2016-04-11T10:52:09-05:00 2015-06-30 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2014-07-01 450308379 Hazen Memorial Hospital Association HAZE 7017482225 510 8th Avenue NE Hazen ND 58545 Darrold Bertsch CEO 7017482225 2016-04-01 1 LISA CHAFFEE CPA P00193453 7012398500 2016-04-01 2014 2016-08-17 19:52:53Z Sakakawea Medical Center Darrold Bertsch 510 8th Avenue NE Hazen ND 58545 13521326 0 X www.sakmedcenter.org X 1943 ND Operation of a hospital, clinic, and an elderly care facility. 10 9 165 93 0 0 481595 652883 11780020 12823196 -23593 12906 31048 31473 12269070 13520458 4500 2000 0 0 6188086 7132632 0 0 0 5074890 5058860 11267476 12193492 1001594 1326966 7805109 11244196 1459004 1938457 6346105 9305739 X Provide high quality care that is measured and continuously improved. Provide individualized care that exceeds expectations of those we serve. Strengthen partnerships with providers to enhance coordination of care and improve system performance. Be a steward of resources. Committ to service excellence. Be a vital contributor to our area communities. Recognize the value of each employee and provide opportunities for personal growth and development that complement the needs of the organization. 0 0 8162432 2000 10808149 Sakakawea Medical Center (SMC) is a 25 bed critical care access hospital providing services in the following areas - acute care, surgery, intermediate and skilled swing bed, emergency room with trauma level V certification, home health, and hospice. Services provided by the ancillary departments include physical therapy, occupational therapy, radiology, digital mammography, bone density, ultrasound, CT, nuclear med, MRI, laboratory, respiratory therapy, cardiac rehab, EKG, EEG, sleep studies, and thallium stress tests. Based on charges foregone Sakakawea Medical Center provided $30,760 in charity care. Also available to all self-pay patients, regardless of financial status, is a 30% discount policy for timely payments. SMC is a participating provider for Medicare, Medicaid, Blue Cross Blue Shield and other insurances.Sakakawea Medical Center reaches out to the communities in the service area through programs such as falls prevention classes, CPR education, ACLS classes, PALS classes, grief support groups, smoking cessation classes, occupational health, free blood pressure checks, a Christmas giving tree project, and health career presentations to high schools. Wellness screenings are provided to area schools and businesses. SMC provides community education programs on requested topics free of charge. It is important for Sakakawea Medical Center to serve our communities by providing all of their health care needs. 883567 1098021 Senior Suites is a basic care facility that was completed in April 1997, it is adjacent to Sakakawea Medical Center. Senior Suites can accommodate 34 residents with single or double rooms. It features a licensed beauty shop, activity room, spacious commons areas and an enclosed nurse's station. The rooms are set up like suites, hence the name "Senior Suites." The facility is available to those in the senior population that requires a minimal amount of supervision, but do not require 24 hour services. The residents are provided with assistance for daily living and medication administration. Resident care census days totaled 9,243 this year. 1292030 917026 To ensure the need for quality health care is met in SMC's service area, Sakakawea Medical Center began managing a rural health clinic in July 2007. The clinic is located directly across the street from the hospital. This provides primary health care for our patients. The clinic is staffed with two physicians and two mid-level providers. A sliding fee scale charity care program is available to patients who qualify financially. 10338029 1 1 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 16 0 1 165 1 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 0 0 0 1 1 0 1 1 1 0 0 0 X Renae Snyder 7017482225 510 8th Avenue NE Hazen ND 58545 X Christie Obenauer President 2.00 X X 0 0 0 Fred Stern Vice President 1.50 X X 0 0 0 Myria Perry Secretary/Treasurer 1.50 X X 0 0 0 Don Lyn Erickson Director 1.50 X 0 0 0 Mark Gerde Director 1.50 X 0 0 0 Robin Richter Director 1.50 X 0 0 0 Sienna Sailer Director 1.50 X 0 0 0 Beverly Huber Director 1.50 X 0 0 0 Kimberly Kessler Director 1.50 X 0 0 0 Todd Lindquist Director 1.50 X 0 0 0 Darrold Bertsch CEO 19.60 X 106416 0 65000 Renae Snyder CFO 40.00 X 72552 0 3617 Robert Volk Midlevel 40.00 X 103951 0 21520 Carl Miller CRNA 36.00 X 124979 0 16126 Rodney Zimmerman Family Practice Physician 40.00 X 268864 0 24459 676762 0 130722 4 0 1 1 Neenan Company LLLP 2607 Midpoint Drive Fort Collins CO 80525 Archistruction 719662 Dr Thomas Kaspari 1351 51st Ave SW Hazen ND 58545 ER Physician Services 126725 Eide Bailly LLP 4310 17th Ave S Fargo ND 58103 Accounting Fees 100538 3 38614 614269 652883 Patient and