PRESENTATION MEDICAL CENTER: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PRESENTATION MEDICAL CENTER (EIN 45-0227391)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-06-22
- IRS object ID
- 201521739349300907
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-06-22T16:23:53-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1545 ASSOCIATES DR STE 101 | AddressLine1 |
| City | DUBUQUE | City |
| State | IA | State |
| ZIP Code | 52002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450227391 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Presentation Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRES | BusinessNameControlTxt |
| Phone | 7014773161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1 |
| City | Rolla | City |
| State | ND | State |
| ZIP Code | 583670759 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mark Kerr | PersonNm |
| Person Title | President/CEO | PersonTitleTxt |
| Phone | 7014773161 | PhoneNum |
| Signature | 2015-06-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Carmen Krantz | PreparerPersonNm |
| PTIN | P00031958 | PTIN |
| Phone | 5635561790 | PhoneNum |
| Preparation | 2015-06-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mark Kerr | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1 |
| City | Rolla | City |
| State | ND | State |
| ZIP Code | 583670759 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,256,165 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pmc-rolla.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1939 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | Acute care hospital that is a major medical provider for Rolette County | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 128 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $421,448 | PYContributionsGrantsAmt |
| CY Contributions Grants | $147,802 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,213,535 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,102,250 | CYProgramServiceRevenueAmt |
| PY Investment Income | $11,723 | PYInvestmentIncomeAmt |
| CY Investment Income | -$76,669 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$108 | PYOtherRevenueAmt |
| CY Other Revenue | -$360 | CYOtherRevenueAmt |
| PY Total Revenue | $9,646,598 | PYTotalRevenueAmt |
| CY Total Revenue | $9,173,023 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $50 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $210 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,938,604 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,271,800 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,999,855 | PYOtherExpensesAmt |
| CY Other Expenses | $4,827,426 | CYOtherExpensesAmt |
| PY Total Expenses | $8,938,509 | PYTotalExpensesAmt |
| CY Total Expenses | $9,099,436 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $708,089 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $73,587 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,005,786 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,745,553 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,708,366 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,290,755 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,297,420 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,454,798 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Presentation Medical Center in union with the Sisters of Mary of the Presentation, is a Catholic healthcare organization. Through the power and example of Jesus Christ and his gospel values, we are committed to joyfully provide wholistic care and healing with integrity, compassion and respect to all we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,716,368 | ExpenseAmt |
| Grant | $210 | GrantAmt |
| Revenue | $9,102,250 | RevenueAmt |
| Desc | Presentation Medical Center (PMC) is a 25-bed acute care hospital located in Rolla, North Dakota. As a Critical Access Hospital, our organization is, by definition, a community benefit. PMC is a critical infrastructure to our community and is a major medical provider for Rolette County, providing inpatient, outpatient and surgical services. In addition, PMC is a key provider of emergency care with over 4,937 ER visits for fiscal year ending 2014. Services in the areas of Clinic, Lab, Radiology, Respiratory Therapy, Physical Therapy, Cardiac Rehab, and Outreach Specialty Physician services, are also provided.Presentation Medical Center had 409 acute patient days, 557 swing-bed days and 1,610 extended swing-bed days.The Medical Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Because the Medical Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The amounts of charges foregone were $29,802 for the year ended September 30, 2014. The estimated costs of the charges foregone, based upon an overall cost-to-charge ratio calculation, for the year ended September 30, 2014 were approximately $30,000.In addition, the Medical Center provides services to other medically indigent patients under certain government reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Medical Center also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable. | Desc |
| Total Program Service Expenses | $7,716,368 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 128 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | 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 | Paula Wilkie | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7014773161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1 |
| City | Rolla | City |
| State | ND | State |
| ZIP Code | 583670759 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| Nathan Neameyer | ||||||||
| Chairman | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Doug Kretschmar | ||||||||
| Vice Chairman | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Mark Kerr | ||||||||
| Secretary/President/CEO | 40.00 | 0.00 | Yes (X) | Yes (X) | $0 | $146,000 | $28,228 | |
