COOPERSTOWN MEDICAL CENTER: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- COOPERSTOWN MEDICAL CENTER (EIN 45-0227753)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2025-10-15
- IRS object ID
- 202512889349302751
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-10-15T14:40:03-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4585 Coleman St Ste 200 | AddressLine1Txt |
| City | Bismarck | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450227753 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cooperstown Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COOP | BusinessNameControlTxt |
| Phone | 7017861700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 107 12th St S | AddressLine1Txt |
| City | Cooperstown | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 584254501 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Nicole Lindsey | PersonNm |
| Person Title | CEO/Administrator | PersonTitleTxt |
| Phone | 7017861700 | PhoneNum |
| Signature | 2025-10-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Lisa Chaffee CPA | PreparerPersonNm |
| PTIN | P00193453 | PTIN |
| Phone | 7012551091 | PhoneNum |
| Preparation | 2025-10-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dakota Regional Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Nicole Lindsey | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 107 12th St S | AddressLine1Txt |
| City | Cooperstown | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 584254501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,826,700 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.dakotaregional.com/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | Provide health care services to the residents including the elderly in the Cooperstown, North Dakota and surrounding communities regardless of the ability to pay. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 74 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $636,654 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,565,677 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,189,592 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,804,332 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,592 | PYInvestmentIncomeAmt |
| CY Investment Income | -$468,367 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$625,520 | PYOtherRevenueAmt |
| CY Other Revenue | $1,870 | CYOtherRevenueAmt |
| PY Total Revenue | $5,203,318 | PYTotalRevenueAmt |
| CY Total Revenue | $6,903,512 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $11,189 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,890 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,031,582 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,970,275 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,086,479 | PYOtherExpensesAmt |
| CY Other Expenses | $2,462,019 | CYOtherExpensesAmt |
| PY Total Expenses | $5,129,250 | PYTotalExpensesAmt |
| CY Total Expenses | $6,438,184 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $74,068 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $465,328 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,947,350 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,832,409 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,286,463 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,706,194 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,660,887 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,126,215 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Cooperstown Medical Center is dedicated to providing high quality healthcare services in a personalized, compassionate, and professional manner. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,093,891 | ExpenseAmt |
| Grant | $5,890 | GrantAmt |
| Revenue | $5,804,332 | RevenueAmt |
| Desc | The Organization operates a 9-bed critical access hospital, 12-unit assisted living facility, and a medical clinic. Helping to relieve the added stress of extended travel, the organization is able to provide locally many of the services found at large hospitals. Through strong affiliations with major medical organizations, Cooperstown Medical Center is able to provide: 24-hour emergency services, occupational therapy, x-ray and laboratory services, electrocardiography, respiratory therapy, incontinence management, therapy, physical therapy, speech therapy, cardiac monitoring/telemetry, swing bed, respite and hospice care. | Desc |
| Total Program Service Expenses | $5,093,891 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 74 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | Judy Monson | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7017861700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 107 12th St S | AddressLine1Txt |
| City | Cooperstown | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 584254501 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 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 |
|---|---|---|---|---|---|---|---|---|
| Barry Getz | ||||||||
| President | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Gerald Stokka | ||||||||
| Vice President | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Benjamin Halvorson | ||||||||
| Secretary/Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| James Halvorson | ||||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Larry Grandalen | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Nicole Lindsey | ||||||||
| CEO - Administrator | 12.00 | 1.00 | Yes (X) | $53,089 | $0 | $8,945 | ||
| Judy Monson | ||||||||
| CFO (As of 11/22) | 28.00 | 1.00 | Yes (X) | $4,410 | $0 | $0 | ||
| Barbara Anderson | ||||||||
| CFO | 28.00 | 1.00 | Yes (X) | $110,718 | $0 | $0 | ||
| Steven Barlow | ||||||||
| Mid-Level/Nurse Practioner | 40.00 | 0.00 | $333,289 | $0 | $35,875 | Yes (X) | ||
| Debra Middleton | ||||||||
| Mid-Level/Nurse Practition | 40.00 | 0.00 | $229,540 | $0 | $14,453 | Yes (X) | ||
| Larissa Haug | ||||||||
| PA (Until 5/23) | 40.00 | 0.00 | $152,672 | $0 | $28,578 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $883,718 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $87,851 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Altru Health System | |||||
