COTEAU DES PRAIRIES HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- COTEAU DES PRAIRIES HOSPITAL (EIN 46-0278210)
- Tax period
- 2009-12-01 to 2010-11-30
- Filed
- 2011-08-26
- IRS object ID
- 201122389349300707
- Schema version
- 2009v1.7
- 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 | 2011-08-26T11:27:58-05:00 | Timestamp |
| Tax Period End Date | 2010-11-30 | 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 Suite 500 | AddressLine1 |
| City | Sioux Falls | City |
| State | SD | State |
| ZIP Code | 571045126 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-12-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460278210 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Coteau des Prairies Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COTE | NameControl |
| Phone | 6056987647 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 Orchard Drive | AddressLine1 |
| City | Sisseton | City |
| State | SD | State |
| ZIP Code | 572622398 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dan Ellis | Name |
| Title | CEO | Title |
| Phone | 6056987647 | Phone |
| Date Signed | 2011-08-26 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Laurie Hanson | Name |
| Phone | 6053391999 | Phone |
| Date Prepared | 2011-08-24 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Dan Ellis | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 Orchard Drive | AddressLine1 |
| City | Sisseton | City |
| State | SD | State |
| ZIP Code | 572622398 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9814625 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.cdphospital.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | SD | StateLegalDomicile |
| Activity Or Mission Description | Provision of healthcare services to the population of Sisseton, SD, and the surrounding area. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 161 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 87860 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 54755 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 8622820 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9722970 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 32183 | InvestmentIncomePriorYear |
| Investment Income Current Year | 20289 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 24008 | OtherRevenuePriorYear |
| Other Revenue Current Year | 16611 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8766871 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9814625 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4788305 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5434302 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3878124 | OtherExpensePriorYear |
| Other Expenses Current Year | 4605536 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8666429 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10039838 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 100442 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -225213 | RevenuesLessExpensesCY |
| Total Assets BOY | 6545198 | TotalAssetsBOY |
| Total Assets EOY | 6275376 | TotalAssetsEOY |
| Total Liabilities BOY | 620916 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 576307 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5924282 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5699069 | NetAssetsOrFundBalancesEOY |
| Mission Description | Quality healthcare with a personal touch close to home. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8944143 | Expense |
| Revenue | 9722970 | Revenue |
| Description | Coteau des Prairies Hospital (CDPH) provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue. The hospital provides healthcare services for the care and treatment of any persons who are acutely ill or who otherwise require medical care and related services. CDPH performed 58 PSA screenings and 10 diabetic screenings to patients at a much reduced cost to the patients. Acute patient days = 1,029, subacute patient days = 502, newborn days = 222, and emergency room visits = 3,872. | Description |
| Total Program Service Expense | 8944143 | 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 |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| 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 |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 15 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 161 | 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 |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | 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 | Larry Moen | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6056984697 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 Orchard Drive | AddressLine1 |
| City | Sisseton | City |
| State | SD | State |
| ZIP Code | 572622398 | 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 | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Mary Carlson | |||||||
| President | 2.00 | X | X | 0 | 0 | 0 | |
| Tom Brewster | |||||||
| Vice President (Thru June 2010) | 2.00 | X | X | 0 | 0 | 0 | |
| Faye Johnston | |||||||
| Vice President (Started June 2010) | 2.00 | X | X | 0 | 0 | 0 | |
| DelRay German | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Terry Jaspers | |||||||
| Treasurer | 2.00 | X | X | 0 | 0 | 0 | |
| Carol Ann Hosmer | |||||||
| Member (Thru Jan 2010) | 1.00 | X | 0 | 0 | 0 | ||
| Debbie Wooley | |||||||
| Member | 1.00 | X | 0 | 0 | 0 | ||
| Steven McCleerey | |||||||
| Member | 1.00 | X | 0 | 0 | 0 | ||
| Vern Donnell | |||||||
| Member (Thru June 2010) | 1.00 | X | 0 | 0 | 0 | ||
