BENNETT COUNTY HOSPITAL AND NURSING HOME: Form 990, tax year 2015
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- Organization
- BENNETT COUNTY HOSPITAL AND NURSING HOME (EIN 43-2040599)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-10-26
- IRS object ID
- 201633009349301273
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-10-26T16:34:41-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 460403496 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASEY PETERSON & ASSOCIATES LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 ST JOSEPH ST SUITE 101 | AddressLine1Txt |
| City | RAPID CITY | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 432040599 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENNETT COUNTY HOSPITAL AND NURSING HOME | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BENN | BusinessNameControlTxt |
| Phone | 6056856622 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 D | AddressLine1Txt |
| City | MARTIN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57551 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Andrew Riggin | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6056856622 | PhoneNum |
| Signature | 2016-10-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEIDRE BUDAHL CPA | PreparerPersonNm |
| PTIN | P01273830 | PTIN |
| Phone | 6053481930 | PhoneNum |
| Preparation | 2016-10-26 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Andrew Riggin | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 D | AddressLine1Txt |
| City | MARTIN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57551 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,964,678 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.bennettcountyhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | Provide healthcare and nursing home services | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 155 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $44,391 | PYContributionsGrantsAmt |
| CY Contributions Grants | $30,373 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,231,212 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,882,062 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$3,178 | PYInvestmentIncomeAmt |
| CY Investment Income | -$56,091 | CYInvestmentIncomeAmt |
| PY Other Revenue | $50,195 | PYOtherRevenueAmt |
| CY Other Revenue | $29,935 | CYOtherRevenueAmt |
| PY Total Revenue | $7,322,620 | PYTotalRevenueAmt |
| CY Total Revenue | $8,886,279 | 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 | $3,796,508 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,813,851 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,457,198 | PYOtherExpensesAmt |
| CY Other Expenses | $4,100,701 | CYOtherExpensesAmt |
| PY Total Expenses | $7,253,706 | PYTotalExpensesAmt |
| CY Total Expenses | $7,914,552 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $68,914 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $971,727 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,915,417 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,209,713 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,794,071 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,116,642 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,121,346 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,093,071 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Caring people working together, as a team, to provide quality healthcare and education for a healthier community. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,140,374 | ExpenseAmt |
| Revenue | $8,817,800 | RevenueAmt |
| Desc | BENNETT COUNTY HOSPITAL AND NURSING HOME IS A CRITICAL ACCESS HOSPITAL LOCATED IN MARTIN, SD. THE ORGANIZATION IS THE ONLY HOSPITAL IN THE COUNTY SERVING APPROXIMATELY 3,600 RESIDENTS. BENNETT COUNTY IS LOCATED BETWEEN INDIAN RESERVATIONS IN A VERY RURAL AREA. BENNETT COUNTY HOSPITAL AND NURSING HOME HAS 20 HOSPITAL BEDS, 43 NURSING BEDS, AND 2 ASSISTED LIVING BEDS. DURING 2015, THE HOSPITAL WING HAD 305 PATIENT BED DAYS AND 423 SWING BED DAYS. THE NURSING HOME HAD 14,109 RESIDENT DAYS. | Desc |
| Total Program Service Expenses | $7,140,374 | 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 | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | 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 | 35 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 155 | 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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 | the organization | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6056856622 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 102 MAJOR ALLEN P O BOX 70D | AddressLine1Txt |
| City | MARTIN | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57551 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DAVID JONES | |||||||
| CHAIRMAN | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Dale McDonnell | |||||||
| SECRETARY/TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Doug O'Bryan | |||||||
| Vice-Chair | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Brad Otte | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Jason Fanning | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Ethel Frein | |||||||
| CEO | 40.00 | Yes (X) | $114,371 | $0 | $5,997 | ||
| Judy Soderlin | |||||||
| CFO | 40.00 | Yes (X) | $46,920 | $0 | $5,997 | ||
| ROSE HOITEN | |||||||
| PHYSICIAN | 40.00 | $189,134 | $0 | $5,997 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $350,425 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $17,991 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DELTA HEALTHCARE PROVIDERS | |||||
| PO BOX 202940 | DALLAS | TX | 75320 | CONTRACT PHYSICAL THERAPY | $131,434 |
| MEDPRO HEALTHCARE STAFFING | |||||
| 1580 SAWGRASS CORPORATE PKWY SUITE | SUNRISE | FL | 33323 | CONTRACT MEDICAL STAFF | $108,692 |
| MEDICAL SOLUTIONS | |||||
| 1010 N 102ND ST | OMAHA | NE | 68114 | CONTRACT MEDICAL ASSISTANCE | $102,225 |
| LUX TRAVEL NURSE INC | |||||
| 13126 COOL BREEZE ROAD | HOT SPRINGS | SD | 57747 | CONTRACT MEDICAL STAFF | $100,042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $30,373 | AllOtherContributionsAmt |
| Total Contributions | $30,373 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENU | 621400 | $8,864,657 | $8,864,657 | |
