EUREKA COMMUNITY & BENEVOLENT HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- EUREKA COMMUNITY & BENEVOLENT HOSPITAL (EIN 46-0246437)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-03-29
- IRS object ID
- 201830889349300518
- Schema version
- 2016v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-03-29T12:07:43-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | 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 | 200 EAST 10TH ST PO BOX 5125 | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571175125 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460246437 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EUREKA COMMUNITY HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EURE | BusinessNameControlTxt |
| Phone | 6052842661 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 517 | AddressLine1Txt |
| City | EUREKA | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57437 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARMEN WEBER | PersonNm |
| Person Title | ADMINISTRATOR | PersonTitleTxt |
| Phone | 6052842661 | PhoneNum |
| Signature | 2018-03-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURIE HANSON | PreparerPersonNm |
| PTIN | P00851848 | PTIN |
| Phone | 6053391999 | PhoneNum |
| Preparation | 2018-03-24 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 198.135.125.43 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-03-24 | IPDt |
| IP Tm | 12:59:28 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 974248CA41D94A414E643A61057C2CD568A63DD6 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B16095FA32523CD326D583884BA37C70A3019BC0 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EUREKA COMM HEALTH SVCS AVERA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARMEN WEBER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 517 | AddressLine1Txt |
| City | EUREKA | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57437 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,589,448 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AVERA.ORG/LOCATIONS/PROFILE/?ID=164 | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1928 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | EUREKA COMMUNITY HEALTH SERVICES AVERA AIMS TO PROVIDE QUALITY, ACCESSIBLE HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 42 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,434 | PYContributionsGrantsAmt |
| CY Contributions Grants | $535,804 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,204,254 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,837,003 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,180 | PYInvestmentIncomeAmt |
| CY Investment Income | $32,831 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,219,868 | PYTotalRevenueAmt |
| CY Total Revenue | $3,405,638 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,240,703 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,553,371 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,019,993 | PYOtherExpensesAmt |
| CY Other Expenses | $1,365,671 | CYOtherExpensesAmt |
| PY Total Expenses | $2,260,696 | PYTotalExpensesAmt |
| CY Total Expenses | $2,919,042 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$40,828 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $486,596 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,434,336 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,145,709 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $882,202 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $824,121 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,552,134 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,321,588 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF EUREKA COMMUNITY HEALTH SERVICES AVERA IS TO PROVIDE QUALITY, ACCESSIBLE HEALTHCARE TO THE RESIDENTS IN OUR REGION. WE RECOGNIZE THE ELEMENTS OF COMPASSION, RESPECT, JUSTICE, AND HOSPITALITY IN CARRYING OUT THIS MISSION. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,544,647 | ExpenseAmt |
| Revenue | $2,864,053 | RevenueAmt |
| Desc | EUREKA COMMUNITY HEALTH SERVICES AVERA (ECHSA) OPERATES A 6-BED ACUTE CARE HOSPITAL, A 10-UNIT ASSISTED LIVING FACILITY AND AND A CLINIC LOCATED IN EUREKA, SOUTH DAKOTA. FOR THE YEAR ENDED JUNE 30, 2017, CLINIC VISITS WERE 2758, ACUTE PATIENT DAYS WERE 174; SWING-BED DAYS WERE 276; AND ASSISTED LIVING DAYS WERE 3212. | Desc |
