COTEAU DES PRAIRIES HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: COTEAU DES PRAIRIES HOSPITAL (EIN 46-0278210)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-16
IRS object ID: 201503209349302700
Schema version: 2014v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule K
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-16T08:56:05-06:00	ReturnTs
Tax Period End	2014-12-31	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 SUITE 500	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571045126	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460278210	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COTEAU DES PRAIRIES HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	COTE	BusinessNameControlTxt
Phone	6056987647	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	205 ORCHARD DRIVE	AddressLine1Txt
City	SISSETON	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	572622398	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MICHAEL COYLE	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	6056987647	PhoneNum
Signature	2015-11-13	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	2015-11-13	PreparationDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	MICHAEL COYLE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	205 ORCHARD DRIVE	AddressLine1Txt
City	SISSETON	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	572622398	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$14,095,447	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CDPHOSPITAL.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1967	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	PROVISION OF HEALTHCARE SERVICES TO THE POPULATION OF SISSETON, SD, AND THE SURROUNDING AREA.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	180	TotalEmployeeCnt
Total Volunteers	12	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$754,301	PYContributionsGrantsAmt
CY Contributions Grants	$431,209	CYContributionsGrantsAmt
PY Program Service Revenue	$13,266,451	PYProgramServiceRevenueAmt
CY Program Service Revenue	$13,629,481	CYProgramServiceRevenueAmt
PY Investment Income	-$10,668	PYInvestmentIncomeAmt
CY Investment Income	$2,042	CYInvestmentIncomeAmt
PY Other Revenue	$22,327	PYOtherRevenueAmt
CY Other Revenue	$32,715	CYOtherRevenueAmt
PY Total Revenue	$14,032,411	PYTotalRevenueAmt
CY Total Revenue	$14,095,447	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,375	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$2,546	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$7,374,778	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$7,875,173	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$2,265	CYTotalFundraisingExpenseAmt
PY Other Expenses	$6,075,450	PYOtherExpensesAmt
CY Other Expenses	$7,605,525	CYOtherExpensesAmt
PY Total Expenses	$13,452,603	PYTotalExpensesAmt
CY Total Expenses	$15,483,244	CYTotalExpensesAmt
PY Revenues Less Expenses	$579,808	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,387,797	CYRevenuesLessExpensesAmt
Total Assets BOY	$16,804,269	TotalAssetsBOYAmt
Total Assets EOY	$14,866,239	TotalAssetsEOYAmt
Total Liabilities BOY	$9,196,215	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$8,645,982	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$7,608,054	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$6,220,257	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	QUALITY CARE WITH A PERSONAL TOUCH, CLOSE TO HOME.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$14,038,203	ExpenseAmt
Grant	$2,546	GrantAmt
Revenue	$13,629,481	RevenueAmt
Desc	COTEAU DES PRAIRIES HOSPITAL (CDPH) IS A 25 BED ACUTE CARE HOSPITAL AND PHYSICIAN CLINICS LOCATED IN SISSETON, SOUTH DAKOTA AND THE SURROUNDING AREA. THE HOSPITAL PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THEN ESTABLISHED RATES. SINCE THE HOSPITAL DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUE. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS $44,000 FOR THE YEAR ENDED DECEMBER 31, 2014. STATISTICS FOR THE PERIOD ENDED DECEMBER 31, 2014, ARE AS FOLLOWS: ACUTE PATIENT DAYS = 1,426, SUBACUTE PATIENT DAYS = 702, NEWBORN DAYS = 248, AND EMERGENCY ROOM VISITS = 4,738.	Desc
Total Program Service Expenses	$14,038,203	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	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	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
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	18	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	180	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	12	GoverningBodyVotingMembersCnt
