COOPERSTOWN MEDICAL CENTER: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
COOPERSTOWN MEDICAL CENTER (EIN 45-0227753)
Tax period
2023-07-01 to 2024-06-30
Filed
2025-12-23
IRS object ID
202513579349300226
Schema version
2023v6.0
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)
Return2025-12-23T11:18:22-06:00ReturnTs
Tax Period End2024-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14585 Coleman St Ste 200AddressLine1Txt
CityBismarckCityNm
State AbbreviationNDStateAbbreviationCd
ZIP58503ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN450227753EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cooperstown Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOOPBusinessNameControlTxt
Phone7017861700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1107 12th St SAddressLine1Txt
CityCooperstownCityNm
State AbbreviationNDStateAbbreviationCd
ZIP584254501ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNicole LindseyPersonNm
Person TitleCEO/AdministratorPersonTitleTxt
Phone7017861700PhoneNum
Signature2025-12-23SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLisa Chaffee CPAPreparerPersonNm
PTINP00193453PTIN
Phone7012551091PhoneNum
Preparation2025-12-22PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Dakota Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerNicole LindseyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1107 12th St SAddressLine1Txt
CityCooperstownCityNm
State AbbreviationNDStateAbbreviationCd
ZIP584254501ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,796,430GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://www.dakotaregional.com/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateNDLegalDomicileStateCd
Activity Or MissionProvide health care services to the residents including the elderly in the Cooperstown, North Dakota and surrounding communities regardless of the ability to pay.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee77TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,565,677PYContributionsGrantsAmt
CY Contributions Grants$1,450,986CYContributionsGrantsAmt
PY Program Service Revenue$5,804,332PYProgramServiceRevenueAmt
CY Program Service Revenue$6,917,599CYProgramServiceRevenueAmt
PY Investment Income-$468,367PYInvestmentIncomeAmt
CY Investment Income-$38,681CYInvestmentIncomeAmt
PY Other Revenue$1,870PYOtherRevenueAmt
CY Other Revenue$2,040CYOtherRevenueAmt
PY Total Revenue$6,903,512PYTotalRevenueAmt
CY Total Revenue$8,331,944CYTotalRevenueAmt
PY Grants And Similar Paid$5,890PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,753CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,970,275PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,285,430CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,462,019PYOtherExpensesAmt
CY Other Expenses$4,161,998CYOtherExpensesAmt
PY Total Expenses$6,438,184PYTotalExpensesAmt
CY Total Expenses$8,453,181CYTotalExpensesAmt
PY Revenues Less Expenses$465,328PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$121,237CYRevenuesLessExpensesAmt
Total Assets BOY$27,832,409TotalAssetsBOYAmt
Total Assets EOY$27,345,540TotalAssetsEOYAmt
Total Liabilities BOY$23,706,194TotalLiabilitiesBOYAmt
Total Liabilities EOY$23,340,562TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,126,215NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,004,978NetAssetsOrFundBalancesEOYAmt
MissionCooperstown Medical Center is dedicated to providing high quality healthcare services in a personalized, compassionate, and professional manner.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$6,877,999ExpenseAmt
Grant$5,753GrantAmt
Revenue$6,917,599RevenueAmt
DescA 9-bed critical access hospital. Helping to relieve the added stress of extended travel, the organization is able to provide locally many of the services found at large hospitals. Through strong affiliations with major medical organizations, Cooperstown Medical Center is able to provide: 24-hour emergency services, occupational therapy, x-ray and laboratory services, electrocardiography, respiratory therapy, incontinence management, therapy, physical therapy, speech therapy, cardiac monitoring/telemetry, chemotherapy, swing bed, respite and hospice care.Desc
Total Program Service Expenses$6,877,999TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
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 Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee77EmployeeCnt
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
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
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 CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
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 Line1Judy MonsonBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7017972221PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1107 12th St SAddressLine1Txt
CityCooperstownCityNm
State AbbreviationNDStateAbbreviationCd
ZIP584254501ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Barry Getz
President1.000.00Yes (X)Yes (X)$0$0$0
Gerald Stokka
Vice President1.000.00Yes (X)Yes (X)$0$0$0
Benjamin Halvorson
Secretary/Treasurer1.000.00Yes (X)Yes (X)$0$0$0
James Halvorson
Director (Until Oct 23)1.001.00Yes (X)$0$0$0
Larry Grandalen
Director1.000.00Yes (X)$0$0$0
Nicole Lindsey
CEO - Administrator12.001.00Yes (X)$57,824$0$11,754
Judy Monson
CFO28.001.00Yes (X)$74,321$0$34,028
Barbara Anderson
CFO (Until Aug 23)28.001.00Yes (X)$73,635$0$0
Steven Barlow
Provider40.000.00$348,322$0$56,262Yes (X)
Lanette Harr-Isakson
Nurse40.000.00$103,361$0$8,790Yes (X)
Liza Ystaas
Provider40.000.00$143,145$0$32,608Yes (X)
Kali Manz
Provider40.000.00$146,005$0$22,523Yes (X)
Debra Middleton
NP (Until Oct 23)40.000.00$156,225$0$25,097Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,102,838TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$191,062TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Altru Health System