| Total Program Service Expenses | $2,544,647 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 42 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOYCE SCHWINGLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6052842661 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 517 | AddressLine1Txt |
| City | EUREKA | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 574370517 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| WAYNE LUTZ | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KEITH KRAMLICH | ||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PAT GRENZ | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| WILLIS SCHNABEL | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KATHY GAB | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GEORGE HULSCHER | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| WANDA JUNDT | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CARMEN WEBER | ||||||
| ADMINISTRATOR | 25.00 | Yes (X) | $54,540 | $0 | $12,956 | |
| JOYCE SCHWINGLER | ||||||
| FINANCE OFFICER | 40.00 | Yes (X) | $37,116 | $0 | $14,856 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $91,656 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $27,812 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AVERA ST LUKE'S HOSPITAL | |||||
| 305 SOUTH STATE STREET | ABERDEEN | SD | 57401 | MGMT, SERVICE LAB,PHYSICAL THERAPY,CONSU | $553,820 |
| HKG ARCHITECTS | |||||
| PO BOX 55 | ABERDEEN | SD | 57402 | ARCHITECTUAL FEES | $291,741 |
| AVERA HEALTH | |||||
| 3900 W AVERA DR | SIOUX FALLS | SD | 57108 | E-EMERGENCY SERVICE FEES | $118,711 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $14,922 | GovernmentGrantsAmt |
| All Other Contributions | $520,882 | AllOtherContributionsAmt |
| Total Contributions | $535,804 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE FEES | 621110 | $2,545,678 | $2,545,678 |
| ASSISTED LIVING FEES | 362399 | $211,240 | $211,240 |
| COMMUNITY HEALTH FEES | 900099 | $49,109 | $49,109 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,976 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,976 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,837,003 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $473 | TotalRevenueColumnAmt |
| Exclusion | $473 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $216,168 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $183,810 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $32,358 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,358 | TotalRevenueColumnAmt |
| Exclusion | $32,358 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,405,638 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,837,003 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $32,831 | 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 | $129,850 | TotalAmt |
| Management And General | $129,850 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,190,367 | TotalAmt |
| Program Services | $1,126,435 | ProgramServicesAmt |
| Management And General | $63,932 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,866 | TotalAmt |
| Program Services | $16,094 | ProgramServicesAmt |
| Management And General | $772 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,816 | TotalAmt |
| Program Services | $125,161 | ProgramServicesAmt |
| Management And General | $5,655 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,472 | TotalAmt |
| Program Services | $77,571 | ProgramServicesAmt |
| Management And General | $7,901 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,689 | TotalAmt |
| Management And General | $47,689 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,205 | TotalAmt |
| Management And General | $36,205 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,681 | TotalAmt |
| Program Services | $380,050 | ProgramServicesAmt |
| Management And General | $3,631 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,527 | TotalAmt |
| Program Services | $844 | ProgramServicesAmt |
| Management And General | $3,683 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,638 | TotalAmt |
