SIOUX CENTER HEALTH: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- SIOUX CENTER HEALTH (EIN 42-0796764)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-04-12
- IRS object ID
- 202511029349300631
- Schema version
- 2023v6.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-04-12T14:34:17-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 345 N Reid Pl Ste 400 | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571037034 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420796764 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sioux Center Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SIOU | BusinessNameControlTxt |
| Phone | 7127221271 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 9th St SE | AddressLine1Txt |
| City | Sioux Center | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51250 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cory Nelson | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7127221271 | PhoneNum |
| Signature | 2025-04-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Laurie Hanson CPA | PreparerPersonNm |
| PTIN | P00851848 | PTIN |
| Phone | 6053391999 | PhoneNum |
| Preparation | 2025-04-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Cory Nelson | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 9th St SE | AddressLine1Txt |
| City | Sioux Center | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $77,181,449 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.siouxcenterhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | To provide medical care for all ages. | ActivityOrMissionDesc |
| Voting Members Governing Body | 36 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 33 | VotingMembersIndependentCnt |
| Total Employee | 764 | TotalEmployeeCnt |
| Total Volunteers | 36 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,159,627 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,105,282 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $56,286,757 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $66,625,503 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,614,855 | PYInvestmentIncomeAmt |
| CY Investment Income | $339,991 | CYInvestmentIncomeAmt |
| PY Other Revenue | $57,398 | PYOtherRevenueAmt |
| CY Other Revenue | $8,976,612 | CYOtherRevenueAmt |
| PY Total Revenue | $65,118,637 | PYTotalRevenueAmt |
| CY Total Revenue | $77,047,388 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $33,785,950 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $37,394,984 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,951,882 | PYOtherExpensesAmt |
| CY Other Expenses | $33,458,027 | CYOtherExpensesAmt |
| PY Total Expenses | $62,747,832 | PYTotalExpensesAmt |
| CY Total Expenses | $70,863,011 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,370,805 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,184,377 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $103,990,651 | TotalAssetsBOYAmt |
| Total Assets EOY | $112,029,574 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $60,754,321 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $61,983,019 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $43,236,330 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $50,046,555 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Bring hope, health and healing to life. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $60,605,372 | ExpenseAmt |
| Grant | $10,000 | GrantAmt |
| Revenue | $66,625,503 | RevenueAmt |
| Desc | Sioux Center Health operates a 19-bed acute-care hospital, a 99-bed nursing care facility, medical clinics, specialty physician clinic and independent/assisted living facilities (24 independent, 62 assisted apartments) located in Sioux Center, Iowa. During the fiscal year ending June 30, 2024, patient days were 1,714, swing-bed days were 853, and newborn days were 439.The Center also provides a wide variety of medically-related activities at less than, or at no cost to residents of communities throughout northwest Iowa. These activities include general community education programs and sponsorship of support groups for victims of chronic disease and their families. Other activities designed to measure or enhance the general health status of residents of the community include: classes related to CPR, diabetes, cardiac rehabilitation and childbirth; participation in health fairs at industrial and community sites throughout the area; cost free screenings to alert people with high blood pressure; providing use of meeting facilities at no charge to cancer, Alzheimer's, diabetes, weight maintenance, "senior and hospice support groups; programs for children; providing speakers for various events and education groups; and representation in community education programs.The Health Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Since the Health Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue. The estimated cost of providing these services was $580,000 for the year ended June 30, 2024, calculated by multiplying the ratio of cost to gross charges for the Health Center by the gross uncompensated charges associated with providing charity care to its patients. | Desc |
| Total Program Service Expenses | $60,605,372 | 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 |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 764 | 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 36 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 33 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Crystal Richter | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7127228153 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 9th St SE | AddressLine1Txt |
| City | Sioux Center | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51250 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (43 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 |