| OTHER REVENUE | 621400 | $6,400 | $6,400 | |
| CAFETERIA | 621400 | $6,340 | $6,340 | |
| HEALTH FAIR REVENUE | 621400 | $4,665 | $4,665 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,882,062 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,167 | TotalRevenueColumnAmt |
| Exclusion | $3,167 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $46,240 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,641 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,599 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,599 | TotalRevenueColumnAmt |
| Exclusion | $28,599 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $60,758 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$59,258 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$59,258 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$59,258 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,336 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,336 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,336 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,886,279 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,817,800 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,106 | 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 | $161,291 | TotalAmt |
| Management And General | $161,291 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,073,933 | TotalAmt |
| Program Services | $2,907,646 | ProgramServicesAmt |
| Management And General | $166,287 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,990 | TotalAmt |
| Program Services | $387,707 | ProgramServicesAmt |
| Management And General | $30,283 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,637 | TotalAmt |
| Program Services | $134,871 | ProgramServicesAmt |
| Management And General | $25,766 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,470 | TotalAmt |
| Management And General | $80,470 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,134,715 | TotalAmt |
| Program Services | $1,053,981 | ProgramServicesAmt |
| Management And General | $80,734 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,052 | TotalAmt |
| Program Services | $42,985 | ProgramServicesAmt |
| Management And General | $2,067 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,091 | TotalAmt |
| Program Services | $406,494 | ProgramServicesAmt |
| Management And General | $24,597 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,909 | TotalAmt |
| Management And General | $164,909 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,747 | TotalAmt |
| Program Services | $103,717 | ProgramServicesAmt |
| Management And General | $23,030 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,161 | TotalAmt |
| Program Services | $38,353 | ProgramServicesAmt |
| Management And General | $3,808 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,971 | TotalAmt |
| Program Services | $11,978 | ProgramServicesAmt |
| Management And General | $9,993 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,575 | TotalAmt |
| Program Services | $7,575 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $623,986 | TotalAmt |
| Program Services | $623,986 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,378 | TotalAmt |
| Program Services | $47,378 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS | $873,226 | $873,226 | |
| MEdical Supplies | $330,061 | $330,061 | |
| Equipment Maintenance | $170,416 | $170,416 | |
| MISCELLANEOUS | $943 | $943 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,914,552 | TotalAmt |
| Program Services | $7,140,374 | ProgramServicesAmt |
| Management And General | $774,178 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $757,878 | BOYAmt |
| EOY | $798,683 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,195,916 | BOYAmt |
| EOY | $1,185,092 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,424,152 | BOYAmt |
| EOY | $2,034,176 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,445 | BOYAmt |
| EOY | $160,477 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,315 | BOYAmt |
| EOY | $51,816 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,004,360 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,024,891 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,345,711 | BOYAmt |
| EOY | $1,979,469 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,915,417 | BOYAmt |
| EOY | $6,209,713 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $472,547 | BOYAmt |
| EOY | $489,446 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,040,105 | BOYAmt |
| EOY | $1,167,825 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,725 | BOYAmt |
| EOY | $30,918 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,694 | BOYAmt |
| EOY | $428,453 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,794,071 | BOYAmt |
| EOY | $2,116,642 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,830,567 | BOYAmt |
| EOY | $3,743,622 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,779 | BOYAmt |
| EOY | $349,449 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,121,346 | BOYAmt |
| EOY | $4,093,071 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,915,417 | BOYAmt |
| EOY | $6,209,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $971,727 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,218,961 | OtherCostOrOtherBasisAmt |
| Depreciation | $379,788 | DepreciationAmt |
| Book Value | $839,173 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,785,399 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,645,103 | DepreciationAmt |
| Book Value | $1,140,296 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,979,469 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $8,030,694 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$873,226 | OtherRevenueAmt |
