PRESENTATION MEDICAL CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PRESENTATION MEDICAL CENTER (EIN 45-0227391)
- Tax period
- 2017-10-01 to 2018-09-30
- Filed
- 2019-07-30
- IRS object ID
- 201902119349300930
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-07-30T13:24:37-05:00 | ReturnTs |
| Tax Period End | 2018-09-30 | 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 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450227391 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Presentation Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRES | BusinessNameControlTxt |
| Phone | 7014773161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1Txt |
| City | Rolla | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 583670759 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Christopher Albertson | PersonNm |
| Person Title | President/CEO | PersonTitleTxt |
| Phone | 7014773161 | PhoneNum |
| Signature | 2019-07-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2019-07-29 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.147.181.47 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-07-29 | IPDt |
| IP Tm | 12:46:06 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B602D594AFD2B0B327E07A06F36CA6A7E42546D0 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 330E77A2EC15986A2DC713C7FDB26B906589BB96 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Christopher Albertson | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1Txt |
| City | Rolla | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 583670759 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,584,237 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pmc-rolla.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1939 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | Acute care hospital that is a major medical provider for Rolette County | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 125 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,607 | PYContributionsGrantsAmt |
| CY Contributions Grants | $29,534 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,232,937 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,494,731 | CYProgramServiceRevenueAmt |
| PY Investment Income | $37,586 | PYInvestmentIncomeAmt |
| CY Investment Income | $57,020 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,311 | PYOtherRevenueAmt |
| CY Other Revenue | -$6,007 | CYOtherRevenueAmt |
| PY Total Revenue | $10,280,819 | PYTotalRevenueAmt |
| CY Total Revenue | $10,575,278 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $202 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,325 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,780,641 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,759,192 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,483,406 | PYOtherExpensesAmt |
| CY Other Expenses | $4,595,604 | CYOtherExpensesAmt |
| PY Total Expenses | $10,264,249 | PYTotalExpensesAmt |
| CY Total Expenses | $10,360,121 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $16,570 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $215,157 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,064,968 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,781,367 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,132,824 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,540,843 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,932,144 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,240,524 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Presentation Medical Center in union with the Sisters of Mary of the Presentation, is a Catholic healthcare organization. Through the power and example of Jesus Christ and his gospel values, we are committed to joyfully provide wholistic care and healing with integrity, compassion and respect to all we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,685,909 | ExpenseAmt |
| Grant | $5,325 | GrantAmt |
| Revenue | $10,494,731 | RevenueAmt |
| Desc | Presentation Medical Center (PMC) is a 25-bed not-for-profit, Critical Access Hospital (CAH) located in Rolla, Rolette County, ND. As a Critical Access Hospital, our organization is, by definition, a community benefit. PMC is a critical infrastructure to our community and is a major medical provider for Rolette County, providing inpatient, outpatient and surgical services. In addition, PMC is a key provider of emergency care with over 5,000 ER visits for fiscal year ending 2018. Services in the areas of Clinic, Lab, Radiology, Respiratory Therapy, Physical Therapy, Cardiac Rehab, and Outreach Specialty Physician services, are also provided.Continued on Schedule O.Presentation Medical Center had 185 acute patient days, 586 swing-bed days and 1,564 extended swing-bed days.The Medical Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Because the Medical Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The estimated costs of the charges foregone, based upon an overall cost-to-charge ratio calculation, for the year ended September 30, 2018 were approximately $83,000.In addition, the Medical Center provides services to other medically indigent patients under certain government reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Medical Center also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable. | Desc |
| Total Program Service Expenses | $8,685,909 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | 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 | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 125 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | 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 | Paula J Wilkie | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7014773161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1Txt |