|---|---|---|---|---|---|---|---|
| Kyle Hiemstra | |||||||
| President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nathan Bakker | |||||||
| Vice President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jennifer Jansen | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Josh Bowar | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Janet Boone | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Bruce Dooyema | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Cory Gotto | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Curt Hohman | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Neil Van Schouwen | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Vernon Beernink | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Terry Boote | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Leslie Brommer | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Tim Byl | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Lisa Christians | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Paul Clousing | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Faye DeKam | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Brenda Dokter | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| David Eekhoff | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Daniel Finley | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Dan Hibma | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Lauren Kaemingk | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Rick Kattenberg | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Heidi Kramer | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Ardith Lein | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| John McDaniel | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Matt Nice | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Scott Peterson | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jeff Timmer | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jaron Vande Hoef | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Dale Vander Berg | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Brian Van Engen | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Doug Van Meetern | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Lyle Vermeer | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Marj Wagner | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Scott Wynja | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Verdean Wynja | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Cory Nelson | |||||||
| CEO | 40.00 | Yes (X) | $302,718 | $0 | $26,869 | ||
| Crystal Richter | |||||||
| CFO | 40.00 | Yes (X) | $129,178 | $0 | $42,354 | ||
| Julie McKay | |||||||
| Physician | 40.00 | $405,661 | $0 | $145,805 | Yes (X) | ||
| Scott Rens | |||||||
| Physician | 40.00 | $449,686 | $0 | $177,213 | Yes (X) | ||
| Lindsay Junk | |||||||
| Physician | 40.00 | $419,228 | $0 | $86,866 | Yes (X) | ||
| Dr Nicholas Mouw | |||||||
| General Surgeon | 40.00 | $849,617 | $0 | $78,752 | Yes (X) | ||
| Jason Koelwyn | |||||||
| Physician | 40.00 | $379,954 | $0 | $135,789 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,936,042 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $693,648 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Prime Time Healthcare LLC | |||||
| 15380 Weir St | Omaha | NE | 68137 | Temp Staffing | $1,516,111 |
| Tri-State Nursing | |||||
| 3100 S Lakeport St | Sioux City | IA | 51106 | Temp Staffing | $573,988 |
| Thomas Posch | |||||
| 234 Marina Dell Ave | Yankton | SD | 57078 | Radiology Readings | $357,692 |
| Michael Tadlock | |||||
| 100 S 11th St | Beresford | SD | 57013 | Anesthesia Services | $332,500 |
| Independent Radiology Services | |||||
| PO Box 2746 | Fargo | ND | 58108 | Radiology | $245,443 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $125,200 | GovernmentGrantsAmt |
| All Other Contributions | $980,082 | AllOtherContributionsAmt |
| Noncash Contributions | $728,356 | NoncashContributionsAmt |
| Total Contributions | $1,105,282 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 623990 | $58,967,295 | $58,967,295 |
| Pharmacy Revenue | 900099 | $3,085,133 | $3,085,133 |
| Assisted and Independent Living | 623990 | $2,227,405 | $2,227,405 |
| Investment in Affiliated | 900099 | $270,493 | $270,493 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,075,177 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,075,177 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $66,625,503 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $426,482 | TotalRevenueColumnAmt |
| Exclusion | $426,482 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $66,289 | 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 | $66,289 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,289 | TotalRevenueColumnAmt |
| Exclusion | $66,289 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $12,650 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $99,141 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$86,491 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$86,491 | TotalRevenueColumnAmt |
| Exclusion | -$86,491 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $67,283 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $34,920 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,363 | TotalRevenueColumnAmt |
| Exclusion | $32,363 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Employee Retention Credit | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $8,877,960 | TotalRevenueColumnAmt |
