COTEAU DES PRAIRIES HOSPITAL: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- COTEAU DES PRAIRIES HOSPITAL (EIN 46-0278210)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-10-31
- IRS object ID
- 201903049349301920
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-10-31T16:38:06-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470585450 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOHMAN AKERLUND & EDDY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 470 | AddressLine1Txt |
| City | AURORA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 688180470 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460278210 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COTEAU DES PRAIRIES HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COTE | BusinessNameControlTxt |
| Phone | 6056987647 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 ORCHARD DRIVE | AddressLine1Txt |
| City | SISSETON | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 572622398 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG KANTOS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6056984601 | PhoneNum |
| Signature | 2019-10-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TIMOTHY J COUFAL CPA | PreparerPersonNm |
| PTIN | P00964304 | PTIN |
| Phone | 4026946404 | PhoneNum |
| Preparation | 2019-10-31 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 199.36.118.40 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-10-31 | IPDt |
| IP Tm | 16:38:06 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B602D594AFD2B0B327E07A06F36CA6A7E42546D0 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B602D594AFD2B0B327E07A06F36CA6A7E42546D0 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CRAIG KANTOS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SAME AS C ABOVE | AddressLine1Txt |
| City | SISSETON | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 572622398 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,259,990 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CDPHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTHCARE SERVICES TO THE POPULATION OF SISSETON, SD, AND THE SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 178 | TotalEmployeeCnt |
| Total Gross UBI | $270 | TotalGrossUBIAmt |
| PY Contributions Grants | $113,624 | PYContributionsGrantsAmt |
| CY Contributions Grants | $122,650 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,879,014 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,101,927 | CYProgramServiceRevenueAmt |
| PY Investment Income | $9,891 | PYInvestmentIncomeAmt |
| CY Investment Income | -$28,087 | CYInvestmentIncomeAmt |
| PY Other Revenue | $18,000 | PYOtherRevenueAmt |
| CY Other Revenue | $15,227 | CYOtherRevenueAmt |
| PY Total Revenue | $18,020,529 | PYTotalRevenueAmt |
| CY Total Revenue | $19,211,717 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,173,070 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,037,992 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,089,435 | PYOtherExpensesAmt |
| CY Other Expenses | $8,747,024 | CYOtherExpensesAmt |
| PY Total Expenses | $18,262,505 | PYTotalExpensesAmt |
| CY Total Expenses | $18,785,016 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$241,976 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $426,701 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,203,516 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,557,235 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,214,454 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,320,547 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,989,062 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,236,688 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | QUALITY CARE WITH A PERSONAL TOUCH, CLOSE TO HOME. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $15,947,070 | ExpenseAmt |
| Revenue | $19,101,927 | RevenueAmt |
| Desc | COTEAU DES PRAIRIES HOSPITAL (CDPH) IS A 25 BED ACUTE CARE HOSPITAL AND PHYSICIAN CLINICS LOCATED IN SISSETON, SOUTH DAKOTA AND THE SURROUNDING AREA. THE HOSPITAL PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THEN ESTABLISHED RATES. SINCE THE HOSPITAL DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUE. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS 31,704 FOR THE YEAR ENDED DECEMBER 31, 2018. STATISTICS FOR THE PERIOD ENDED DECEMBER 31, 2018, ARE AS FOLLOWS: ACUTE PATIENT DAYS = 1,076, SWING-BED PATIENT DAYS = 641, NEWBORN NURSERY DAYS = 261, EMERGENCY ROOM VISITS = 4,531, CLINIC VISITS = 17,348, AND NUMEROUS OTHER OUTPATIENT VISITS. | Desc |
| Total Program Service Expenses | $15,947,070 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 178 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MYLA PETERSON CONTROLLER | PersonNm |
| Phone | 6056984605 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 ORCHARD DRIVE | AddressLine1Txt |