Independent Voting Member	12	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	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MYLA PETERSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6056984697	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	205 ORCHARD DRIVE	AddressLine1Txt
City	SISSETON	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	572622398	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 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
MARY CARLSON
PRESIDENT	2.00	Yes (X)	Yes (X)	$0	$0	$0
FAYE JOHNSTON
VICE PRESIDENT	2.00	Yes (X)	Yes (X)	$0	$0	$0
TERRY JASPERS
TREASURER	2.00	Yes (X)	Yes (X)	$0	$0	$0
KENT THOELKE
SECRETARY	2.00	Yes (X)	Yes (X)	$0	$0	$0
DEBRA WOOLEY
MEMBER	1.00	Yes (X)		$0	$0	$0
STEVEN MCCLEEREY
MEMBER	1.00	Yes (X)		$0	$0	$0
ERIN CAMERON
MEMBER	1.00	Yes (X)		$0	$0	$0
VIVIAN HOVE
MEMBER	1.00	Yes (X)		$0	$0	$0
GERALDINE OPSAL
MEMBER	1.00	Yes (X)		$0	$0	$0
VERN DONNELL
MEMBER	1.00	Yes (X)		$0	$0	$0
YVONNE HIPPEN
MEMBER	1.00	Yes (X)		$0	$0	$0
DAVE GLEASON
MEMBER	1.00	Yes (X)		$0	$0	$0
DAN ELLIS
CEO (JAN - NOV)	40.00		Yes (X)	$148,125	$0	$20,567
MICHEAL COYLE
CEO (BEGINNING DEC)	40.00		Yes (X)	$3,080	$0	$10,477
LARRY MOEN
CFO	40.00		Yes (X)	$77,509	$0	$12,858
STANLEY GALLAGHER DO
OSTEOPATHY	40.00			$707,991	$0	$8,408	Yes (X)
JUDY BEUMER MD
OB GYN	32.00			$326,318	$0	$21,641	Yes (X)
DAVID STAUB MD
FAMILY PRACTICE	20.00			$389,441	$0	$10,908	Yes (X)
LINDA PETERSON MD FACOG
FAMILY PRACTICE	24.00			$161,569	$0	$11,811	Yes (X)
BRADLEY GALLAGHER PA-C
FAMILY PRACTICE	40.00			$112,844	$0	$4,960	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,926,877	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$101,630	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	6	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Field	Value	IRS element (for citing)
Person	CHARLES PRYZMUS	PersonNm

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1004 5TH AVENUE NORTH	AddressLine1Txt
City	WHEATON	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56296	ZIPCd

Field	Value	IRS element (for citing)
Services	ANESTHESIA SERVICES	ServicesDesc
Compensation	$125,250	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Government Grants	$199,974	GovernmentGrantsAmt
All Other Contributions	$231,235	AllOtherContributionsAmt
Total Contributions	$431,209	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE	622110	$13,577,480	$13,577,480
SUPPORTING REVENUE	900099	$29,036	$29,036
CAFETERIA REVENUE	722514	$22,965	$22,965

Field	Value	IRS element (for citing)
Total Program Service Revenue	$13,629,481	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,042	TotalRevenueColumnAmt
Exclusion	$2,042	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$32,715	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$32,715	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$32,715	TotalRevenueColumnAmt
Exclusion	$32,715	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,095,447	TotalRevenueColumnAmt
Related Or Exempt Func Income	$13,629,481	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$34,757	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$2,546	TotalAmt
Program Services	$2,546	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$262,535	TotalAmt
Management And General	$262,535	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$6,140,477	TotalAmt
Program Services	$5,755,969	ProgramServicesAmt
Management And General	$384,508	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$121,763	TotalAmt
Program Services	$112,216	ProgramServicesAmt
Management And General	$9,547	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$863,155	TotalAmt
Program Services	$777,841	ProgramServicesAmt
Management And General	$85,314	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$487,243	TotalAmt
Program Services	$425,641	ProgramServicesAmt
Management And General	$61,602	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$17,098	TotalAmt
Management And General	$17,098	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$40,750	TotalAmt
Management And General	$40,750	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,457,310	TotalAmt
Program Services	$2,049,654	ProgramServicesAmt
Management And General	$407,656	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$19,439	TotalAmt
Program Services	$1,804	ProgramServicesAmt
Management And General	$17,635	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$596,436	TotalAmt
Program Services	$481,391	ProgramServicesAmt
Management And General	$114,249	ManagementAndGeneralAmt
Fundraising	$796	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$239,692	TotalAmt
Program Services	$239,692	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$124,511	TotalAmt