Resident Services 621400 12199791 12199791 Other Program Revenue 623000 525016 525016 Education 623000 74849 74849 Cafeteria 623000 23540 23540 12823196 11842 11842 23828 0 23828 23828 23828 1064 0 1064 1064 1064 8513 868 7645 7645 13520458 12823196 0 44379 X 2000 2000 269905 269905 67671 67671 5754370 5293706 460664 179981 46143 133838 442291 112142 330149 418414 378415 39999 9740 9740 13520 13520 55602 55602 1962133 1830560 131573 34522 2701 31821 270766 127213 143553 379556 379413 143 54647 41800 12847 13697 5837 7860 349336 349336 111037 11006 100031 Medical Supplies 1015191 1015191 Bad Debt Expense 469816 469816 Food 126585 126585 Dues & Subscriptions 79807 53413 26394 112905 25081 87824 12193492 10338029 1855463 0 5581 7328 2238611 2912178 1391256 1361975 324678 372250 41385 62588 10387054 7425349 1744897 2961705 870054 876662 465182 2107427 723465 582083 7805109 11244196 952950 1010017 39943 492690 326407 13364 562090 1459004 1938457 X 5815518 7132622 480587 2123117 50000 50000 6346105 9305739 7805109 11244196 X 1326966 1632668 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 65405 285 65690 64983 422 65405 63893 1090 64983 62933 960 63893 61518 1415 62933 0.76120 0.23880 0 0 23092 23092 5787927 4753727 1034200 3106287 2593105 513182 1469748 78517 1391231 2961705 Interest in Net Assets of Sakakawea Medical Center Foundation 2107427 F 2107427 Patronage Credit Asset 582083 582083 Construction Payables 412090 Estimated Third Party Payor Settlements 150000 562090 X 14679486 1172429 1172429 13507057 13401 13401 13520458 11719852 0 11719852 473640 473640 12193492 Part V, Line 4: The Medical Center's policy is to maintain sufficient financial stability for the operations of Medical Center. Interest income is to be transferred to the temporarily restricted endowment funds until the Board determines how the funds are to be used. In establishing this policy, the Medical Center considered the long-term expected return on its endowments. The spending policy states that distributions of earnings can be made if the Board of Directors deems it prudent to do so taking into account certain statutory factors included in the UPMIFA. Distributions may be made at least annually, but do not need to be done. Part X, Line 2: The Medical Center is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Medical Center is subject to income tax on any net income that is derived from business activities that are unrelated to its exempt purpose. The Medical Center has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS. The Medical Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Reported in Revenue on Audited Financials -469,816. Change in Interest in Net Assets of Sakakawea Medical Center Foundation 1,642,245. Part XI, Line 4b - Other Adjustments: Auxiliary Revenue Not Included in Audited Financials 13,401. Part XII, Line 4b - Other Adjustments: Auxiliary Expenses Not Included in Audited Financials 3,824. Provision for Bad Debts Reported in Revenue on Audited Financials 469,816. 1 1 X 1 X 125.000000000000 1 X 1 1 0 0 22000 22000 0.00190 217138 214750 2388 0.00020 239138 214750 24388 0.00210 13897 13897 0.00120 47214 19168 28046 0.00240 1541996 1014000 527996 0.04500 1603107 1033168 569939 0.04860 1842245 1247918 594327 0.05070 2 1575 1575 0.00010 10 12723 12723 0.00110 3 1253 1253 0.00010 15 15551 15551 0.00130 0 469816 29129 4346501 4425627 -79126 X 1 1 1 1 Sakakawea Medical Center 510 8th Ave NE Hazen ND 58545 www.sakmedcenter.org 5024A X X X X Hazen Memorial Hospital Association 1 0 0 1 X X X X X X X X X 12 1 0 1 1 X www.sakmedcenter.org 1 12 1 www.sakmedcenter.org 0 0 1 X 125.000000000000 200.000000000000 X X X X X 1 1 X X X 1 X http://www.sakmedcenter.org/general_services/business_office.htm X http://www.sakmedcenter.org/general_services/business_office.htm X http://www.sakmedcenter.org/general_services/business_office.htm X X X X X X 1 X 0 X X X 1 X 0 0 Hazen Memorial Hospital Association Part V, Section B, Line 5: A community survey, focus group, providers, representatives from public health, and individual interviews. Hazen Memorial Hospital Association Part V, Section B, Line 6b: Also included were Custer Public Health Unit, Coal Country Community Health Centers, Knife River Care Center, and Mercer County Ambulance. Hazen Memorial Hospital Association Part V, Section B, Line 11: SMC has addressed each need that was identified in each most recently conducted CHNA:1) Obesity, Physical Inactivity: Have initiated community and worksite wellness programs for all ages and are promoting physical activity, good nutrition and good health throughout the community. Have invested the resources to have on staff a "Certified Worksite Wellness Consultant" available for community business/organization wishing to initiate their own programs. 