| Program Services | $77,535 | ProgramServicesAmt |
| Management And General | $18,103 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,236 | TotalAmt |
| Program Services | $414 | ProgramServicesAmt |
| Management And General | $29,822 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,830 | TotalAmt |
| Program Services | $55,443 | ProgramServicesAmt |
| Management And General | $2,387 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,265 | TotalAmt |
| Program Services | $9,060 | ProgramServicesAmt |
| Management And General | $205 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,907 | TotalAmt |
| Program Services | $3,907 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,788 | TotalAmt |
| Program Services | $15,788 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,632 | TotalAmt |
| Program Services | $67,632 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,999 | TotalAmt |
| Management And General | $18,999 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $368,056 | $368,056 | |
| EQUIPMENT AND REPAIRS | $139,292 | $136,920 | $2,372 |
| BAD DEBTS | $54,768 | $54,768 | |
| DUES AND SUBSCRIPTIONS | $22,211 | $19,481 | $2,730 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,947 | TotalAmt |
| Program Services | $9,488 | ProgramServicesAmt |
| Management And General | $459 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,919,042 | TotalAmt |
| Program Services | $2,544,647 | ProgramServicesAmt |
| Management And General | $374,395 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,414 | BOYAmt |
| EOY | $410,052 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,452 | BOYAmt |
| EOY | $480,822 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,153 | BOYAmt |
| EOY | $60,933 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,262 | BOYAmt |
| EOY | $45,265 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,822,754 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,996,066 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $604,153 | BOYAmt |
| EOY | $826,688 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $902,902 | BOYAmt |
| EOY | $1,321,949 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,434,336 | BOYAmt |
| EOY | $3,145,709 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,014 | BOYAmt |
| EOY | $217,468 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,593 | BOYAmt |
| EOY | $44,793 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $357,045 | BOYAmt |
| EOY | $332,310 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,550 | BOYAmt |
| EOY | $229,550 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $882,202 | BOYAmt |
| EOY | $824,121 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $955,309 | BOYAmt |
| EOY | $1,437,193 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $589,108 | BOYAmt |
| EOY | $876,678 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,717 | BOYAmt |
| EOY | $7,717 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,552,134 | BOYAmt |
| EOY | $2,321,588 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,434,336 | BOYAmt |
| EOY | $3,145,709 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $486,596 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$7,339 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $290,197 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,440 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $705 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $9,145 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,554 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$114 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $8,440 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,748 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$194 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $8,554 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,779 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $969 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $8,748 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,717 | BeginningYearBalanceAmt |
| Contributions | $62 | ContributionsAmt |