| 1200 S Columbia Road | Grand Forks | ND | 58201 | Therapy and Software Services | $304,504 |
| Griggs County Care Center | |||||
| 107 12th St S | Cooperstown | ND | 58425 | Shared services/laundry | $197,213 |
| DMS Health Technologies | |||||
| PO Box 670747 | Dallas | TX | 75267 | Mobile Diagnostic Services | $145,205 |
| Netcenter Technologies | |||||
| 2536 Main Ave W | West Fargo | ND | 58078 | IT Services | $121,743 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $250,810 | RelatedOrganizationsAmt |
| Government Grants | $1,313,767 | GovernmentGrantsAmt |
| All Other Contributions | $1,100 | AllOtherContributionsAmt |
| Total Contributions | $1,565,677 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient and Resident Revenue | 623000 | $5,320,458 | $5,320,458 |
| Assisted Living Rental | 623000 | $249,976 | $249,976 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $233,898 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $233,898 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,804,332 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,313 | TotalRevenueColumnAmt |
| Exclusion | $32,313 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $424,378 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $422,508 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,870 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,870 | TotalRevenueColumnAmt |
| Exclusion | $1,870 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500,680 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$500,680 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$500,680 | TotalRevenueColumnAmt |
| Exclusion | -$500,680 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,903,512 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,804,332 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$466,497 | 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 | $5,890 | TotalAmt |
| Program Services | $5,890 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,315 | TotalAmt |
| Management And General | $205,315 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,318 | TotalAmt |
| Management And General | $65,318 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,148,306 | TotalAmt |
| Program Services | $2,739,704 | ProgramServicesAmt |
| Management And General | $408,602 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,505 | TotalAmt |
| Program Services | $51,774 | ProgramServicesAmt |
| Management And General | $11,731 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,632 | TotalAmt |
| Program Services | $230,067 | ProgramServicesAmt |
| Management And General | $27,565 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,199 | TotalAmt |
| Program Services | $187,675 | ProgramServicesAmt |
| Management And General | $42,524 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,408 | TotalAmt |
| Program Services | $408 | ProgramServicesAmt |
| Management And General | $63,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $962,720 | TotalAmt |
| Program Services | $663,031 | ProgramServicesAmt |
| Management And General | $299,689 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,796 | TotalAmt |
| Program Services | $12,568 | ProgramServicesAmt |
| Management And General | $14,228 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,315 | TotalAmt |
| Program Services | $294,707 | ProgramServicesAmt |
| Management And General | $27,608 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,326 | TotalAmt |
| Management And General | $9,326 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,077 | TotalAmt |
| Program Services | $195,011 | ProgramServicesAmt |
| Management And General | $69,066 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,678 | TotalAmt |
| Program Services | $41,613 | ProgramServicesAmt |
| Management And General | $4,065 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,507 | TotalAmt |
| Program Services | $21,732 | ProgramServicesAmt |
| Management And General | $7,775 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,635 | TotalAmt |
| Program Services | $58,865 | ProgramServicesAmt |
| Management And General | $6,770 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,262 | TotalAmt |
| Program Services | $184,452 | ProgramServicesAmt |
| Management And General | $4,810 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,647 | TotalAmt |
| Program Services | $2,349 | ProgramServicesAmt |
| Management And General | $22,298 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $308,222 | $308,222 | |
| Dues and Subscriptions | $64,108 | $35,169 | $28,939 |
| Repairs and Maintenance | $32,653 | $32,653 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,665 | TotalAmt |
| Program Services | $28,001 | ProgramServicesAmt |
| Management And General | $25,664 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,438,184 | TotalAmt |
| Program Services | $5,093,891 | ProgramServicesAmt |
| Management And General | $1,344,293 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,094,290 | BOYAmt |
| EOY | $921,614 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,597 | BOYAmt |
| EOY | $1,063,892 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,081 | BOYAmt |
| EOY | $90,954 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,686 | BOYAmt |
| EOY | $99,028 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,019,789 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,318,200 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,644,079 | BOYAmt |
| EOY | $13,701,589 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $561,617 | BOYAmt |
| EOY | $1,495,737 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $10,459,595 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,947,350 | BOYAmt |
| EOY | $27,832,409 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,715,130 | BOYAmt |
| EOY | $783,539 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $777,021 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,000 | BOYAmt |
| EOY | $25,900 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,938,939 | BOYAmt |