2) Mental Health Care Providers, Mental Health Issues: Coal Country Community Health Center is spearheading the effort to address these issues and relies on the collaborative partners (to include SMC) to assist by providing additional resources for programming, education, and as well as tapping into financial and staffing availability. In addition, both CCCHC and SMC have opted to screen all clinic and emergency room patients, hospital, basic care and home health care admits for depression by incorporating the PHQ2 and PHQ9 screening criteria for all initial patient encounters. If a patient screens positive on the PHQ9, referrals are made for appropriate follow-up and or intervention. In addition, visiting specialists (Psychologist) from Bismarck travel to our area on a regular basis to treat patients with Mental Health issues.3) Smoking: Medical Providers provide counseling and alternatives for their patients. Custer Health and NDDoH in conjunction with local providers, promote education and awareness campaigns. SMC has gone so far as to initiate a policy making the entire SMC campus smoke free.3) Diabetes: CCCHC and SMC have started a pre-diabetic course which is a 16 week course and has a post course after that. This has been very successful with all participants meeting their weight loss goals. In addition a Chronic Disease Support Group was implemented in June 2015 with monthly meetings scheduled at CCCHC.4) Uninsured residents: Charity care and sliding fee policy information and applications are available for download on the SMC website; and are available at the medical clinic and hospital business office. In conjunction, posts and bi-annual notices regarding the Charity Care Program and/or sliding fee policy are on Facebook and advertised in the local papers. HHS has awarded CCCHC funds to provide Health Insurance Marketplace Enrollment Assistance. An outreach & Enrollment Specialist is now on staff at CCCHC and is certified as an application counselor to enroll residents in our service area.5) Excessive drinking: This is a public health priority and is being spearheaded by Custer Health as outlined in the Custer Health 2015 - 2019 Community Health Improvement Plan - Mercer/Oliver CHIP, page 13.6) Number of primary care providers: SMC actively participates in events to recruit providers to our area. A collaborative effort between SMC, CCCHC & KRCC has resulted in the combining of resources to provide for a full time, Human Resources professional that is spearheading the effort to maintain, sustain and recruit healthcare staffing within the service area. 7) Awareness of local services: SMC has developed a Public Relations/Marketing Plan that is updated as needed. SMC continually works on promoting, advertising and distributing healthcare information through a variety of venues and media. In addition, SMC has created a Facebook site and program information is posted as appropriate. Hazen Memorial Hospital Association Part V, Section B, Line 13h: Sakakawea Medical Center offers two separate programs for discounted care. The self-pay discount policy is available for uninsured patients regardless of income. A discount of 30% is allowed if regular monthly payments are remitted in a specified time frame. The charity care program provides discounted care to patients based on family income according to FPG guidelines. The sliding fee scale allows discounts from 20% to 100% of charges. Charges are discounted by 27% before the sliding fee scale is applied (for uninsured applicants only.) The program is available for uninsured patients as well as co-pays and deductibles for insured patients.The self-pay discounts program cannot be combined with the charity care program. However, the Hospital counsels all self-pay individuals to determine if their potential charity care discount would result in a better discount if they apply for charity care. The patients that use the self-pay discount are typically the patients that do not want to submit their financial information or patients that would not qualify under the charity care policy. Hazen Memorial Hospital Association Part V, Section B, Line 15e: An individual must complete an application and submit supporting documentation such as check stubs or an income tax return. All of the staff in the Business Office billing department are able to assist individuals with any questions they have regarding the application process. Hazen Memorial Hospital Association Part V, Section B, Line 16i: In addition to the full FAP being available upon request, information referencing the FAP is provided in summary format on the clinic's website, attached to the billing invoices, as well as posted in the admissions office, emergency rooms and waiting rooms. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Hazen Memorial Hospital Association Part V, Section B, line 16a website: http://www.sakmedcenter.org/general_services/business_office.htm Hazen Memorial Hospital Association Part V, Section B, line 16b website: http://www.sakmedcenter.org/general_services/business_office.htm Hazen Memorial Hospital Association Part V, Section B, line 16c website: http://www.sakmedcenter.org/general_services/business_office.htm 2 Sakakawea Hazen Clinic 517 8th Ave NE Hazen ND 58545 Clinic Senior Suites at Sakakawea 813 7th St NE Hazen ND 58545 Basic Care Facility Part I, Line 3c: Sakakawea Medical Center offers two separate programs for discounted care. The self pay discount policy is available for uninsured patients regardless of income. A discount of 30% is allowed if regular monthly payments are remitted in a specified time frame. This program cannot be combined with the Charity Care program.The charity care program provides discounted care to patients based on family income according to FPG guidelines. The sliding fee scale allows discounts from 20% to 100% of charges. The program is available for uninsured patients as well as co-pays and deductibles for insured patients. Part I, Line 7: Charity care is based on the total direct and indirect costs related to providing services to patients and based on average ratios of cost to charges. Unreimbursed Medicaid was converted to cost using the cost-to-charge ratio derived from the relevant cost center on the Medicare cost report. Community health improvement services and health professionals education reflect actual expenses recorded to the general ledger. Subsidized health services costs were calculated based on information from the Medicare cost report. Part I, Ln 7 Col(f): For the purposes of calculating the percentage on Part 1, Line F, $469,816 of bad debt was backed out of total operating expenses. Part II, Community Building Activities: The CEO serves on two boards for economic development (Mercer County Economic Development and Hazen Community Development), one board for workforce development (Job Development Authority), eight boards for community health improvement advocacy (Community Health Association of the Mountain Plains States, National Rural Accountable Care Organization, North Dakota Hospital Association, Area Health Education Center, Mercer County Ambulance, Northland Healthcare Alliance, Technical Advisory Services, and Community Healthcare Association of the Dakotas). The Director of Patient Care serves on four boards (Bismarck State College Advisory Board, University of Mary Advisory Board, North Dakota CAH Quality, and North Dakota Risk Management Society). Part III, Line 2: Bad debt expense is reported at charges. Payments and discounts are posted to patient bills. Part III, Line 3: There are most likely some patients in bad debt who would qualify for charity care, but they have not completed the application and remitted the required payment. Based on the poverty level of the service area, 6.2%, the estimated amount of bad debt expense that is attributable to patients eligible under the organization's financial assistance policy would be approximately $29,129. Part III, Line 4: The footnote to the Organization's financial statements can be found on page nine of the attached audited financial statements. Part III, Line 8: Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare & Medicaid Services. The costs themselves are a community benefit as the community would not receive these services if we did not provide them. Part III, Line 9b: If a patient has applied for charity care previously, an application is sent with the monthly statement. Once determined the patient is eligible, the charity care discount portion is written off. The remaining patient portion then falls under the same collection practices of all other accounts. Our policy requires a new charity care application every six months. Part VI, Line 2: Sakakawea Medical Center consults with local physicians to identify community healthcare needs. The SMC staff participates in local and regional organizations and activities including Chamber of Commerce and economic development boards. The CEO routinely attends city council and county commission meetings to solicit input and engage in dialogue relating to healthcare needs and services.Sakakawea Medical Center has collaborated with other local providers to conduct a community health needs assessment which will inventory service delivery assets, identify needs and create a foundation for undertaking strategic initiatives. Part VI, Line 3: Charity care information is sent with the monthly statements to all uninsured patients as well as patients that are not making adequate monthly payments. Approximately 100 notices are sent out per month with the statements. Inpatients and surgical patients are informed at time of admission about charity care. A social worker visits with all self pay inpatients to inform them about the charity care, Medicaid (state program), and self pay discount policies. Brochures have been printed that describe our charity care and discount policies. The brochures are available