| Sr Margaret Rose Pfeifer | ||||||||
| Director | 0.50 | 43.60 | Yes (X) | $0 | $0 | $0 | ||
| Sr Marlyss Dionne | ||||||||
| Director | 0.50 | 41.30 | Yes (X) | $0 | $0 | $0 | ||
| Sr Dorothy Bunce | ||||||||
| Director | 0.50 | 40.30 | Yes (X) | $0 | $0 | $0 | ||
| Paul Grann | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| John Hardy | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jane Sivertson | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Paula Wilkie | ||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $0 | $111,630 | $26,071 | ||
| Michael Pfeifer | ||||||||
| Former-Secretary/Pres/CEO | 0.00 | 0.00 | $0 | $188,139 | $21,796 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $445,769 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $76,095 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Sisters of Mary of the Presentation Heal | |||||
| 1202 Page Dr SW | Fargo | ND | 58106 | Professional & administrative services | $477,158 |
| Ram Paneru MD | |||||
| 2318 W Fallcreek Ct | Grand Forks | ND | 58201 | ER physician services | $339,255 |
| Dakota Travel Nurse | |||||
| 502 W Main Street | Mandan | ND | 58554 | Locum nursing services | $291,427 |
| Roy Cordy MD | |||||
| 914 3rd Avenue S Unit | Fargo | ND | 58103 | ER physician services | $289,500 |
| AMN HealthCare | |||||
| PO Box 281939 | Atlanta | GA | 303841939 | Locum nursing services | $182,627 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $10,000 | RelatedOrganizationsAmt |
| Government Grants | $36,951 | GovernmentGrantsAmt |
| All Other Contributions | $100,851 | AllOtherContributionsAmt |
| Total Contributions | $147,802 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenu | 622110 | $8,725,123 | $8,725,123 |
| EHR incentive | 900099 | $178,471 | $178,471 |
| Outside laundry revenu | 812300 | $150,326 | $150,326 |
| Supporting revenue | 900099 | $48,330 | $48,330 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,102,250 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$387 | TotalRevenueColumnAmt |
| Exclusion | -$387 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,500 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,860 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$360 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$360 | TotalRevenueColumnAmt |
| Exclusion | -$360 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $76,282 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$76,282 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$76,282 | TotalRevenueColumnAmt |
| Exclusion | -$76,282 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,173,023 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,102,250 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$77,029 | 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 | $210 | TotalAmt |
| Program Services | $210 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,543,750 | TotalAmt |
| Program Services | $3,115,666 | ProgramServicesAmt |
| Management And General | $428,084 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,266 | TotalAmt |
| Program Services | $79,973 | ProgramServicesAmt |
| Management And General | $13,293 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,594 | TotalAmt |
| Program Services | $341,087 | ProgramServicesAmt |
| Management And General | $48,507 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,190 | TotalAmt |
| Program Services | $226,087 | ProgramServicesAmt |
| Management And General | $19,103 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $464,904 | TotalAmt |
| Management And General | $464,904 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,426 | TotalAmt |
| Management And General | $5,426 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,452 | TotalAmt |
| Management And General | $40,452 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,073,382 | TotalAmt |
| Program Services | $1,822,817 | ProgramServicesAmt |
| Management And General | $250,565 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,061 | TotalAmt |
| Management And General | $9,061 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,019 | TotalAmt |
| Program Services | $144,437 | ProgramServicesAmt |
| Management And General | $76,582 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,914 | TotalAmt |
| Program Services | $263,423 | ProgramServicesAmt |
| Management And General | $491 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,865 | TotalAmt |
| Program Services | $31,058 | ProgramServicesAmt |
| Management And General | $16,807 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $784 | TotalAmt |
| Management And General | $784 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,286 | TotalAmt |
| Program Services | $22,286 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $462,857 | TotalAmt |
| Program Services | $462,857 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,497 | TotalAmt |
| Program Services | $62,497 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $715,034 | $715,034 | |
| Bad debt expense | $324,876 | $324,876 | |
| Food | $97,547 | $97,547 | |
| Dues & subscriptions | $15,355 | $6,513 | $8,842 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167 | TotalAmt |
| Management And General | $167 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,099,436 | TotalAmt |
| Program Services | $7,716,368 | ProgramServicesAmt |
| Management And General | $1,383,068 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $177,314 | BOYAmt |
| EOY | $380,211 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,178,897 | BOYAmt |
| EOY | $1,417,058 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,180 | BOYAmt |
| EOY | $179,957 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,948 | BOYAmt |
| EOY | $52,715 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,241,859 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,549,456 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,274,537 | BOYAmt |