1200 S Columbia RoadGrand ForksND58201Therapy and Software Services$386,560
Netcenter Technologies
2536 Main Ave WWest FargoND58078IT Services$161,416
RTG Medical
4611 E 22nd StreetFreemontNE68025Radiology Services$145,556
National Medical Resources
2792 E Broadway AveBismarckND58501Provider Locums$133,935
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Related Organizations$1,040,000RelatedOrganizationsAmt
Government Grants$410,986GovernmentGrantsAmt
Total Contributions$1,450,986TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient and Resident Revenue623000$6,296,088$6,296,088
Assisted Living Rental623000$197,115$197,115

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$424,396TotalRevenueColumnAmt
Related Or Exempt Func Income$424,396RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$6,917,599TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$425,805TotalRevenueColumnAmt
Exclusion$425,805ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,040RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,040RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,040TotalRevenueColumnAmt
Exclusion$2,040ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$464,486OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$464,486OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$464,486TotalRevenueColumnAmt
Exclusion-$464,486ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,331,944TotalRevenueColumnAmt
Related Or Exempt Func Income$6,917,599RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$36,641ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$5,753TotalAmt
Program Services$5,753ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$238,732TotalAmt
Management And General$238,732ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$67,194TotalAmt
Management And General$67,194ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,392,395TotalAmt
Program Services$2,950,137ProgramServicesAmt
Management And General$442,258ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$48,817TotalAmt
Program Services$40,109ProgramServicesAmt
Management And General$8,708ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$287,345TotalAmt
Program Services$264,270ProgramServicesAmt
Management And General$23,075ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$250,947TotalAmt
Program Services$206,185ProgramServicesAmt
Management And General$44,762ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$28,076TotalAmt
Program Services$151ProgramServicesAmt
Management And General$27,925ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$58,124TotalAmt
Management And General$58,124ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,547,859TotalAmt
Program Services$1,223,244ProgramServicesAmt
Management And General$324,615ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$13,296TotalAmt
Program Services$214ProgramServicesAmt
Management And General$13,082ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$40,026TotalAmt
Program Services$19,342ProgramServicesAmt
Management And General$20,684ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$245,504TotalAmt
Program Services$202,169ProgramServicesAmt
Management And General$43,335ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$26,006TotalAmt
Program Services$22,659ProgramServicesAmt
Management And General$3,347ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$24,139TotalAmt
Program Services$15,191ProgramServicesAmt
Management And General$8,948ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$609,982TotalAmt
Program Services$532,331ProgramServicesAmt
Management And General$77,651ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$825,284TotalAmt
Program Services$757,388ProgramServicesAmt
Management And General$67,896ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$108,000TotalAmt
Program Services$108,000ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$473,361$473,361
Dues and Subscriptions$76,922$14,448$62,474
Repairs and Maintenance$32,974$32,839$135

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$52,445TotalAmt
Program Services$10,208ProgramServicesAmt
Management And General$42,237ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,453,181TotalAmt
Program Services$6,877,999ProgramServicesAmt
Management And General$1,575,182ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$921,614BOYAmt
EOY$2,396EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$400,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,063,892BOYAmt
EOY$1,518,168EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$90,954BOYAmt
EOY$88,542EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$99,028BOYAmt
EOY$123,229EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$18,727,849LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,106,319LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,701,589BOYAmt
EOY$13,621,530EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,495,737BOYAmt
EOY$529,586EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$10,459,595BOYAmt
EOY$11,062,089EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,832,409BOYAmt
EOY$27,345,540EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$783,539BOYAmt
EOY$550,167EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$25,900BOYAmt
EOY$26,880EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$22,765,536BOYAmt
EOY$22,417,475EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$131,219BOYAmt
EOY$346,040EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,706,194BOYAmt
EOY$23,340,562EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,126,215BOYAmt
EOY$4,004,978EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,126,215BOYAmt
EOY$4,004,978EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,832,409BOYAmt