| Exclusion | $8,877,960 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,877,960 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,047,388 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,625,503 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,316,603 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $10,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $505,501 | TotalAmt |
| Management And General | $505,501 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,547 | TotalAmt |
| Program Services | $247,547 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,225,640 | TotalAmt |
| Program Services | $26,266,013 | ProgramServicesAmt |
| Management And General | $1,959,627 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,144,152 | TotalAmt |
| Program Services | $1,057,238 | ProgramServicesAmt |
| Management And General | $86,914 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,429,197 | TotalAmt |
| Program Services | $4,962,000 | ProgramServicesAmt |
| Management And General | $467,197 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,842,947 | TotalAmt |
| Program Services | $1,686,709 | ProgramServicesAmt |
| Management And General | $156,238 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,395 | TotalAmt |
| Management And General | $12,395 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $857,492 | TotalAmt |
| Management And General | $857,492 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,645,300 | TotalAmt |
| Program Services | $7,654,594 | ProgramServicesAmt |
| Management And General | $1,990,706 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,203 | TotalAmt |
| Program Services | $2,222 | ProgramServicesAmt |
| Management And General | $207,981 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,583,288 | TotalAmt |
| Program Services | $1,362,402 | ProgramServicesAmt |
| Management And General | $2,220,886 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,810 | TotalAmt |
| Program Services | $90,086 | ProgramServicesAmt |
| Management And General | $432,724 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $834,218 | TotalAmt |
| Program Services | $833,064 | ProgramServicesAmt |
| Management And General | $1,154 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,503 | TotalAmt |
| Program Services | $117,255 | ProgramServicesAmt |
| Management And General | $16,248 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,528 | TotalAmt |
| Program Services | $86,528 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,783,699 | TotalAmt |
| Program Services | $1,481,439 | ProgramServicesAmt |
| Management And General | $302,260 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,867,090 | TotalAmt |
| Program Services | $5,098,206 | ProgramServicesAmt |
| Management And General | $768,884 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,738 | TotalAmt |
| Program Services | $135,906 | ProgramServicesAmt |
| Management And General | $261,832 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $8,343,638 | $8,343,638 | |
| Food | $866,615 | $859,249 | $7,366 |
| Taxes | $192,913 | $192,738 | $175 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,597 | TotalAmt |
| Program Services | $118,538 | ProgramServicesAmt |
| Management And General | $2,059 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,863,011 | TotalAmt |
| Program Services | $60,605,372 | ProgramServicesAmt |
| Management And General | $10,257,639 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,281,107 | BOYAmt |
| EOY | $8,477,917 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,139,515 | BOYAmt |
| EOY | $16,740,670 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $942,545 | BOYAmt |
| EOY | $1,238,655 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,703 | BOYAmt |
| EOY | $740,750 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $112,918,567 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $46,511,436 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,747,507 | BOYAmt |
| EOY | $66,407,131 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,413,477 | BOYAmt |
| EOY | $8,382,478 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,067,409 | BOYAmt |
| EOY | $4,710,390 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $623,970 | BOYAmt |
| EOY | $486,893 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,002 | BOYAmt |
| EOY | $9,029 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,160,416 | BOYAmt |
| EOY | $4,835,661 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,990,651 | BOYAmt |
| EOY | $112,029,574 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,686,754 | BOYAmt |
| EOY | $6,414,186 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,331,807 | BOYAmt |
| EOY | $6,002,386 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,186,709 | BOYAmt |
| EOY | $44,591,581 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,549,051 | BOYAmt |
| EOY | $4,974,866 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,754,321 | BOYAmt |
| EOY | $61,983,019 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,306,998 | BOYAmt |
| EOY | $48,885,224 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $929,332 | BOYAmt |
| EOY | $1,161,331 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,236,330 | BOYAmt |
| EOY | $50,046,555 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,990,651 | BOYAmt |
| EOY | $112,029,574 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,184,377 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $625,848 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $247,170 | BeginningYearBalanceAmt |
| End Year Balance | $247,170 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $247,170 | BeginningYearBalanceAmt |
| End Year Balance | $247,170 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $247,170 | BeginningYearBalanceAmt |
| End Year Balance | $247,170 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $247,170 | BeginningYearBalanceAmt |