| EOY | $22,765,536 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $830,373 | BOYAmt |
| EOY | $131,219 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,286,463 | BOYAmt |
| EOY | $23,706,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,160,887 | BOYAmt |
| EOY | $4,126,215 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,660,887 | BOYAmt |
| EOY | $4,126,215 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,947,350 | BOYAmt |
| EOY | $27,832,409 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $465,328 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $599 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $599 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Organization is a member of several organizations that take part in lobbying. A portion of the dues paid to the various organizations is for lobbying costs. These various organizations advocate on behalf of their members by supporting legislation that is in their collective interests. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $395,017 | OtherCostOrOtherBasisAmt |
| Book Value | $395,017 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,561,386 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,927,744 | DepreciationAmt |
| Book Value | $10,633,642 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,500,445 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,305,698 | DepreciationAmt |
| Book Value | $2,194,747 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $562,941 | OtherCostOrOtherBasisAmt |
| Depreciation | $84,758 | DepreciationAmt |
| Book Value | $478,183 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,701,589 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Estimated Third Party Payors | $382,000 |
| Right of Use Assets | $105,467 |
| Investment in Sales-Type Lease | $9,972,128 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,459,595 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Interest Payable | $22,073 |
| Lease Liability | $109,146 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $131,219 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,326,020 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,326,020 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$422,508 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$422,508 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,903,512 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,860,692 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $422,508 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $422,508 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,438,184 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,438,184 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | Security deposits advanced by tenants of the assisted living units are held in trust by the Organization. These funds are included in cash and cash equivalents and accounts payable in the consolidated financial statements. Tenant security deposits totaled $25,900 and $25,000 at June 30, 2023 and 2022. |
| Part X, Line 2: | The Medical Center believes 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 consolidated 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 4b - Other Adjustments: | Rental expenses included in Revenue for Tax return -422,508. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses included in Revenue for tax return 422,508. |
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 | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $364,207 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $338,667 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00400 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $372,207 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $338,667 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $33,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $949,685 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $668,053 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $281,632 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04370 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $949,685 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $668,053 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $281,632 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04370 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,321,892 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,006,720 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $315,172 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04890 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $339,706 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $112,103 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,193,787 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,206,806 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,019 | 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 | Cooperstown Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 107 12th St S | AddressLine1Txt |
| City | Cooperstown | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58425 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.coopermc.com | WebsiteAddressTxt |
| State License | 5010 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cooperstown 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 | 21 | 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 | https://www.dakotaregional.com/about-7 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.dakotaregional.com/about-7 | 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 |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.dakotaregional.com/about-7 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.dakotaregional.com/about-7 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.dakotaregional.com/about-7 | 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 Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Cooperstown Medical Center | Part V, Section B, Line 5: To gather feedback from the community, residents of the area were given the opportunity to participate in a survey. Seventy-five CMC service area residents completed the survey. Additional information was collected through five key informant interviews with community members. The input from the residents, who primarily reside in Griggs County, represented the broad interests of the communities in the service area. Together with secondary data gathered from a wide range of sources, the survey presents a snapshot of the health needs and concerns in the community. A community group met on March 28, 2022. Twelve community members attended the meeting. |
