2021-04-01T16:38:38-05:00 2020-06-30 450250958 Eide Bailly LLP 1730 Burnt Boat Loop Ste 100 Bismarck ND 585030886 990 2019-07-01 450308379 Hazen Memorial Hospital Association HAZE 7017482225 510 8th Avenue NE Hazen ND 58545 Brian Williams Current CEO 7017482225 2021-03-26 1 Lisa Chaffee CPA P00193453 7012551091 2021-03-26 2019 2022-09-23 18:48:47Z Sakakawea Medical Center Brian Williams 510 8th Avenue NE Hazen ND 58545 16054941 0 X www.smcnd.org X 1943 ND To be the preeminent providers of innovative and collaborative healthcare services. 10 9 177 53 0 0 586051 842262 15796940 15010760 70150 63057 133681 137942 16586822 16054021 18000 7500 0 0 8115306 7841801 0 0 0 8453463 8528238 16586769 16377539 53 -323518 39206345 42712806 27556221 31369344 11650124 11343462 X Working together as partners to enhance the lives of area residents by providing a neighborhood of patient centered healthcare services that promote wellness, prevention, and care coordination. 0 0 12484372 7500 13797757 Sakakawea Medical Center (SMC) is a 13 bed critical access hospital providing services in the following areas - acute care, observation, surgery, intermediate and skilled swing bed, emergency room with trauma level V certification, Saturday urgent care, and hospice. Services provided by the ancillary departments include physical therapy, occupational therapy, radiology, 3D mammography, bone density, ultrasound, CT, nuclear med, MRI, laboratory, respiratory therapy, cardiac rehab, EKG, Holter Monitor, and thallium stress tests. Based on charges foregone Sakakawea Medical Center provided $116,826 in charity care. Also available to all self-pay patients, regardless of financial status, is a 30% discount policy for timely payments. SMC is a participating provider for Medicare, Medicaid, Blue Cross Blue Shield and other insurances.Sakakawea Medical Center reaches out to the communities in the service area through programs such as falls prevention classes, CPR education, ACLS classes, PALS classes, grief support groups, smoking cessation classes, occupational health, free blood pressure checks, a Christmas giving tree project, a Community Care nurse and health career presentations to high schools. SMC sponsors several community events that promote good health and wellness education including Healthy Halloween Bash, Women's World of Wellness and Mammography Marathon. Wellness screenings are provided to area schools and businesses. SMC provides community education programs on requested topics free of charge. It is important for Sakakawea Medical Center to serve our communities by providing all of their health care needs. 1090086 1213003 Senior Suites is a basic care facility that was completed in April 1997. It is adjacent to Sakakawea Medical Center. Senior Suites can accommodate 34 residents with single or double rooms. It features a licensed beauty shop, activity room, spacious commons areas and an enclosed nurse's station. The rooms are set up like suites, hence the name "Senior Suites." The facility is available to those in the senior population that require a minimal amount of supervision, but do not require 24 hour services. The residents are provided with assistance for daily living and medication administration. Resident care census days totaled 8,195 this year. 13574458 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 12 0 1 177 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 0 0 0 1 1 0 1 1 1 0 0 0 X Melissa Dillman 7017482225 510 8th Avenue NE Hazen ND 58545 X Michael Schmit Surgeon 40.00 X 329992 0 26774 Darrold Bertsch CEO 19.60 X 156114 0 58500 Carl Miller CRNA 36.00 X 153468 0 30167 Alyssa Kelsch Pharmacist 40.00 X 121900 0 13621 Kimberley Myklebust FNP-C 36.00 X 115986 0 32805 Marcie Schulz Director of Patient Care 40.00 X 110890 0 27673 Renae Snyder -CFO Jul-Mar PRN (Mar-Jun) 40.00 X 91303 0 7649 Melissa Dillman CFO (Apr-Jun) 36.00 X 50699 0 2808 Christie Obenauer President 2.00 X X 0 0 0 Fred Stern Vice President 1.50 X X 0 0 0 Myria Perry Secretary/Treasurer 1.50 X X 0 0 0 Don Lyn Erickson Director 1.50 X 0 0 0 Mark Gerde Director 1.50 X 0 0 0 Robin Richter Director 1.50 X 0 0 0 Sienna Sailer Director 1.50 X 0 0 0 Beverly Huber Director 1.50 X 0 0 0 Keith Johnson Director 1.50 X 0 0 0 Todd Lindquist Director 1.50 X 0 0 0 1130352 0 199997 6 0 1 1 Dr Thomas Kaspari MD PC 1351 51st Ave SW Hazen ND 58545 ER Physician Services 124580 1 620335 221927 842262 Patient and Resident Services 621400 14603139 14603139 Other Program Revenue 623000 251930 251930 Education 623000 83056 83056 Cafeteria 623000 72635 72635 15010760 63057 63057 135262 0 135262 135262 135262 3600 920 2680 2680 16054021 15010760 