EOY$27,345,540EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$121,237ReconcilationRevenueExpnssAmt
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)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$234GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$234TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe Organization is a member of several organizations that take part in lobbying. A portion of the dues paid to the various organizations is for lobbying costs. These various organizations advocate on behalf of their members by supporting legislation that is in their collective interests.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$395,017OtherCostOrOtherBasisAmt
Book Value$395,017BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,068,298OtherCostOrOtherBasisAmt
Depreciation$3,340,089DepreciationAmt
Book Value$10,728,209BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,699,855OtherCostOrOtherBasisAmt
Depreciation$1,645,702DepreciationAmt
Book Value$2,054,153BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$564,679OtherCostOrOtherBasisAmt
Depreciation$120,528DepreciationAmt
Book Value$444,151BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,621,530TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Estimated Third Party Payors$890,000
Right of Use Assets$313,180
Investment in Sales-Type Lease$9,858,909
FieldValueIRS element (for citing)
Total Book Value Other Assets$11,062,089TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Related Party Payable$210
Interest Payable$30,167
Lease Liability$315,663
FieldValueIRS element (for citing)
Total Liability$346,040TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$8,331,944TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$8,331,944RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$8,331,944TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,453,181TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$8,453,181ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,453,181TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:Security deposits advanced by tenants of the assisted living units are held in trust by the Organization. These funds are included in cash and cash equivalents and accounts payable in the consolidated financial statements. Tenant security deposits totaled $26,880 and $25,900 at June 30, 2024 and 2023.
Part X, Line 2:The Medical Center believes that they have appropriate support for any tax positions taken affecting their annual filing requirements, and as such, do not have any uncertain tax positions that are material to the consolidated 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.

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
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,000NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$417,178TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$392,217DirectOffsettingRevenueAmt
Net Community Benefit Expns$24,961NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$435,178TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$392,217DirectOffsettingRevenueAmt
Net Community Benefit Expns$42,961NetCommunityBenefitExpnsAmt
Total Expense0.00510TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,261,391TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$814,145DirectOffsettingRevenueAmt
Net Community Benefit Expns$447,246NetCommunityBenefitExpnsAmt
Total Expense0.05290TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,261,391TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$814,145DirectOffsettingRevenueAmt
Net Community Benefit Expns$447,246NetCommunityBenefitExpnsAmt
Total Expense0.05290TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,696,569TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,206,362DirectOffsettingRevenueAmt
Net Community Benefit Expns$490,207NetCommunityBenefitExpnsAmt
Total Expense0.05800TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$501,465BadDebtExpenseAmt
Bad Debt Expense Attributable$167,155BadDebtExpenseAttributableAmt
Reimbursed By Medicare$3,307,807ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$3,337,168CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$29,361MedicareSurplusOrShortfallAmt

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 Line1Cooperstown Medical Center DBA DRMCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1107 12th St SAddressLine1Txt
CityCooperstownCityNm
State AbbreviationNDStateAbbreviationCd
ZIP58425ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.dakotaregional.comWebsiteAddressTxt
State License5010StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
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 Line1Cooperstown Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
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
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Page 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Page 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Page 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Page 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Page 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Cooperstown Medical CenterPart V, Section B, Line 5: To gather feedback from the community, residents of the area were given the opportunity to participate in a survey. Seventy-five CMC service area residents completed the survey. Additional information was collected through five key informant interviews with community members. The input from the residents, who primarily reside in Griggs County, represented the broad interests of the communities in the service area. Together with secondary data gathered from a wide range of sources, the survey presents a snapshot of the health needs and concerns in the community. A community group met on March 28, 2022. Twelve community members attended the meeting.