| End Year Balance | $7,779 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.84390 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.15620 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,583 | OtherCostOrOtherBasisAmt |
| Book Value | $18,583 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,799,082 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,616,924 | DepreciationAmt |
| Book Value | $182,158 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $456,252 | OtherCostOrOtherBasisAmt |
| Depreciation | $379,142 | DepreciationAmt |
| Book Value | $77,110 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $548,837 | OtherCostOrOtherBasisAmt |
| Book Value | $548,837 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $826,688 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| INTEREST IN AVERA FOUNDATION | $918,903 | F |
| ASSETS LIMITED AS TO USE - AVERA POOLED INVESTMENTS | $403,046 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,321,949 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| TENANT SECURITY DEPOSITS | $2,550 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENT | $227,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $229,550 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,346,158 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$7,339 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$52,141 | OtherRevenueAmt |
| Revenue Not Reported | -$59,480 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,405,638 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,405,638 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,864,274 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,864,274 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $54,768 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $54,768 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,919,042 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | EARNINGS ON ENDOWMENTS ARE INTENDED TO PROVIDE ADDITIONAL REAL GROWTH THROUGH NEW GIFTS AND INVESTMENT RETURN. |
| PART X, LINE 2: | THE ORGANIZATION IS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE ORGANIZATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE ORGANIZATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE ORGANIZATION CURRENTLY HAS NO INCOME THAT IT HAS DETERMINED TO BE SUBJECT TO UNRELATED BUSINESS INCOME TAX. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSES -54,768. CHANGE IN INTEREST IN UNRESTRICTED NET ASSETS OF FOUNDATION 2,627. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSES 54,768. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,598 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00590 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,598 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00590 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,208 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,033 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $175 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $505,399 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $175,060 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $330,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11530 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $68 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $508,675 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $178,093 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $330,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11540 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $546,273 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $198,703 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $347,570 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12130 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $54,768 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $1,156,208 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $1,167,496 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$11,288 | 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 | EUREKA COMMUNITY HEALTH SERVICES AVERA | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 410 9TH STREET | AddressLine1Txt |
| City | EUREKA | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57437 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.AVERA.ORG/LOCATIONS | WebsiteAddressTxt |