| End Year Balance | $247,170 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $247,170 | BeginningYearBalanceAmt |
| End Year Balance | $247,170 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,263,964 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,205,656 | OtherCostOrOtherBasisAmt |
| Book Value | $4,469,620 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $88,019,222 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,476,952 | DepreciationAmt |
| Book Value | $56,542,270 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,086,153 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,819,989 | DepreciationAmt |
| Book Value | $4,266,164 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,343,572 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,214,495 | DepreciationAmt |
| Book Value | $1,129,077 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $66,407,131 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Deferred Compensation | $3,723,483 |
| Estimated third-party payor settlements | $810,000 |
| Security deposits | $295,554 |
| Operating lease liability | $145,829 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,974,866 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $77,673,236 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $625,848 | OtherRevenueAmt |
| Revenue Not Reported | $625,848 | RevenueNotReportedAmt |
| Revenue Subtotal | $77,047,388 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $77,047,388 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $70,863,011 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $70,863,011 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $70,863,011 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The Health Center's endowment consists of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The Center does not have a formal policy or agreement with the Foundation covering the distribution of endowment fund earnings. The Center expects the Foundation to allow its endowment to grow consistent with the Center's objective to maintain the purchasing power of the endowment assets in order to provide additional real growth through new gifts and investment return. However, there is no current intention of using the permanently endowed funds. |
| Part X, Line 2: | The Health Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Health Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
| Part XI, Line 2d - Other Adjustments: | Change in net assets of Avera Health Foundation 625,848. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 35 | PersonsServedCnt |
| Total Community Benefit Expns | $580,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $580,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $3,354,781 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,229,785 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,124,996 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01590 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 35 | PersonsServedCnt |
| Total Community Benefit Expns | $3,934,781 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,229,785 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,704,996 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02410 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1754 | PersonsServedCnt |
| Total Community Benefit Expns | $10,515 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,515 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $15,161 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,161 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 10764 | PersonsServedCnt |
| Total Community Benefit Expns | $15,858,650 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,791,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,067,628 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05740 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $58,125 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $58,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 12568 | PersonsServedCnt |
| Total Community Benefit Expns | $15,942,451 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,791,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,151,429 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05850 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 12603 | PersonsServedCnt |
| Total Community Benefit Expns | $19,877,232 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,020,807 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,856,425 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08260 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,455,522 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $100,431 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $13,443,925 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,689,437 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$245,512 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sioux Center Health | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 9th St SE | AddressLine1Txt |
| City | Sioux Center | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.siouxcenterhealth.org | WebsiteAddressTxt |