Cooperstown Medical CenterPart V, Section B, Line 11: The community members voted on the needs identified to determine the ones deemed most significant. The needs were ranked as follows:1. Attracting and retaining young families2. Having enough child daycare services3. Not enough affordable housing4. Availability of mental health services5. Depression and anxiety for all agesFrom those top five priorities, each person voted on the one concern they felt was the most important. The rankings were: 1. Attracting and retaining young families (3 votes) 2. Having enough child daycare services (2 votes) 3. Availability of mental health services (2 votes) 4. Depression and anxiety for all ages (2 votes)The Hospital will not address the following health needs identified in the CHNA due to limited resources and the need to allocate significant resources to the two priority health needs identified above: 1. Attracting and retaining young families. 2. Adequate childcare services.In fiscal year 2024, the following actions were taken to address the needs of the latest CHNA:We added two mental health professionals, so we now have mental health services available two times a week with varying services. A couple of service providers are able to prescribe medicine and one provides therapy. Because childcare services were identified as a need on the assessment, internal and external conversations occurred on the possibility of addressing this need but did not work out. In FY24, the Chief Nursing Officer continued to attended parent teacher conferences and other events at the school promoting suicide prevention and mental health awareness. The CNO also worked with the school paramedic on educational presentations as well as suicide prevention.
Part V, Section B, Line 7a and 10a:https://www.dakotaregional.com/about-7
Part V, Section B, Line 16a-c:Line 16a: https://www.dakotaregional.com/about-7Line 16b: https://www.dakotaregional.com/about-7Line 16c: https://www.dakotaregional.com/payment-policy

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report.
Part II, Community Building Activities:The Organization participates in community building activities, however, the activities are too difficult to quantify and are not tracked.
Part III, Line 2:The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients.
Part III, Line 3:CMC used the percentage of charity care/financial assistance applications that were denied due to lack of sufficient information or were never returned to determine the amount of implicit price concessions that is attributable to patients who would likely qualify for charity. For FY 2024 approximately 33% of applications lacked information or were never returned after patient was given an application to complete.
Part III, Line 4:The footnote to the Organization's financial statements can be found on pages 13 and 14 of the attached audited financial statements.
Part III, Line 8:Hospital services remibursed on a fee schedule are not included in the Medicare calculations per the 990 instructions. Had this been reported the Hospital would have had a greater loss from Medicare services of $59,813.$39,819 - Medicare fee schedule revenue($99,632) - Medicare estimated costs of care relating to payment($59,813) - Net (shortage)
Part III, Line 9b:When patients are known to qualify for financial assistance, they are requested to fill out a financial assistance application and collection actions are stopped. If an application is returned with insufficient information a telephone call and/or a letter is sent indicating what is still needed to process the application. If no response is received, the application will be reviewed by the Financial Assistance/Community Care Program committee to determine if collection proceedings should resume or if presumptive charity care be allowed. Patients will be notified when the facility determines the amount of financial assistance approved.
Part VI, Line 2:The Organization typically offers wellness screenings once a year at no cost to the public. The wellness screenings help the Organization to assess health needs of the community. Included are blood pressure checks, diabetes screenings, pulmonary and respiratory screenings, and education on good health. This often results in follow-up care after results of screenings are reviewed. A community health needs assessment was also conducted during the 6/30/25 fiscal year end to help assess needs in the community.
Part VI, Line 3:Patients receive charity care information through the business office. The Organization mails brochures regarding the program in past due statements. The Organization also gives the brochure to people in the community known to the Organization that do not have insurance upon arrival for a visit. The charity care information is part of the intake process.
Part VI, Line 4:As of the census of 2020, there were 2,306 people and 946 households residing in the county. The population density was 3.4 people per square mile. There were 1,378 housing units. The racial makeup of the county was 95.70% White, 0.30% Asian, 0.40% Black, 0.6% American Indian and Alaska Native persons, and 3.0% from other races. There were 946 households out of which 23.0% had children under the age of 18 living with them, 51.2% were married couples living together, and 24.6% had a female householder with no husband present. The average family size was 3.23.In the county the population was spread out with 23.4% under the age of 19, 4.4% from 20 to 24, 15.6% from 25 to 44, 27.8% from 45 to 64, and 28.8% who were 65 years of age or older. The median age was 50.6 years. The median income for a household in the county was $64,737, and the median income for a family was $92,500. About 10.1% of the population were below the poverty line, including 7.3% of those under age 18 and 14.1% of those ages 65 or over.