| City | SISSETON | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 572622398 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TERRY JASPERS | ||||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| FAYE JOHNSTON | ||||||||
| VICE PRESIDE | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MATT GLYNN | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| YVONNE HIPPEN | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ERIN CAMERON | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVE GLEASON | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 0.25 | ||
| STEVEN MCCLEEREY | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 0.25 | ||
| PAT DADY | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GREG WEAVER | ||||||||
| COO/INTERIM | 40.00 | Yes (X) | $117,201 | $0 | $19,397 | |||
| MICHAEL COYLE | ||||||||
| FORMER CEO | Yes (X) | $27,895 | $0 | $3,581 | ||||
| CRAIG KANTOS | ||||||||
| CEO | 40.00 | Yes (X) | $0 | $0 | $0 | |||
| STANLEY GALLAGER DO | ||||||||
| FAMILY PRACT | 40.00 | $474,807 | $0 | $25,414 | Yes (X) | |||
| JUDY BEUMER MD | ||||||||
| FAMILY PRACT | 40.00 | $459,586 | $0 | $24,591 | Yes (X) | |||
| JOSEPH RILEY DO | ||||||||
| OB/GYN | 40.00 | $392,274 | $0 | $31,136 | Yes (X) | |||
| RAMON MORALES MD | ||||||||
| GENERAL SURG | 40.00 | $371,935 | $0 | $31,136 | Yes (X) | |||
| SHERRYL TOMBOULIAN MD | ||||||||
| FAMILY PRACT | 40.00 | $358,897 | $0 | $31,136 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,202,595 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $166,391 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FISHER ANESTHESIA PLC | |||||
| 420TH STREET | ALTON | IA | 51003 | ANESTHESIA SVSC | $300,000 |
| LUTZ | |||||
| 13616 CALIFORNIA STREET SUITE 300 | OMAHA | NE | 68154 | CFO/ACCOUNTING | $180,784 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $122,650 | AllOtherContributionsAmt |
| Total Contributions | $122,650 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | $18,106,986 | $18,106,986 |
| 340B PHARMACY REVENUE | 446110 | $863,585 | $863,585 |
| OTHER REVENUE | 900099 | $131,356 | $131,356 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,101,927 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,143 | TotalRevenueColumnAmt |
| Exclusion | $17,143 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,043 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,957 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,957 | TotalRevenueColumnAmt |
| Exclusion | $14,957 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $45,230 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$45,230 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$45,230 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$45,230 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NON-PATIENT LAB | Desc |
| Business | 621500 | BusinessCd |
| Total Revenue Column | $270 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $270 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $270 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,211,717 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,056,697 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $270 | UnrelatedBusinessRevenueAmt |
| Exclusion | $32,100 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,201 | TotalAmt |
| Management And General | $117,201 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,089,616 | TotalAmt |
| Program Services | $7,319,501 | ProgramServicesAmt |
| Management And General | $770,115 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,282 | TotalAmt |
| Program Services | $244,243 | ProgramServicesAmt |
| Management And General | $40,039 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,546,893 | TotalAmt |
| Program Services | $1,329,023 | ProgramServicesAmt |
| Management And General | $217,870 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,697 | TotalAmt |
| Management And General | $65,697 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,775 | TotalAmt |
| Management And General | $47,775 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,692,069 | TotalAmt |
| Program Services | $3,331,101 | ProgramServicesAmt |
| Management And General | $360,968 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,811 | TotalAmt |
| Management And General | $111,811 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,365 | TotalAmt |
| Program Services | $298,216 | ProgramServicesAmt |
| Management And General | $185,149 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $786,911 | TotalAmt |
| Management And General | $786,911 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,294 | TotalAmt |
| Program Services | $195,294 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,041 | TotalAmt |
| Program Services | $55,483 | ProgramServicesAmt |