| City | Rolla | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 583670759 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Doug Kretschmar | |||||||||
| Chair | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Jane Sivertson | |||||||||
| Vice Chair | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Chris Albertson | |||||||||
| Secr/President/CEO as of Oct 1, 2017 | 40.00 | 0.00 | Yes (X) | Yes (X) | $0 | $40,000 | $9,326 | ||
| Sr Marlyss Dionne | |||||||||
| Director | 0.50 | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| Sr Dorothy Bunce | |||||||||
| Director | 0.50 | 0.30 | Yes (X) | $0 | $0 | $0 | |||
| Gerry Krech | |||||||||
| Director (until June 2018) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Matt Odermann | |||||||||
| Director (as of July 2018) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Steven McAtee | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Paula Wilkie | |||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $0 | $126,128 | $32,051 | |||
| Kimberly Benning FNP-BC | |||||||||
| Clinic/Emergency | 40.00 | 0.00 | $162,891 | $0 | $25,314 | Yes (X) | |||
| Micahel Questell DO | |||||||||
| Family Medicine | 40.00 | 0.00 | $244,737 | $0 | $24,216 | Yes (X) | |||
| Jody Shapr NP | |||||||||
| Emergency Services | 40.00 | 0.00 | $103,520 | $0 | $12,066 | Yes (X) | |||
| Mark Kerr | |||||||||
| Former Secretary/President/CEO | 0.00 | 0.00 | $0 | $161,827 | $27,766 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $511,148 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $327,955 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $130,739 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SMP Health Systems | |||||
| PO Box 10007 | Fargo | ND | 58103 | Management services | $496,431 |
| AMN Healthcare | |||||
| PO Box 281939 | Atlanta | GA | 303841939 | Locum coverage services | $411,287 |
| Medical Solutions | |||||
| 1010 N 102nd St Suite 300 | Omaha | NE | 68114 | Nursing services | $375,871 |
| Roy Cordy MD | |||||
| PO Box 845 | Rolla | ND | 58367 | ER physician services | $328,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $29,250 | GovernmentGrantsAmt |
| All Other Contributions | $284 | AllOtherContributionsAmt |
| Total Contributions | $29,534 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenue | 622110 | $9,919,991 | $9,919,991 |
| Pharmacy revenue | 622110 | $348,079 | $348,079 |
| Outside laundry revenue | 812300 | $187,010 | $187,010 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,651 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,651 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,494,731 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $51,807 | TotalRevenueColumnAmt |
| Exclusion | $51,807 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,952 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $8,959 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$6,007 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$6,007 | TotalRevenueColumnAmt |
| Exclusion | -$6,007 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,213 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,213 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,213 | TotalRevenueColumnAmt |
| Exclusion | $5,213 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,575,278 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,494,731 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $51,013 | 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 | $5,325 | TotalAmt |
| Program Services | $5,325 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,745,740 | TotalAmt |
| Program Services | $4,244,052 | ProgramServicesAmt |
| Management And General | $501,688 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,796 | TotalAmt |
| Program Services | $88,838 | ProgramServicesAmt |
| Management And General | $15,958 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $573,795 | TotalAmt |
| Program Services | $513,137 | ProgramServicesAmt |
| Management And General | $60,658 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $334,861 | TotalAmt |
| Program Services | $299,161 | ProgramServicesAmt |
| Management And General | $35,700 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $527,016 | TotalAmt |
| Management And General | $527,016 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,078 | TotalAmt |
| Management And General | $10,078 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,727 | TotalAmt |
| Management And General | $46,727 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,380,358 | TotalAmt |
| Program Services | $1,259,182 | ProgramServicesAmt |
| Management And General | $121,176 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,736 | TotalAmt |
| Management And General | $13,736 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,583 | TotalAmt |
| Program Services | $165,244 | ProgramServicesAmt |
| Management And General | $74,339 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,275 | TotalAmt |
| Program Services | $259,365 | ProgramServicesAmt |
| Management And General | $910 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,862 | TotalAmt |
| Program Services | $17,714 | ProgramServicesAmt |
| Management And General | $8,148 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,571 | TotalAmt |
| Management And General | $1,571 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,506 | TotalAmt |
| Program Services | $19,506 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,728 | TotalAmt |
| Program Services | $266,728 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,503 | TotalAmt |
| Program Services | $60,503 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $787,283 | $787,283 | |
| Repairs and maintenance | $466,461 | $223,865 | $242,596 |
| Bad debt expense | $331,839 | $331,839 | |
| Food | $100,894 | $100,894 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,184 | TotalAmt |