| Erin Cameron | |||||||
| Member | 1.00 | X | 0 | 0 | 0 | ||
| Clayton Halverson | |||||||
| Member | 1.00 | X | 0 | 0 | 0 | ||
| Cheryl Karst | |||||||
| Member | 1.00 | X | 0 | 0 | 0 | ||
| Vivian Hove | |||||||
| Member | 1.00 | X | 0 | 0 | 0 | ||
| Tom Wagner | |||||||
| Member | 1.00 | X | 0 | 0 | 0 | ||
| Dan Ellis | |||||||
| CEO (started March 2010) | 40.00 | X | 0 | 0 | 0 | ||
| Shelley Marmon | |||||||
| HR Manager/Interim CEO | 40.00 | X | 70476 | 0 | 286 | ||
| Larry Moen | |||||||
| CFO | 40.00 | X | 51349 | 0 | 1577 | ||
| Dr Judy Beumer | |||||||
| MD | 32.00 | 320928 | 0 | 651 | X | ||
| Dr David Staub | |||||||
| MD | 20.00 | 260740 | 0 | 5074 | X | ||
| Dr David Kleinberg | |||||||
| MD | 16.00 | 265637 | 0 | 925 | X | ||
| Dr Linda Peterson | |||||||
| MD | 24.00 | 120331 | 0 | 5902 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1089461 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 14415 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Charles Pryzmus | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1004 5th Avenue North | AddressLine1 |
| City | Wheaton | City |
| State | MN | State |
| ZIP Code | 56296 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Anesthesia Services | DescriptionOfServices |
| Compensation | 106024 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Government Grants | 17255 | GovernmentGrants |
| All Other Contributions | 37500 | AllOtherContributions |
| Total Contributions | 54755 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Program Service Rev. | 622110 | 9692741 | 9692741 |
| Cafeteria Rev. | 900099 | 22038 | 22038 |
| Misc Rev. | 900099 | 8191 | 8191 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9722970 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20289 | TotalRevenueColumn |
| Exclusion | $20,289 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 16611 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 16611 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16611 | TotalRevenueColumn |
| Exclusion | $16,611 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9814625 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9722970 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $36,900 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 297306 | Total |
| Management And General | 297306 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4068752 | Total |
| Program Services | 3817472 | ProgramServices |
| Management And General | 251280 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101254 | Total |
| Program Services | 96896 | ProgramServices |
| Management And General | 4358 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 303337 | Total |
| Program Services | 295517 | ProgramServices |
| Management And General | 7820 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 663653 | Total |
| Program Services | 585159 | ProgramServices |
| Management And General | 78494 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13343 | Total |
| Management And General | 13343 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32797 | Total |
| Management And General | 32797 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 450824 | Total |
| Program Services | 438011 | ProgramServices |
| Management And General | 12813 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32409 | Total |
| Management And General | 32409 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132483 | Total |
| Program Services | 8989 | ProgramServices |
| Management And General | 123494 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 288163 | Total |
| Program Services | 80751 | ProgramServices |
| Management And General | 207412 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121522 | Total |
| Program Services | 121522 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15103 | Total |
| Program Services | 15103 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79871 | Total |
| Program Services | 59392 | ProgramServices |
| Management And General | 20479 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 413299 | Total |
| Program Services | 413299 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141823 | Total |
| Program Services | 141823 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 1982781 | 1982781 | |
| Bad Debt | 506524 | 506524 | |
| Equip. Rental and Maint | 368294 | 367886 | 408 |
| License and Permit | 5952 | 4952 | 1000 |
| Sales Tax | 4434 | 1750 | 2684 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15914 | Total |
| Program Services | 6316 | ProgramServices |
| Management And General | 9598 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10039838 | Total |
| Program Services | 8944143 | ProgramServices |
| Management And General | 1095695 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1476393 | BOY |
| EOY | 841429 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1958247 | BOY |
| EOY | 2330271 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 207913 | BOY |
| EOY | 208786 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121626 | BOY |
| EOY | 122286 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7924386 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5151782 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2781019 | BOY |
| EOY | 2772604 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6545198 | BOY |
| EOY | 6275376 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 617916 | BOY |
| EOY | 569231 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3000 | BOY |