| Management And General | $10,558 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,465 | TotalAmt |
| Program Services | $19,465 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,257 | TotalAmt |
| Program Services | $291,257 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $898,763 | TotalAmt |
| Program Services | $898,763 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,013 | TotalAmt |
| Program Services | $99,150 | ProgramServicesAmt |
| Management And General | $69,863 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,726,979 | $1,715,411 | $11,568 |
| LICENSES AND PERMITS | $137,839 | $95,418 | $42,421 |
| FOOD | $54,745 | $54,745 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,785,016 | TotalAmt |
| Program Services | $15,947,070 | ProgramServicesAmt |
| Management And General | $2,837,946 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $469,080 | BOYAmt |
| EOY | $1,516,980 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,215,785 | BOYAmt |
| EOY | $2,973,922 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $364,134 | BOYAmt |
| EOY | $472,332 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,587 | BOYAmt |
| EOY | $45,325 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,064,741 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,011,488 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,681,818 | BOYAmt |
| EOY | $8,053,253 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,212 | BOYAmt |
| EOY | $54,523 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $348,900 | BOYAmt |
| EOY | $440,900 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,203,516 | BOYAmt |
| EOY | $13,557,235 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,485,780 | BOYAmt |
| EOY | $1,437,847 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,738 | BOYAmt |
| EOY | $59,984 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,645,936 | BOYAmt |
| EOY | $6,440,813 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $381,903 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,214,454 | BOYAmt |
| EOY | $8,320,547 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,989,062 | BOYAmt |
| EOY | $5,211,188 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $25,500 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,989,062 | BOYAmt |
| EOY | $5,236,688 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,203,516 | BOYAmt |
| EOY | $13,557,235 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $426,701 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,179,075 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $74,103 | BeginningYearBalanceAmt |
| Contributions | $25,500 | ContributionsAmt |
| Investment Earnings Or Losses | $392 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $99,995 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $96,385 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $448 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $22,730 | OtherExpendituresAmt |
| End Year Balance | $74,103 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $473,293 | BeginningYearBalanceAmt |
| Contributions | $22,730 | ContributionsAmt |
| Investment Earnings Or Losses | $362 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $400,000 | OtherExpendituresAmt |
| End Year Balance | $96,385 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $403,709 | ContributionsAmt |
| Investment Earnings Or Losses | $4,885 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $64,699 | OtherExpendituresAmt |
| End Year Balance | $473,293 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.74500 | BoardDesignatedBalanceEOYPct |
| Term Endowment Balance EOY | 0.25500 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,556 | OtherCostOrOtherBasisAmt |
| Book Value | $13,556 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,929,714 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,707,020 | DepreciationAmt |
| Book Value | $6,222,694 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,885,417 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,140,169 | DepreciationAmt |
| Book Value | $1,745,248 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $236,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $164,299 | DepreciationAmt |
| Book Value | $71,755 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,053,253 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | 74,495 OF FUNDS ARE BOARD DESIGNATED FOR CAPITAL IMPROVEMENTS AND DEBT REDEMPTION. 25,500 ARE RESTRICTED BY DONOR FOR CAPITAL PURCHASES. |