| Program Services | $43,273 | ProgramServicesAmt |
| Management And General | $13,911 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,360,121 | TotalAmt |
| Program Services | $8,685,909 | ProgramServicesAmt |
| Management And General | $1,674,212 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $752,798 | BOYAmt |
| EOY | $365,312 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $923,183 | BOYAmt |
| EOY | $1,429,827 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $196,359 | BOYAmt |
| EOY | $229,328 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,386 | BOYAmt |
| EOY | $19,099 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,885,529 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,774,463 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $844,699 | BOYAmt |
| EOY | $1,111,066 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,826,350 | BOYAmt |
| EOY | $2,182,735 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $493,193 | BOYAmt |
| EOY | $444,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,064,968 | BOYAmt |
| EOY | $5,781,367 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $741,767 | BOYAmt |
| EOY | $971,230 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $391,057 | BOYAmt |
| EOY | $569,613 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,132,824 | BOYAmt |
| EOY | $1,540,843 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,932,144 | BOYAmt |
| EOY | $4,240,524 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,932,144 | BOYAmt |
| EOY | $4,240,524 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,064,968 | BOYAmt |
| EOY | $5,781,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $215,157 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $99,578 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$6,355 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $76,778 | OtherCostOrOtherBasisAmt |
| Book Value | $76,778 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $115,183 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $4,207,899 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,874,971 | DepreciationAmt |
| Book Value | $448,111 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,466,591 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,880,414 | DepreciationAmt |
| Book Value | $586,177 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,078 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,078 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,111,066 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SMPHS pooled investment funds | Desc |
| Book Value | $2,182,735 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,182,735 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Estimated third-party payor settlements | Desc |
| Book Value | $444,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $444,000 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,343,017 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $99,578 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$331,839 | OtherRevenueAmt |
| Revenue Not Reported | -$232,261 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,575,278 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,575,278 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,028,282 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,028,282 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $331,839 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $331,839 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,360,121 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Medical Center is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Medical Center is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose, if applicable. The Medical Center has determined that it is not subject to unrelated business income and has not filed and Exempt Organization Business Income Tax Return (Form 990-T) with the IRS. 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: | Provision for bad debts recorded in expenses for Form 990 -331,839. |
| Part XII, Line 4b - Other Adjustments: | Provisions for bad debts recorded in expenses for Form 990 331,839. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $83,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $83,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,033,126 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,704,644 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $328,482 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03280 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,116,126 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,704,644 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $411,482 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04110 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $107,720 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,325 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $104,395 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01040 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,471,280 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,449,104 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,176 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,198 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,101 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,595,198 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,456,530 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $138,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,711,324 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,161,174 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $550,150 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05490 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,216 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,216 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,280 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,280 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,496 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,496 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $331,839 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $132,736 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,973,259 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,006,784 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$33,525 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | Presentation Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1Txt |