Program Services	$112,631	ProgramServicesAmt
Management And General	$11,880	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$22,880	TotalAmt
Program Services	$14,465	ProgramServicesAmt
Management And General	$8,415	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$326,891	TotalAmt
Program Services	$326,891	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$827,025	TotalAmt
Program Services	$827,025	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$191,778	TotalAmt
Program Services	$191,778	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$1,575,840	$1,575,840
BAD DEBT	$1,029,037	$1,029,037
FOOD	$58,698	$58,698
LICENSE AND PERMITS	$58,109	$53,294	$4,815

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$20,031	TotalAmt
Program Services	$1,790	ProgramServicesAmt
Management And General	$16,772	ManagementAndGeneralAmt
Fundraising	$1,469	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$15,483,244	TotalAmt
Program Services	$14,038,203	ProgramServicesAmt
Management And General	$1,442,776	ManagementAndGeneralAmt
Fundraising	$2,265	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$3,009,247	BOYAmt
EOY	$329,999	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,803,316	BOYAmt
EOY	$3,300,865	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$248,707	BOYAmt
EOY	$253,232	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$89,318	BOYAmt
EOY	$123,058	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$16,996,873	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$6,380,068	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$9,957,181	BOYAmt
EOY	$10,616,805	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$80,500	BOYAmt
EOY	$77,280	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$616,000	BOYAmt
EOY	$165,000	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,804,269	BOYAmt
EOY	$14,866,239	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$942,937	BOYAmt
EOY	$1,041,698	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$163,256	BOYAmt
EOY	$45,745	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$7,381,155	BOYAmt
EOY	$7,208,539	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$350,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$708,867	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$9,196,215	BOYAmt
EOY	$8,645,982	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,608,054	BOYAmt
EOY	$6,220,257	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,608,054	BOYAmt
EOY	$6,220,257	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$16,804,269	BOYAmt
EOY	$14,866,239	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$1,387,797	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
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

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,556	OtherCostOrOtherBasisAmt
Book Value	$13,556	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,922,600	OtherCostOrOtherBasisAmt
Depreciation	$2,870,978	DepreciationAmt
Book Value	$8,051,622	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,915,818	OtherCostOrOtherBasisAmt
Depreciation	$3,396,111	DepreciationAmt
Book Value	$2,519,707	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$144,899	OtherCostOrOtherBasisAmt
Depreciation	$112,979	DepreciationAmt
Book Value	$31,920	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$10,616,805	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$12,954,152	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$1,029,037	OtherRevenueAmt
Revenue Not Reported	-$1,029,037	RevenueNotReportedAmt
Revenue Subtotal	$13,983,189	RevenueSubtotalAmt
Other Revenues Not Included	$112,258	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$112,258	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$14,095,447	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$14,454,207	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$14,454,207	ExpensesSubtotalAmt
Other Expenses Not Included	$1,029,037	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$1,029,037	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$15,483,244	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART X, LINE 2:	THE ORGANIZATION IS STRUCTURED AS 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 HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. 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:	PROVISION FOR BAD DEBTS INCLUDED IN REVENUE FOR FINANCIAL STATEMENTS -1,029,037.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	CONTRIBUTIONS FOR LONG-LIVED ASSETS INCLUDED IN REVENUE FOR FORM 990 112,258.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBTS INCLUDED IN REVENUE FOR FINANCIAL STATEMENTS 1,029,037.