| Cooperstown Medical Center | Part V, Section B, Line 11: The community members voted on the needs identified to determine the ones deemed most significant. The needs were ranked as follows:1. Attracting and retaining young families2. Having enough child daycare services3. Not enough affordable housing4. Availability of mental health services5. Depression and anxiety for all agesFrom those top five priorities, each person voted on the one concern they felt was the most important. The rankings were: 1. Attracting and retaining young families (3 votes) 2. Having enough child daycare services (2 votes) 3. Availability of mental health services (2 votes) 4. Depression and anxiety for all ages (2 votes)The Hospital will not address the following health needs identified in the CHNA due to limited resources and the need to allocate significant resources to the two priority health needs identified above: 1. Attracting and retaining young families. 2. Adequate childcare services.In FY23, we did the following to address needs in the CHNA:We now have mental health services available two times a week with varying services. A couple service providers are able to prescribe medicine and one provides therapy. In FY23, we also had our Chief Nursing Officer attend parent teacher conferences and other events at the local school promoting suicide prevention and other mental health awareness. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | 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. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. |
| Part II, Community Building Activities: | The Organization participates in community building activities, however, the activities are too difficult to quantify and are not tracked. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. |
| Part III, Line 3: | CMC used the percentage of charity care/financial assistance applications that were denied due to lack of sufficient information or were never returned to determine the amount of implicit price concessions that is attributable to patients who would likely qualify for charity. For FY 2023 approximately 33% of applications lacked information or were never returned after patient was given an application to complete. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on pages 13 and 14 of the attached audited financial statements. |
| Part III, Line 8: | Hospital services remibursed on a fee schedule are not included in the Medicare calculations per the 990 instructions. Had this been reported the Hospital would have had a greater loss from Medicare services of $59,894.$36,347 - Medicare fee schedule revenue($96,241) - Medicare estimated costs of care relating to payment($59,894) - Net (shortage) |
| Part III, Line 9b: | When patients are known to qualify for financial assistance, they are requested to fill out a financial assistance application and collection actions are stopped. If an application is returned with insufficient information a telephone call and/or a letter is sent indicating what is still needed to process the application. If no response is received, the application will be reviewed by the Financial Assistance/Community Care Program committee to determine if collection proceedings should resume or if presumptive charity care be allowed. Patients will be notified when the facility determines the amount of financial assistance approved. |
| Part VI, Line 2: | The Organization typically offers wellness screenings once a year at no cost to the public. The wellness screenings help the Organization to assess health needs of the community. Included are blood pressure checks, diabetes screenings, pulmonary and respiratory screenings, and education on good health. This often results in follow-up care after results of screenings are reviewed. A community health needs assessment was also conducted during the 6/30/25 fiscal year end to help assess needs in the community. |
| Part VI, Line 3: | Patients receive charity care information through the business office. The Organization mails brochures regarding the program in past due statements. The Organization also gives the brochure to people in the community known to the Organization that do not have insurance upon arrival for a visit. The charity care information is part of the intake process. |
| Part VI, Line 4: | As of the census of 2020, there were 2,306 people and 946 households residing in the county. The population density was 3.4 people per square mile. There were 1,378 housing units. The racial makeup of the county was 95.70% White, 0.30% Asian, 0.40% Black, 0.6% American Indian and Alaska Native persons, and 3.0% from other races. There were 946 households out of which 23.0% had children under the age of 18 living with them, 51.2% were married couples living together, and 24.6% had a female householder with no husband present. The average family size was 3.23.In the county the population was spread out with 23.4% under the age of 19, 4.4% from 20 to 24, 15.6% from 25 to 44, 27.8% from 45 to 64, and 28.8% who were 65 years of age or older. The median age was 50.6 years. The median income for a household in the county was $64,737, and the median income for a family was $92,500. About 10.1% of the population were below the poverty line, including 7.3% of those under age 18 and 14.1% of those ages 65 or over. |