| SCHEDULE D, PAGE 3, PART X | THE HOSPITAL BELIEVE THAT THEY HAVE APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS, AND AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 1.750000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,740 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,740 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,452,572 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,880,754 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $571,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03040 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,482,312 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,880,754 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $601,558 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03200 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,175 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,960 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,215 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,224 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,224 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,399 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,960 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $34,439 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,519,711 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,883,714 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $635,997 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03390 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,181 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,181 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,493 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,960 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,533 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,674 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,960 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,714 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $415,499 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $207,749 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,848,791 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,135,685 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$286,894 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | COTEAU DES PRAIRIES | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 ORCHARD DRIVE | AddressLine1Txt |
| City | SISSETON | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57262 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | CDPHEALTH.COM | WebsiteAddressTxt |
| State License | 60020 | 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 RHC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COTEAU DES PRAIRIES | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | CDPHEALTH.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CDPHEALTH.COM/ABOUT-US | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 175.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.CDPHEALTH.COM/ABOUT-US/FINANCIAL- | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.CDPHEALTH.COM/ABOUT-US/FINANCIAL- | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.CDPHEALTH.COM/ABOUT-US/FINANCIAL- | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, COTEAU DES PRAIRIES - PART V, LINE 3E | 1. OBESITY AND CHRONIC DISEASE MANAGEMENT. 2. BEHAVIORAL AND MENTAL HEALTH. 3. ALCOHOL, DRUG, AND SUBSTANCE USE/ABUSE. 4. SUICIDE PREVENTION. 5. PREVENTATIVE SERVICES. 6. ACCESS TO CARE/TELEHEALTH TO PATIENTS. |
| FACILITY 1, COTEAU DES PRAIRIES - PART V, LINE 3J | A CORRECTION UPON AUDIT NEEDS TO BE MADE. THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) HAS A REFERENCE THE 2012 IMPLENTATION STRATAGY (IS) BUT THAT SHOULD BE A REFERENCE TO THE 2015 IS. |
| FACILITY 1, COTEAU DES PRAIRIES - PART V, LINE 5 | THE HOSPITAL CONDUCTED COMMUNITY SURVEYS ONLINE AND IN PERSON, AND CONDUCTED AN INTERNAL STAKE HOLDER SURVEY. THERE WERE ALSO COMMUNITY AND ELITE INTERVIEWS WITH SWO, HIS, COMMUNITY LEADERS OF SERVICE AREAS AND EMERGENCY MEDICAL PERSONNEL, COMMUNITY MEMBERS, AND MEDICAL PRACTITIONERS. |
| FACILITY 1, COTEAU DES PRAIRIES - PART V, LINE 11 | THE FOLLOWING NEEDS WILL NOT BE ADDRESSED DUE TO OTHER ORGANIZATIONS IN THE COMMUNITY ADDRESSING. 1. TEEN PREGNANCY/UNSAFE SEX: SEVERAL KEY CONSTITUENT GROUPS WITHIN THE COMMUNITY HAVE ESTABLISHED PROGRAMS THAT ADDRESS THESE ISSUES. 2. AFFORDABLE HEALTH CARE: AFFORDABLE HEALTH CARE IS A NATIONAL ISSUE - ONE MUCH LARGER THAN CAN BE ADEQUATELY ADDRESSED BY A SMALL, CRITICAL ACCESS HOSPITAL. 3. ECONOMIC DEVELOPMENT/AFFORDABLE HOUSING: ACTIVITIES ARE UNDERWAY IN THE COMMUNITY THAT ADEQUATELY ADDRESS THE NEED EXPRESSED BY THE COMMUNITY MEMBERS THROUGHOUT THIS ASSESMENT. |
| FACILITY 1, COTEAU DES PRAIRIES - PART V, LINE 16J | A SUMMARY OF THE CHARITY CARE POLICY IS POSTED IN THE HOSPITAL'S MAIN ENTRANCE/ADMISSION AREAS, THE MAIN ENTRANCE/ADMISSION AREAS FOR EACH OF THE CLINICS, AND IN THE EMERGENCY ROOMS AND WAITING ROOMS. CDPH PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS, WHEN APPLICABLE. IN ADDITION, CDPH PERSONNEL DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHEN APPLICABLE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| BROWNS VALLEY CLINIC | ||||