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	175.000000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$44,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$44,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,536,094	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,163,594	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$372,500	NetCommunityBenefitExpnsAmt
Total Expense	0.02580	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,580,094	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,163,594	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$416,500	NetCommunityBenefitExpnsAmt
Total Expense	0.02880	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,458	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,848	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,610	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,283,107	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,719,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,563,907	NetCommunityBenefitExpnsAmt
Total Expense	0.17740	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,046	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,046	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,302,611	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,732,048	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,570,563	NetCommunityBenefitExpnsAmt
Total Expense	0.17780	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,882,705	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,895,642	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,987,063	NetCommunityBenefitExpnsAmt
Total Expense	0.20660	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$1,029,037	BadDebtExpenseAmt
Bad Debt Expense Attributable	$514,519	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$3,619,634	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$3,675,052	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$55,418	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	COTEAU DES PRAIRIES HOSPITAL & CLINIC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	205 ORCHARD DRIVE	AddressLine1Txt
City	SISSETON	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57262	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.CDPHOSPITAL.COM	WebsiteAddressTxt
State License	60020	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	1 PROVIDER BASED RURAL HEALTH CLINIC	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	COTEAU DES PRAIRIES HOSPITAL & CLINIC	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
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	13	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 7D NARRATIVE.	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	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE 7D NARRATIVE.	StrategyWebsiteURLTxt
Strategy Attached	0	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	150.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	175.000000000000	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 Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
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
Medicare Rates	Yes (X)	MedicareRatesInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
COTEAU DES PRAIRIES HOSPITAL & CLINIC	PART V, SECTION B, LINE 5: THE HOSPITAL CONDUCTED COMMUNITY SURVEYS ONLINE AND IN PERSON, AND CONDUCTED AN INTERNAL STAKE HOLDER SURVEY. THERE WERE ALSO COMMUNITY AND ELITE INTERVIEWS WITH SWO, HIS, COMMUNITY LEADERS OF SERVICE AREAS AND EMERGENCY MEDICAL PERSONNEL, COMMUNITY MEMBERS, AND MEDICAL PRACTITIONERS.
COTEAU DES PRAIRIES HOSPITAL & CLINIC	PART V, SECTION B, LINE 7D: THE CHNA AND IMPLEMENTAION STRATEGY ARE AVAILABLE AT HTTP://WWW.CDPHEALTH.COM/NEWS/DEFAULT.ASPX?DATE=12/1/2013
COTEAU DES PRAIRIES HOSPITAL & CLINIC	PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WILL NOT BE ADDRESSED DUE TO OTHER ORGANIZATIONS IN THE COMMUNITY ADDRESSING.1. TEEN PREGNANCY/UNSAFE SEX: SEVERAL KEY CONSTITUENT GROUPS WITHIN THE COMMUNITY HAVE ESTABLISHED PROGRAMS THAT ADDRESS THESE ISSUES.2. AFFORDABLE HEALTH CARE: AFFORDABLE HEALTH CARE IS A NATIONAL ISSUE - ONE MUCH LARGER THAN CAN BE ADEQUATELY ADDRESSED BY A SMALL, CRITICAL ACCESS HOSPITAL.3. ECONOMIC DEVELOPMENT/AFFORDABLE HOUSING: ACTIVITIES ARE UNDERWAY IN THE COMMUNITY THAT ADEQUATELY ADDRESS THE NEED EXPRESSED BY THE COMMUNITY MEMBERS THROUGHOUT THIS ASSESSMENT.A SEPARATE OB WING WAS COMPLETED AND OPERATING IN MAY 2014. THE COMPLETED WING HAS 2 - 1 ROOM SUITES.
COTEAU DES PRAIRIES HOSPITAL & CLINIC	PART V, SECTION B, LINE 16I: A SUMMARY OF THE CHARITY CARE POLICY IS POSTED IN THE HOSPITAL'S MAIN ENTRANCE/ADMISSION AREAS, THE MAIN ENTRANCE/ADMISSION AREAS FOR EACH OF THE CLINICS, AND IN THE EMERGENCY ROOMS AND WAITING ROOMS. CDPH PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS, WHEN APPLICABLE. IN ADDITION, CDPH PERSONNEL DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHEN APPLICABLE.
