2014-06-26T08:21:18-05:00 2013-09-30 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2012-10-01 460401085 Lemmon Area Medical Association LEMM 6053743871 401 6th Avenue West PO Box 479 Lemmon SD 57638 Chad Abel 6053743871 2014-06-10 1 Laurie Hanson P00851848 6053391999 2014-05-27 2012 2015-11-30 17:44:51Z X Five Counties Nursing Home Chad Abel 401 6th Avenue West PO Box 479 Lemmon SD 57638 2728976 0 X www.fivecounties.org X 1952 SD To provide health care to the residents of Lemmon, South Dakota. 7 7 69 75 0 0 86835 163391 2664996 2515701 472 -2276 24000 35776 2776303 2712592 0 0 0 0 1680978 1765106 0 0 0 1252462 1245268 2933440 3010374 -157137 -297782 2460746 2238476 1301323 1359082 1159423 879394 Five Counties Nursing Home is committed to preserving and improving the quality of life for the people we serve. 0 0 2725054 2515701 Lemmon Area Medical Association ("Association") is a nonprofit association whose purpose is to operate Five Counties Nursing Home and to raise the funds necessary for its operation. Five Counties Nursing Home consists of a 43-bed nursing home and a 10-unit assisted living facility. For the year ended September 30, 2013, the Association provided 14,066 nursing home days of care and 196 days of assisted living. 2725054 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 16 0 1 69 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 0 0 X Lemmon Area Medical Association 6053743871 PO Box 479 Lemmon SD 57638 Bryan Peterson 1.00 X X 0 0 0 Jeannie Ericsson 1.00 X X 0 0 0 Debra Ruen 1.00 X X 0 0 0 Mel Maxon 1.00 X X 0 0 0 Richard Greff 1.00 X 0 0 0 Kim Petik 1.00 X 0 0 0 Mark Evans 1.00 X 0 0 0 Patricia Raasch Oct-Jul 40.00 X 26208 0 6572 Deb Arbogast 40.00 X 128966 0 10154 Rita Kling 40.00 X 105222 0 8771 260396 0 25497 2 0 0 0 Prime Time Healthcare LLC 306 E 1st St Ste 2 Papillion NE 68046 Nursing Staff 180705 Dakota Travel Nurse 502 W Main St Mandan ND 58554 Nursing Staff 122350 2 163391 163391 Program Svc Revenue 623000 2450793 2450793 Other Revenue 900099 38946 38946 Assisted Living 623000 19140 19140 Dietary Revenue 623000 6822 6822 2515701 259 259 25000 0 25000 25000 25000 4974 7509 -2535 -2535 -2535 19651 8875 10776 10776 2712592 2515701 0 33500 X 6359 6359 1373912 1249951 123961 9670 8768 902 272651 248809 23842 102514 92953 9561 456 456 24927 24927 457604 449336 8268 7703 7703 74457 50183 24274 121880 121179 701 24393 13345 11048 129 129 54018 54018 201153 201153 20390 20390 Supplies - Program Rela 195073 195073 Equipment Maintenance 28073 19767 8306 Sale Tax Expense 12350 12350 Dues and Subscription 4627 4627 18035 18035 3010374 2725054 285320 0 658832 573687 108094 95557 35237 36952 10425 4648 4699393 3171761 1648158 1527632 2460746 2238476 166688 217102 1134635 1141980 1301323 1359082 X 756288 526933 301175 239774 101960 112687 1159423 879394 2460746 2238476 -297782 17753 0 X 0 1 X 0 0 X 215533 280506 263900 86835 163391 1010165 2576087 2602379 2406017 2664996 2535352 12784831 2791620 2882885 2669917 2751831 2698743 13794996 0 871896 769495 724185 784643 765603 3915822 871896 769495 724185 784643 765603 3915822 9879174 42871 26871 23468 24472 25259 142941 42871 26871 23468 24472 25259 142941 2834491 2909756 2693385 2776303 2724002 13937937 0.70880 0.72960 0.01030 0.01350 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 9354 68100 71629 5825 0 105081 21272 126353 82085 22996 105081 65951 16134 82085 36138 30721 172 1081 65951 33353 3529 172 916 36138 0.00000 0.97000 0.03000 1 0 4837 4837 2445871 1386950 1058921 2153040 1710454 442586 95645 74357 21288 1527632 X 2739220 17753 8875 26628 2712592 0 2712592 3019249 8875 8875 3010374 0 3010374 Part IV, Line 1b: Funds are held in trust for residents. The organization acts as a payee for residents. Description of Intended Use of Endowment Funds: Part V, Line 4: Will use interest for capital expenditures but first the funds must reach $150,000 before the organization will begin to receive the interest Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Association 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 Association is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. The Association 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 Association will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. Best for Last 19651 19651 7000 1875 19651 19651 7000 1875 8875 10776 Form 990, Part VI, Section A, line 8b The organization does not have committees with broad authority to act on behalf of the governing board. Form 990, Part VI, Section B, line 11 The Administrator reviews the 990 in detail. After his review, the 990 is provided to each board member. The Administrator presents the 990 to the Board of Directors at the meeting held prior to its filing. The 990 is not filed until each board member has been given a copy of it and given ample time to review it. Form 990, Part VI, Section B, line 12c Board members, department heads and the Administrator are covered by the policy. Any potential conflicts are directed to the Secretary. The Board of Directors determines whether a conflict exists. If the person with the conflict is a board member, that person is required to leave the meeting during the discussion. If a conflict exists, the board member involved is required to abstain from voting. Form 990, Part VI, Section B, line 15a The organization uses salary information provided by South Dakota Association of Healthcare Organizations (SDAHO) to determine the appropriate level of compensation for the Administrator. The Administrator's compensation does not exceed the amount determined by SDAHO surveys. Minutes are kept regarding the discussion, deliberation, and determination of the Administrator's salary. The process for determining compensation was last undertaken in 2013. Form 990, Part VI, Section C, line 19 The conflict of interest policy, bylaws, and articles of incorporation are available to the general public upon request. The financial statements are not available to the general public. Other Fees Form 990, Part IX, line 11g Professional Medical Fees: Program service expenses 449,336. Management and general expenses 0. Fundraising expenses 0. Total expenses 449,336. Fiscal services: Program service expenses 0. Management and general expenses 5,218. Fundraising expenses 0. Total expenses 5,218. Consulting and management: Program service expenses 0. Management and general expenses 3,050. Fundraising expenses 0. Total expenses 3,050. Lemmon Prairie Pines Apartments 401 Sixth Avenue West Lemmon SD 576380479 460442677 Low Income Housing SD 501(c)(3) 9 None 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0