| Part VI, Line 5: | The Organization offers a variety of services to the community to assist in taking away the burden of having to travel for medical care. The Organization also assists in accommodating any financial concerns through the charity care program. By doing both, the Organization hopes to better the well-being of the community. The Board of Directors is comprised of persons who reside in the primary service area. Medical staff privileges are given to all qualified physicians in the community. The Organization is affiliated with Emergency Heart Network, St. Paul Ramsey Burn Center, and Life Flight. When available, surplus funds are used to upgrade patient care equipment and facility infrastructure.The organization continued to offer COVID-19 screenings available at no cost to the public, unless a physician visit was required due to the patient's condition. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Steven Barlow | ||||||||||||||
| Mid-Level/Nurse Practioner | $333,289 | $0 | $0 | $0 | $0 | $0 | $6,218 | $0 | $31,084 | $0 | $370,591 | $0 | $0 | $0 |
| Debra Middleton | ||||||||||||||
| Mid-Level/Nurse Practition | $229,540 | $0 | $0 | $0 | $0 | $0 | $4,567 | $0 | $11,274 | $0 | $245,381 | $0 | $0 | $0 |
| Larissa Haug | ||||||||||||||
| PA (Until 5/23) | $152,672 | $0 | $0 | $0 | $0 | $0 | $3,863 | $0 | $25,831 | $0 | $182,366 | $0 | $0 | $0 |
| Nicole Lindsey | ||||||||||||||
| CEO - Administrator | $53,089 | $0 | $0 | $0 | $0 | $0 | $2,124 | $0 | $7,249 | $0 | $62,462 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Nicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The amounts reported in Part VII and on schedule J represent 30 percent of her compensation. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Darnell Lindsey | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Husband of CEO, Nicole Lindsey | RelationshipDescriptionTxt |
| Transaction | $65,318 | TransactionAmt |
| Transaction | Compensation | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1a | An Executive Committee may be appointed or dissolved by a majority vote of the Board of Directors. If so formed, the Executive Committee, in addition to the Chairman of the board and the Administrator, shall consist of the Secretary, the Treasurer, and one (1) additional member of the Board of Directors elected by the board at its first meeting after its election. The Executive Committee shall have power to transact all regular business of the Cooperstown Medical Center during the period between the meetings of the Board of Directors, subject to any prior limitations imposed by the Board and with the understanding that all matters of major importance will be referred to the Board of Directors. Minutes of the Executive Committee meetings shall be submitted to the Board, and its actions shall be subject to approval or disapproval at the next regular Board meeting. |
| Form 990, Part VI, Section A, line 2 | Nicole Lindsey and Barbara Anderson have a business relationship. Barbara Anderson and James Halvorson have a family relationship. Gerald Stokka and Barry Getz have a family relationship. |
| Form 990, Part VI, Section A, line 6 | The Organization has members consisting of those persons who are 18 years of age or above residing in the area served by Cooperstown Medical Center. |
| Form 990, Part VI, Section A, line 7a | The Members elect the Board of Directors. |
| Form 990, Part VI, Section B, line 11b | The CFO reviews the Form 990 prior to filing with the Internal Revenue Service. The Board of Directors also receives a copy of the Form 990 by email prior to it being filed with the IRS. |
| Form 990, Part VI, Section B, line 12c | Each board member annually and upon hire each corporate officer, executive, department director, supervisor or other individual, duly authorized by the governing body to conduct business on behalf of Cooperstown Medical Center signs a statement which affirms that such person: 1) has received a copy of the conflict of interest policy; 2) has read and understands the policy; 3) has agreed to comply with the policy; 4) understands that the organization is and includes charitable organizations and that in order to maintain its federal tax exemption it must engage primarily in activities which further one or more of its tax-exempt purposes. If a conflict arises, the board will assign a disinterested person to investigate alternatives to the proposed transaction or arrangement. The interested member is to provide information to the board, however not influence the board regarding their decision. |
| Form 990, Part VI, Section B, line 15 | Nicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The CFO's, Judy Monson and Barbara Anderson, were compensated for their services to the Organization as well as for their services to Griggs County Care Center (GCCC) an unrelated organization. Their compensation was determined by an agreement between both the Organization's board of directors and that of GCCC. Thirty percent of their compensation is billed to and reimbursed by GCCC. The amounts reported in part VII represent all of their compensation including the thirty percent that is billed to GCCC. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request and at the annual meeting. |
| Form 990, Part IX, line 11g | Professional Fees: Program service expenses 153,110. Management and general expenses 75,924. Fundraising expenses 0. Total expenses 229,034. Purchased Services: Program service expenses 482,832. Management and general expenses 223,765. Fundraising expenses 0. Total expenses 706,597. Consultant Fees: Program service expenses 27,089. Management and general expenses 0. Fundraising expenses 0. Total expenses 27,089. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cooperstown Medical Center Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 107 12th St S | AddressLine1Txt |
| City | Cooperstown | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58425 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450450301 | EIN |
| Primary Activities | To support the programs of the Cooperstown Medical Center | PrimaryActivitiesTxt |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cooperstown Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| 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 | Yes (1) | 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 | 0 | 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 | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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