MOBRIDGE REGIONAL HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MOBRIDGE REGIONAL HOSPITAL (EIN 46-0255944)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-08-13
IRS object ID
201522259349300707
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

FieldValueIRS element (for citing)
Return2015-08-13T07:08:54-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 EAST 10TH ST PO BOX 5125AddressLine1
CitySIOUX FALLSCity
StateSDState
ZIP Code571175125ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN460255944EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mobridge Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMOBRBusinessNameControlTxt
Phone6058453692PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11401 10th Ave WAddressLine1
CityMobridgeCity
StateSDState
ZIP Code57601ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAngelia SvihovecPersonNm
Person TitleCEOPersonTitleTxt
Phone6058453692PhoneNum
Signature2015-08-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLaurie HansonPreparerPersonNm
PTINP00851848PTIN
Phone6053391999PhoneNum
Preparation2015-08-12PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerAngelia SvihovecPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11401 10th Ave WAddressLine1
CityMobridgeCity
StateSDState
ZIP Code57601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$19,969,233GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.mobridgehospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1959FormationYr
Legal Domicile StateSDLegalDomicileStateCd
Activity Or MissionProviding healthcare to people throughout the region.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee220TotalEmployeeCnt
Total Volunteers200TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,406,967PYContributionsGrantsAmt
CY Contributions Grants$1,216,140CYContributionsGrantsAmt
PY Program Service Revenue$16,222,019PYProgramServiceRevenueAmt
CY Program Service Revenue$17,626,965CYProgramServiceRevenueAmt
PY Investment Income$51,632PYInvestmentIncomeAmt
CY Investment Income-$24,877CYInvestmentIncomeAmt
PY Other Revenue$79,290PYOtherRevenueAmt
CY Other Revenue$98,917CYOtherRevenueAmt
PY Total Revenue$17,759,908PYTotalRevenueAmt
CY Total Revenue$18,917,145CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,396,702PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,748,751CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,417,830PYOtherExpensesAmt
CY Other Expenses$8,775,128CYOtherExpensesAmt
PY Total Expenses$16,814,532PYTotalExpensesAmt
CY Total Expenses$18,523,879CYTotalExpensesAmt
PY Revenues Less Expenses$945,376PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$393,266CYRevenuesLessExpensesAmt
Total Assets BOY$20,379,024TotalAssetsBOYAmt
Total Assets EOY$22,913,693TotalAssetsEOYAmt
Total Liabilities BOY$8,016,595TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,157,998TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,362,429NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,755,695NetAssetsOrFundBalancesEOYAmt
MissionThe mission of Mobridge Regional Hospital is to provide high quality healthcare services in a compassionate and professional manner for people throughout the region.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$16,579,571ExpenseAmt
Revenue$17,732,197RevenueAmt
DescMobridge Regional Hospital (MRH) provides healthcare services to persons throughout the region. During the fiscal year ended September 30, 2014, the hospital provided care to the North Central Region of South Dakota, and the South Central Region of North Dakota. The hospital had: 1,737 Patient Days 1,474 Acute Care Days 695 Swing Bed Care Days 3,285 Emergency Room Visits20,411 Rural Health Clinic Visits 5,856 Assisted Living Days (Prairie Sunset Village)Desc
Total Program Service Expenses$16,579,571TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document16IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee220EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Renae TisdallBusinessNameLine1
FieldValueIRS element (for citing)
Phone6058458164PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 580AddressLine1
CityMobridgeCity
StateSDState
ZIP Code57601ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Bill Bachmeier
Chairman1.00Yes (X)Yes (X)$0$0$0
Dennis Schnabel
Chairman (until Jan 2014)1.00Yes (X)Yes (X)$0$0$0
Delphine Steuck
Vice Chair1.00Yes (X)Yes (X)$0$0$0
Heidi Roshau
Treasurer1.00Yes (X)Yes (X)$0$0$0
Dr Tom Swanson
Secretary1.00Yes (X)Yes (X)$0$0$0
Jake Kraft
Director1.00Yes (X)$0$0$0
Wally Schott
Director1.00Yes (X)$0$0$0
Dr Leonard Linde
Director1.00Yes (X)$0$0$0
Barb Gross
Director1.00Yes (X)$0$0$0
Laurie Bauer
Director1.00Yes (X)$0$0$0
Donald Paulson
Director (until Aug 2014)1.00Yes (X)$0$0$0
Lori Hiel
Director1.00Yes (X)$0$0$0
Dr Travis Henderson
Internal Medicine/Director40.00Yes (X)$242,406$0$27,229
Dr Robert Marciano
Family MD/Director40.00Yes (X)$284,451$0$20,241
Angelia Svihovec
CEO40.00Yes (X)$0$0$0
Dr Bela Csaki
Surgeon40.00$312,549$0$18,858Yes (X)
Renae Tisdall
CFO40.00Yes (X)$77,313$0$26,045
Dr Colette Reule
Family MD40.00$265,595$0$25,558Yes (X)
Dr Kenric Malmberg
Family MD40.00$240,820$0$24,705Yes (X)
Debbie Smith
CRNA40.00$232,330$0$21,530Yes (X)
Dr Josh Henderson
Internal Medicine40.00$200,397$0$22,688Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,855,861TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$186,854TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K12IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