| State License | 840080H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 2 provider based clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sioux Center Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Line 7d | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Line 7d | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V description in Section C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Sioux Center Health | Part V, Section B, Line 5: Sioux Center Health conducted its Community Health Needs Assessment (CHNA) partly as a collaborative process with three other hospitals and the public health agency in Sioux County, Community Health Partners of Sioux County. Sioux Center Health, along with Community Health Partners, gathered quantitative and qualitative data to determine the best suitable health initiatives that will make a lasting impact for our communities. Each hospital collected input from individuals representing the community as well as those with public health expertise. In order to avoid duplication of effort, the four critical access hospitals in Sioux County worked collaboratively with Community Health Partners to complete this community health needs assessment with a process that began in October of 2021. |
| Sioux Center Health | Part V, Section B, Line 6a: Hegg Memorial Health System Orange City Area Health System Hawarden Regional Healthcare |
| Sioux Center Health | Part V, Section B, Line 6b: Community Health Partners of Sioux County, the local public health agency for Sioux County.Promise Community Health Center |
| Sioux Center Health | Part V, Section B, Line 7d: https://www.siouxcenterhealth.org/wp-content/uploads/2022-Community-Health-Needs-Assessment.pdfPart V, Section B, Line 10a:https://www.siouxcenterhealth.org/wp-content/uploads/2022-CHNA-Report.pdf |
| Sioux Center Health | Part V, Section B, Line 11: A summary of the health issues raised through community input was presented to the collaborative planning group along with the secondary data report. On May 11, 2022, Community Health Partners convened a stakeholder meeting with attendees representing the participating healthcare organizations. Participants reviewed a summary of all assessments (community input, secondary data), identified and prioritized key issues. To determine priorities that healthcare systems will address collaboratively, the collaborative team used the Stakeholder Survey Results, Community Health Status Report, and stakeholder meeting input to generate a list of health needs / issues. Identified issues were: *Health care access*Heart disease*Mental health access *Social determinants While each of the health needs identified is important for overall community health, two additional health needs that came up during the assessment were substance use/abuse and dental services for Medicaid. Thanks to several partnerships in Sioux County, a county-wide Health Improvement Planning group has been established and has sub-groups currently working on these two areas. Sioux Center Health is well represented in this group.In the current year the facility has taken the following actions to address:Mental Health: Provided 24/7 coverage as a resource for those patients needing mental health services. Sioux Center Health utilizes contractual telehealth behavioral services, which have 24-hour behavioral assessments using a video camera. These services provide us with knowledge of available inpatient resources and makes calls to behavioral health facilities to help find placement, should a patient need further treatment. Sioux Center Health continued to build behavioral health programming within our medical clinics. Our Licensed Outpatient Therapists in combination with our Psychiatric-Mental Health Nurse Practitioner works with individuals and families to meet their life-long goals and achieve their emotional well-being. We offer medically managed treatment plans for all ages: children, adolescents, and adults. Sioux Center Health utilizes the mental health resources in Sioux City, Sioux Falls and surrounding areas for those adolescent patients who are requiring inpatient care for mental health needs and detox/treatment. Sioux Center Health has established relationships with local/area mental health agencies and will continue to utilize their services where appropriate. Ongoing staff training in recognizing signs and/or treatment of mental health concerns will continue to be provided.Social Determinants of Health:Sioux Center Health provides a bilingual Care Coordinator to ensure education for how to navigate the health care system, including financial assistance and programs. Financial counselors are on staff at Sioux Center Health to address financial aspects of health care with patients. Sioux Center Health provides on-site certified medical interpreters to provide fluid, transparent, and accurate communication. Our interpreter services are provided free of charge to the individuals being served, are available during clinic hours on weekdays and provide 24-hour video remote interpretation using healthcare appropriate remote audio and visual language service providers. Sioux Center supports All Kids Can, an organization whose mission is to make healthy living activities accessible to children of all ages through monetary assistance and to provide consistent support and encouragement along the way. Through our EMR we have started screening all inpatient admissions for Social Determinants of Health (SDOH). If there is something that flags on the assessment, our social workers are notified and meet with the patients.Heart Disease Prevention:Sioux Center Trails Council is actively developing new trails. Sioux Center Health has worked closely with this community group and has a representative that sits on this committee to provide valuable input. Sioux Center Health is a partner for Siouxperman Triathlon, Harvest Half Marathon and 10k run and community health fair. Sioux Center Health employs a diabetic educator, a registered dietician, and pharmacist who work with patients and community members to manage obesity related issues and provide education surrounding effective weight management and the associated health benefits.Healthcare Access:Sioux Center Health ensures a healthcare provider is at each of its locations. Medical providers from Sioux Center Health visit Crown Pointe Estates (independent, assisted, and care center) on a regular basis, as well as Hillcrest and Pleasant Acres senior living facilities. Sioux Center Health provides translation services through in-person interpreters. Financial counselors are on staff at Sioux Center Health to address financial aspects of health care with patients. Sioux Center Health continues to evaluate the needs of our communities and continues to hire or contract with additional providers as necessary. Sioux Center Health has also increased access to care through the addition of a Same Day Primary Care Clinic staffed by Advance Practice Providers. This clinic helps create additional access to healthcare providers in a timely manner. |