in waiting rooms, ER, the clinics and admitting offices. Part VI, Line 4: Hazen Memorial Hospital Association serves the communities in Mercer County and the surrounding area, including the towns of Hazen, Beulah, Stanton, Zap, Golden Valley, Center and Pick City. Sakakawea Medical Center, located in Hazen, is the only hospital in the county. The nearest hospital is located more than 60 miles away. Attached to the hospital is Senior Suites, a basic care facility. The Association manages one rural health clinic in Hazen. The combined total population of the county is approximately 8,746. The average annual wage in Mercer County for 2014 was $62,712. The current unemployment rate is 4.3%. Sakakawea Medical Center's payer mix for this fiscal year included 10% uninsured patients and 4% Medicaid patients. All patients presenting to the facility are cared for regardless of their ability to pay. Part VI, Line 5: As a critical access hospital, Sakakawea Medical Center provides a variety of health and wellness services to our service area. The organization subsidizes primary care services provided at the Sakakawea Hazen Clinic, ensuring that primary care is available in the local communities. SMC also subsidizes home health services to ensure those residents who are homebound have the health care they need. The emergency room is staffed 24 hours a day and is available to all regardless of ability to pay. The Board of Directors is comprised of county-wide volunteers; three are from Hazen, six from Beulah, and one from Stanton. The directors have various occupations including power plant manager, bank vice president, accounting supervisor, engineer, chiropractor, and business owner. The directors are not employed by SMC nor are they family members of employees.Medical privileges are extended to all physicians in the county.Sakakawea Medical Center's Hospice staff is assisted by 65 volunteers from the area communities. The staff at Senior Suites, the basic care facility, is served by 18 community volunteers. The surgical program at Sakakawea Medical Center is assisted by 10 community volunteers. Surplus funds are invested back into the facility through equipment upgrades and building improvements. Recent investments include the purchase of a chest compression system, a hematology machine, a glidescope and cautery equipment for the operating room. In addition, more continuing education is being offered to the staff by means of webinars and workshops. An employee assistance program is available for staff and family members which provides free confidential assessments, counseling, or referral services by trained professionals.Sakakawea Medical Center is investing in the future of healthcare professionals by implementing a nursing program. We are partnering with other health care providers in the county, a community health center and a nursing home, to offer Interactive Video Network (IVN) classes in our facility. Hands-on skill work and clinicals are taught by registered nurses employed by our organization. Upon completion of an 11 month program, students will receive a certificate in practical nursing. An additional 9 month program enables the students to receive an Associate Degree in Nursing and become eligible to test for their registered nurse license. Sakakawea Medical Center also supports state universities and high schools by offering rural medical experiences to area students. Throughout the year, students are provided with practice opportunities in nursing, lab, PT or the emergency room.Beginning in 2015, Sakakawea Medical Center is also assisting the Dakota College at Bottineau, ND with their Medical Assistant Program. Students study through on line courses provided by Dakota College. The hands-on skills are taught by registered nurses in our facility weekly. Students can complete a one year program for a diploma, or a two year program for a degree. X X X X X 0 1 0 0 0 0 0 0 0 Darrold Bertsch CEO 106416 0 0 0 0 0 65000 0 0 0 171416 0 0 0 Rodney Zimmerman Family Practice Physician 268864 0 0 0 0 0 7819 0 16685 0 293368 0 0 0 Part I, Line 4b SMC paid $65,000 in premiums for a 457(f) plan for Darrold Bertsch, CEO. This amount is reflected in Schedule J, Part II, deferred compensation. Schedule J, Part II: Darrold Bertsch, CEO, is an employee of Coal Country Community Health Center (CCCHC) and provides CEO services to both SMC and CCCHC. However, as an employee of CCCHC, Darrold now receives his W-2 from CCCHC. Sakakawea Medical Center reimburses CCCHC for part of Darrold's salary based on a contract. The compensation reported in Part VII of the core form and Part II of Schedule J reflects total base compensation SMC reimbursed CCCHC for his services solely to SMC, which was reported on his 2014 Form W-2 from CCCHC. In the calendar year 2014, Darrold received $106,416 in base salary from CCCHC related to his services as SMC CEO. The