0 200999 X 4000 4000 3500 3500 391848 391848 80037 14969 65068 6180477 5660295 520182 211125 194752 16373 520757 464789 55968 457557 403539 54018 3069 3069 66587 66587 2544609 2451875 92734 37471 37471 221103 112204 108899 118020 118020 573828 547654 26174 23531 18255 5276 441817 326725 115092 2657640 1979220 678420 220375 8484 211891 Medical Supplies 1103476 1103476 Food 153778 153778 Dues & Subscriptions 115247 89153 26094 247687 37790 209897 16377539 13574458 2803081 0 3876 14662 5259542 11229586 1920354 1058620 332580 359448 112368 99788 36382351 10376236 28450388 26006115 1224525 1243211 1117526 1130897 785186 1570479 39206345 42712806 955686 982381 3209966 9430283 9207689 17170252 16556008 0 1413300 27556221 31369344 X 10464937 10144540 1185187 1198922 11650124 11343462 39206345 42712806 X -323518 16856 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2246 2246 0 Part II-B, Line 1: The organization pays dues to NDHA and AHA and a portion of those membership fee is attributable to lobbying. 67661 364 68025 67124 537 67661 66403 721 67124 66117 286 66403 65690 427 66117 0.00000 0.73500 0.26500 0 0 23092 23092 27172941 6274291 20898650 7530529 3773362 3757167 1655789 328583 1327206 26006115 X 16062143 13371 13371 16048772 5249 5249 16054021 16368805 0 16368805 8734 8734 16377539 Part V, Line 4: The Medical Center's policy is to maintain sufficient financial stability for the operations of Medical Center. Interest income is to be transferred to the temporarily restricted endowment funds until the Board determines how the funds are to be used. In establishing this policy, the Medical Center considered the long-term expected return on its endowments. The spending policy states that distributions of earnings can be made if the Board of Directors deems it prudent to do so taking into account certain statutory factors included in the UPMIFA. Distributions may be made at least annually, but do not need to be done. Part X, Line 2: The Medical 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 Medical 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 Interest in Net Assets of Sakakawea Medical Center Foundation 13,371. Part XI, Line 4b - Other Adjustments: Net Auxiliary Revenue Not Included in Audited Financials 5,249. Part XII, Line 4b - Other Adjustments: Auxiliary Expenses Not Included in Audited Financials 8,734. 1 1 X 1 X 1 X 1 1 1 0 0 107000 107000 0.00650 181497 137445 44052 0.00270 288497 137445 151052 0.00920 113143 113143 0.00690 55046 20854 34192 0.00210 168189 20854 147335 0.00900 456686 158299 298387 0.01820 4 9027 9027 0.00060 7 21655 21655 0.00130 4 1077 1077 0.00010 15 31759 31759 0.00200 0 265611 1944 7461410 7622374 -160964 X 1 1 1 1 Sakakawea Medical Center 510 8th Ave NE Hazen ND 58545 www.smcnd.org 5024A X X X X Hazen Memorial Hospital Association 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X See Pg 8 Supplemental Information X See Pg 8 Supplemental Information X 1 18 1 See Pg 8 Supplemental Information 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X https://www.smcnd.org/assets/docs/caring_program_policy.pdf X https://www.smcnd.org/assets/docs/caring_program_policy.pdf X https://www.smcnd.org/assets/docs/caring_program_policy.pdf X X X X X X 1 X 0 X X X 1 X 0 0 Hazen Memorial Hospital Association Part V, Section B, Line 5: Community surveys were conducted beginning in October 2018. Community meetings were held in October 2018 and March 2019. Additionally, key informant interviews were conducted in October 2018 by the Center for Rural Health. Organizations participating in the meetings included Sakakawea Medical Center, Coal Country Community Health Clinics, Knife River Care Center, Mercer County Ambulance, Southwestern District Health Unit, Hilltop Home of Comfort, and UND Center for Rural Health. Hazen Memorial Hospital Association Part V, Section B, Line 6b: Organizations participating include Coal Country Community Health Clinics, Knife River Care Center, Mercer County Ambulance, Southwestern District Health Unit, Hilltop Home of Comfort, and UND Center for Rural Health. Hazen Memorial Hospital Association Part V, Section B, Line 11: In the most recent CHNA conducted the following needs were identified availability of mental health services, youth drug use and abuse (including prescription drugs), availability of resources to help elderly stay in their homes, youth depression/anxiety, and attracting and retaining young families.Identified Need: Availability of behavioral health services (mental health & substance abuse/treatment)Outputs/Outcomes:-CCCHC has implemented tele-behavioral health services -SMC and CCCHC partner to provide continuous