MOBRIDGE REGIONAL HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MOBRIDGE REGIONAL HOSPITAL (EIN 46-0255944)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-14
- IRS object ID
- 201222279349301347
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T15:41:14-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 EAST 10TH STREET PO BOX 5125 | AddressLine1 |
| City | SIOUX FALLS | City |
| State | SD | State |
| ZIP Code | 571175125 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460255944 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOBRIDGE REGIONAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MOBR | NameControl |
| Phone | 6058453692 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 580 | AddressLine1 |
| City | MOBRIDGE | City |
| State | SD | State |
| ZIP Code | 57601 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANGELIA SVIHOVEC | Name |
| Title | CEO | Title |
| Phone | 6058453692 | Phone |
| Date Signed | 2012-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LAURIE HANSON | Name |
| Phone | 6053391999 | Phone |
| Date Prepared | 2012-08-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ANGELIA SVIHOVEC | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 580 | AddressLine1 |
| City | MOBRIDGE | City |
| State | SD | State |
| ZIP Code | 57601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16276441 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MOBRIDGEHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1959 | YearFormation |
| State Legal Domicile | SD | StateLegalDomicile |
| Activity Or Mission Description | PROVIDING HEALTHCARE TO PEOPLE THROUGHOUT THE REGION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 180 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1066313 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 190133 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14215894 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 14204803 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 77629 | InvestmentIncomePriorYear |
| Investment Income Current Year | 57910 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 85058 | OtherRevenuePriorYear |
| Other Revenue Current Year | 86418 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15444894 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14539264 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7344583 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7780487 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6282650 | OtherExpensePriorYear |
| Other Expenses Current Year | 6481946 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 13627233 | TotalExpensesPriorYear |
| Total Expenses Current Year | 14262433 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1817661 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 276831 | RevenuesLessExpensesCY |
| Total Assets BOY | 17134975 | TotalAssetsBOY |
| Total Assets EOY | 16958515 | TotalAssetsEOY |
| Total Liabilities BOY | 7236331 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6783040 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9898644 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10175475 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF MOBRIDGE REGIONAL HOSPITAL IS TO PROVIDE HIGH QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE AND PROFESSIONAL MANNER FOR PEOPLE THROUGHOUT THE REGION. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 12842187 | Expense |
| Revenue | 14204803 | Revenue |
| Description | MOBRIDGE REGIONAL HOSPITAL (MRH) PROVIDES HEALTHCARE SERVICES TO PERSONS THROUGHOUT THE REGION. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2011, THE HOSPITAL HAD: 1,620 PATIENT DAYS 916 ACUTE CARE DAYS29,283 OUTPATIENT VISITS 5,502 ASSISTED LIVING DAYS (PRAIRIE SUNSET VILLAGE) | Description |
| Total Program Service Expense | 12842187 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 24 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 180 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RENAE TISDALL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6058458164 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 580 | AddressLine1 |
| City | MOBRIDGE | City |
| State | SD | State |
| ZIP Code | 57601 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DENNIS SCHNABEL | ||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| DELPHINE STEUCK | ||||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| BILL BACHMEIER | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| HEIDI ROSHAU | ||||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| JAKE KRAFT | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| WALLY SCHOTT | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DONALD PAULSON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DR LEONARD LINDE | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DR TRAVIS HENDERSON | ||||||||
| PHYSICIAN/DIRECTOR | 40.00 | X | 218515 | 0 | 24005 | X | ||
| DR ROBERT MARCIANO | ||||||||
| PHYSICIAN/DIRECTOR | 40.00 | X | 270542 | 0 | 18069 | X | ||
| BARB GROSS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DR TOM SWANSON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DOUG SCOTT THRU JAN 2011 | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| BENJAMIN STOICK THRU JAN 2011 | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ANGELIA SVIHOVEC | ||||||||