non-taxable benefits reported in Part II are in relation to the 457(f) plan premiums paid on his behalf by SMC. Union State Bank (USB) Board Pres. C. Obenauer constructively owns >35% of USB Bond Refinance X 663689 268461 0 1 1 Union State Bank (USB) Board Pres. C. Obenauer constructively owns >35% of USB Refinance Equipment X 506000 57946 0 1 1 326407 Jocelyn Bertsch Wife of CEO 67671 Employee Compensation 0 Form 990, Part VI, Section A, line 1 There were 10 board of directors at fiscal year end, but the board president only votes to break a tie. The Executive Committee shall consist of the President, Vice President and Secretary/Treasurer of the Board. The CEO of the corporation shall serve without voting powers. The Executive Committee shall have the power to transact all business of the corporation during the interim between meetings of the Board of Directors, provided that any action so taken shall not conflict with the policies and express wishes of the Board of Directors, and that it shall refer all matters of major importance to the full Board of Directors. This committee shall meet as required. In the current fiscal year, the Executive Committee did not meet to make any decisions on behalf of the full governing board. Form 990, Part VI, Section A, line 6 Any person, firm, association, or corporation interested in the activities of this organization, and residing in the service area, may become a member thereof, provided that he has first made a contribution to the association at some time. Each member has one voting right. Form 990, Part VI, Section A, line 7a The members elect the Board of Directors on an annual basis. Form 990, Part VI, Section A, line 7b The members must also approve/disapprove the dissolution of the organization or the merger or consolidation of the organization with another corporation. Form 990, Part VI, Section A, line 8b All items discussed at committee meetings are brought to the full board for recommendations for board action. The organization did not have any committees that acted on behalf of the board. Form 990, Part VI, Section B, line 11 Upon receipt of the draft Form 990, a copy will be forwarded to the board members for their review and comment. Form 990, Part VI, Section B, line 12c The Board of Directors is covered by the conflict of interest policy. Only one conflict has been disclosed this fiscal year by a member of the Board of Directors. The director who has acknowledged the conflict of interest is excused from the board meeting whenever there is discussion about the relevant issue. Although the written policy as of June 30, 2015 did not address the officers of the organization, the officers do review and comply with the policy and disclose to the board of directors if a conflicts does exist. After the conflict is self-reported that officer abstains completely from the decision process of the issue at hand. Form 990, Part VI, Section B, line 15 The CEO was paid by an unrelated organization that used comparability data to review and determine his compensation. For purposes of determining the CFO's compensation package at Sakakawea Medical Center, a variety of resources are used. The Organization takes into consideration what is appropriate compensation for that respective position, based on their market. The Organization uses salary surveys from the North Dakota Hospital Association and also refers to the public 990 information from similar sized hospitals in North Dakota. The CFO is evaluated by the CEO annually and the compensation is based on the above information. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available if specifically requested. Form 990, Part VII: Darrold Bertsch, CEO, is an employee of Coal Country Community Health Center (CCCHC) and provides CEO services to both SMC and CCCHC. However, as an employee of CCCHC, Darrold now receives his W-2 from CCCHC. Sakakawea Medical Center reimburses CCCHC for part of Darrold's salary based on a contract. The compensation reported in Part VII of the core form and Part II of Schedule J reflects total base compensation SMC reimbursed CCCHC for his services solely to SMC, which was reported on his 2014 Form W-2 from CCCHC. In the calendar year 2014, Darrold received $106,416 in base salary from CCCHC related to his services as SMC CEO. The non-taxable benefits reported in Part VII column f are in relation to the 457(f) plan premiums paid on his behalf by SMC. Form 990, Part IX, line 11g Medical Purchased Services: Program service expenses 1,735,993. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,735,993. Other Purchased Services: Program service expenses 94,567. Management and general expenses 131,573. Fundraising expenses 0. Total expenses 226,140. Form 990, Part XI, line 9: Change in Interest in Net Assets of Sakakawea Medical Center Foundation 1,642,245. Change in Net Assets of Hazen Memorial Hospital Auxiliary -9,577.