| 106 4TH STREET SOUTH | BROWNS VALLEY | MN | 56219 | FAMILY PRACTICE CLINIC |
| ROSHOLT CLINIC | ||||
| 116 WEST MAIN STREET | ROSHOLT | SD | 57260 | FAMILY PRACTICE CLINIC |
| HERMAN CLINIC | ||||
| 204 5TH ST EAST | HERMAN | MN | 56248 | FAMILY PRACTICE CLINIC |
| SISSETON CLINIC | ||||
| 205 ORCHARD DRIVE | SISSETON | SD | 57262 | FAMILY PRACTICE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | NO BAD DEBT EXPENSE IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) AS BAD DEBT EXPENSE OF 776,271 IS REPORTED WITH NET PATIENT SERVICE REVENUE ON FORM 990, PART VIII, LINE 2.A., CONSISTENT WITH THE FINANCIAL STATEMENTS. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A 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, LINE 7E, IS COMPILED USING ACTUAL COSTS. |
| PART II - COMMUNITY BUILDING ACTIVITIES | CDP TRAVELS TO VARIOUS COMMUNITIES IN WITHIN 30 MILES FOR "TOE CLINICS" THIS SERVICE IS OFFERED TO ANYONE NO MATTER AGE, GENDER, ETHNICITY. CDP EMPLOYEES ARE ACTIVE IN COMMUNITY MEETINGS WITH IHS, ALIVE ROBERTS COUNTY, SD DEPT HUMAN SERVICES, SWO COLLEGE. MEETINGS HAVE A RANGE OF AGENDA'S THAT INCLUDE HEALTHY BABIES 0-5, SUICIDE PREVENTION, MENTAL HEALTH, COMMON PATIENTS IN THE COMMUNITY HEALTH & WELLNESS, PROMOTING HEALTHY PREGNANCIES. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | OVERALL COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2. BAD DEBT EXPENSE REPORTED ON FORM 990, PART VIII, LINE 2A WAS 776,721. |
| PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE | BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE IS ESTIMATED BASED ON INCOME LEVELS AND ETHNICITY IN THIS AREA. MORE THAN 50% OF CDPH CHARGES ARE GENERATED BY THE NATIVE AMERICAN POPULATION. STATISTICS SHOW THE AVERAGE HOUSEHOLD INCOME OF NATIVE AMERICAN FAMILIES IN ROBERTS COUNTY IS TWO- THIRDS OF THAT OF OTHER ETHNIC GROUPS. VIRTUALLY ALL NATIVE AMERICANS QUALIFY FOR CHARITY CARE, THUS THE ORGANIZATION ESTIMATES APPROXIMATELY 50% OF BAD DEBT IS ATTRIBUTABLE TO PERSONS WHO WOULD QUALIFY FOR CHARITY CARE. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 9 AND 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THE HOSPITAL PROVIDES SERVICES TO MEDICARE PATIENTS KNOWING THERE COULD BE A SHORTFALL BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT TO THE HOSPITAL. THEREFORE; THE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. TOTAL REVENUE RECEIVED FROM MEDICARE (INCLUDING DSH AND IME) IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT (INCLUDING LSA). BOTH THE 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 CENTERS FOR MEDICAID AND MEDICARE SERVICES. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | FOR PATIENTS WHO QUALIFY FOR CHARITY CARE AND ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, COTEAU DES PRAIRIES HOSPITAL AND CLINIC MAY OFFER EXTENDED PAYMENT PLANS. THE HOSPITAL WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS. THE HOSPITAL WILL FIRST MAKE REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THE FINANCIAL ASSISTANCE POLICY. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | THE PRIORITY OF CDPH IS TO PROMOTE THE HEALTH OF SISSETON AND ALSO THE SURROUNDING RURAL COMMUNITIES. PLEASE REFER TO SCHEDULE H, PART V, LINE 5. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | CDPH UTILIZES MULTIPLE METHODS FOR PATIENT EDUCATION OF FINANCIAL ASSISTANCE. PLEASE SEE SCHEDULE H, PART V, LINE 16. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | CDPH IS A SOLE COMMUNITY PROVIDER WITH AN 8 MEMBER VOLUNTEER BOARD OF DIRECTORS WHO ALL RESIDE IN THE PRIMARY SERVICE AREA. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED INDIVIDUALS AS THEY ARE REQUESTED. IF CDPH WERE TO HAVE SURPLUS FUNDS, THE FUNDS WOULD BE APPLIED TO PATIENT CARE IMPROVEMENTS AND ALSO TO REDUCE THE NEED FOR RATE INCREASES FOR THE PATIENTS. THE EMERGENCY ROOM IS STAFFED 24 HOURS A DAY, 7 DAYS A WEEK, AND PATIENTS ARE WELCOMED REGARDLESS OF RACE OR THE ABILITY TO PAY FOR THE SERVICES. CDPH PARTICIPATES IN ALL GOVERNMENT-SPONSORED HEALTH PROGRAMS INCLUDING MEDICARE, MEDICAID, INDIAN HEALTH SERVICES, AND VETERAN AFFAIRS BENEFITS. THE HOSPITAL AND CLINICS WELCOME STUDENTS FOR TRAINING AND COLLEGE ROTATIONS IN VARIOUS HEALTHCARE PROFESSIONS. |
| ADDITIONAL INFORMATION | PART I, LINE 3C: PLEASE REFER TO SCHEDULE H, PART V, LINE 13. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (true) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| STANLEY GALLAGER DO | ||||
| FAMILY PRACTICE | $474,807 | $11,000 | $14,414 | $500,221 |
| JUDY BEUMER MD | ||||
| FAMILY PRACTICE | $459,586 | $11,000 | $13,591 | $484,177 |
| JOSEPH RILEY DO | ||||
| OB/GYN | $392,274 | $11,000 | $20,136 | $423,410 |
| RAMON MORALES MD | ||||
| GENERAL SURGEON | $371,935 | $11,000 | $20,136 | $403,071 |
| SHERRYL TOMBOULIAN MD | ||||