| EOY | $1,692,403 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,229,151 | BOYAmt |
| EOY | $1,078,915 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,000 | BOYAmt |
| EOY | $30,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $897,759 | BOYAmt |
| EOY | $914,294 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,005,786 | BOYAmt |
| EOY | $5,745,553 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $968,816 | BOYAmt |
| EOY | $1,088,379 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,842 | BOYAmt |
| EOY | $331,594 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $687,708 | BOYAmt |
| EOY | $870,782 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,708,366 | BOYAmt |
| EOY | $2,290,755 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,060,707 | BOYAmt |
| EOY | $3,369,101 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $236,713 | BOYAmt |
| EOY | $85,697 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,297,420 | BOYAmt |
| EOY | $3,454,798 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,005,786 | BOYAmt |
| EOY | $5,745,553 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $73,587 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $90,359 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$6,568 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | 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 | $75,778 | OtherCostOrOtherBasisAmt |
| Book Value | $75,778 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,872,880 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,735,498 | DepreciationAmt |
| Book Value | $137,382 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,273,380 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,794,137 | DepreciationAmt |
| Book Value | $1,479,243 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,821 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,821 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,692,403 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Estimated third-party payor settlements | $456,000 |
| Other receivables | $458,294 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $914,294 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $8,935,544 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $90,359 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$218,242 | OtherRevenueAmt |
| Revenue Not Reported | -$127,883 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,063,427 | RevenueSubtotalAmt |
| Other Revenues Not Included | $109,596 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $109,596 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,173,023 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,774,560 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,774,560 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $324,876 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $324,876 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,099,436 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 net income that is derived from business activities that are unrelated to its exempt purpose, if applicable. 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 recorded in expenses for Form 990 -324,876. Net assets released from restriction recorded in revenue for financial stmts 106,634. |
| Part XI, Line 4b - Other Adjustments: | Temp restr contributions recorded in fund balance for financial statements 85,697. Unrestricted contributions recorded in fund balance for financial statements 23,899. |
| Part XII, Line 4b - Other Adjustments: | Provisions for bad debts recorded in expenses for Form 990 324,876. |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $31,010 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $31,010 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 897 | PersonsServedCnt |
| Total Community Benefit Expns | $30,505 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,350 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,155 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,983,554 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,961,845 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,709 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 27 | PersonsServedCnt |
| Total Community Benefit Expns | $10,118 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,118 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 924 | PersonsServedCnt |
| Total Community Benefit Expns | $2,024,177 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,966,195 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $57,982 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00670 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 924 | PersonsServedCnt |
| Total Community Benefit Expns | $2,055,187 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,966,195 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $88,992 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01020 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $2,153 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,153 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 3161 | PersonsServedCnt |
| Total Community Benefit Expns | $12,183 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 3161 | PersonsServedCnt |
| Total Community Benefit Expns | $14,336 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,336 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $324,876 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $162,438 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,990,421 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,021,906 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$31,485 | 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 | Presentation Medical Center | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 2nd Avenue NE | AddressLine1 |