| Sioux Center Health | Part V, Section B, Line 13h: Sioux Center Health provides free care based on meeting presumptive eligibility requirements listed in the policy. |
| Sioux Center Health | Part V, Section B, Line 16j: Self pay patients are given a self-pay packet that explains financial assistance. A statement is sent out to all patients indicating financial assistance is available upon request. The charity care and other financial assistance options are discussed with inpatients if requested. |
| Sioux Center Health | Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital has confirmed no FAP eligible patients had elective procedures. |
| PART V SECTION B LINE 16 | Financial Assistance Policy :siouxcenterhealth.org/patients-visitors/billing-and-financial-assistance/financial-assistance-policy/Financial assistance application:siouxcenterhealth.org/wp-content/uploads/Financial-Assistance-Application-English.pdfFinancial Assistance Plain Language Summary:siouxcenterhealth.org/wp-content/uploads/Summary-of-Financial-Assistance.pdf |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Hawarden Medical Clinic | ||||
| 920 Avenue F | Hawarden | IA | 51023 | Physician clinic |
| 2 - Crown Pointe Estates | ||||
| 1400 7th Ave SE | Sioux Center | IA | 51250 | Nursing Facility, Independent and Assisted Living |
| 3 - Home Health & Hospice | ||||
| 1400 7th Ave SE | Sioux Center | IA | 51250 | Home health and hospice |
| 4 - Occupational Health Center | ||||
| 38 19th St SW | Sioux Center | IA | 51250 | Occupational health |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Sioux Center Health (SCH) provides free care based on meeting presumptive eligibility requirements listed in the policy. Federal Poverty Guidelines and financial asset-liabilities are used to determine eligibility for discounted care.Additional factors used to determine financial assistance eligibility include Asset level, medical indigency, and underinsurance status.Part I, Line 6b:The community benefit report is maintained at Sioux Center Health, mailed to community members, and is available to the public upon request. |
| Part I, Line 7: | Charity care expense on line 7a and Medicaid on line 7b were converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Lines 7e, 7f, and 7i: Costs are reported based on data from the general ledger accounting system. The general ledger accounting system addresses all patient segments (inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, and self-pay). The cost for subsidized health services reported on line 7g was determined using the facility's cost accounting system. |
| Part I, Line 7g: | Physician clinic costs are included in subsidized health services. Revenues of $792,412 and costs of $1,318,700 were included for a net community benefit of $526,288. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. |
| Part III, Line 3: | The estimated amount of implicit price concession attributable to patients that could have been eligible for charity care is based on estimated calculations from our collection agency. The agency calculated 6.9% of the total amount in collections could be charity care due to bankruptcy, deceased and charity adjustments on current accounts. |
| Part III, Line 4: | The footnote that describes implicit price concessions is on pages 14-15 of the attached audited financial statements. |
| Part III, Line 8: | Medicare allowable cost of care was calculated from the Medicare cost report for fiscal year ending 6/30/24. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. The Medicare cost report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. |
| Part III, Line 9b: | Accounts that meet the criteria for the financial assistance policy will be wrien off in accordance with the financial assistance policy. Accounts that do not meet the criteria for financial assistance will proceed through the collection process. If, during the collection process, it is determined that an account in collection belongs to a patient who is eligible for financial assistance, the account will be removed from collection and returned to the hospital for resolution. |
| Part VI, Line 2: | Sioux Center Health has a broad based Board of Directors providing community feedback on a quarterly basis. The organization normally holds an open public meeting annually to listen to issues of the community and share information regarding services and programs. The Hospital analyzes statistical data through IHA and Iowa Public Health to determine disease related needs, services and market share. The Hospital works closely with Community Health Partners to identify and address community health related needs. Additionally, the Hospital conducted a community health needs assessment during the year ended 6/30/22 in compliance with 501(r). |