| State License | 10538 | 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 | EUREKA COMMUNITY HEALTH SERVICES AVERA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE NARRATIVE FOR 7D | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V LINE 7D | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 (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 | HTTP://WWW.AVERA.ORG/LOCATIONS/PROFILE/?ID=164 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.AVERA.ORG/LOCATIONS/PROFILE/?ID=164 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.AVERA.ORG/LOCATIONS/PROFILE/?ID=164 | 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 |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| 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 (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| EUREKA COMMUNITY HEALTH SERVICES AVERA | PART V, SECTION B, LINE 5: FOCUS GROUPS WERE CONDUCTED IN OCTOBER AND NOVEMBER. ONE FOCUS GROUP INCLUDED THE AMBULANCE SQUAD PRESIDENT, THE COUNTY CORONER, THE MINISTERIAL ASSOCIATION PRESIDENT, THE COUNTY SHERIFF AND HIS DEPUTY, THE COUNTY EMERGENCY MANAGER, THE EUREKA FIRE DEPARTMENT CHIEF, THE NURSING HOME ADMINISTRATOR, THE FACILITY DIRECTOR OF PATIENT SERVICES, AND THE CEO OF THE MEDICAL FACILITY.A SECOND FOCUS GROUP INCLUDED THE HOSPITAL'S MEDICAL STAFF COMMITTEE, CONSISTING OF SENIOR LEADERS AND PRIMARY CARE PROVIDERS. A THIRD FOCUS GROUP INCLUDED THE BOARD OF TRUSTEES. A FOURTH FOCUS GROUP WAS THE CAPITAL CAMPAIGN STEERING COMMITTEE CONSISTING OF THE TOWN PHARMACIST, A CITY COUNCIL MEMBER, A RETIRED SCHOOL TEACHER, A RETIRED PASTOR, A COMMUNITY BUSINESS WOMAN, A FORMER STATE LEGISLATOR AND 7 LOCAL FARMERS AND RANCHERS FROM ACROSS MCPHERSON COUNTY.IN ADDITION, TO ENSURE THAT THE ORGANIZATION INCLUDED INPUT FROM THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN THE NEEDS OF THE ELDERLY OF OUR COMMUNITY, THE EUREKA COMMUNITY HEALTH SERVICES AVERA HOME HEALTH/DSS HOMEMAKING DIRECTOR WAS ALSO ASKED TO ANSWER THE SERIES OF QUESTIONS UTILIZED IN THE PRIMARY DATA COLLECTION. THE MCPHERSON COUNTY PUBLIC HEALTH NURSE ALSO ANSWERED THE SERIES OF QUESTIONS UTILIZED IN THE PRIMARY DATA COLLECTION.SECONDARY DATA COLLECTION INCLUDED THE RESEARCH OF MCPHERSON COUNTY DEMOGRAPHICS AND HEALTH RELATED STATISTICS AND OBTAINING RELIABLE DATA THROUGH INTERNET RESEARCH. SOURCES OF THIS DATA INCLUDE U.S. CENSUS BUREAU, COUNTY HEALTH RANKINGS & ROADMAPS, US DEPARTMENT OF HEALTH AND HUMAN SERVICES, SOUTH DAKOTA DEPARTMENT OF HEALTH, AND THE SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS. |
| EUREKA COMMUNITY HEALTH SERVICES AVERA | PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT HTTP://WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/#EUREKA |
| EUREKA COMMUNITY HEALTH SERVICES AVERA | PART V, SECTION B, LINE 11: SIGNIFICANT NEEDS IDENTIFIED THROUGH THE CHNA PROCESS INCLUDE NEW, UPDATED FACILITIIES, HEART DISEASE, AND RECRUITMENT OF PROVIDERS. ECHSA IS ADDRESSING ALL OF THESE NEEDS.THE CAPITAL CAMPAIGN FUNDRAISER FOR A NEW FACILITY WAS SUCCESSFUL AND WITH APPROVAL FROM USDA THE BOARD OF DIRECTORS VOTED IN JULY OF 2017 TO PROCEED WITH THE CONSTRUCTION OF A NEW FACILITY. THE CONSTRUCTION PROJECT HAS STARTED AND IS ONGOING WITH A POSSIBLE COMPLETION DATE SOMETIME IN THE FALL OF 2018.THE RECRUITMENT FOR A PA/NP BEGAN IN MARCH 2016 AND THE HOSPITAL HIRED A PA IN AUGUST, 2016. WE WILL BEGIN RECRUITING FOR A MD OR PA/NP IN THE NEAR FUTURE DUE TO OUR CURRENT DOCTOR EXPRESSING THE DESIRE TO RETIRE IN 2 TO 3 YEARS. EMT CLASSES WERE OFFERED BY VIDEO CONFERENCE WITH AVERA MCKENNAN STARTING IN JANUARY OF 2017. BY PROVIDING THE CLASSES THROUGH VIDEO CONFERENCE, WE WERE ABLE TO BRING THE CLASSES RIGHT TO OUR COMMUNITY AND INTERESTED PERSONS DID NOT HAVE TO TRAVEL TO RECEIVE THE EDUCATION NEEDED TO BECOME AN EMT, AND THE COST OF THE CLASS WAS LESS EXPENSIVE. THERE WERE 3 PARTICIPANTS THAT TOOK THE CLASS THAT CONCLUDED IN MAY OF 2017. ALL 3 PARTICIPANTS TOOK THE NATIONAL EXAM WITH 2 OF THEM PASSING THE EXAM AND BECOMING CERTIFIED EMT'S AND WHO ARE NOW SERVING ON OUR LOCAL AMBULANCE SQUAD.EDUCATION AND PREVENTION OF HEART DISEASE WAS DONE THROUGH THE OFFERING