| EOY | 7076 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 620916 | BOY |
| EOY | 576307 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5924282 | BOY |
| EOY | 5699069 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5924282 | BOY |
| EOY | 5699069 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6545198 | BOY |
| EOY | 6275376 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 13556 | OtherCostOrOtherBasis |
| Book Value | 13556 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3698326 | OtherCostOrOtherBasis |
| Depreciation | 2358804 | Depreciation |
| Book Value | 1339522 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4007597 | OtherCostOrOtherBasis |
| Depreciation | 2696879 | Depreciation |
| Book Value | 1310718 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 204907 | OtherCostOrOtherBasis |
| Depreciation | 96099 | Depreciation |
| Book Value | 108808 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2772604 | TotalOfBookValueLandBuildings |
| Total Revenue | 9814625 | TotalRevenue |
| Total Expenses | 10039838 | TotalExpenses |
| Excess Or Deficit For Year | -225213 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -225213 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 10847756 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 1033131 | OtherRevenues |
| Revenue Not Rptd F990 | 1033131 | RevenueNotRptdF990 |
| Revenue Subtotal | 9814625 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9814625 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 10899259 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 859421 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 859421 | ExpensesNotRptdF990 |
| Expenses Subtotal | 10039838 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 10039838 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | The Hospital is organized as a nonprofit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Hospital has implemented Accounting Standards Codification 740, Income Taxes, (ASC 740). The Hospital undergoes an annual analysis of their various tax positions, assessing the likelihood of those positions being upheld upon examination with relevant tax authorities, as defined by ASC 740. For the thirteen month period ended December 31, 2010 and the year ended November 30, 2009, the unrecognized tax liability accrual was zero. The Hospital is no longer subject to federal tax examination by tax authorities for years before 2007. The Hospital will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. |
| Part XII, Line 2d - Other Adjustments: | Less December 2010 Revenue : 1033131. | |
| Part XIII, Line 2d - Other Adjustments: | Less December 2010 Expenses: 859421. | |
| Coteau des Prairies Hospital received audited financial statements for a 13 month period beginning 12/1/2009 and ending 12/31/2010 to reflect a change in year end. For tax return presentation, the twelve month period, 12/1/2009 thru 11/30/2010, was broken out and presented on the 2009 Form 990. In addition, a short year 2010 Form 990 will be filed for December 2010 to accurately present the 2010 information. The Part X statement above, is from the audited finacial statement report for the thirteen month period ended 12/31/2010. |
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 |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 175.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27061 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 27061 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1927603 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1899257 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 28346 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00300 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 877864 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 627192 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 250672 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02630 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2832528 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2526449 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 306079 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03210 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Persons Served | 451 | PersonsServed |
| Total Community Benefit Expense | 1490 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1490 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3190 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3190 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1965541 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1658418 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 307123 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03220 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1500 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1500 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Persons Served | 451 | PersonsServed |
| Total Community Benefit Expense | 1971721 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1658418 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 313303 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03290 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Persons Served | 451 | PersonsServed |
| Total Community Benefit Expense | 4804249 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4184867 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 619382 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06500 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $264,806 | BadDebtExpenseAmount |