| City | Rolla | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 583670759 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.pmc-rolla.com | WebsiteAddressTxt |
| State License | 5045 | 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 | 1 provider based clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Presentation Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.pmc-rolla.com/forms-documents.html | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.pmc-rolla.com/forms-documents.html | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 | www.pmc-rolla.com/forms-documents.html | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.pmc-rolla.com/forms-documents.html | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.pmc-rolla.com/forms-documents.html | 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 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 Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Presentation Medical Center | Part V, Section B, Line 5: The PMC CEO and other staff participated in the community focus group and made copies of the survey available to staff and patients at the clinic and hospital. In order to not burden community members by repeating the assessment process recently completed by Rolette County Public Health, Presentation Medical Center chose to distribute an abbreviated survey. The questions selected, by PMC, were from a list of elective questions routinely used by the Center for Rural Health when conducting other CHNAs. The intent was to gather feedback from community residents more specific to the services provided by PMC hospital and clinic and not duplicate the recent CHNA survey. Eighty-one PMC service area residents completed the PMC survey. Additional information was also collected through a community meeting. The input from the residents represented broad interests of the communities in the service area, which primarily reside in Rolette County. Information gathered through the PMC survey and community meeting, the Rolette County Public Health CHNA process, and secondary data gathered from a wide range of sources, presents a valuable snapshot of health needs and concerns in the service area. |
| Presentation Medical Center | Part V, Section B, Line 11: The following needs were identified in the recently conducted community health needs assessment. Actions will be taken in the following fiscal year due to the timing of the completion of the Implementation Strategy.Tier I Needs:1. The ability to recruit and retain primary health care providers (MD, DO, PA, and NP):One of the main concerns from the community needs assessment was the limited number of primary health care providers in Rolette County. While this is a concern of most of the rural counties in North Dakota, Presentation Medical Center is keenly aware of the importance of continual recruitment and the value of retaining our medical staff. Our Medical staff consists of 2 Physicians, 3 Family Nurse Practitioner, and Physician Assistant. During fiscal year 2018, Presentation Medical Center continues to utilize its Medical Provider Recruitment/Retention Plan. The plan has been successful in helping Presentation Medical Center recruit new medical providers and has identified changes in certain operations which provide greater provider satisfaction and greater healthcare delivery to the population of Rolette County. As such, Presentation Medical Center has changed clinic hours to 10-hour days as identified using the Medical Provider Recruitment/Retention Plan.Tier II Needs:1. High Rates of Diabetes:The high rate of diabetes is a medical issue that the 2016 Community Health Assessment revealed, and the same issue was also identified as high priority in 2013. Presentation Medical Center has committed to providing a nurse educator to host weekly diabetes education for the general public of the area. These education events have continued to run through fiscal year 2018 and will continue to be facilitated at PMC. PMC will work closely with Rolette County Public Department on public education information that has a focus on diabetes prevention and obesity, as well as support group activities. During 2018 Presentation Medical Center Clinic has established and implemented a Diabetes Control section to its quality dashboards and reports these measures quarterly to the Central Quality Improvement/Peer Review Committee. Presentation Medical Center continues to host weekly Diabetes Education sessions for the community.2. Alcohol/Drug Use and Abuse:As alcohol/drug use and abuse were listed high on the PMC health concerns, as well as the 2015 Rolette County Public Health Needs Assessment, the survey dictates that attention must be focused at this continued health issue in our area. PMC is an active participant and collaborator in RCPH's education and awareness program as it is presented to the community and at awareness events. In fiscal year 2018, Presentation Medical Center, in collaboration with Rolette County Public Health and the Rural Mental Health Consortium, sponsored two community forums entitled "the Opioid Epidemic," whereby community members were shown a video on the opioid epidemic and allowed to participate in a discussion with a panel of North Dakota experts on opioid abuse and addiction. Presentation Medical Center continues to work with Rolette County Public Health to jointly, and strategically, address Alcohol/Drug Abuse in the community. As such, the CEO of Presentation Medical Center is a member of the Rolette County Public Health Coalition. |