COTEAU DES PRAIRIES HOSPITAL & CLINIC	PART V, SECTION B, LINE 20E: PRIOR TO INITIATING ANY COLLECTION ACTIONS LISTED IN SCHEDULE H, PART V, LINE 19, PATIENTS WERE MADE AWARE OF THE FINANCIAL ASSISTANCE POLICY THROUGH SIGNAGE IN ADMISSIONS AND PHONE CALLS BY HOSPITAL STAFF PRIOR TO BEING SENT TO COLLECTION. PATIENT ACCOUNTS WERE NOT SENT TO COLLECTION UNTIL PATIENTS WERE OFFERED THE FINANCIAL ASSISTANCE POLICY. AFTER BEING OFFERED THE FINANCIAL ASSISTANCE POLICY, THE PATIENT HAS UP TO 90 DAYS TO COMPLETE THE REQUEST.

Field	Value	IRS element (for citing)
Facility	3	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
BROWNS VALLEY CLINIC
106 4TH STREET SOUTH	BROWNS VALLEY	MN	56219	FAMILY PRACTICE CLINIC
ROSHOLT CLINIC
116 WEST MAIN STREET	ROSHOLT	SD	57260	FAMILY PRACTICE CLINIC
HERMAN CLINIC
204 5TH ST EAST	HERMAN	MN	56248	FAMILY PRACTICE CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	PLEASE REFER TO SCHEDULE H, PART V, LINE 13.
PART I, LINE 7:	CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E AND CASH AND IN-KIND DONATIONS, LINE 7I WERE COMPILED USING ACTUAL COSTS AND RECORDED IN CBISA SOFTWARE. THE COST FOR SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $1,029,037 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE.
PART II, COMMUNITY BUILDING ACTIVITIES:	NONE
PART III, LINE 2:	BAD DEBT WRITE-OFFS ARE RECORDED USING GROSS CHARGES. WHEN A PAYMENT IS RECEIVED OR A DISCOUNT IS GIVEN ON A BAD DEBT ACCOUNT IT OFFSETS THE CURRENT FISCAL YEAR BAD DEBT EXPENSE. BAD DEBT EXPENSE REPORTED ON LINE 2 IS AT CHARGES AS PRESENTED ON THE FINANCIAL STATEMENTS.
PART III, LINE 3:	BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE IS ESTIMATED BASED ON INCOME LEVELS AND ETHNICITY IN THIS AREA. MORE THAN 50% OF CDPH CHARGES ARE GENERATED BY THE NATIVE AMERICAN POPULATION. STATISTICS SHOW THE AVERAGE HOUSEHOLD INCOME OF NATIVE AMERICAN FAMILIES IN ROBERTS COUNTY IS TWO-THIRDS OF THAT OF OTHER ETHNIC GROUPS. VIRTUALLY ALL NATIVE AMERICANS QUALIFY FOR CHARITY CARE, THUS THE ORGANIZATION ESTIMATES APPROXIMATELY 50% OF BAD DEBT IS ATTRIBUTABLE TO PERSONS WHO WOULD QUALIFY FOR CHARITY CARE.
PART III, LINE 4:	THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 6 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE HOSPITAL PROVIDES SERVICES TO MEDICARE PATIENTS KNOWING THERE COULD BE A SHORTFALL BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT TO THE HOSPITAL. THEREFORE, THE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT.TOTAL REVENUE RECEIVED FROM MEDICARE (INCLUDING DSH AND IME) IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT (INCLUDING LSA). BOTH THE TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICAID AND MEDICARE SERVICES.
PART III, LINE 9B:	FOR PATIENTS WHO QUALIFY FOR CHARITY CARE AND ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, COTEAU DES PRAIRIES HOSPITAL AND CLINIC MAY OFFER EXTENDED PAYMENT PLANS. THE HOSPITAL WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS. THE HOSPITAL WILL FIRST MAKE REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THE FINANCIAL ASSISTANCE POLICY.