OF SCREENING OPPORTUNITIES THROUGH SCREENING AMERICA (STROKE & YOUNG HEARTS SCREENING). CONSUMER TO LAB SCREENING DONE AT A REDUCED COST TO CONSUMERS CONTINUES TO BE DONE IN THE FALL OF EACH YEAR. WE CONTINUE TO HAVE COMMUNITY HEALTH NURSE, NURSING STAFF AND EMT STAFF DISPLAY AND PRESENT HEART DISEASE INFORMATION AT COMMUNITY MEETINGS AND EVENTS. WE CONTINUE TO EDUCATE THE PUBLIC ABOUT THE NU-VAL POINT SYSTEM USED AT THE LOCAL GROCERY STORE TO PROMOTE HEALTHY EATING CHOICES. WE CONTINUE TO PUBLISH ARTICLES ON HEART DISEASE IN THE NEWSPAPER AND TO PRESENT ON THE LOCAL RADIO SHOW "EUREKA SHOW". WE ALSO CONTINUE TO PROMOTE THE ORGANIZATIONS CARDIAC REHAB PROGRAM TO PROMOTE HEALTHY HEARTS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - EUREKA COMMUNITY HOSPITAL | ||||
| 401 9TH ST | EUREKA | SD | 57437 | ASSISTED LIVING FACILITY |
| 2 - EUREKA MEDICAL CLINIC- AVERA | ||||
| 401 9TH ST | EUREKA | SD | 57437 | CLINIC CENTER |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | OUR COMMUNITY BENEFIT REPORT IS INCLUDED IN THE COMMUNITY BENEFIT REPORT THAT IS SUBMITTED TO AVERA HEALTH BY AVERA ST. LUKE'S. IT IS AVAILABLE THROUGH THE WEBSITE AND REQUESTED MAILING, AND IS FILED WITH THE CATHOLIC HEALTH ASSOCIATION. |
| PART I, LINE 7: | LINE 7E AND 7I WERE OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINE 7B WAS DETERMINED BASED ON AN OVERALL COST TO CHARGE RATIO. LINE 7G WAS OBTAINED FROM THE MEDICARE COST REPORT. |
| PART I, LN 7 COL(F): | PART I, LINE 7 COL (F): THE AMOUNT OF BAD DEBT EXPENSE BASED ON CHARGES OF $54,768 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. |
| PART III, LINE 2: | IF AN ACCOUNT IS WRITTEN OFF TO BAD DEBTS, PAYMENTS RECEIVED AFTER THE WRITE OFF FOR THAT ACCOUNT ARE POSTED TO THE CURRENT YEAR BAD DEBT ACCOUNTAS AN OFFSET AGAINST THE EXPENSE. |
| PART III, LINE 3: | THE ORGANIZATION DOES NOT BELIEVE ANY PORTION OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. |
| PART III, LINE 4: | THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS FOUND ON PAGE SIX AND SEVEN OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 6/30/17. MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | WHEN AN ACCOUNT IS UNPAID AND COLLECTION EFFORTS ARE UNSUCCESSFUL BY THE FACILITY IT MAY BE NECESSARY TO FILE WITH A COLLECTION AGENCY FOR FURTHER COLLECTION EFFORTS. IF AT ANY TIME AFTER AN ACCOUNT IS TURNED OVER TO A COLLECTION AGENCY, IT IS DETERMINED THE PATIENT IS ELIGIBLE FOR CHARITY CARE OR ANY OTHER FINANCIAL ASSISTANCE THE COLLECTION AGENCY WILL BE NOTIFIED TO STOP ANY COLLECTION EFFORTS ON THE ACCOUNT AND THE ACCOUNT WILL BE GIVEN BACK TO THE HOSPITAL. |
| PART VI, LINE 2: | EUREKA COMMUNITY HEALTH SERVICES AVERA CONDUCTS PATIENT SATISFACTION SURVEYS WHICH CAN LEAD TO INFORMATION REGARDING NEEDED SERVICES. IN ADDITION, INTERACTIVE QUESTIONS ARE ASKED ABOUT SERVICES AND RESULTS ARE REPORTED BACK TO THE OFFICERS AND BOARD. ECHSA CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING FISCAL YEAR END 6/30/16. |
| PART VI, LINE 3: | ECHSA HAS SIGNS POSTED THROUGHOUT THE FACILITY REGARDING FINANCIAL ASSISTANCE. A SUMMARY SHEET EXPLAINING FINANCIAL ASSISTANCE IS GIVEN TO DISCHARGED PATIENTS AND ALSO MADE AVAILABLE TO THE PUBLIC THROUGHOUT THE REST OF THE FACILITY. ECHSA WILL ALSO POST THIS INFORMATION PERIODICALLY IN THE LOCAL NEWSPAPER. |
| PART VI, LINE 4: | ECHSA IS LOCATED IN THE TOWN OF EUREKA, SOUTH DAKOTA, WHICH IS IN MCPHERSON COUNTY. MCPHERSON COUNTY HOLDS THE DISTINCTION OF HAVING THE HIGHEST PERCENTAGE OF ITS COUNTY POPULATION OVER THE AGE OF 65 IN THE STATE OF SOUTH DAKOTA. AS OF THE AMERICAN COMMUNITY SURVEY(ACS) OF 2014, THERE ARE 2,401 PEOPLE AND 1,028 HOUSEHOLDS RESIDING IN THE COUNTY.IN 2010, 30 PERCENT OF THE COUNTY'S POPULATION WAS AGE 65 AND OVER. THE ECONOMY IN MCPHERSON COUNTY HAS REMAINED RELATIVELY STABLE.THE MEDIAN INCOME FOR A HOUSEHOLD IN THE COUNTY WAS $37,602. MALES HAD A MEDIAN INCOME OF $37,188 VERSUS $33,824 FOR FEMALES. THE PER CAPITA INCOME FOR THE COUNTY WAS $22,515. ABOUT 16.6 PERCENT OF THE POPULATION IS BELOW THE POVERTY LINE. |