| Presentation Medical Center | Part V, Section B, Line 13h: Presentation Medical Center also evaluates a patient's family size, income and demographics to determine eligibility for additional free or discounted care to low income individuals. |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Presentation Medical Center also evaluates a patient's family size and demographics to determine eligibility for additional free or discounted care to low income individuals. |
| Part I, Line 6a: | Presentation Medical Center's community benefit report can be found on its website at pmc-rolla.com. |
| Part I, Line 7: | Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services and in-kind contributions to community groups are reported based on actual expenses recorded in the organization's general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. |
| Part I, Ln 7 Col(f): | The amount of bad debt expense removed from total expenses to determine the percentage was $331,839. |
| Part II, Community Building Activities: | The Social Service department provides information, assistance and referrals to community members seeking such services, particularly during times of medical crisis.Case Management Services are provided to patients, their family members and community members. Those individuals requiring substance abuse referrals and assistance require intensive services. Due to the significant number of social issues in Rolette County, case management services are provided to connect patients with the services that they need to regain/maintain their health status. Every effort is made to assist patients in obtaining the services that they require to maintain good health and a quality lifestyle. Transportation services are provided to patients who need rides home following hospitalization and for appointments for specialized care. These are patients who do not have family or friends who are willing or able to transport them for these appointments. By assisting with transportation, patients are able to receive specialty consultation services that allow them to enhance the quality of their life.Meals are also provided for caregivers and lodging is offered for family members who choose to remain in the hospital with their loved one.PMC Director of Physical Therapy is part of the Rolette County Health Board and attends meetings and makes policies for Rolette County. |
| Part III, Line 2: | Bad debt expense is the write-off of a patient's account for services provided by the Hospital after all payments, discounts, and contractual allowances have been applied. Accounts that qualify or may qualify for financial assistance or charity care are not written off to bad debt. Payments received on accounts previously written off to bad debt reduces bad debt expense. Bad debt expense on line 2 is reported at charges as presented on the financial statements. |
| Part III, Line 3: | The estimated amount of the Organization's bad debt expense attributable to patients eligible under the Organization's charity care policy is calculated based on an estimate of applications denied due to lack of information. This is estimated at 40%. Presentation Medical Center estimates the amount of bad debt expense attributable to patient's under the charity care policy because the Organization knows that some accounts are written off to bad debt that may have been charity care if the patient had completed the paper work. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on pages 6 and 7 of the attached audited financial statements. |
| Part III, Line 8: | Presentation Medical Center provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the Medicare shortfall is considered a community benefit.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicaid and Medicare Services. |
| Part III, Line 9b: | Presentation Medical Center believes it has an obligation to make every effort possible to collect for services rendered from all patients who have the ability to pay their account. There are no collection efforts for patients who qualify for charity care or financial assistance, indigent patients, or patients that have set up payment arrangements. If a portion of an account is written off to charity care, any personal portion due follows the same collection procedures as other accounts. For patients who are indigent, Presentation Medical Center has a Charity Care provision with the appropriate application process. For self pay patients, Presentation Medical Center offers a prompt payment discount of 25% for payment in full within 30 days from the date of their first statement. |
| Part VI, Line 2: | Presentation Medical Center strives to provide basic healthcare services to its communities. We have worked with the Rolette County Public Health, Rolette County Police Department, Rolla Community Ambulance, Rolette County Social Services and other community departments to provide basic care to the members of our community. Working with these organizations allows us to provide different services to our community and to make sure that one of these entities is able to provide care and or cover for one another.Our community health needs assessment is completed and posted to our website to meet the requirements of 501(r). |