education about community resources available related to mental health -CCCHC providers are now certified to offer EMDR (eye movement desensitization and reprocessing) therapy-Implemented Intensive Outpatient Program (IOP)-Brought in new providers to offer more behavioral health services and serve more of the communityIdentified Need: Substance Use & AbuseOutputs/Outcomes:-Behavioral health coalition now holds regular quarterly meetings-Patients are screened for Substance Abuse Disorders (SUD) during ER visits to ensure proper referrals are being made-Education provided to community members, including law enforcement and healthcare employees, about the availability of SUD resources and services-Organization of a syringe exchange programIdentified Need: Availability of resources to help elderly stay in their homesOutputs/Outcomes:-Increased referrals to Palliative Care from the hospital and clinic visits-Increased awareness of options for elderly community resource brochures are now distributed in the communities -Continue offering and expand transportation service for patients to medical appointments -Research the possibility of offering a volunteer-operated transportation service to ensure all patients can safely be transported to appointments Hazen Memorial Hospital Association Part V, Section B, Line 13h: Sakakawea Medical Center offers two separate programs for discounted care. The self-pay discount policy is available for uninsured patients regardless of income. A discount of 30% is allowed if regular monthly payments are remitted in a specified time frame. The charity care program provides discounted care to patients based on family income according to FPG guidelines. The sliding fee scale allows discounts from 30% to 100% of charges. The program is available for uninsured patients as well as co-pays and deductibles for insured patients.The self-pay discounts program cannot be combined with the charity care program. However, the Hospital counsels all self-pay individuals to determine if their potential charity care discount would result in a better discount if they apply for charity care. The patients that use the self-pay discount are typically the patients that do not want to submit their financial information or patients that would not qualify under the charity care policy. Hazen Memorial Hospital Association Part V, Section B, Line 15e: An individual must complete an application and submit supporting documentation such as check stubs or an income tax return. All of the staff in the Business Office billing department are able to assist individuals with any questions they have regarding the application process. Hazen Memorial Hospital Association Part V, Section B, Line 16j: In addition to the full FAP being available upon request, information referencing the FAP is attached to the billing invoices, as well as posted in the admissions office, emergency rooms and waiting rooms. Schedule H, Part V, Line 7a/b, Line 10 & Line 16a/b/c URL Links: Line 7a:https://www.smcnd.org/assets/docs/community_health_2019.pdfLine 7b:https://www.smcnd.org/assets/docs/community_health_2019.pdfLine 10:https://www.smcnd.org/assets/docs/implementation_plan_2019.pdf 1 1 - Senior Suites 813 7th St NE Hazen ND 58545 Basic Care Facility Part I, Line 3c: Sakakawea Medical Center offers two separate programs for discounted care. The self pay discount policy is available for uninsured patients regardless of income. A discount of 30% is allowed if regular monthly payments are remitted in a specified time frame. This program cannot be combined with the Charity Care program.The charity care program provides discounted care to patients based on family income according to FPG guidelines. The sliding fee scale allows discounts from 30% to 100% of charges. The program is available for uninsured patients as well as co-pays and deductibles for insured patients. Part I, Line 7: Charity care is based on the total direct and indirect costs related to providing services to patients and based on average ratios of cost to charges. Unreimbursed Medicaid was converted to cost using the cost-to-charge ratio derived from the relevant cost center on the Medicare cost report. Community health improvement services, health professionals education, and cash and in-kind contributions for community benefit reflect actual expenses recorded to the general ledger. Part II, Community Building Activities: The CEO serves on one board for community support - Energy Capital Child Care Cooperative, five boards for community health improvement advocacy North Dakota State Health Council, Northland Healthcare Alliance, North Dakota Rural Health Association, Knife River Care Center, and Community Healthcare Association of the Dakotas. The Director of Patient Care serves on five boards - Bismarck State College Advisory Board, University of Mary Advisory Board, ND Governor's Nursing Workforce, North Dakota CAH Quality, and ND Honoring Choices Committee. The CFO, Surgeon, and OR Nurse Coordinator all serve on the Mercer County Ambulance Board. The Surgeon also serves on the Riverdale and Wilton Ambulance Board. The HIM Director serves on the Dakota Central Social Service Board. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Medical Center determines its estimate of implicit price concessions based on its historical collection experience with this class of patients and residents. Part III, Line 3: There are most likely some patients in implicit price concessions who would qualify for charity care, but they have not completed the application and remitted the required payment. We used charity care as a percentage of total revenues to figure that the estimated amount of implicit price concessions that are attributable to patients eligible under the organization's financial assistance policy would be approximately $1,944. Part III, Line 4: The financial statement footnote regarding implicit price concessions may be found on page 12-13 of the audited financial statements. Part III, Line 8: Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare & Medicaid Services. The costs themselves are a community benefit as the community would not receive these services if we did not provide them. Part III, Line 9b: If a patient has applied for charity care previously, an application is sent with the monthly statement. Once it is determined that the patient is eligible, the charity care discount portion is written off. The organization does not send patient accounts to collections within the first 120 days of the date of the first invoice for a service. The organization allows the patient up to 240 days from the date of the first invoice for that service to complete the charity care application. If the patient account is with the collection agency within the 240 days of the first invoice and it is determined they qualify for charity care, the organization will notify the collection agency of the amount of charity care that applies to the account. The remaining patient portion then falls under the same collection practices of all other accounts. Our policy requires a new charity care application every six months. Part VI, Line 2: Sakakawea Medical Center consults with local physicians to identify community healthcare needs. The SMC staff participates in local and regional organizations and activities including Chamber of Commerce and economic development boards. The CEO routinely attends city council and county commission meetings to solicit input and engage in dialogue relating to healthcare needs and services.Sakakawea Medical Center has collaborated with other local providers to conduct a community health needs assessment which will inventory service delivery assets, identify needs and create a foundation for undertaking strategic initiatives. Part VI, Line 3: Charity care information is sent with the monthly statements to all uninsured patients as well as patients that are not making adequate monthly payments. Approximately 100 notices are sent out per month with the statements. Inpatients and surgical patients are informed at time of admission about charity care. A social worker visits with all self-pay inpatients to inform them about the charity care, Medicaid (state program), and self-pay discount policies. Brochures have been printed that describe our charity care and discount policies. The brochures are available in waiting rooms, ER, the clinics and admitting offices. In addition to these efforts, the financial assistance policy is also available on the website. Part VI, Line 4: Hazen Memorial Hospital Association serves the communities in Mercer County and the surrounding area, including the towns of Hazen, Beulah, Stanton, Zap, Golden Valley, Center and Pick City. Sakakawea Medical Center, located in Hazen, is the only hospital in the county. The nearest hospital is located more than 60 miles away. Attached to the hospital is Senior Suites, a basic care facility. The combined total population of the county is approximately 8,462. The average per capita income in Mercer County for 2020 was $39,025. The current unemployment rate is 4.1%. Sakakawea Medical Center's payer mix for this fiscal year included 3% uninsured patients and 2% Medicaid patients. All patients presenting to the facility are cared for regardless of their ability to