PART VI, LINE 2:	THE PRIORITY OF CDPH IS TO PROMOTE THE HEALTH OF SISSETON AND ALSO THE SURROUNDING RURAL COMMUNITIES. PLEASE REFER TO SCHEDULE H, PART V, LINE 5.
PART VI, LINE 3:	CDPH UTILIZES MULTIPLE METHODS FOR PATIENT EDUCATION OF FINANCIAL ASSISTANCE. PLEASE SEE SCHEDULE H, PART V, LINE 16.
PART VI, LINE 4:	CDPH IS LOCATED IN SISSETON, A RURAL COMMUNITY IN THE NORTHEAST CORNER OF SOUTH DAKOTA WITH THE NEXT CLOSEST HEALTHCARE FACILITY BEING APPROXIMATELY 50 MILES AWAY. CDPH SERVES VARIOUS ETHNIC GROUPS. AN INDIAN HEALTH SERVICES (IHS) CLINIC IS LOCATED WITHIN 1 MILE OF THE HOSPITAL. CDPH SERVES AS THE MAIN EMERGENCY ROOM FOR THE IHS PATIENTS DURING OFFICE HOURS AND AFTER HOURS. THE 2014 ESTIMATED POPULATION IN SISSETON, SD WAS 2,702. APPROXIMATELY 45.19% OF THE SISSETON AREA PEOPLE ARE WHITE, 49.59% ARE NATIVE AMERICAN, AND 5.22% ARE TWO OR MORE RACES.THE ESTIMATED POPULATION IN ROBERTS COUNTY, SD IN 2014 WAS 10,374. APPROXIMATELY 60.4% OF ROBERTS COUNTY AREA PEOPLE ARE WHITE, 34.4% ARE NATIVE AMERICAN, 3.1% ARE TWO OR MORE RACES, AND 1% CLAIM HISPANIC OR LATINO.
PART VI, LINE 5:	CDPH IS A SOLE COMMUNITY PROVIDER WITH A 12 MEMBER VOLUNTEER BOARD OF DIRECTORS WHO ALL RESIDE IN THE PRIMARY SERVICE AREA. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED INDIVIDUALS AS THEY ARE REQUESTED. IF CDPH WERE TO HAVE SURPLUS FUNDS, THE FUNDS WOULD BE APPLIED TO PATIENT CARE IMPROVEMENTS AND ALSO TO REDUCE THE NEED FOR RATE INCREASES FOR THE PATIENTS. THE EMERGENCY ROOM IS STAFFED 24 HOURS A DAY, 7 DAYS A WEEK AND PATIENTS ARE WELCOMED REGARDLESS OF RACE OR THE ABILITY TO PAY FOR THE SERVICES. CDPH PARTICIPATES IN ALL GOVERNMENT-SPONSORED HEALTH PROGRAMS INCLUDING MEDICARE, MEDICAID, INDIAN HEALTH SERVICES, AND VETERAN AFFAIRS BENEFITS. THE HOSPITAL AND CLINICS WELCOME STUDENTS FOR TRAINING AND COLLEGE ROTATIONS IN VARIOUS HEALTHCARE PROFESSIONS.