| CEO | 40.00 | X | 139562 | 0 | 20416 | |||
| RENAE TISDALL | ||||||||
| CFO | 40.00 | X | 68692 | 0 | 23163 | |||
| DR BELA CSAKI | ||||||||
| PHYSICIAN | 40.00 | 271065 | 0 | 18069 | X | |||
| DR COLETTE DUCHENEAUX | ||||||||
| PHYSICIAN | 40.00 | 316154 | 0 | 17443 | X | |||
| DR KENRIC MALMBERG | ||||||||
| PHYSICIAN | 40.00 | 187204 | 0 | 15293 | X | |||
| DR JOSH HENDERSON | ||||||||
| PHYSICIAN | 40.00 | 188606 | 0 | 14201 | X | |||
| DEBBIE SMITH | ||||||||
| CRNA | 40.00 | 191482 | 0 | 18090 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1851822 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 168749 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| NORTH STAR CONSTRUCTION | |||||
| PO BOX 726 | SPEARFISH | ND | 57783 | INDEPENDENT CONTRACTOR TO BUILD MCLAUGHL | 309855 |
| ST ALEXIUS MEDICAL CENTER | |||||
| 900 EAST BROADWAY | BISMARCK | ND | 58506 | IT SERVICES, CEO SALARY, SUPPLIES, ETC | 216920 |
| MONDAK IMAGING SERVICES | |||||
| 11 SOUTH 7TH ST 241 | MILES CITY | MT | 59301 | MRI SERVICES | 179893 |
| NORTHERN PLAINS LAB | |||||
| PO BOX 2036 | BISMARCK | ND | 58502 | OUTSOURCE LABORATORY SERVICES | 143943 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 169724 | GovernmentGrants |
| All Other Contributions | 20409 | AllOtherContributions |
| Total Contributions | 190133 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REV | 622110 | 13655505 | 13655505 |
| ASSISTED LIVING REV | 623110 | 478297 | 478297 |
| ANCILLARY CHARGES | 900099 | 90965 | 90965 |
| CHNG IN INT-MOBRIDGE H | 900099 | -19964 | -19964 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 14204803 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 57910 | TotalRevenueColumn |
| Exclusion | $57,910 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 86418 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 86418 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 86418 | TotalRevenueColumn |
| Exclusion | $86,418 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1737177 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1737177 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14539264 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14204803 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $144,328 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 806206 | Total |
| Program Services | 549648 | ProgramServices |
| Management And General | 256558 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6309354 | Total |
| Program Services | 5692421 | ProgramServices |
| Management And General | 616933 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 223831 | Total |
| Program Services | 198718 | ProgramServices |
| Management And General | 25113 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 441096 | Total |
| Program Services | 389088 | ProgramServices |
| Management And General | 52008 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46561 | Total |
| Management And General | 46561 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8023 | Total |
| Management And General | 8023 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43571 | Total |
| Management And General | 43571 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 451695 | Total |
| Program Services | 451534 | ProgramServices |
| Management And General | 161 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75021 | Total |
| Program Services | 5550 | ProgramServices |
| Management And General | 69471 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229390 | Total |
| Program Services | 62963 | ProgramServices |
| Management And General | 166427 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47629 | Total |
| Program Services | 21973 | ProgramServices |
| Management And General | 25656 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 303084 | Total |
| Program Services | 299474 | ProgramServices |
| Management And General | 3610 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36327 | Total |
| Program Services | 36327 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60577 | Total |
| Program Services | 48066 | ProgramServices |
| Management And General | 12511 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 259916 | Total |
| Program Services | 259916 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1058883 | Total |
| Program Services | 1058883 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 999833 | Total |
| Program Services | 999833 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 1451462 | 1451462 | |
| BAD DEBT | 818573 | 818573 | |
| REPAIRS AND MAINTENANCE | 397571 | 350920 | 46651 |
| MINOR EQUIPMENT | 103211 | 103211 | |
| DUES & SUBSCRIPTIONS | 62422 | 21323 | 41099 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28197 | Total |
| Program Services | 22304 | ProgramServices |
| Management And General | 5893 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14262433 | Total |
| Program Services | 12842187 | ProgramServices |
| Management And General | 1420246 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5476524 | BOY |
| EOY | 5402123 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2207030 | BOY |
| EOY | 2212552 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 467670 | BOY |
| EOY | 492187 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57774 | BOY |