| City | Rolla | City |
| State | ND | State |
| ZIP Code | 583670759 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.pmc-rolla.com | WebsiteAddressTxt |
| State License | 5045 | 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 clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Presentation Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.pmc-rolla.com | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| Other Needs Addressed | Yes (X) | OtherNeedsAddressedInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| 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 |
|---|---|
| Presentation Medical Center | Part V, Section B, Line 3: A survey was distributed to gather feedback from the community. The survey was designed to collect information related to community-perceived health needs. Two versions of a survey tool were distributed to two different audiences: (1) community members and (2) health care professionals.One-on-one interviews with key informants were conducted in person in Rolla on June 18, 2012. Telephone interviews were held on June 21, 2012. A representative of the Center for Rural Health conducted the interviews. These interviewees represented the broad interests of the community served by PMC. They included representatives of the medical community, business community, nonprofit agencies, and public health. Included among the informants was a public health nurse with special knowledge in public health acquired through several years of direct care experience in the community, including working with medically underserved, low income and Native populations, as well as with populations with chronic diseases. Also included was an employee from Job Service North Dakota who interacts with low income and minority populations.A focus group met and included the Mayor, medical service providers, business leaders and city personnel from various communities in Presentation Medical Center's service area. |
| Presentation Medical Center | Part V, Section B, Line 6i: Presentation Medical Center has adopted an implementation strategy to address the community health needs identified in its Community Health Needs Assessment. The implementation strategy is posted to the Hospital's website at www.pmc-rolla.com. |
| Presentation Medical Center | Part V, Section B, Line 7: The assessment identified and requested the addition of services that Presentation Medical Center is unable to provide at this time. Those services include:1. A surgeon who lives in Rolla, ND. This service requires not only a surgeon, but also extensive support staff, including specialty nurses and either an anesthesiologist or nurse anesthetist.2. An obstetrician for maternity care and deliveries, since there is a high birth rate in the area. As stated above, this service would also require anesthesiology, specialty nurses and support staff. Additionally, the malpractice insurance premiums are high, and logistical support would result in unjustifiable costs.3. Occupational therapy service requires specialty personnel and equipment, as well as designated space for a treatment room and office.While all these programs would be beneficial to the community, the logistics, personnel and resources to provide these services are not readily available or financially feasible.Needs met during FY2014 are as follows:1. Limited number of health care providers:A new provider was added at Presentation Medical Center in October 2014. Adding additional health care providers is ongoing.2. Importance of Customer Service:Additional training resources and surveys for clinic and emergency room patients are used. Presentation Medical Center participated in the monthly HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Breakthrough Series Webinar in 2014. A two day seminar "Service Excellence Initiative" is scheduled in the next fiscal year.3. Elevated Rates of Diabetes:Presentation Medical Center committed to providing reduced rate lab screening from once per year to twice per year. The Hospital worked closely with Rolette County Public Health Department on public education information that has a focus on diabetes prevention and obesity, as well as support group activities. Ongoing needs are as follows:1. Increased Marketing Efforts:Services provided at Presentation Medical Center will be printed in additional materials and relayed through social media. Public relations and the Executive Committee will look at all current methods of information delivery and make recommendations for the improvement of marketing/service awareness.2. Implement increased Outreach Specialty Providers:A feasibility study will be performed in conjunction with Trinity Medical Center in Minot, ND, to identify the need and ability to add an Ear, Nose and Throat specialist and Oncology Specialist to our Specialty Outreach clinic at Presentation Medical Center. This task will be ongoing with new services added in 2015.3. Collaboration of Medical Providers and Facilities:Presentation has a key relationship with Trinity Medical Center in Minot, ND, to serve as the tertiary facility and main receiving hospital for patients that need a level of care that is unavailable at the Hospital. The Hospital will actively seek to partner with medical providers and facilities to enhance the quality of care in Rolette County that are in line with the Hospital's level of care and operational model as well as the mission and vision. |
| Presentation Medical Center | Part V, Section B, Line 12i: Presentation Medical Center also evaluates a patient's family size, income and demographics to determine eligibility for additional free or discounted care to low income individuals. |