PART VI, LINE 6:	N/A

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	Yes (1)	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 (5 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAN ELLIS
CEO (JAN - NOV)	$148,125	$0	$0	$0	$0	$0	$3,360	$0	$17,405	$0	$168,890	$0	$0	$0
STANLEY GALLAGHER DO
OSTEOPATHY	$707,991	$0	$0	$0	$0	$0	$0	$0	$8,605	$0	$716,596	$0	$0	$0
JUDY BEUMER MD
OB GYN	$326,318	$0	$0	$0	$0	$0	$0	$0	$21,854	$0	$348,172	$0	$0	$0
DAVID STAUB MD
FAMILY PRACTICE	$389,441	$0	$0	$0	$0	$0	$0	$0	$10,908	$0	$400,349	$0	$0	$0
LINDA PETERSON MD FACOG
FAMILY PRACTICE	$161,569	$0	$0	$0	$0	$0	$0	$0	$12,009	$0	$173,578	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 5	FormAndLineReferenceDesc
Explanation	PHYSICIANS ARE PAID 38% OF THEIR RESPECTIVE PROVIDER/CPT CODE REVENUE.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CITY OF SISSETON SOUTH DAKOTA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	466000460	BondIssuerEIN
Bond Issued	2012-07-06	BondIssuedDt
Issue Price	$7,450,000	IssuePriceAmt
Purpose	FUND HOSPITAL REMODELING AND BUILDING ADDITION PROJECT	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$241,461	RetiredAmt
Total Proceeds	$7,450,000	TotalProceedsAmt
Capitalized Interest	$59,310	CapitalizedInterestAmt
Issuance Costs From Proceeds	$122,280	IssuanceCostsFromProceedsAmt
Capital Expenditures	$7,077,281	CapitalExpendituresAmt
Other Spent Proceeds	$191,129	OtherSpentProceedsAmt
Substantial Completion	2014	SubstantialCompletionYr
Current Refunding	0	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	0	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (1)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	0	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1	THE EXECUTIVE COMMITTEE CONSISTS OF THE PRESIDENT, VICE PRESIDENT, THE SECRETARY, THE TREASURER AND ONE OTHER MEMBER OF THE BOARD TO BE ELECTED BY THE BOARD AT THE ANNUAL MEETING. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL & CLINIC DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD. SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE WILL BE REFERRED TO THE BOARD. MINUTES OF THE EXECUTIVE COMMITTEE MEETINGS ARE AVAILABLE TO THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11	THE BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 PRIOR TO FILING. THE CFO REVIEWS THE 990 IN DETAIL.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY IS COMPLETED ANNUALLY AND COVERS OFFICERS AND BOARD MEMBERS. THE DETERMINATION OF WHETHER A CONFLICT EXISTS IS MADE AT THE BOARD OF DIRECTORS LEVEL, AS IS THE REVIEW OF ACTUAL CONFLICTS. ANY PERSON DETERMINED TO HAVE A CONFLICT WILL HAVE AN OPPORTUNITY TO EXPLAIN THE SITUATION, AND HE/SHE WILL BE REQUIRED TO REFRAIN FROM VOTING.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION FOR THE CEO IS DETERMINED THROUGH INDIVIDUAL NEGOTIATIONS WITH THE EXECUTIVE COMMITTEE AND THE CEO. THE EXECUTIVE COMMITTEE USES SALARY SURVEYS TO DETERMINE WHAT CONSTITUTES REASONABLE COMPENSATION. NEGOTIATIONS WITH THE EXECUTIVE COMMITTEE INCLUDE A PERFORMANCE EVALUATION. AN EVALUATION IS DONE ANNUALLY BY THE EXECUTIVE COMMITTEE, AND APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION OF CDPH'S OFFICERS IS DETERMINED THROUGH DISCUSSIONS BETWEEN THE EXECUTIVE COMMITTEE AND THE CEO. THE EXECUTIVE COMMITTEE USES SALARY SURVEYS TO DETERMINE WHAT CONSTITUTES REASONABLE COMPENSATION. DISCUSSIONS WITH THE EXECUTIVE COMMITTEE INCLUDE A PERFORMANCE EVALUATION. AN EVALUATION IS DONE ANNUALLY BY THE EXECUTIVE COMMITTEE, AND APPROVED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 475,470. MANAGEMENT AND GENERAL EXPENSES 34,601. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 510,071. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 656,277. MANAGEMENT AND GENERAL EXPENSES 43,786. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 700,063. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 227,254. MANAGEMENT AND GENERAL EXPENSES 329,269. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 556,523. CONSULTING FEES: PROGRAM SERVICE EXPENSES 690,653. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 690,653.