pay. Part VI, Line 5: As a critical access hospital, Sakakawea Medical Center provides a variety of health and wellness services to our service area. The organization subsidizes home care services to ensure those residents who are homebound have the health care they need. The emergency room is staffed 24 hours a day and is available to all regardless of ability to pay. The Board of Directors is comprised of county-wide volunteers; four are from Hazen, five from Beulah, and one from Stanton. The directors have various occupations including power plant manager, bank president, accounting supervisor, engineer, chiropractor, and business owner. The directors are not employed by SMC.Medical privileges are extended to all physicians in the county.Sakakawea Medical Center's Hospice staff is assisted by 43 volunteers from the area communities. The staff at Senior Suites, the basic care facility, is served by 10 community volunteers. Surplus funds are invested back into the facility through equipment purchases and facility improvements. This past year, SMC adapted new EMR (Electronic Medical Record) for their Hospice program. Other equipment purchases included a Defibrillator Unit, new server and computers, and a new ER bed. SMC Hospice program also had a new furnace put in their building for facility improvements. Future surplus funds will be used to meet debt service requirements and any needed equipment additions or replacements. In addition, more continuing education is being offered to the staff by means of webinars and workshops. An employee assistance program is available for staff and family members which provides free confidential assessments, counseling, or referral services by trained professionals.Sakakawea Medical Center is investing in the future of healthcare professionals by implementing a nursing program. We are partnering with other health care providers in the county, a community health center and a nursing home, to offer Interactive Video Network (IVN) classes in our facility. Hands-on skill work and clinicals are taught by registered nurses employed by our organization. Upon completion of an 11 month program, students will receive a certificate in practical nursing. An additional 9 month program enables the students to receive an Associate Degree in Nursing and become eligible to test for their registered nurse license. Sakakawea Medical Center also supports state universities and high schools by offering rural medical experiences to area students. Throughout the year, students are provided with practice opportunities in nursing, lab, PT or the emergency room.Beginning in 2015, Sakakawea Medical Center is also assisting the Dakota College at Bottineau, ND with their Medical Assistant Program. Students study through on line courses provided by Dakota College. The hands-on skills are taught by registered nurses in our facility weekly. Students can complete a one year program for a diploma, or a two year program for a degree. X X X X X 0 1 0 0 0 0 0 0 0 Michael Schmit Surgeon 329992 0 0 0 0 0 11200 0 15619 0 356811 0 0 0 Darrold Bertsch CEO 156114 0 0 0 0 0 58500 0 0 0 214614 0 0 0 Carl Miller CRNA 153468 0 0 0 0 0 6597 0 23615 0 183680 0 0 0 Part I, Line 4b SMC paid $58,500 in premiums for a 457(f) plan for Darrold Bertsch, CEO. This amount is reflected in Schedule J, Part II, deferred compensation. Schedule J, Part II: Darrold Bertsch, CEO, is an employee of Coal Country Community Health Center (CCCHC) and provides CEO services to both SMC and CCCHC. However, as an employee of CCCHC, Darrold now receives his W-2 from CCCHC. Sakakawea Medical Center reimburses CCCHC for part of Darrold's salary based on a contract. The compensation reported in Part VII of the core form and Schedule J, Part II reflects total base compensation, benefits and payroll taxes associated with this compensation on which SMC reimbursed CCCHC for his services solely to SMC, which was reported on his 2019 Form W-2 from CCCHC. In the calendar year 2019, Darrold received $156,114 from CCCHC related to the reimbursement of his services as SMC CEO. The deferred compensation reported in Part II are in relation to the 457(f) plan premiums SMC paid on his behalf. This deferred compensation is not included in the amount SMC reimburses CCCHC. Union State Bank (USB) Family ownership >35% of Union State Bank through Hazen Bancorporation HC PACE Loan X 10258000 9207689 0 1 1 9207689 Jocelyn Bertsch Wife of CEO 65068 Employee Compensation 0 Bonnie Johnson Wife of Board Member Keith Johnson 14970 Employee Compensation 0 Form 990, Part VI, Section A, line 1 There were 10 board of directors at fiscal year end, but the board