| Presentation Medical Center | Part V, Section B, Line 14g: A brochure is provided to every patient when they register outlining our payment expectations and explaining our Community Caring Program. An application for the Community Caring Program is included with the first statement of every private pay patient. Our Charity Care application can be obtained on our website. Notification about charity care is available in emergency rooms, admitting and registration departments, the Business office, and other public areas within the Hospital. Information is also included in patient bills and patient information packets. At registration, patients are given the Payment Policy and Community Caring Program handout. This handout explains patient responsibilities, insurance billing guidelines, financing and payment options, and the Community Caring guidelines. |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Presentation Medical Center also evaluates a patient's family size and demographics to determine eligibility for additional free or discounted care to low income individuals. |
| Part I, Line 6a: | Presentation Medical Center's community benefit report can be found on its website at pmc-rolla.com. |
| Part I, Line 7: | Charity care expense was converted to cost on line 7a based on the cost-to-charge ratio derived from Worksheet 2. Inpatient and outpatient Hospital services provided to Medicaid program beneficiaries are primarily paid on a cost-related basis, therefore there is no community benefit related to Medicaid on line 7b. Community health improvement services and in-kind contributions to community groups, lines 7e and 7i, are reported based on actual expenses recorded in the organization's general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. |
| Part I, Ln 7 Col(f): | The amount of bad debt expense removed from total expenses to determine the percentage was $324,876. |
| Part II, Community Building Activities: | Case Management provided information, assistance, and referrals to community members seeking such services, particularly during times of medical crisis. The Presentations News Letter was provided to over 2,800 individuals providing the community with important health information.Caregiver meals were provided to 317 individuals. A caregiver gives so much of their time helping others they often don't have the time to get a meal. The meal is supplied so they can focus on caring for their loved one. |
| Part III, Line 2: | Bad debt expense is the write-off of a patient's account for services provided by the Hospital after all payments, discounts, and contractual allowances have been applied. Accounts that qualify or may qualify for financial assistance or charity care are not written off to bad debt. Payments received on accounts previously written off to bad debt reduces bad debt expense. Bad debt expense on line 2 is reported at charges as presented on the financial statements. |
| Part III, Line 3: | The estimated amount of the Organization's bad debt expense attributable to patients eligible under the Organization's charity care policy is calculated based on an estimate of applications denied due to lack of information. Presentation Medical Center estimates the amount of bad debt expense attributable to patient's under the charity care policy because the Organization knows that some accounts are written off to bad debt that may have been charity care if the patient had completed the paper work. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on page 8 of the attached audited financial statements. |
| Part III, Line 8: | Presentation Medical Center provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the Medicare shortfall is considered a community benefit.Total revenue received from Medicare is the gross reimbursement plus settlement. Both 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: | Presentation Medical Center believes it has an obligation to make every effort possible to collect for services rendered from all patients who have the ability to pay their account. There are no collection efforts for patients who qualify for charity care or financial assistance, indigent patients, or patients that have set up payment arrangements. If a portion of an account is written off to charity care, any personal portion due follows the same collection procedures as other accounts. For patients who are indigent, Presentation Medical Center has a Charity Care provision with the appropriate application process. For self pay patients, Presentation Medical Center offers a prompt payment discount of 25% for payment in full within 30 days from the date of their first statement. |
| Part VI, Line 2: | Presentation Medical Center strives to provide basic healthcare services to its communities. We have worked with the Public Health for Rolette County, Rolette County Police Department, Rolla Community Ambulance, Rolette County Social Services and other community departments to provide basic care to the members of our community. Working with these individuals allows us to provide different services to our community and to make sure that one of these entities is able to provide care and or cover for one another.Our community health needs assessment is completed and posted to our website to meet the requirements of 501(r). |
| Part VI, Line 3: | Presentation Medical Center is committed to providing care to persons who are uninsured, underinsured, ineligible for government programs, or otherwise unable to pay for medically necessary care. Our Community Caring Program was established in 2005. We have seen a continual increase every year in charity care as we try to get patients involved in the program before their accounts are sent to collections. A brochure is provided to every patient when they register outlining our payment expectations and explaining our Community Caring Program. An application for the Community Caring Program is included with the first statement of every private pay patient and is also available on our website. Notification about charity care is available in emergency rooms, admitting and registration departments, the Business office, and other public areas within the Hospital. Information is also included in patient bills and patient information packets. At registration, patients are given the Payment Policy and Community Caring Program handout. This handout explains patient responsibilities, insurance billing guidelines, financing and payment options, and the Community Caring guidelines. |