| PART VI, LINE 5: | THE FACILITY IS GOVERNED BY A SEVEN MEMBER VOLUNTARY BOARD OF TRUSTEES COMPRISED OF PEOPLE LIVING WITHIN THE SERVICE AREA. THESE MEMBERS HAVE NO BUSINESS OR FAMILY TIES TO THE ORGANIZATION. ECHSA EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN THE SERVICE AREA AND CURRENTLY HAS TWO PHYSICIANS, 1 EMPLOYED PA, ONE CONTRACTED PA ON STAFF. ALL FUNDS GENERATED BY THE FACILITY ARE REINVESTED INTO THE FACILITY THROUGH THE CONTINUED PROVISION OF HEALTHCARE SERVICES. ECHSA IS A CRITICAL ACCESS HOSPITAL WITH 24HR EMERGENCY ROOM SERVICES AND IS OPEN TO ALL PEOPLE REGARDLESS OF ABILITY TO PAY. |
| PART VI, LINE 6: | ECHSA IS A MANAGED FACILITY OF AVERA HEALTH. AVERA HEALTH AND ECHSA WORK COOPERATIVELY TO ENHANCE HEALTHCARE THROUGHOUT THE COMMUNITY SERVED BY THE HOSPITAL. AS A MANAGED FACILITY, THE HOSPITAL IS ABLE TO PARTICIPATE IN AVERA E-CARE SERVICES. ECSHA BEGAN UTILIZING AVERA'S E-EMERGENCY SERVICES DURING THE FISCAL YEAR ENDED 6/30/17.ECHSA ALSO HAS ACCESS TO "BACK OFFICE" SUPPORT SERVICES, SUCH AS LEGAL CONSULTATION, QUALITY BENCHMARKING, CODING, COMPUTER SERVICES, CONTRACT NEGOTIATIONS, ADMINISTRATIVE CONSULTATION, GROUP PURCHASING, HUMAN RESOURCE ASSISTANCE AND MANY OTHER SERVICES. AVERA HEALTH IS ABLE TO PROVIDE THESE SERVICES TO ECHSA AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT AND RESIDENT CARE. AVERA HEALTH AND ECHSA DEDICATE RESOURCES TO ENDEAVORS THAT MAKE A POSITIVE DIFFERENCE TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. THESE ACTIVITIES INCLUDE LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENTS IN THE COMMUNITY, CONTRIBUTIONS TO NONPROFIT COMMUNITY ORGANIZATIONS, NONPROFIT EVENT SPONSORSHIPS, DONATED MEDICAL SUPPLIES, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH SCREENINGS, FLU-SHOT CLINICS, COMMUNITY HEALTH EDUCATION AND VARIOUS OTHER ACTIVITIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 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 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990 PART VII, LINE 5 | FormAndLineReferenceDesc |
| Explanation | CARMEN WEBER, ADMINISTRATOR, IS COMPENSATED THROUGH AN ARRANGEMENT WITH AVERA ST. LUKE'S HOSPITAL, 305 S STATE ST, ABERDEEN, SD 57401. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | THE HOSPITAL PURCHASED A CLINIC AND E-EMERGENCY BECAME AVAILABLE ON OCTOBER 1, 2016. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE HOSPITAL BOARD DOES NOT HAVE COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ADMINISTRATOR AND FINANCE OFFICER REVIEW THE 990 IN DETAIL. AFTER THEIR REVIEW, THE 990 IS PROVIDED TO EACH BOARD MEMBER. THE 990 IS FILED AFTER EACH BOARD MEMBER HAS RECEIVED A COPY. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY INCLUDES ALL BOARD MEMBERS AND OFFICERS OF THE ORGANIZATION. THE ADMINISTRATOR TAKES KNOWN CONFLICTS TO THE BOARD. THE BOARD IS RESPONSIBLE FOR THE REVIEW AND DETERMINATION OF WHETHER A CONFLICT EXISTS. IF A PERSON IS DETERMINED TO HAVE A CONFLICT, HE/SHE IS REQUIRED TO ABSTAIN FROM DISCUSSION, DELIBERATION AND VOTING ON THE MATTER CAUSING THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD FILLS OUT A WRITTEN EVALUATION ON THE ADMINISTRATOR, AND MEETS WITH AVERA ST. LUKE'S TO DISCUSS THE EVALUATION. DETERMINATION OF COMPENSATION IS A COLLABORATIVE EFFORT BETWEEN THE ORGANIZATION AND AVERA ST. LUKE'S. THE ADMINISTRATOR REVIEWS RATES FOR PERSONS IN THE FINANCE OFFICER POSITION ACROSS THE REGION, AND DETERMINES THE AMOUNT OF THE AGGREGATE INCREASE TO APPLY TO THE SALARY OF THE FINANCE OFFICER WHICH IS THEN APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE DOCUMENTS ARE AVAILABLE FOR VIEWING ON-SITE ONLY. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 342,312. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 342,312. LABORATORY PURCHASE LAB : PROGRAM SERVICE EXPENSES 30,747. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,747. CONSULTING FEES : PROGRAM SERVICE EXPENSES 6,991. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,991. PT FINANCIAL SVC COLLECTION FEES-AM : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,219. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,219. ADMINISTRATION FINANCE SVC CHARGES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,412. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,412. |
| FORM 990, PART XI, LINE 9: | CHANGE IN TEMPORARILY RESTRICTED NET ASSET 290,197. |