JDH Construction
PO Box 1511AberdeenSD57401General Contractor$2,268,766
St Alexius Medical Center
900 East BroadwayBismarckND58506IT services, CEO salary, supplies, etc$288,471
CPI Group
7400 E Orchard Rd 270Greenwood VillageCO80111Architect Services$277,557
Northern Plains Lab
PO Box 2036BismarckND58502Outsource laboratory services$119,109
Mondak Imaging Services
11 South 7th St 241Miles CityMT59301MRI services$118,708
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$930,970GovernmentGrantsAmt
All Other Contributions$285,170AllOtherContributionsAmt
Total Contributions$1,216,140TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue623110$16,958,066$16,958,066
Assisted Living Revenue623110$494,285$494,285
Change in Foundation Interest900099$108,220$108,220
Ancillary Charges900099$66,394$66,394
FieldValueIRS element (for citing)
Total Program Service Revenue$17,626,965TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,022TotalRevenueColumnAmt
Exclusion$16,022ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$98,917RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$98,917RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$98,917TotalRevenueColumnAmt
Exclusion$98,917ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,011,189SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,052,088SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$40,899SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$40,899TotalRevenueColumnAmt
Exclusion-$40,899ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,917,145TotalRevenueColumnAmt
Related Or Exempt Func Income$17,626,965RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$74,040ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$860,626TotalAmt
Program Services$598,816ProgramServicesAmt
Management And General$261,810ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,126,234TotalAmt
Program Services$6,482,429ProgramServicesAmt
Management And General$643,805ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$238,126TotalAmt
Program Services$217,108ProgramServicesAmt
Management And General$21,018ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,022,443TotalAmt
Program Services$1,022,443ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$501,322TotalAmt
Program Services$448,886ProgramServicesAmt
Management And General$52,436ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$91,212TotalAmt
Management And General$91,212ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,477TotalAmt
Management And General$5,477ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$54,551TotalAmt
Management And General$54,551ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$612,334TotalAmt
Program Services$612,334ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$87,655TotalAmt
Program Services$5,491ProgramServicesAmt
Management And General$82,164ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$254,334TotalAmt
Program Services$112,085ProgramServicesAmt
Management And General$142,249ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$144,940TotalAmt
Program Services$2,271ProgramServicesAmt
Management And General$142,669ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$357,241TotalAmt
Program Services$352,690ProgramServicesAmt
Management And General$4,551ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$39,138TotalAmt
Program Services$39,138ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$54,433TotalAmt
Program Services$48,585ProgramServicesAmt
Management And General$5,848ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$200,689TotalAmt
Management And General$200,689ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,581,195TotalAmt
Program Services$1,581,195ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$176,578TotalAmt
Program Services$80,927ProgramServicesAmt
Management And General$95,651ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,989,523$1,989,523
BAD DEBT$1,806,778$1,806,778
EQUIPMENT AND MAINTENAN$1,113,935$1,113,935
DUES AND SUBSCRIPTIONS$37,747$37,747

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$167,368TotalAmt
Program Services$64,937ProgramServicesAmt
Management And General$102,431ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,523,879TotalAmt
Program Services$16,579,571ProgramServicesAmt
Management And General$1,944,308ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,183,801BOYAmt
EOY$4,004,159EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,895,950BOYAmt
EOY$3,981,080EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$30,054BOYAmt
EOY$18,296EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$514,594BOYAmt
EOY$343,195EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$183,699BOYAmt
EOY$139,556EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$28,560,303LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,828,745LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,041,180BOYAmt
EOY$12,731,558EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$835,513BOYAmt
EOY$320,461EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$694,233BOYAmt
EOY$1,375,388EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$20,379,024BOYAmt
EOY$22,913,693EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,665,770BOYAmt
EOY$1,566,894EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,524,527BOYAmt
EOY$1,167,197EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,130,000BOYAmt
EOY$3,800,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$431,990BOYAmt