| Part VI, Line 3: | Patients are made aware of financial assistance programs (English and Spanish) in a variety of ways:1. Self-pay patients are given a self-pay packet that explains financial assistance, payment plans, and the Hospital's 10% lump sum payment options. The self-pay packet includes a Medicaid application. 2. A statement is sent out to all patients indicating financial assistance is available upon request.3. The financial assistance application is available on the Hospital website in English and Spanish versions.4. The financial assistance application is available at the registration and ER desk in English and Spanish versions.5. Financial assistance information is included in SCH Facebook posts to increase awareness.Additionally, the financial assistance policy is available upon request and on the Sioux Center Health website. |
| Part VI, Line 4: | Sioux Center Health serves both the local Sioux Center community and the surrounding area of Sioux County, Iowa, which is primarily rural and located in the northwest part of the state. According to the U.S. Census Bureau Quick Facts, the population of Sioux County in 2023 is 36,246. The county is home to three other critical access hospitals, and Sioux Center is also served by a Federally Qualified Health Center (FQHC). Nearly 90% of Sioux Center Health's discharges come from Sioux County. The 2023 population of Sioux Center is 8,543 as reported by the US Census Bureau Quick Facts, with the median family income of $84,736. The workforce in Sioux Center is primarily composed of management, business, science, and arts professionals, making up the largest share of workers. Among the population aged 16 and older, 71.5% are employed, with a negligible unemployment rate. Additionally, 6.9% of the population lives below the poverty line, and 6% lacks health insurance. |
| Part VI, Line 5: | Sioux Center Health has a strong community focused perspective. The governing board is comprised of 36 volunteer members that reside in the community and primary service area. The Hospital is focused on its mission and serving people regardless of their ability to pay. The Hospital participates in mission projects throughout the year yielding support for various causes from local missions that provide after school activities, counseling, or domestic abuse services. This support comes in the form of paid staff volunteering their time, Hospital sponsored fundraisers, and direct financial support from the Hospital and its employees. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are used to make improvements in patient care, medical education, and research.Sioux Center Health has a strong mission to bring hope, health and healing to life. The Hospital offers services for our patients, residents and family to support the mind, body and spirit. The Hospital operates an emergency room and is available to anyone, regardless of their ability to pay. The Hospital supports continuing education and training of all the healthcare professionals and assist in providing both internal and external opportunities. Sioux Center Health supports the communities it serves by being an active participant in the community. The hospital offers opportunities to volunteer for community events, has staff that participate in governance through chambers, businesses and churches. Also, the staff participate in various advisory groups supporting all ranges of ages and educational levels. The hospital supports advocacy activities focused on improved public health from organization walks, educational seminars and information shared with the public through various communication means. |
| Part VI, Line 6: | The Hospital is a managed facility of Avera Health. Avera Health and the Hospital work cooperatively to enhance healthcare throughout the community served by the Hospital. The Hospital also has access to "back office" support services, such as legal consultation, quality benchmarking, coding, computer services, contract negotiations, administrative consultation, group purchasing, human resource assistance and many other services. Avera Health is able to provide these services to the Hospital at a cost below that which the Hospital could otherwise achieve. In turn, local caregivers are able to devote more resources to patient and resident care. Avera Health and the Hospital dedicate resources to endeavors that make a positive difference to improve the health of the communities they serve. These activities include leadership development and training for community members, economic development, physical improvements in the community, contributions to nonprofit community organizations, nonprofit event sponsorships, donated medical supplies, community health education and support groups, health screenings, flu-shot clinics, community health education and various other activities. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwest Iowa Community College | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 603 W park St | AddressLine1Txt |
| City | Sheldon | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 421275893 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $10,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | SCHOLARSHIP | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | SCH provides the money for scholarships directly to Northwest Iowa Community College Foundation (NICCF). NICCF determines and processes the scholarship funding. Applications and supporting materials are received directly from the applicant. The health instructors at Northwest Iowa Community College make the selection of who receives the money from the group of eligible applicants. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Nicholas Mouw | ||||||||||||||
| General Surgeon | $685,009 | $0 | $141,152 | $0 | $23,456 | $0 | $43,748 | $0 | $35,649 | $0 | $929,014 | $0 | $0 | $0 |
| Scott Rens | ||||||||||||||
| Physician | $443,607 | $0 | $4,766 | $0 | $1,313 | $0 | $125,689 | $0 | $52,169 | $0 | $627,544 | $0 | $0 | $0 |