| Part VI, Line 3: | Presentation Medical Center is committed to providing care to persons who are uninsured, underinsured, ineligible for government programs, or otherwise unable to pay for medically necessary care. Our Community Caring Program was established in 2005. We have seen a continual increase every year in charity care as we try to get patients involved in the program before their accounts are sent to collections. A brochure is provided to every patient when they register outlining our payment expectations and explaining our Community Caring Program. Notification about charity care is available in emergency rooms, admitting and registration departments, the Business office, and other public areas within the Hospital. Information is also included in patient bills and patient information packets. At registration, patients are given the Payment Policy and Community Caring Program handout. This handout explains patient responsibilities, insurance billing guidelines, financing and payment options, and the Community Caring guidelines. |
| Part VI, Line 4: | Presentation Medical Center (PMC) is a 25-bed not-for-profit, Critical Access Hospital (CAH) located in Rolla, Rolette County, ND. As a Critical Access Hospital, our organization is, by definition, a community benefit. PMC is a critical infrastructure to our community and is a major medical provider for Rolette County, providing inpatient, outpatient and surgical services. In addition, PMC is a key provider of emergency care with over 5,000 ER visits for fiscal year ending 2018. Services in the areas of Clinic, Lab, Radiology, Respiratory Therapy, Physical Therapy, Cardiac Rehab, and Outreach Specialty Physician services, are also provided.PMC is highly dependent upon government Payors. In the Fiscal Year ending 09/30/2018, Medicaid was the payor for 15.7% of inpatients and 50.4% of outpatients, while Medicare was the payor for 75.7% of inpatients and 25.1% of total outpatients. By virtue of where we are located and the services that we provide, we are a benefit to our community.The service area of PMC includes Rolette and part of Towner County. Rolette County has a total population of 14,531 with 78.0% the population being Native American. With this census, 1.92% of North Dakota's population lives in Rolette County. The per capita income for Rolette County is $17,744 compared with North Dakota's per capita income of $37,313 with 26.7% of the county living below the poverty guidelines. (Source: U.S. Census Bureau). |
| Part VI, Line 5: | Presentation Medical Center works to address the basic healthcare needs in Rolette County and the surrounding communities. The Hospital is a major medical provider for the county providing inpatient, outpatient, and surgical services. In addition, Presentation Medical Center is a key provider of emergency care. The emergency room is open 24 hours and is available regardless of a person's ability to pay.Presentation Medical Center extends medical staff privileges to all qualified physicians who meet PMC's Medical Staff Bylaws. Surplus funds are used for equipment upgrades and facility improvements. A majority of the organization's governing body resides in Rolla, ND and none are employees nor contractors of the organization. The governing body does not have any family relationships with each other.In addition to our very existence, PMC believes that there are additional areas that highlight our benefit to the community. By being what and who we are, we strive to be a good community citizen and an asset to the communities that we serve. PMC routinely provides a variety of services that address needs within the community.PMC provided an annual Healthy Community Day that offers educational material and health screenings, including laboratory screenings that provide information about an individuals' general health condition. These services are offered to all community residents.Staff support and office space is provided to the Rural Mental Health Consortium. This allows mental health services to be available in the community on a weekly basis.Sport Injury evaluation and screenings are provided to area High School students and staff members from Physical Therapy provide support at local athletic events.PMC provides Pastoral Care services to all our patients and the community members. Pastoral Care serves as a liaison with the area Ministerial Associations.Supply donations are given out to patients. PMC will provide linen facilities to outside organizations in need. PMC donated cash to various community groups and local school in FY 2018.The area public schools participate in third grade tours. The schools are also offered the opportunity to participate in tours at the request of their teachers. Laboratory students also have the opportunity to obtain clinical experience at PMC.PMC identifies patients where educational classes are held to help control their diabetes.PMC has supplied public speakers for outside entities in the surrounding community. |
| Part VI, Line 6: | We are an affiliate of the Sisters of Mary of the Presentation Health Corporation. Presentation Medical Center operates in accordance with the mission, vision, and values of the Sisters of Mary of the Presentation Health Corporation. Our annual budgeting process includes an assessment of how our budget demonstrates a commitment to the values of the system and the system works to ensure we are always mindful of our duty to care for the poor and those in need. Presentation Medical Center has a Strategic Plan developed from themes set forth by the health system for all affiliates. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Paula Wilkie | ||||||||||||||
| CFO | $0 | $113,510 | $0 | $7,790 | $0 | $4,828 | $0 | $5,459 | $0 | $28,171 | $0 | $159,758 | $0 | $0 |
| Kimberly Benning FNP-BC | ||||||||||||||
| Clinic/Emergency | $162,891 | $0 | $0 | $0 | $0 | $0 | $5,677 | $0 | $19,637 | $0 | $188,205 | $0 | $0 | $0 |
| Micahel Questell DO | ||||||||||||||
| Family Medicine | $244,737 | $0 | $0 | $0 | $0 | $0 | $2,596 | $0 | $21,620 | $0 | $268,953 | $0 | $0 | $0 |
| Mark Kerr | ||||||||||||||