EOY$3,299,489EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$264,308BOYAmt
EOY$324,418EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,016,595BOYAmt
EOY$10,157,998EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,683,291BOYAmt
EOY$11,956,609EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$679,138BOYAmt
EOY$799,086EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,362,429BOYAmt
EOY$12,755,695EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,379,024BOYAmt
EOY$22,913,693EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$393,266ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$95,575OtherCostOrOtherBasisAmt
Book Value$95,575BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,832,960OtherCostOrOtherBasisAmt
Depreciation$7,254,080DepreciationAmt
Book Value$7,578,880BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,362,474OtherCostOrOtherBasisAmt
Depreciation$8,265,699DepreciationAmt
Book Value$4,096,775BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,269,294OtherCostOrOtherBasisAmt
Depreciation$308,966DepreciationAmt
Book Value$960,328BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,731,558TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Deferred Financing Costs$75,070
Under Indenture Agreements$615,717
Interest in Foundation$684,601
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,375,388TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Premium on Bonds Payable$9,957
Deferred Compensation Plan Payable$314,461
FieldValueIRS element (for citing)
Total Liability$324,418TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$16,990,419TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$1,704,021OtherRevenueAmt
Revenue Not Reported-$1,704,021RevenueNotReportedAmt
Revenue Subtotal$18,694,440RevenueSubtotalAmt
Other Revenues Not Included$222,705OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$222,705RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$18,917,145TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$16,717,101TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$16,717,101ExpensesSubtotalAmt
Other Expenses Not Included$1,806,778OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,806,778ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$18,523,879TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The Organization is a South Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Organization is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital 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:Bad Debt Reclassified as Expense -1,806,778. Net assets released from restriction 102,757.
Part XI, Line 4b - Other Adjustments:Change in interest in Foundation 108,220. Restricted grants and contributions 114,485.
Part XII, Line 4b - Other Adjustments:Bad Debt Reclassified as Expense 1,806,778.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$94,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$94,000NetCommunityBenefitExpnsAmt
Total Expense0.00560TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,217,695TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,573,413DirectOffsettingRevenueAmt
Net Community Benefit Expns$644,282NetCommunityBenefitExpnsAmt
Total Expense0.03850TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,311,695TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,573,413DirectOffsettingRevenueAmt
Net Community Benefit Expns$738,282NetCommunityBenefitExpnsAmt
Total Expense0.04410TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,997,140TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$742,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,254,890NetCommunityBenefitExpnsAmt
Total Expense0.13490TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,997,140TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$742,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,254,890NetCommunityBenefitExpnsAmt
Total Expense0.13490TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,308,835TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,315,663DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,993,172NetCommunityBenefitExpnsAmt
Total Expense0.17900TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,806,778BadDebtExpenseAmt
Bad Debt Expense Attributable$1,355,084BadDebtExpenseAttributableAmt
Reimbursed By Medicare$4,985,621ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$5,014,507CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$28,886MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mobridge Regional HospitalBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11401 10th Avenue WAddressLine1
CityMobridgeCity
StateSDState
ZIP Code57601ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.mobridgehospital.orgWebsiteAddressTxt
State License48404StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mobridge Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLsee 5dOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
Other Needs AddressedYes (X)OtherNeedsAddressedInd
All Needs Addressed0AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Available On RequestYes (X)AvailableOnRequestInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledYes (1)AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Mobridge Regional HospitalPart V, Section B, Line 3: The facility obtained data for the community health needs assessment through focus groups, surveys and personal interviews involving community leaders, community healthcare providers, coordinating agencies, community members and the underserved population.