| Part VI, Line 4: | Presentation Medical Center (PMC) is a 25-bed not-for-profit, Critical Access Hospital (CAH) located in Rolla, Rolette County, ND. Rolla, ND is located in north central North Dakota, next to the Canadian border. Presentation Medical Center is located approximately 40 miles from Bottineau, 120 miles northeast of Minot, 170 miles northwest of Grand Forks, 205 miles northeast of Bismarck, and 240 miles northwest of Fargo. The nearest city with a population > 50,000 is Bismarck, ND.PMC is highly dependent upon government payors and is a Medicaid Disproportionate Share Hospital. In the Fiscal Year ending 09/30/2014, revenue from the Medicare, Medicaid, and Blue Cross programs accounted for approximately 39%, 32%, and 18% of the Medical Center's gross patient service revenue. By virtue of where we are located and the services that we provide, we are a benefit to our community.The service area of PMC includes Rolette and part of Towner Counties. Rolette County has a total population of 14,582 with 76.6% of the population being Native American. With this census, 2.01% of North Dakota's population lives in Rolette County. The per capita income for Rolette County is $15,285 compared with North Dakota's per capita income of $28,700 with 36.2% of the county living below the poverty guidelines. (Source: U.S. Census Bureau).The closest healthcare facility is 7 miles away located in Belcourt, ND, which is an Indian Healthcare Facility. All other hospitals are located 40 plus miles from Presentation Medical Center. Presentation Medical Center's tertiary facility is located over 120 miles away in Minot, ND. It is in the best interest of the community to be able to offer basic healthcare needs due to the distance that the patient must travel. |
| Part VI, Line 5: | Presentation Medical Center works to address the basic healthcare needs in Rolette County and the surrounding communities. The Hospital is a major medical provider for the county providing inpatient, outpatient, and surgical services. In addition, Presentation Medical Center is a key provider of emergency care. The emergency room is open 24 hours and is available regardless of a persons ability to pay.Presentation Medical Center extends medical staff privileges to all qualified physicians who meet PMC's Medical Staff Bylaws. Surplus funds are used for equipment upgrades and facility improvements. A majority of the organization's governing body resides in Rolla, ND and none are employees nor contractors of the organization. The governing body does not have any family relationships with each other.In addition to our very existence, PMC believes that there are additional areas that highlight our benefit to the community. By being what and who we are, we strive to be a good community citizen and an asset to the communities that we serve. PMC routinely provides a variety of services that address needs within the community.PMC provided an annual Healthy Community Day that offers educational material and health screenings, including laboratory screenings that provide information about an individuals' general health condition. These services are offered to all community residents.Physical Therapy and Pharmacy students also had the opportunity to obtain clinical experience at PMC.Blood drives are sponsored two times per year. United Blood Services uses the Inservice Room as a collection site and the Lab and Admission staff members are responsible for recruiting and coordinating donors.Staff support and office space is provided to the Rural Mental Health Consortium. This allows mental health services to be available in the community on a weekly basis.Meals are also provided for caregivers and lodging is offered for family members who choose to remain in the hospital with their loved one.Sport Injury evaluation and screenings are provided to area High School students and staff members from Physical Therapy provide support at local athletic events.PMC provides education to schools informing about living a healthy lifestyle through exercise and nutrition.PMC provides Pastoral Care services to all our patients and the community members. Pastoral Care serves as a liaison with the area Ministerial Associations.Supply donations are given out to patients. PMC will provide linen facilities to outside organizations in need. |
| Part VI, Line 6: | We are an affiliate of the Sisters of Mary of the Presentation Health Corporation. Presentation Medical Center operates in accordance with the mission, vision, and values of the Sisters of Mary of the Presentation Health Corporation. Our annual budgeting process includes an assessment of how our budget demonstrates a commitment to the values of the system and the system works to ensure we are always mindful of our duty to care for the poor and those in need. Presentation Medical Center has a Strategic Plan developed from themes set forth by the health system for all affiliates. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark Kerr | ||||||||||||||
| Secretary/President/CEO | $0 | $140,000 | $0 | $0 | $0 | $6,000 | $0 | $8,024 | $0 | $22,363 | $0 | $176,387 | $0 | $0 |
| Michael Pfeifer | ||||||||||||||
| Former-Secretary/Pres/CEO | $0 | $143,210 | $0 | $33,196 | $0 | $11,733 | $0 | $12,444 | $0 | $11,549 | $0 | $212,132 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Question 3: | FormAndLineReferenceDesc |