| EOY | 119033 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 19364845 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 11891095 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7672185 | BOY |
| EOY | 7473750 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 546198 | BOY |
| EOY | 556364 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 707594 | BOY |
| EOY | 702506 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17134975 | BOY |
| EOY | 16958515 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1755202 | BOY |
| EOY | 1586309 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19000 | BOY |
| EOY | 19000 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5050000 | BOY |
| EOY | 4755000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 298103 | BOY |
| EOY | 279795 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 114026 | BOY |
| EOY | 142936 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7236331 | BOY |
| EOY | 6783040 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9284551 | BOY |
| EOY | 9682213 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 614093 | BOY |
| EOY | 493262 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9898644 | BOY |
| EOY | 10175475 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17134975 | BOY |
| EOY | 16958515 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 276831 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 95575 | OtherCostOrOtherBasis |
| Book Value | 95575 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10527105 | OtherCostOrOtherBasis |
| Depreciation | 6155038 | Depreciation |
| Book Value | 4372067 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8367172 | OtherCostOrOtherBasis |
| Depreciation | 5461960 | Depreciation |
| Book Value | 2905212 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 374993 | OtherCostOrOtherBasis |
| Depreciation | 274097 | Depreciation |
| Book Value | 100896 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7473750 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PREMIUM ON BONDS PAYABLE | $13,614 |
| DEFERRED COMPENSATION PLAN PAYABLE | $129,322 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 142936 | TotalOfAmounts |
| Total Revenue | 14539264 | TotalRevenue |
| Total Expenses | 14262433 | TotalExpenses |
| Excess Or Deficit For Year | 276831 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 276831 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 14539264 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 14539264 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 14539264 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 14262433 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 14262433 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 14262433 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | 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. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 101902 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 101902 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00760 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1679131 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1738470 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -59339 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1781033 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1738470 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 42563 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00760 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 785477 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 388537 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 396940 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02950 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 785477 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 388537 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 396940 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02950 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2566510 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2127007 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 439503 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03710 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $403,036 | BadDebtExpenseAmount |
| Amount Attributable To | 342580 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4758262 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4693789 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 64473 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOBRIDGE REGIONAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1401 10TH AVENUE W | AddressLine1 |
| City | MOBRIDGE | City |
| State | SD | State |
| ZIP Code | 57601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| PRAIRIE SUNSET VILLAGE | ||||
| 1320 W GRAND XING | MOBRIDGE | SD | 57601 | ASSISTED LIVING & SENIOR HOUSING |
| MOBRIDGE MEDICAL CLINIC | ||||
| 1309 10TH AVE W | MOBRIDGE | SD | 57601 | PROVIDER BASED MEDICAL CLINIC |
| WEST RIVER HEALTH CLINIC | ||||
| 103 1ST AVENUE E | MCLAUGHLIN | SD | 57642 | PROVIDER BASED RURAL HEALTH CLINIC |
| WEST DAKOTA HEALTH CLINIC | ||||
| 906 MAIN | TIMBER LAKE | SD | 57656 | PROVIDER BASED RURAL HEALTH CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: IN ADDITION TO USING FPG GUIDELINES, MRH UTILIZES AN ASSET TEST FOR FREE OR DISCOUNTED CARE ALONG WITH CONSIDERATION OF THE AMOUNT OF THE PATIENT'S BILL. |