Mobridge Regional HospitalPart V, Section B, Line 5d: www.mobridgehospital.org/community-outreach/
Mobridge Regional HospitalPart V, Section B, Line 6i: The organization's implementation strategy can be accessed at www.mobridgehospital.org/community-outreach/Financial feasibility studies for identified needs were completed by St. Alexius Medical Center.
Mobridge Regional HospitalPart V, Section B, Line 7: Pursuant to the implementation strategy adopted by Mobridge Regional Hospital, providing cancer care and kidney dialysis will not be addressed. Because of Mobridge's size, the ability to recruit and retain physicians to provide cancer care and highly specialized care is nearly impossible. Financial feasibility studies were completed for needs identified. We found the cost to add kidney dialysis was far too great and we are therefore unable to provide this particular service. Additionally, the community had a concern regarding travel for the treatment of cancer. The Organization has and continues to meet the need of helping patients with travel expenses by supporting the local cancer foundation.
Mobridge Regional HospitalPart V, Section B, Line 14g: A financial assistance notice is made part of the billing invoice. A financial assistance notice is posted in the emergency room, waiting rooms, and admissions office, and the full policy is made available upon request.
Mobridge Regional HospitalPart V, Section B, Line 18e: Provided financial assistance information with patient discharge materials.
Mobridge Regional HospitalPart V, Section B, Line 20d: The maximum amount charged to a patient under the financial assistance policy for emergency and medically necessary care is 50% of the gross charges. This is based on the lowest discount under the charity care policy of 50%. The Financial Assistance Policy has been updated to comply with Section 501(r).
Mobridge Regional HospitalPart V, Section B, Line 21: The hospital provides a reduction to gross charges under the following conditions: patients indicate they have family income of no more than 300% of FPG, are uninsured or underinsured, and complete the required paperwork to be eligible for financial assistance.The hospital has not determined the amount generally billed under the various proposed methods of calculation. Therefore, it is possible a patient under the financial assistance policy could have paid more than the amount generally billed.
Mobridge Regional HospitalPart V, Section B, Line 22: The financial assistance policy covers medically necessary services only. Therefore, the hospital may have charged FAP-eligible individuals an amount equal to gross charges for nonmedically necessary services.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
Prairie Sunset Village
1320 W Grand XingMobridgeSD57601Assisted Living & Senior Housing
Mobridge Medical Clinic
1309 10th Ave WMobridgeSD57601Provider Based Rural Health Clinic
West River Health Clinic
103 1st Avenue EMcLaughlinSD57642Provider Based Rural Health Clinic
West Dakota Health Clinic
906 MainTimber LakeSD57656Provider Based Rural Health Clinic

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:MRH offers financial assistance discounts of up to 95% to patients that are at or below 80% of FPG and financial assistance discounts of up to 90% for patients at 81%-90% of FPG. Please refer to Part V, Line 12 for other factors used in determining financial assistance eligibility.
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. Line 7b was determined using the Medicaid PS&R report and the general ledger accounting system. Line 7g was determined using the Medicare cost report for fiscal year ending 9/30/14.
Part I, Ln 7 Col(f):Bad debt expense of $1,806,778 was subtracted from total operating expense.
Part III, Line 4:a) Bad debt expense on Part III Lines 2 and 3 is based on charges. When a payment is received or a discount given on a bad debt account it offsets the current fiscal year bad debt expense through a recovery of bad debt account. b) Bad debt expense attributable to financial assistance is estimated based on income levels. A large portion of MRH charges are generated by those below the poverty level. Statistics prove that most of the mentioned patients qualify for financial assistance. After review, MRH estimates approximately 75% of bad debt at cost is attributable to persons who would qualify for financial assistance. c) The footnote for bad debt expense is located on pages 8 and 9 of the attached audited financial statements.
