by an independent group using comparability data and recommendations are presented to the President/CEO and/or Board of Directors for approval. | |
| Form 990, Part VI, Section C, line 19 | An annual report is available to the public that includes financial statements. | |
| Form 990, Part III | -The St. Alexius Medical Center Rehabilitation Center has been accredited from the Commission on Accreditation of Rehabilitation Facilities (CARF). This accreditation represents the highest level of accreditation that can be awarded to an organization and shows the organization's substantial conformance to the standards established by CARF. -St. Alexius was awarded the 100 Top Hospital Cardiovascular Benchmarks for Success Study, 9th Edition per Thomson Healthcare. Thomson Healthcare developed the 100 Top Cardiovascular Hospitals' study to identify high-performing cardiovascular hospitals nationally and to set performance targets for improving clinical outcomes and management of the high-risk, high-cost cardiovascular service line. To qualify, hospitals must achieve high scores across eight equally weighted performance criteria that reflect clinical processes and outcomes, volume, efficiency and cost. -St. Alexius received a health care quality award for our own overall performance on the Centers for Medicare & Medicaid Services quality measures. The award is based on the hospital's performance and degree of improvement on the quality measures for the treatment of acute myocardial infarction, heart failure, pneumonia, and surgical care. This award is a reflection of the commitment we have made to provide quality health care to the patients we serve. -One of our Emergency Room physicians earned the Best Doctor in America award. The Best Doctors in America database is the result of a survey of more than 40,000 physicians in the United States. Only those doctors recognized to be in the top 3-5% of their specialty earn the honor of being named one of the Best Doctors in America. The only way to be recognized as one of the best Doctors in America is for a doctor to earn high marks for clinical ability from his or her peers. -St. Alexius was the first in western ND to offer non-surgical treatment of atrial septal defect (ASD). ASD is a hole between the two upper chambers of the heart and is most commonly diagnosed in infants and children. If the defect is large and doesn't close patients may be more susceptible to colds, pneumonia and other infectious diseases. Left untreated, ASD can lead to heart arrhythmias, heart failure, high blood pressure, stroke and even death. Traditionally, the only treatment for ASD was open heart surgery. With the AMPLATZER device, it allows a less invasive, non-surgical approach to treat our patients with ASD. By using this device, most patients leave the hospital within 24 hours and resume normal activity soon thereafter. -The Noninvasive Cardiovascular Lab has accreditation in the area of Extracranial Cerebrovascular Testing and Peripheral Venous Testing by the Intersocietal Commission for the Accreditation of Vascular Laboratories. -St. Alexius has been awarded an accreditation by the Commission on Laboratory Accreditation of the College of American Pathologists (CAP). The CAP accreditation program is recognized by the federal government as being equal to or more stringent than the government's own inspection program. The inspectors examine the laboratory's records and quality control of procedures for the preceding two years. This stringent inspection program is designed to specifically ensure the highest standard of care for the laboratory's patients. -St. Alexius performed our first carotid stent procedure utilizing the current FDA approved Embolic Protection System. This procedure provides a minimally invasive treatment alternative to conventional open carotid artery surgery to patients who are at high surgical risk. The embolic protection system is designed to capture and remove particles of plaque that might be dislodged during the procedure, which could potentially lead to stroke and other complications. -St. Alexius was only one of fourteen hospitals in the entire United States to gain an award for Patient Safety, Patient Quality and Patient satisfaction from the HealthGrades Rating organization. -St. Alexius provides and supports an inpatient Psychiatric Unit and a Partial Psych outpatient unit. -St. Alexius was recently named a Top 50 Hospital by Becker's Hospital Review | Statement of Program Service Accomplishment Continuance: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Alexius Heart & Lung Clinic LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 East Broadway Avenue | AddressLine1 |
| City | Bismarck | City |
| State | ND | State |
| ZIP Code | 58501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861123162 | EIN |
| Primary Activities | Speciality Clinic-Cardiology, etc. | PrimaryActivities |
| Legal Domicile State | ND | LegalDomicileState |
| Total Income | -4163159 | TotalIncome |
| EOY Assets | 2543486 | EOYAssets |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Garrison Memorial Hospital | |||||||||
| 407 3rd Ave SE | Garrison | ND | 58540 | 450227752 | Hospital | ND | 501(c)(3) | 3 | N/A |
| Bismarck Cancer Center | |||||||||
| 500 N 8th Street | Bismarck | ND | 58501 | 450454363 | Cancer Treatment | ND | 501(c)(3) | 9 | N/A |
| Benedictine Sisters of the Annunciation BMV | |||||||||
| 7520 University Drive | BISMARCK | ND | 58504 | 450261530 | Religious Purposes | ND | 501(c)(3) | 1 | N/A |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Plains Lab | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 N 9 St | AddressLine1 |
| City | Bismarck | City |
| State | ND | State |
| ZIP Code | 585014507 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 841641341 | EIN |
| Primary Activity | Lab Operation | PrimaryActivity |
| Legal Domicile State | ND | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | Unrelated | PredominantIncomeType |
| Share Of Total Income | 922448 | ShareOfTotalIncome |
| Share Of EOY Assets | 3192005 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Central Dakota Hospital Laundry Inc | |||||||||||
| 1300 Industrial Dr | Bismarck | ND | 58501 | 450317366 | Hospital Laundry | ND | N/A | C | 20445 | 782450 | 0.50000 |
| St Alexius Health Services Inc | |||||||||||
| 900 East Broadway Ave | Bismarck | ND | 58501 | 450402817 | General Business Purpose | ND | N/A | C | 1263 | 1.00000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Northern Plains Laboratory | |
| R | 775000 |
| Bismarck Cancer Center | |
| R | 195000 |