| Explanation | Presentation Medical Center does not pay compensation to the President/CEO. This individual is compensated by Sisters of Mary of the Presentation Health Corporation, a related organization, for services to the Medical Center. Sisters of Mary of the Presentation Health Corporation uses one or more of the methods in Part I, question 3 to determine compensation. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Mark Kerr, Paula Wilkie and Sr. Margaret Rose Pfeifer have business relationships with each other. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is the Sisters of Mary of the Presentation Health Corporation. |
| Form 990, Part VI, Section A, line 7a | The member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The member is also entitled to one vote on every other matter to be voted on by the member. Votes cast on behalf of the member are cast by the Chief Executive Officer of Sisters of Mary of the Presentation Health Corporation. |
| Form 990, Part VI, Section A, line 7b | The authority to act on the following matters are exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer. |
| Form 990, Part VI, Section A, line 8b | The Organization does not have committees with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is distributed to the governing body before it is filed. The CEO and CFO review the Form 990. |
| Form 990, Part VI, Section B, line 12c | Each Director must submit in writing to the Chairperson of the Board and the CEO a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chairperson of the Board reviews the statements of the Directors and the Vice Chairperson of the Board reviews the statement filed by the Chairperson. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chairperson of the Board has authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chairperson, the Vice Chairperson has authority to require the Chairperson remove himself in the same matter. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he will not participate in the deliberations or vote on it. |
| Form 990, Part VI, Section B, line 15 | The Organization's CEO and CFO are both compensated by Sisters of Mary of the Presentation Health Corporation, a related organization. The compensation process is determined by the related organization. The Sisters of Mary of the Presentation Health Corporation Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. The Sisters of Mary of the Presentation Health Corporation Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon written request. |
| Form 990, Part IX, line 11g | Purchased services: Program service expenses 1,660,351. Management and general expenses 51,441. Fundraising expenses 0. Total expenses 1,711,792. Repairs and maintenance: Program service expenses 162,466. Management and general expenses 183,907. Fundraising expenses 0. Total expenses 346,373. Professional fees: Program service expenses 0. Management and general expenses 15,217. Fundraising expenses 0. Total expenses 15,217. |
| Form 990, Part XI, line 9: | Equity transfer to Sisters of Mary of the Presentation Health Corporation -6,568. |
| Form 990, Part XII, Line 2c: | The governing board of Sisters of Mary of the Presentation assumes responsibility for oversight of the audit for Presentation Medical Center. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Sisters of Mary of the Presentation Health Corporation | |||||||||||
| 1202 Page Drive SW | Fargo | ND | 58103 | 450359620 | Facilitates management and operations of ten related facilities | ND | 501(c)(3) | Line 11a, I | SMP Maryvale Provincial Center | 0 | |
| St Andrew's Hospital Foundation | |||||||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450413201 | Provide support to St. Andrew's Hospital | ND | 501(c)(3) | Line 11a, I | SMP Health Corporation | 0 | |
| SMP Prairieland Home Health Agency | |||||||||||
| 1102 Page Drive SW | Fargo | ND | 581060007 | 450391192 | Home health and supportive services | ND | 501(c)(3) | Line 9 | SMP Health Corporation | 0 | |
| St Andrew's Hospital | |||||||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450226426 | Provision of health care services | ND | 501(c)(3) | Line 3 | SMP Health Corporation | 0 | |
| St Aloisius Hospital | |||||||||||
| 325 East Brewster Street | Harvey | ND | 58341 | 450226729 | Provision of health care services | ND | 501(c)(3) | Line 3 | SMP Health Corporation | 0 | |
| St Margaret's Hospital | |||||||||||
| 600 East First Street | Spring Valley | IL | 61362 | 362167884 | Provision of health care services | IL | 501(c)(3) | Line 3 | SMP Health Corporation | 0 | |
| Sisters of Mary of the Presentation Long Term Care | |||||||||||
| 1202 Page Drive SW | Fargo | ND | 581060007 | 752999939 | Provide extended care and medically related services | ND | 501(c)(3) | Line 9 | SMP Health Corporation | 0 | |
| St Margaret's Hospital Foundation | |||||||||||
| 600 East First Street | Spring Valley | IL | 61362 | 364042262 | Provide support to St. Margaret's Hospital | IL | 501(c)(3) | Line 11a, I | SMP Health Corporation | 0 | |
| Sisters of Mary of the Presentation Maryvale Provincial Center | |||||||||||
| 11550 River Road | Valley City | ND | 58072 | 450281923 | Work for the glory of God | ND | 501(c)(3) | Line 1 | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Andrew's Bottineau Clinic LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 316 Ohmer Street | AddressLine1 |
| City | Bottineau | City |
| State | ND | State |
| ZIP Code | 58318 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450451306 | EIN |
| Primary Activities | Provision of health care services | PrimaryActivitiesTxt |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rolette Clinic Inc | ||||||||||||
| PO Box 759 | Rolla | ND | 58367 | 450308335 | Leasing | ND | Presentation Medical Center | C | -$655 | 0.66670 | Yes (1) | |
| SMP Enterprises | ||||||||||||
| PO Box 10007 | Fargo | ND | 581060007 | 363486506 | Collection Agency | ND | C | 0 | N/A | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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