Part III, Line 8:Medicare Allowable Cost of Care was calculated from the Medicare Cost Report for fiscal year ending 9/30/14. The entire shortfall should be treated as a community benefit. The shortfall is the direct result of sequestration enactments put in place by the Federal government.
Part III, Line 9b:The patient account specialist at the Mobridge Regional Hospital keeps on file all guarantors who have qualified for financial assistance and applies the financial assistance to all accounts when the guarantor balance becomes due. Updated financial information is requested annually for any changes in financial assistance that may apply.
Part VI, Line 2:Mobridge Regional Hospital (MRH) is committed to providing high quality healthcare services to all people throughout the region. The facility provides family medicine, internal medicine, OB, ICU, ALS, ambulance service, emergency care, and surgical services to all people who are in need of those services. MRH currently is working in collaboration with Walworth County and the State of South Dakota to provide Community Health Services, including family planning services, adult health, and child immunizations. MRH's management strives to listen to the community needs. If new healthcare needs arise, administration will complete an analysis of cost/benefit for the new service to be offered. MRH's administration believes in being out in the public at events to answer questions that may surface about the facility. During the year ended 9/30/13 the community health needs assessment was completed. Please see Schedule H Part V for more information.
Part VI, Line 3:MRH posts its financial assistance policy, or a summary thereof, and financial assistance contact information in the admissions areas and clinic areas in which eligible patients are likely to be present. The facility provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients with discharge materials. The Patients Account Manager discusses with the patient the availability of various government benefits, such as Medicaid or state programs, and assists the patient with qualification for such programs, where applicable.MRH's financial assistance program is available to both new and established patients. The financial assistance policy covers all medically necessary services provided by the institution that are ordered by physicians.MRH's financial assistance program is available to all patients who indicate an inability to pay and meet the criteria as established by the hospital for all or a portion of their outstanding hospital bill.
Part VI, Line 4:MRH is located in a small rural community in Walworth County, South Dakota, known as Mobridge. According to the 2010 Census, Mobridge has a population of 3,465 people racially comprised of mainly Caucasian (75.67%) and Native Americans (20.46%). The community borders the Standing Rock Reservation and the Cheyenne River Reservation which accounts for the larger Native American population and relations with Indian Health Services. The median household income of Mobridge is $37,417, and the median family income is $52,316. Roughly 17.6% of the population is below the poverty line. The facility owns and operates clinics in Mobridge, McLaughlin and Timber Lake. The facility serves patients from a six county area (Walworth, Ziebach, Corson, Dewey, Campbell and Potter) and is approximately one hundred miles from another hospital with a higher level of care offered. According to the 2010 Census, Ziebach county is the poorest county in America, and 62% of people living in this county are under federal poverty guidelines. Corson County ranked 9th of the poorest counties in America. The poverty level in Mobridge is 59.1% greater than the South Dakota average and 75.5% greater than the National average. The median earnings for males is 50.3% greater than the median earnings for females in Mobridge.