president only votes to break a tie. The Executive Committee shall consist of the President, Vice President and Secretary/Treasurer of the Board. The CEO of the corporation shall serve without voting powers. The Executive Committee shall have the power to transact all business of the corporation during the interim between meetings of the Board of Directors, provided that any action so taken shall not conflict with the policies and express wishes of the Board of Directors, and that it shall refer all matters of major importance to the full Board of Directors. This committee shall meet as required. In the current fiscal year, the Executive Committee did not meet to make any decisions on behalf of the full governing board. Form 990, Part VI, Section A, line 6 Any person, firm, association, or corporation interested in the activities of this organization, and residing in the service area, may become a member thereof, provided that he has first made a contribution to the association at some time. Each member has one voting right. Form 990, Part VI, Section A, line 7a The members elect the Board of Directors on an annual basis. Form 990, Part VI, Section A, line 7b The members must also approve/disapprove the dissolution of the organization or the merger or consolidation of the organization with another corporation. Form 990, Part VI, Section A, line 8b All items discussed at committee meetings are brought to the full board for recommendations for board action. The organization did not have any committees that acted on behalf of the board. Form 990, Part VI, Section B, line 11b Upon receipt of the draft Form 990, a copy will be forwarded to the board members for their review and comment. Form 990, Part VI, Section B, line 12c The Board of Directors is covered by the conflict of interest policy. Only one conflict has been disclosed this fiscal year by a member of the Board of Directors. The director who has acknowledged the conflict of interest is excused from the board meeting whenever there is discussion about the relevant issue. Although the written policy as of June 30, 2016 did not address the officers of the organization, the officers do review and comply with the policy and disclose to the board of directors if a conflicts does exist. After the conflict is self-reported that officer abstains completely from the decision process of the issue at hand. Form 990, Part VI, Section B, line 15 The CEO was paid by an unrelated organization that annually used comparability data to review and determine his compensation. The decision was made by the Board of Directors from both the unrelated organization and Sakakawea Medical Center. For purposes of determining the CFO's compensation package at Sakakawea Medical Center, a variety of resources are used. The Organization takes into consideration what is appropriate compensation for that respective position, based on their market. The Organization uses salary surveys from the North Dakota Hospital Association and also refers to the public 990 information from similar sized hospitals in North Dakota. The CFO is evaluated by the CEO annually and the compensation is based on the above information. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available if specifically requested. Form 990, Part VII: Darrold Bertsch, CEO, is an employee of Coal Country Community Health Center (CCCHC) and provides CEO services to both SMC and CCCHC. However, as an employee of CCCHC, Darrold now receives his W-2 from CCCHC. Sakakawea Medical Center reimburses CCCHC for part of Darrold's salary based on a contract. The compensation reported in Part VII of the core form and Schedule J, Part II reflects total base compensation, benefits and payroll taxes associated with this compensation on which SMC reimbursed CCCHC for his services solely to SMC, which was reported on his 2019 Form W-2 from CCCHC. In the calendar year 2019, Darrold received $156,114 from CCCHC related to the reimbursement of his services as SMC CEO. The deferred compensation reported in Part II are in relation to the 457(f) plan premiums SMC paid on his behalf. This deferred compensation is not included in the amount SMC reimburses CCCHC. Form 990, Part IX, line 11g Medical Purchased Services: Program service expenses 2,361,786. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,361,786. Other Purchased Services: Program service expenses 90,089. Management and general expenses 92,734. Fundraising expenses 0. Total expenses 182,823. Form 990, Part XI, line 9: Change in Interest in Net Assets of Sakakawea Medical Center Foundation 13,371. Change in Net Assets of Hazen Memorial Hospital Auxiliary 3,485.