| FAMILY PRACTICE | $358,897 | $11,000 | $20,136 | $390,033 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 5A | FormAndLineReferenceDesc |
| Explanation | THREE PHYSICIANS ARE PAID 38% OF THEIR RESPECTIVE PROVIDER/CPT CODE REVENUE. OTHER PHYSICIANS AND MID-LEVEL PROVIDERS ARE PAID UNDER PRIOR CONTRACTS NOT RELATED TO THE REVENUE GENERATED. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF SISSETON SOUTH DAKOTA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 466000460 | BondIssuerEIN |
| Bond Issued | 2012-07-06 | BondIssuedDt |
| Issue Price | $7,450,000 | IssuePriceAmt |
| Purpose | FUND HOSPITAL REMODELING AND BUILDING ADDITION PROJECT. | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,009,187 | RetiredAmt |
| Total Proceeds | $7,450,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $122,280 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $7,077,281 | CapitalExpendituresAmt |
| Other Spent Proceeds | $191,129 | OtherSpentProceedsAmt |
| Substantial Completion | 2014 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | false | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | CITY OF SISSETON, SOUTH DAKOTA SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: CITY OF SISSETON, SOUTH DAKOTA (B) DESCRIPTION OF PURPOSE: FUND HOSPITAL REMODELING AND BUILDING ADDITION PROJECT | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | COTEAU DES PRAIRIES HOSPITAL (CDPH) IS A 25 BED ACUTE CARE HOSPITAL AND PHYSICIAN CLINICS LOCATED IN SISSETON, SOUTH DAKOTA AND THE SURROUNDING AREA. THE HOSPITAL PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THEN ESTABLISHED RATES. SINCE THE HOSPITAL DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUE. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS 31,704 FOR THE YEAR ENDED DECEMBER 31, 2018. STATISTICS FOR THE PERIOD ENDED DECEMBER 31, 2018, ARE AS FOLLOWS: ACUTE PATIENT DAYS = 1,076, SWING-BED PATIENT DAYS = 641, NEWBORN NURSERY DAYS = 261, EMERGENCY ROOM VISITS = 4,531, CLINIC VISITS = 17,348, AND NUMEROUS OTHER OUTPATIENT VISITS. |
| FORM 990, PART VI | SECTION A, LINE 1: THE EXECUTIVE COMMITTEE CONSISTS OF THE PRESIDENT, VICE PRESIDENT, THE SECRETARY, THE TREASURER, AND ONE OTHER MEMBER OF THE BOARD TO BE ELECTED BY THE BOARD AT THE ANNUAL MEETING. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL & CLINIC DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD. SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE WILL BE REFERRED TO THE BOARD. MINUTES OF THE EXECUTIVE COMMITTEE MEETINGS ARE AVAILABLE TO THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 AFTER FILING. THE CEO REVIEWS THE 990 IN DETAIL. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS COMPLETED ANNUALLY AND COVERS OFFICERS AND BOARD MEMBERS. THE BOARD IS GIVEN A CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS TO SIGN. THE DETERMINATION OF WHETHER A CONFLICT EXISTS IS MADE AT THE BOARD OF THE DIRECTORS LEVEL, AS IS THE REVIEW OF ACTUAL CONFLICTS. ANY PERSON DETERMINED TO HAVE A CONFLICT WILL HAVE AN OPPORTUNITY TO EXPLAIN THE SITUTATION, AND HE/SHE WILL BE REQUIRED TO REFRAIN FROM VOTING. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO IS PROVIDED THROUGH THE HOSPITAL'S MANAGEMENT SERVICE AGREEMENT WITH SANFORD HEALTH. COMPENSATION FOR THE CEO IS DETERMINED THROUGH INDIVIDUAL NEGOTIATIONS WITH SANFORD HEALTH, THE HOSPITAL EXECUTIVE COMMITTEE AND THE CEO. SANFORD HEALTH AND THE HOSPITAL EXECUTIVE COMMITTEE USE SALARY SURVEYS TO DETERMINE WHAT CONSTITUTES REASONABLE COMPENSATION. NEGOTIATIONS WITH SANFORD HEALTH AND THE HOSPITAL EXECUTIVE COMMITTEE INCLUDE A PERFORMANCE EVALUATION. AN EVALUATION IS DONE ANNUALLY BY SANFORD HEALTH AND THE HOSPITAL'S EXECUTIVE COMMITTEE, AND APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION OF THE CDPH'S OFFICERS IS DETERMINED THROUGH DISCUSSIONS BETWEEN THE EXECUTIVE COMMITTEE AND THE CEO. THE EXECUTIVE COMMITTEE USES SALARY SURVEYS TO DETERMINE WHAT CONSTITUTES REASONABLE COMPENSATION. DISCUSSIONS WITH THE EXECUTIVE COMMITTEE INCLUDE A PERFORMANCE EVALUATION. AN EVALUATION IS DONE ANNUALLY BY THE EXECUTIVE COMMITTEE, AND APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES 1,868,030 157,428 0 REPAIRS & MAINTENANCE 279,837 19,065 0 PROFESSIONAL FEES 932,149 4,426 0 COLLECTION FEES 0 10,756 0 CONTRACT LABOR 251,085 169,293 0 TOTAL 3,331,101 360,968 0 |
| FORM 990, PART XI, LINE 9 | NET ASSET TRANSFER TO TLC -1,179,075 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COTEAU DES PRAIRIES FOUNDATION | ||||||||||
| 205 ORCHARD DRIVE | SISSETON | SD | 572622398 | 800446054 | FUNDRAISE | SD | 501C3 | 7 | N/A | false |
| TEKAKWITHA NURSING CENTER INC | ||||||||||
| 6 E CHESTNUT ST | SISSETON | SD | 57262 | 411809912 | LTC | SD | 501C3 | 10 | N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COTEAU DES PRAIRIES FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $77,475 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
Comments