Part VI, Line 5:The Mobridge Regional Hospital is committed to the patients we serve, regardless of race, color, religion, sex, disability, or ability to pay. The organization's financial assistance adjustments have continued to trend up over the past few years, and we continue to focus budget efforts to continue this trend. MRH is 100 miles from another healthcare facility with a higher level of care and participates in the North Dakota and South Dakota trauma systems with level III and level IV certifications, respectively. MRH continues a broad level of board involvement for Corson, Dewey, and Walworth Counties to monitor community needs in those areas. MRH continues to be a popular place for medical students to complete clinical rotations, and we continue to offer a wide variety of certification classes to nurses and the members of the community including EMT-B, PALS, ACLS, TNCC, ALSO, NALS, EMT-I, and CPR. MRH has developed a worksite wellness program within the organization and has goals to work with other businesses in the community to promote overall healthy lifestyles.MRH provides various health screenings available to the community and surrounding communities throughout the year. The health screenings include free cholesterol checks, BMI, blood pressure and waist/hip ratios. These preventative health screenings promote the general health of the community.The hospital has a Board of Directors comprised of volunteers who reside in the service area. Medical staff privileges are extended to all qualified physicians in the area. All qualified physicians who show an interest must go through a credential review and board approval. Surplus funds, if available, are reinvested in the facilities to improve patient care.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Dr Travis Henderson
Internal Medicine/Director$211,583$0$22,685$0$8,138$0$9,583$0$18,059$0$270,048$0$0$0
Dr Robert Marciano
Family MD/Director$219,999$0$59,440$0$5,012$0$10,200$0$10,463$0$305,114$0$0$0
Dr Bela Csaki
Surgeon$303,332$0$0$0$9,217$0$10,200$0$9,266$0$332,015$0$0$0
Dr Colette Reule
Family MD$181,870$0$78,242$0$5,483$0$10,200$0$15,722$0$291,517$0$0$0
Dr Kenric Malmberg
Family MD$180,547$0$54,708$0$5,565$0$9,419$0$15,642$0$265,881$0$0$0
Debbie Smith
CRNA$231,537$0$0$0$793$0$9,393$0$12,537$0$254,260$0$0$0
Dr Josh Henderson
Internal Medicine$176,750$0$17,885$0$5,762$0$7,794$0$15,240$0$223,431$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 7FormAndLineReferenceDesc
ExplanationThe physicians are paid based on relative value unit based production.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1City of Mobridge South DakotaBusinessNameLine1
FieldValueIRS element (for citing)
Bond Issuer EIN466000320BondIssuerEIN
CUSIP607429BA4CUSIPNum
Bond Issued2007-05-08BondIssuedDt
Issue Price$5,773,898IssuePriceAmt
PurposeRefinance bonds issued 1997 used for construction; purchase CT, Clinic & EMRPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,955,000RetiredAmt
Total Proceeds$5,773,898TotalProceedsAmt
In Reserve Fund$265,908InReserveFundAmt
Issuance Costs From Proceeds$88,005IssuanceCostsFromProceedsAmt
Capital Expenditures$1,000,000CapitalExpendituresAmt
Other Spent Proceeds$4,416,499OtherSpentProceedsAmt
Substantial Completion2008SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance RefundingYes (1)AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDate Rebate Computation PerformedFormAndLineReferenceDesc
ExplanationIssuer Name: City of Mobridge, South Dakota Date the Rebate Computation was Performed: 07/13/2012ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 3MRH currently has a management agreement with St. Alexius Medical Center in Bismarck, ND. The agreement provides the CEO, Angelia K. Svihovec, and information technology support at a cost to MRH. The original management agreement date was January 1, 2000. Angelia Svihovec, CEO, received W-2 compensation of $155,737 during the calendar year ended 12/31/13.
Form 990, Part VI, Section A, line 6There is only one class of member; all members have one vote (same voting rights).
Form 990, Part VI, Section A, line 7aThe nominating committee nominates candidates for election. The members vote on candidates at the annual meeting.
Form 990, Part VI, Section A, line 8bThere is no committee with the authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11The CEO, CFO, and Finance Committee will review the Form 990 prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cThe conflict of interest policy covers the entire Board of Directors. If a conflict should arise, it would first go to the CEO for evaluation, then to the Board of Directors for final evaluation. The Board of Directors is responsible for making the final decision in determining if a conflict exists. If a conflict is found, the person(s) involved would be required to abstain from discussions and voting on the item causing the conflict.
Form 990, Part VI, Section B, line 15The Finance Committee determines and approves the physician contracts, including compensation. The CEO's salary is determined using a salary survey and discussions with the management company. The Finance Committee approves the salary of the CEO annually. The Board of Directors approves the Finance Committee minutes, which include discussions regarding the CEO's salary. Salaries for other Officers or members of management are determined by the CEO through the use of salary survey information from SDAHO and employee service and experience files. Salary increases were implemented on September 8th, 2013.
Form 990, Part VI, Section C, line 19Documents are made available upon request.

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