| Amount Attributable To | 135703 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 2744162 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 2740308 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 3854 | 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 |
Form990 Schedule H Part V Form990ScheduleHPartV (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| Coteau des Prairies Hospital & Clinic | |||||||
| 205 Orchard Drive | Sisseton | SD | 57262 | X | X | X | Rural Health Clinic, Home Health Agency, Swing Bed |
| Browns Valley Clinic | |||||||
| 106 4th Street South | Browns Valley | MN | 56219 | Family Practice Clinic | |||
| Rosholt Clinic | |||||||
| 116 West Main Street | Rosholt | SD | 57260 | Family Practice Clinic | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: CDPH offers free care to patients with a family income not to exceed 150% of Federal Poverty Guidelines. In addition to the FPG test, CDPH also looks at the patient's asset values as well as their uninsured or underinsured insurance coverage status. For discounted care, CDPH patients will qualify with a family income not to exceed 175% of FPG. In addition to FPG, CDPH also looks at the patient's asset values as well as their uninsured or underinsured insurance coverage status. | IncomeBasedCriteria |
| Costing Method Used | Part I, Line 7: Lines 7a, 7b and 7c were determined using the ratio of patient care costs to charges calculated in IRS Worksheet 2. Lines 7e, 7f and 7i were obtained utilizing the actual general ledger system. Line 7g was obtained from the Medicare cost report. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: The expenses of the Rural Health Clinic total $1,733,870 which is comprised of payroll, benefits, professional fees, supplies, sales tax and advertising. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: Bad debt expense of $506,524 was subtracted from total operating expense. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: a) The cost-to-charge ratio was calculated using Worksheet 2.b) When a payment is received or a discount is given on a bad debt account it offsets the current fiscal year bad debt expense. c) Bad debt expense attributable to charity care is estimated based on income levels and ethnicity in this area. More that 50% of CDPH charges are generated by the Native American population. Statistics show the average household income of Native American families in Roberts County is two-thirds of that of other ethnic groups. Virtually all Native Americans qualify for charity care, thus the organization estimates approximately 50% 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 receivables is reduced by a valuation allowance that reflects management's best estimate of amounts that will not be collected from patients and third-party payors. Management reviews patient receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Medicare allowable cost of care was calculated from the Medicare cost report for the period ending 12/31/2010. The Medicare Cost Report was filed in accordance with the audited financial statements, and represented a 13 month period. For tax return presentation, the twelve month period, 12/1/2009 thru 11/30/2010, was broken out and presented on the 2009 Form 990 Schedule H. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: The priority of CDPH is to promote the health of Sisseton and also the surrounding rural communities. CDPH held 11 events through the year which included blood pressure screening, blood glucose testing, annual PSA screening, diabetic screening, and also a complete heart screening. Through outreach to our community, including our 2 outreach clinics, the home health department, and through working with local, state and federal departments, CDPH determines the health care needs of the community, and works to ensure the services and events provided to the community are beneficial and in accordance with the community's health care needs. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: CDPH utilizes multiple methods for patient education of financial assistance. A summary of the charity care policy is posted in the hospital's main entrance/admission areas and also in the main entrance/admission areas for each of the clinics. CDPH provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process, when applicable. In addition, CDPH personnel discuss with the patient the availability of various government benefits, such as Medicaid or state programs, and assist the patient with qualification for such programs, when applicable. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Sisseton is a rural community in the northeast corner of South Dakota with the next closest healthcare facility being approximately 50 miles away. CDPH serves various ethnic groups. An IHS clinic is located within 1 mile of the hospital. CDPH serves as the main Emergency Room for the IHS patients during office hours and after hours. Sisseton has a population of 2,572 - of that population 38.9% are 62 years or older, and 43.2% are of Native American heritage. Sisseton's total population includes the following statistics: 24.9% have attended 9th thru 12th grade without a diploma; 24.2% have a household income of $14,999 or less; and 23.2% hold poverty status for families with children under 18 years. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: None | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: CDPH is a sole community provider with an 11 member volunteer Board of Directors who all reside in the primary service area. Medical staff privileges are extended to all qualified individuals as they are requested. If CDPH were to have surplus funds, the funds would be applied to patient care improvements and also to reduce the need for rate increases for the patients. The emergency room is staffed 24 hours a day, 7 days a week and patients are welcomed regardless of race or the ability to pay for the services. CDPH participates in all government-sponsored health programs including Medicare, Medicaid, Indian Health Services, and Veteran Affairs benefits. The hospital and clinics welcome students for training and college rotations in various healthcare professions. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: N/A | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 | 1 | 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 | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 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 Judy Beumer | |||||||||||||
| 320928 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 651 | 0 | 321579 | 0 | 0 | 0 |
| Dr David Staub | |||||||||||||
| 260740 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 5074 | 0 | 265814 | 0 | 0 | 0 |
| Dr David Kleinberg | |||||||||||||
| 265637 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 925 | 0 | 266562 | 0 | 0 | 0 |
| Dr Linda Peterson | |||||||||||||
| 120331 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 5902 | 0 | 126233 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 5 | ReturnReference |
| Explanation | Physicians are paid 38% of their respective provider/CPT code revenue. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part III, line 2 | New Program Services | In December 2009, CDPH added a CT scanning unit onsite as a way to offer the service to patients 24 hours a day 7 days a week. CDPH purchased and reopened the Rosholt Clinic in August 2010 to supply healthcare to the northeast corner of Roberts County, South Dakota, along with rural North Dakota and rural Minnesota communities. Licensed Respiratory Therapy services were added at CDPH in December 2009 to better patient respiratory care. |
| Form 990, Part VI, Section A, line 4 | The Board of Directors of CDPH proposed and accepted changes to the organization's bylaws which became effective June 15, 2010. The changes include the following: a) The number of directors shall not be more than 12, but never less than required by law, and no person who is a credentialed medical professional or employee of CDPH or spouse of either. b) A majority of the directors shall constitute a quorum for the transaction of business. c) The Board of Directors shall hold an annual meeting no later than 90 days after the end of the fiscal year. d) The chairperson or President shall be elected for a term of 1 year. e) Addition and updates to the list of CEO/Administrator's authority and responsibilities which include: 1) Accepting general control of all ordering of goods and supplies as are needed to operate the hospital. However, there shall be a restriction of all capital and service contracts exceeding $5,000.00. 2) Regulating the hours and duties of the hospital employees and see to it that at all times there is competent help on duty which will meet the requirements of the State Department of Health. However, wage ranges, annual increases or new positions shall be approved by the Board. 3) Sign and deliver in the name of the Corporation any contracts or other instruments necessary in the ordinary course of business. f) The fiscal year of the corporation shall now follow the calendar and run January 1st through December 31st. g) All Board of Directors are required to sign the Conflict of Interest Policy and the Confidentiality Agreement. | |
| Form 990, Part VI, Section B, line 11 | The Director of Finance reviews the 990 in detail. After his review, the 990 is provided to each board member. The Director of Finance presents the 990 to the Board of Directors at the meeting held prior to its filing if so requested by any board member. Whether presented in a board meeting or not, the 990 is not filed until each board member has been given a copy of it and given ample time to review it. | |
| Form 990, Part VI, Section B, line 12c | All board members and officers are covered by the Conflict of Interest Policy. The determination of whether a conflict exists are made at the Board of Directors level, as are the review of actual conflicts. Any person determined to have a conflict will have an opportunity to explain the situation, and he/she will be required to refrain from voting. | |
| Form 990, Part VI, Section B, line 15 | Compensation for the CEO is determined through individual negotiations with the executive committee and the CEO. The executive committee uses salary surveys to determine what constitutes reasonable compensation. Negotiations with the executive committee include a performance evaluation. An evaluation is done annually by the executive committee, and approved by the Board of Directors. Compensation of CDPH's officers or key employees is determined through discussions between the executive committee and the CEO. The executive committee uses salary surveys to determine what constitutes reasonable compensation. Discussions with the executive committee include a performance evaluation. An evaluation is done annually by the executive committee, and approved by the Board of Directors. | |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy and financial statements are available upon request. |
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