| PART I, LINE 6A: MRH'S COMMUNITY BENEFIT INFORMATION IS INCLUDED IN THE HOSPITAL'S ANNUAL REPORT, WHICH IS MAILED OUT TO MEMBERS AND IS AVAILABLE IN THE LOBBY AT THE HOSPITAL AND CLINICS. |
| PART I, LINE 7: LINE 7A WAS DETERMINED USING THE RATIO OF PATIENT CARE COSTS TO CHARGES CALCULATED IN IRS WORKSHEET 2. 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 9/30/11. |
| PART I, L7 COL(F): BAD DEBT EXPENSE OF $818,573 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. |
| PART III, LINE 4: A) THE COST TO CHARGE RATIO WAS CALCULATED USING IRS WORKSHEET 2 FOR THE FISCAL YEAR ENDING 9/30/2011.B) 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. C) BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE IS ESTIMATED BASED ON INCOME LEVELS. A LARGE PORTION OF MRH CHARGES ARE GENERATED BY THE NATIVE AMERICAN POPULATION AND THOSE BELOW THE POVERTY LEVEL. STATISTICS PROVE THAT MOST OF THE MENTIONED PATIENTS QUALIFY FOR CHARITY CARE. AFTER REVIEW, MRH ESTIMATES APPROXIMATELY 85% OF BAD DEBT AT COST IS ATTRIBUTABLE TO PERSONS WHO WOULD QUALIFY FOR CHARITY CARE. D) FOOTNOTE FROM FINANCIAL STATEMENT: THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT AND RESIDENT RECEIVABLES BY PAYOR CLASS AND USES AGING OF INDIVIDUAL ACCOUNTS TO ESTIMATE AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND RESIDENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. MANAGEMENT ALSO REVIEWS ACCOUNTS TO DETERMINE IF CLASSIFICATION OF CHARITY CARE IS APPROPRIATE. |
| PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 9/30/11. |
| 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. |
| PART VI, LINE 3: MRH POSTS ITS CHARITY CARE 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 CHARITY CARE PROGRAM IS AVAILABLE TO BOTH NEW AND ESTABLISHED PATIENTS. THE CHARITY CARE POLICY COVERS ALL MEDICALLY NECESSARY SERVICES PROVIDED BY THE INSTITUTION THAT ARE ORDERED BY PHYSICIANS.MRH'S CHARITY CARE 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. |
| PART VI, LINE 6: 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 CHARITY CARE WRITE-OFFS 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 ALSO 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 ALSO 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR TRAVIS HENDERSON | |||||||||||||
| 192758 | 0 | 25622 | 0 | 135 | 0 | 8650 | 0 | 15355 | 0 | 242520 | 0 | 0 | 0 |
| DR ROBERT MARCIANO | |||||||||||||
| 207160 | 0 | 62724 | 0 | 658 | 0 | 9800 | 0 | 8269 | 0 | 288611 | 0 | 0 | 0 |
| ANGELIA SVIHOVEC | |||||||||||||
| 139144 | 0 | 0 | 0 | 418 | 0 | 5823 | 0 | 15636 | 0 | 161021 | 0 | 0 | 0 |
| DR BELA CSAKI | |||||||||||||
| 265796 | 0 | 0 | 0 | 5269 | 0 | 9800 | 0 | 8269 | 0 | 289134 | 0 | 0 | 0 |
| DR COLETTE DUCHENEAUX | |||||||||||||
| 208139 | 0 | 107821 | 0 | 194 | 0 | 9800 | 0 | 7643 | 0 | 333597 | 0 | 0 | 0 |
| DR KENRIC MALMBERG | |||||||||||||
| 178943 | 0 | 0 | 0 | 8261 | 0 | 7023 | 0 | 8269 | 0 | 202496 | 0 | 0 | 0 |
| DR JOSH HENDERSON | |||||||||||||
| 165609 | 0 | 0 | 0 | 22997 | 0 | 1846 | 0 | 12355 | 0 | 202807 | 0 | 0 | 0 |
| DEBBIE SMITH | |||||||||||||
| 183596 | 0 | 0 | 0 | 7886 | 0 | 7475 | 0 | 10615 | 0 | 209572 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 7 | THE PHYSICIANS ARE PAID BASED ON PRODUCTION. | |
| PART III | SCHEDULE J, PART II: ANGELIA SVIHOVEC'S COMPENSATION: THE CEO IS COMPENSATED FOR HER SERVICES THROUGH A MANAGEMENT AGREEMENT WITH ST. ALEXIUS MEDICAL CENTER IN BISMARCK, ND. | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF MOBRIDGE SOUTH DAKOTA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 466000320 | IssuerEIN |
| CUSIP Number | 607429BA4 | CUSIPNumber |
| Date Issued | 2007-05-08 | DateIssued |
| Issue Price | 5773898 | IssuePrice |
| Description Of Purpose | REFINANCED EXISTING TAX-EXEMPT BONDS AND PURCHASE CT, CLINIC AND EMR. | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 5773898 | TotalProceeds |
| Amount In Reserve Fund | 269394 | AmountInReserveFund |
| Refunding Escrow | 4416499 | RefundingEscrow |
| Issuance Costs From Proceeds | 88005 | IssuanceCostsFromProceeds |
| Capital Expenditures | 1000000 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | MRH 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. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THERE IS ONLY ONE CLASS OF MEMBER; ALL MEMBERS HAVE ONE VOTE (SAME VOTING RIGHTS). | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE NOMINATING COMMITTEE NOMINATES CANDIDATES FOR ELECTION. THE MEMBERS VOTE ON CANDIDATES AT THE ANNUAL MEETING. | |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE IS NO COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CEO, CFO, AND FINANCE COMMITTEE WILL REVIEW THE FORM 990 PRIOR TO FILING WITH THE IRS. | |
| THE 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 12C | |
| THE 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 KEY EMPLOYEES ARE DETERMINED BY THE CEO THROUGH THE USE OF SALARY SURVEY INFORMATION FROM SDAHO AND EMPLOYEE SERVICE AND EXPERIENCE FILES. SALARY INCREASES WERE IMPLEMENTED IN SEPTEMBER 2010, AND MOST RECENTLY IN DECEMBER 2011. | FORM 990, PART VI, SECTION B, LINE 15 | |
| DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 |
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