| Former Secretary/President/CEO | $0 | $129,838 | $0 | $19,031 | $0 | $12,958 | $0 | $8,614 | $0 | $20,998 | $0 | $191,439 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Presentation Medical Center does not pay compensation to the President/CEO. This individual is compensated by Sisters of Mary of the Presentation Health System, a related organization, for services to the Medical Center. Sisters of Mary of the Presentation Health System uses one or more of the methods in Part I, question 3 to determine compensation. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Mark Kerr, Paula Wilkie, and Chris Albertson have a business relationship. Gerry Krech and Paula Wilkie have a family relationship. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is the Sisters of Mary of the Presentation Health System. |
| Form 990, Part VI, Section A, line 7a | The member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The member is also entitled to one vote on every other matter to be voted on by the member. Votes cast on behalf of the member are cast by the Chief Executive Officer of Sisters of Mary of the Presentation Health System. |
| Form 990, Part VI, Section A, line 7b | The authority to act on the following matters are exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer. |
| Form 990, Part VI, Section A, line 8b | The Organization does not have committees with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is distributed to the governing body before it is filed. The CEO and CFO review the Form 990. |
| Form 990, Part VI, Section B, line 12c | Each Director must submit in writing to the Chairperson of the Board and the CEO a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chairperson of the Board reviews the statements of the Directors and the Vice Chairperson of the Board reviews the statement filed by the Chairperson. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chairperson of the Board has authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chairperson, the Vice Chairperson has authority to require the Chairperson remove himself in the same matter. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he will not participate in the deliberations or vote on it. |
| Form 990, Part VI, Section B, line 15 | The Organization's CEO and CFO are both compensated by Sisters of Mary of the Presentation Health System, a related organization. The compensation process is determined by the related organization. The Sisters of Mary of the Presentation Health System Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. The Sisters of Mary of the Presentation Health System Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon written request. |
| Form 990, Part IX, line 11g | Purchased services: Program service expenses 1,256,936. Management and general expenses 103,845. Fundraising expenses 0. Total expenses 1,360,781. Professional fees: Program service expenses 0. Management and general expenses 17,331. Fundraising expenses 0. Total expenses 17,331. Contracted services: Program service expenses 2,246. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,246. |
| Form 990, Part XI, line 9: | Equity transfer to Sisters of Mary of the Presentation Health Corporation -6,355. |
| Form 990, Part XII, Line 2c: | The governing board of Sisters of Mary of the Presentation Health System assumes responsibility for oversight of the audit for Presentation Medical Center. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Sisters of Mary of the Presentation Health System | ||||||||||
| 1202 Page Drive SW | Fargo | ND | 58103 | 450359620 | Facilitates management and operations of ten related facilities | ND | 501(c)(3) | Line 12a, I | SMP Health Ministry | 0 |
| St Andrew's Hospital Foundation | ||||||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450413201 | Provide support to St. Andrew's Hospital | ND | 501(c)(3) | Line 12a, I | SMP Health System | 0 |
| Prairieland Home Care | ||||||||||
| 1102 Page Drive SW | Fargo | ND | 58103 | 450391192 | Home health and supportive services | ND | 501(c)(3) | Line 10 | SMP Health System | 0 |
| St Andrew's Hospital | ||||||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450226426 | Provision of health care services | ND | 501(c)(3) | Line 3 | SMP Health System | 0 |
| St Aloisius Hospital | ||||||||||
| 325 East Brewster Street | Harvey | ND | 58341 | 450226729 | Provision of health care services | ND | 501(c)(3) | Line 3 | SMP Health System | 0 |
| St Margaret's Hospital | ||||||||||
| 600 East First Street | Spring Valley | IL | 61362 | 362167884 | Provision of health care services | IL | 501(c)(3) | Line 3 | SMP Health System | 0 |
| Sisters of Mary of the Presentation Long Term Care | ||||||||||
| 1202 Page Drive SW | Fargo | ND | 58103 | 752999939 | Provide extended care and medically related services | ND | 501(c)(3) | Line 10 | SMP Health System | 0 |
| St Margaret's Hospital Foundation | ||||||||||
| 600 East First Street | Spring Valley | IL | 61362 | 364042262 | Provide support to St. Margaret's Hospital | IL | 501(c)(3) | Line 12a, I | SMP Health System | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| St Andrew's Bottineau Clinic LLC | |||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450451306 | Provision of health care services | ND | N/A |
| Valley Regional Health Services L3C | |||||||
| 4391 Venture Drive | Peru | IL | 613541014 | 273891281 | Outpatient oncology services | IL | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SMP Enterprises | |||||||||
| PO Box 10007 | Fargo | ND | 581060007 | 363486506 | Collection agency | ND | N/A | C | 0 |
| SMP Enterprises - IL | |||||||||
| 600 East 1st Street | Spring Valley | ND | 61362 | 363456566 | Healthcare management | IL | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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