| Julie McKay | ||||||||||||||
| Physician | $378,945 | $0 | $25,662 | $0 | $1,054 | $0 | $106,448 | $0 | $40,002 | $0 | $552,111 | $0 | $0 | $0 |
| Jason Koelwyn | ||||||||||||||
| Physician | $329,079 | $0 | $27,319 | $0 | $23,556 | $0 | $86,776 | $0 | $49,658 | $0 | $516,388 | $0 | $0 | $0 |
| Lindsay Junk | ||||||||||||||
| Physician | $364,020 | $0 | $6,628 | $0 | $48,580 | $0 | $61,506 | $0 | $25,722 | $0 | $506,456 | $0 | $0 | $0 |
| Cory Nelson | ||||||||||||||
| CEO | $298,571 | $0 | $3,000 | $0 | $1,147 | $0 | $7,472 | $0 | $20,139 | $0 | $330,329 | $0 | $0 | $0 |
| Crystal Richter | ||||||||||||||
| CFO | $128,953 | $0 | $225 | $0 | $0 | $0 | $4,800 | $0 | $38,194 | $0 | $172,172 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4b | Lindsay Junk $24,521 |
| Schedule J, Part II: | Cory Nelson, CEO, was compensated through an arrangement with Avera McKennan, 800 E 21st Street, Sioux Falls, SD 57105, through June 30, 2023. Effective July 1, 2023, the CEO became an employee of Sioux Center Health. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Hull Iowa | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 426004780 | BondIssuerEIN |
| Bond Issued | 2017-12-18 | BondIssuedDt |
| Issue Price | $8,300,000 | IssuePriceAmt |
| Purpose | Hospital Facility Revenue Refunding Bond, Series 2017(2012 issue). | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,160,594 | RetiredAmt |
| Total Proceeds | $8,300,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $156,681 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $8,143,319 | OtherSpentProceedsAmt |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Kim Bosma | |||
| Family member of Cory Gotto, Director | $71,291 | Compensation as an employee | 0 |
| Val Hiemstra | |||
| Family member of Cory Gotto, Director | $56,459 | Compensation as an employee | 0 |
| Heather Van Engen | |||
| Family member of Brian Van Engen, Director | $18,539 | Compensation as an employee | 0 |
| Matt De Kam | |||
| Family member of Faye De Kam, Director | $101,259 | Compensation as an employee | 0 |
Schedule M IRS990ScheduleM
Real Estate Other RealEstateOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $728,356 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Market value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 1 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Column (b): | FormAndLineReferenceDesc |
| Explanation | Column B represents the number of contribution received. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | Inspire sleep apnea surgery. Sports medicine. Couples therapy. |
| Form 990, Part VI, Section A, line 1a | The Executive Committee is composed of four officers: President, Vice President, Secretary, Treasurer, and seven board members. The Executive Committee shall have power to transact all regular business of the facility during the interim between the meetings of the Board of Directors, provided any action taken shall not conflict with the policies and expressed wishes of the Board of Directors and that it shall refer all matters of major importance to the Board of Directors. |
| Form 990, Part VI, Section A, line 2 | Board members Verdean Wynja and Scott Wynja have a family relationship. Board members Dale Vander Berg and Cory Gotto have a business relationship. |
| Form 990, Part VI, Section A, line 7a | One member of the governing body is appointed by Avera McKennan. |
| Form 990, Part VI, Section B, line 11b | The 990 is emailed to members of the Board of Directors for review and any questions are addressed prior to filing the return with the IRS. |
| Form 990, Part VI, Section B, line 12c | Officers, Directors and Trustees are required to complete conflict of interest questionnaires which are monitored and tracked. The questionnaires are reviewed by the Board for any possible conflicts with any noted conflicts being brought to management's attention. Conflicts are also reviewed at the Board level. After a conflict is deemed to exist, the individual(s) involved must abstain from the discussion and vote related to the issue. |
| Form 990, Part VI, Section B, line 15a | Through July 1, 2023, the CEO was employed through a management agreement with Avera McKennan. The CEO was considered a common law employee of Sioux Center Health. Avera McKennan annually reviewed the compensation of the CEO, using comparability data and a performance rating system, and met with the Board of Directors of SCH. Avera Mckennan recommended a salary adjustment for the CEO. The Board of Directors was responsible for approval of the salary adjustment. The deliberation and decision was documented at Avera McKennan and in the board minutes. Effective July 1, 2023, the CEO became an employee of SCH. Compensation for the CEO is determined by the board of directors after his performance review is completed. Compensation for the CFO is reviewed and approved annually by the CEO and Human Resources. Market data is used to determine an appropriate salary range. The review process and salary adjustment is documented in the personnel file. |
| Form 990, Part VI, Section C, line 19 | The documents are made available upon request. |
| Form 990, Part IX, line 11g | Professional Fees: Program service expenses 747,597. Management and general expenses 595,164. Fundraising expenses 0. Total expenses 1,342,761. Purchased services: Program service expenses 6,476,839. Management and general expenses 1,377,057. Fundraising expenses 0. Total expenses 7,853,896. Repairs and maintenance: Program service expenses 430,158. Management and general expenses 18,485. Fundraising expenses 0. Total expenses 448,643. |
| Form 990, Part XI, line 9: | Change in interest in net assets of Avera Health Foundation 625,848. |
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