Part VI, Line 5:The Organization offers a variety of services to the community to assist in taking away the burden of having to travel for medical care. The Organization also assists in accommodating any financial concerns through the charity care program. By doing both, the Organization hopes to better the well-being of the community. The Board of Directors is comprised of persons who reside in the primary service area. Medical staff privileges are given to all qualified physicians in the community. The Organization is affiliated with Emergency Heart Network, St. Paul Ramsey Burn Center, and Life Flight. When available, surplus funds are used to upgrade patient care equipment and facility infrastructure.The organization continued to offer COVID-19 screenings available at no cost to the public, unless a physician visit was required due to the patient's condition.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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
Steven Barlow
Provider$348,322$0$0$0$0$0$7,259$0$50,546$0$406,127$0$0$0
Debra Middleton
NP (Until Oct 23)$156,225$0$0$0$0$0$4,677$0$21,964$0$182,866$0$0$0
Liza Ystaas
Provider$143,145$0$0$0$0$0$0$0$34,152$0$177,297$0$0$0
Kali Manz
Provider$146,005$0$0$0$0$0$0$0$24,067$0$170,072$0$0$0
Nicole Lindsey
CEO - Administrator$57,824$0$0$0$0$0$2,657$0$9,561$0$70,042$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 3FormAndLineReferenceDesc
ExplanationNicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The amounts reported in Part VII and on schedule J represent 30 percent of her compensation.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonDarnell LindseyPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionHusband of CEO, Nicole LindseyRelationshipDescriptionTxt
Transaction$67,194TransactionAmt
TransactionCompensationTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1aAn Executive Committee may be appointed or dissolved by a majority vote of the Board of Directors. If so formed, the Executive Committee, in addition to the Chairman of the board and the Administrator, shall consist of the Secretary, the Treasurer, and one (1) additional member of the Board of Directors elected by the board at its first meeting after its election. The Executive Committee shall have power to transact all regular business of the Cooperstown Medical Center during the period between the meetings of the Board of Directors, subject to any prior limitations imposed by the Board and with the understanding that all matters of major importance will be referred to the Board of Directors. Minutes of the Executive Committee meetings shall be submitted to the Board, and its actions shall be subject to approval or disapproval at the next regular Board meeting.
Form 990, Part VI, Section A, line 2Nicole Lindsey and Barbara Anderson have a business relationship. Barbara Anderson and James Halvorson have a family relationship. Gerald Stokka and Barry Getz have a family relationship.
Form 990, Part VI, Section A, line 6The Organization has members consisting of those persons who are 18 years of age or above residing in the area served by Cooperstown Medical Center.
Form 990, Part VI, Section A, line 7aThe Members elect the Board of Directors.
Form 990, Part VI, Section B, line 11bThe CFO reviews the Form 990 prior to filing with the Internal Revenue Service. The Board of Directors also receives a copy of the Form 990 by email prior to it being filed with the IRS.
Form 990, Part VI, Section B, line 12cEach board member annually and upon hire each corporate officer, executive, department director, supervisor or other individual, duly authorized by the governing body to conduct business on behalf of Cooperstown Medical Center signs a statement which affirms that such person: 1) has received a copy of the conflict of interest policy; 2) has read and understands the policy; 3) has agreed to comply with the policy; 4) understands that the organization is and includes charitable organizations and that in order to maintain its federal tax exemption it must engage primarily in activities which further one or more of its tax-exempt purposes. If a conflict arises, the board will assign a disinterested person to investigate alternatives to the proposed transaction or arrangement. The interested member is to provide information to the board, however not influence the board regarding their decision.
Form 990, Part VI, Section B, line 15Nicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The CFO's, Judy Monson and Barbara Anderson, were compensated for their services to the Organization as well as for their services to Griggs County Care Center (GCCC) an unrelated organization. Their compensation was determined by an agreement between both the Organization's board of directors and that of GCCC. Thirty percent of their compensation is billed to and reimbursed by GCCC. The amounts reported in part VII represent all of their compensation including the thirty percent that is billed to GCCC.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request and at the annual meeting.
Form 990, Part IX, line 11gProfessional Fees: Program service expenses 584,352. Management and general expenses 3,631. Fundraising expenses 0. Total expenses 587,983. Purchased Services: Program service expenses 615,873. Management and general expenses 320,984. Fundraising expenses 0. Total expenses 936,857. Consultant Fees: Program service expenses 23,019. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,019.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Cooperstown Medical Center FoundationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1107 12th St SAddressLine1Txt
CityCooperstownCityNm
State AbbreviationNDStateAbbreviationCd
ZIP58425ZIPCd
FieldValueIRS element (for citing)
EIN450450301EIN
Primary ActivitiesTo support the programs of the Cooperstown Medical CenterPrimaryActivitiesTxt
Legal Domicile StateNDLegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity StatusLine 7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Cooperstown Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Cooperstown Medical Center FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$1,040,000InvolvedAmt
Method Of Amount DeterminationGeneral LedgerMethodOfAmountDeterminationTxt

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