| Revenue Not Reported | -$873,226 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,903,920 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$17,641 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$17,641 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $8,886,279 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,058,969 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $17,643 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $17,643 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,041,326 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $873,226 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $873,226 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $7,914,552 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | The liability account reflects amounts held by the Hospital for nursing home residents to use for personal expenses. |
| Part X, Line 2: | As of December 31, 2015, the Organization had no uncertain tax positions that qualify for either recognition or disclosure in the financial statements. The Organization's income tax filings are subject to audit by various taxing authorities. Management continually evaluates expiring statutes of limitation, audits, proposed settlements, changes in tax law and new authoritative rulings. The Organization believes their estimates are appropriate based on current facts and circumstances. Interest and penalties assessed by income taxing authorities, if any, are included in interest expense. |
| Part XI, Line 2d - Other Adjustments: | Provision for bad debts -873,226. |
| Part XI, Line 4b - Other Adjustments: | Rental Expenses netted against revenue on 990 -17,641. rounding |
| Part XII, Line 2d - Other Adjustments: | Rental expenses netted against revenue on 990 17,641. rounding 2. |
| Part XII, Line 4b - Other Adjustments: | Provision for Bad Debts 873,226. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| 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 | 0 | 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 | $17,121 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,121 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,279,087 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,118,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $160,408 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02280 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,296,208 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,118,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $177,529 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02520 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,296,208 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,118,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $177,529 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02520 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $873,226 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $560,611 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,294,409 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,208,743 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $85,666 | 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 | Bennett County Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 102 Major Allen | AddressLine1Txt |
| City | Martin | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57551 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.bennettcountyhospital.com | WebsiteAddressTxt |
| 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 | BEnnett County Hospital | 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 |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.BENNETTCOUNTYHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BENNETTCOUNTYHOSPITAL.COM | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| 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 |
| 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 |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.BENNETTCOUNTYHOSPITAL.COM | FAPAvailableOnWebsiteURLTxt |
| 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BEnnett County Hospital | Part V, Section B, Line 5: THe Hospital is an active participant in nationwide quality improvement projects through South Dakota Foundation for Medical Care the QIO for Medicare and Medicaid programs in South Dakota. The Hospital also used information from the Centers for disease control and prevention and the national center for chronic disease prevention and health promotion. These sources were compared to goals established by the surgeon general in "healthy people 2010 (HP2010) and the target population of Bennett County Hospital. |
| BEnnett County Hospital | Part V, Section B, Line 11: SUSTAINABILITY OF BENNETT COUNTY HEALTH CARE (HOSPITAL AND NURSING HOME) WILL BE INFLUENCED BY THE FOLLOWING GOALS AND MEASURES IMPLEMENTED:1. TO KEEP THE ORGANIZATION MOVING BY CASH FLOWING TO ENSURE ACCESS TO EMERGENCY, ACUTE, SKILLED SWING BED, HOME HEALTH AND LONG TERM CARE FOR THE COUNTY AND RESERVATION AREAS.2. A CPA FIRM HAS BEEN INVOLVED TO ENSURE COST ACCOUNTING IS MAXIMIZED FOR ORGANIZATIONAL DIRECTION.3. A CONSULTANT TO ASSIST WITH LONG TERM CARE BUDGETING, AND OPERATIONAL ASSISTANCE CONTINUES TO BE ENGAGED TO IMPROVE OPERATIONAL SUCCESS.4. SUCCESSFUL OPENING AND OPERATION OF ON-SITE RURAL HEALTH CLINIC5. THE ORGANIZATION HAS IMPLEMENTED AN ELECTRONIC HEALTH RECORD SYSTEM AND MUST CONTINUE TO MEET THE REQUIREMENTS AND DEADLINES PROPOSED BY THE CENTER FOR MEDICARE SERVICES TO MAXIMIZE QUALITY CARE AND FINANCIAL REIMBURSEMENT.6. THE HOSPITAL IS ASSESSING THE NEED AND SUSTAINABILITY OF EMPLOYING A PHYSICIAN TO FUNCTION SPECIFICALLY ON THE BCHC TEAM.7. THE FACILITY CONTINUES TO FACE WORK FORCE CHALLENGES.8. THE HOSPITAL COMPLETED THE HEN PROJECT WITH THE QIO AND WILL PARTICIPATE IN THE NEW COLLABORATIVE HIIN.THE TRANSPORTATION ISSUE HAS BEEN DISCUSSED WITH PRAIRIE HILLS TRANSIT IN SPEARFISH, SD AND THE PINE RIDGE INDIAN TRIBE WITH NO SUCCESSFUL OUTCOMES FROM COMMUNITY MEETINGS THAT HAVE BEEN HELD. |
| BEnnett County Hospital | Part V, Section B, Line 18d: Bennett County Hospital and Nursing Home internal and external collection practices take into account the extent to which the patient qualifies for charity, a patient's good faith effort to apply for a government program or for charity from Bennett County Hospital and Nursing Home, and a patient's good faith effort to comply with his or her payment agreements with Bennett County Hospital and Nursing Home. For patients who qualify for charity and who are cooperating in good faith to resolve their hospital bills, Bennett County Hospital and Nursing Home may offer extended payment plans to eligible patients, will not impose wage garnishments or liens on primary residences, will not send unpaid bills to outside collection agencies, and will cease all collection efforts. |
| BEnnett County Hospital | Part V, Section B, Line 20e: The policy is posted in emergency rooms, waiting rooms, and in the admission office in an effort to communicate with policy to patients at the time of service. |
| BEnnett County Hospital | Part V, Section B, Line 22d: Rates charged to FAP eligible individuals are based on the US Department of Health approved sliding fee scale that is also used by the federally qualified health center in Martin |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | Costing method is ratio of patient cost to charges as determined with worksheet 2 in the instructions for schedule H. |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 873,226. |
| Part II, Community Building Activities: | THe Hospital currently does not engage in any community building activities. |
| Part III, Line 4: | Patient and resident receivables are uncollateralized patient, resident and third-party payor obligations. Payments of patient and resident receivables are allocated to the specific claims identified on the remittance advice or, if unspecified, are applied to the earliest unpaid claim.The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's best estimate of amounts that will not be collected from patients, residents and third-party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third-parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision. |
| Part III, Line 8: | Medicare allowable costs are determined directly from Medicare Cost report using methodologies prescribed by Medicare. |
| Part III, Line 9b: | THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS PRIOR TO COLLECTION PRACTICES BEING PERFORMED. |
| Part VI, Line 2: | AN OUTSIDE CONSULTANT CAME TO THE FACILITY AND PERFORMED AN ENVIRONMENTAL SCAN. THIS CONSISTED OF A MEETING WITH THE BENNETT COUNTY HOSPITAL EXECUTIVE TEAM AND MEMBERS OF OUR COMMUNITY. WE INVITED FIFTEEN BUSINESS OWNERS AND PROMINENT MEMBERS OF THE COMMUNITY TO A STRATEGIC PLANNING MEETING. THIS LISTENING OPPORTUNITY ASSISTED IN MAKING RECOMMENDATIONS TO OUR BOARD OF DIRECTORS IN THE CONTINUED PLANNING AND DIRECTION TO DEVELOP SHORT AND LONG TERM VISION OF HEALTHCARE FOR THE REGION. IN ADDITION SURVEYS WERE SENT OUT TO VARIOUS MEMBERS OF THE COMMUNITY WITH A 50% RETURN RATE. IN THE SUMMER OF 2013, THE HOSPITAL HIRED A CONSULTANT TO HELP WITH STRATEGIC PLANNING. DURING THIS PLANNING SESSION WITH THE BOARD AND KEY MANAGEMENT, CONSIDERATION WAS GIVEN TO COMMUNITY NEEDS. |
| Part VI, Line 3: | We have posted our charity care policy on our web site, www.bennettcountyhospital.com. Our billing staff in the facility informs patients of our financial assistance program when patients are having difficulties in paying for their healthcare. In addition, we have posted the policy in numerous locations within the facility. |
| Part VI, Line 4: | Martin is a community with a population of approximately 1,100, within Bennett County. The local economy is largely agriculturally based. Our facility is the sole hospital for Bennett County, which has a population of approximately 3,600. Bennett County is situated between the Pine Ridge and Rosebud Indian reservation. Because of this proximity, approximately 56% of the population is Native American. On average, approximately 88% of our facility patients are Native American. Although primarily served by the Indian Health Service (IHS), Native Americans within Martin utilize our facility. In many situations, our facility does not get reimbursed by IHS for the care provided to their beneficiaries. This is a tremendous financial burden imposed upon us, in addition to serving other community members who may require financial assistance. In addition, Bennett County and it's neighboring county (Todd) are the 25th and 5th, respectively, poorest counties in the United States. 33.8% of the Bennett County population has an income level below 100% of the federal poverty level. |
| Part VI, Line 5: | Our Board of Directors consists of community members who are accessible to community members for input into services provided. Each year, we provide a health fair for community members. Various health information topics are provided to the community. |
| Part VI, Line 7, Reports Filed With States | SD |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROSE HOITEN | PersonNm |
| Title | PHYSICIAN | TitleTxt |
| Base Compensation Filing Org | $189,134 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $5,997 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $195,131 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | THe form 990 is reviewed by management as prepared by a CPA. A copy of the filed 990 is provided to the board. |
| Form 990, Part VI, Section B, line 12c | The Organization requires officers and board members to disclose potential conflicts of interest annually and potential conflicts are monitored by the business office throughout the year and brought to the attention of the board as necessary. |
| Form 990, Part VI, Section B, line 15 | Compensation for the Administrator is determined by the board of directors. Data from the South Dakota Association of Healthcare Organizations is used to determine reasonable compensation for the Administrator. All other employee compensation is determined by the Administrator. Comparability data from the South Dakota Association of Healthcare Organizations is used. |
| Form 990, Part VI, Section C, line 19 | The hospital makes governing documents, the conflict of interest policy, and financial statements available to the public upon request. |
| Form 990, Part IX, line 11g | Other Professional Fees: Program service expenses 1,053,981. Management and general expenses 80,734. Fundraising expenses 0. Total expenses 1,134,715. |
| Form 990, Part XI, line 9: | ROUNDING -2. |
| form 990 part XI line 2c | The Organization has not changed the process for the selection of an independent auditor or oversight of the independent auditor by the board of directors. |
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