HILLSBORO MEDICAL CENTER: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- HILLSBORO MEDICAL CENTER (EIN 45-0230400)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-01-11
- IRS object ID
- 201130129349300828
- Schema version
- 2009v1.4
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-01-11T11:17:56-06:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | 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 | 4310 17TH AVE S PO BOX 2545 | AddressLine1 |
| City | FARGO | City |
| State | ND | State |
| ZIP Code | 581082545 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450230400 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLSBORO MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HILL | NameControl |
| Phone | 7014365755 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 609 | AddressLine1 |
| City | HILLSBORO | City |
| State | ND | State |
| ZIP Code | 58045 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John Rieke | Name |
| Title | CEO/Administrator | Title |
| Phone | 7014365755 | Phone |
| Date Signed | 2010-12-21 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LISA CHAFFEE CPA | Name |
| Phone | 7012398500 | Phone |
| Date Prepared | 2010-12-21 | 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 | Patricia Dirk | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 609 | AddressLine1 |
| City | HILLSBORO | City |
| State | ND | State |
| ZIP Code | 58045 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6907724 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.hillsboromedicalcenter.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1946 | YearFormation |
| State Legal Domicile | ND | StateLegalDomicile |
| Activity Or Mission Description | To provide quality health care and living services with dignity and individualized care. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 165 | TotalNbrEmployees |
| Total Nbr Volunteers | 80 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 211985 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 201722 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5733496 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6478650 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 61006 | InvestmentIncomePriorYear |
| Investment Income Current Year | 59779 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 23630 | OtherRevenuePriorYear |
| Other Revenue Current Year | 167573 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6030117 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6907724 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3271390 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3636005 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3016188 | OtherExpensePriorYear |
| Other Expenses Current Year | 3731450 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6287578 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7367455 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -257461 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -459731 | RevenuesLessExpensesCY |
| Total Assets BOY | 17446358 | TotalAssetsBOY |
| Total Assets EOY | 16155907 | TotalAssetsEOY |
| Total Liabilities BOY | 14390492 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13571478 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3055866 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2584429 | NetAssetsOrFundBalancesEOY |
| Mission Description | The mission of the Hillsboro Medical Center is to provide quality health care and living services with dignity and individualized care. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6806286 | Expense |
| Revenue | 6478650 | Revenue |
| Description | The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individuals ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services,emergency services and ambulance services. Charity care provided for fiscal year ended June 30, 2010, based on charges foregone was $22,074.Hillsboro Medical Services also operates a skilled nursing facility. The Home provides nursing services, meals, housekeeping, laundry and activities for residents. | Description |
| Total Program Service Expense | 6806286 | 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 | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 33 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 165 | 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 |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | 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 | Darlene Swanson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7016363211 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 609 | AddressLine1 |
| City | Hillsboro | City |
| State | ND | State |
| ZIP Code | 58045 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Curt Kaufman | ||||||
| Chair | 3.00 | X | X | 0 | 0 | 0 |
| Kathy Evenson | ||||||
| Vice Chair | 1.00 | X | X | 0 | 0 | 0 |
| Steve Doeden | ||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 |
| Brenda Muller | ||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 |
| Kay Malme | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Wes Ecker | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Wayne Koering | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Chris McInnes | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Cel Baumgartner | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Jeff McInnes | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Ed Laxdahl | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Patricia Dirk | ||||||
| Chief Executive Officer | 40.00 | X | 84400 | 0 | 9861 | |
| Travis Scheving | ||||||
| Chief Financial Officer | 40.00 | X | 61405 | 0 | 6535 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 145805 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 16396 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Nor-Son | |||||
| 7900 Hastings Road | Baxter | MN | 56425 | Construction | 1850004 |
| Sanford Health | |||||
| PO Box 2010 | Fargo | ND | 58122 | Various Medical Service Contracts and Ma | 641566 |
| DMS Health | |||||
| SDS 12-2208 PO Box 86 | Minneapolis | MN | 55486 | X-Ray Fees | 179029 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Related Organizations | 27073 | RelatedOrganizations |
| Government Grants | 155352 | GovernmentGrants |
| All Other Contributions | 19297 | AllOtherContributions |
| Total Contributions | 201722 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient & Resident | 900099 | 6417080 | 6417080 |
| Miscellaneous Revenue | 900099 | 61570 | 61570 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6478650 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 59779 | TotalRevenueColumn |
| Exclusion | $59,779 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 167573 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 167573 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 167573 | TotalRevenueColumn |
| Exclusion | $167,573 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6907724 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6478650 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $227,352 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166550 | Total |
| Management And General | 166550 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2903689 | Total |
| Program Services | 2748402 | ProgramServices |
| Management And General | 155287 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64951 | Total |
| Program Services | 61477 | ProgramServices |
| Management And General | 3474 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 231881 | Total |
| Program Services | 219480 | ProgramServices |
| Management And General | 12401 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 268934 | Total |
| Program Services | 254552 | ProgramServices |
| Management And General | 14382 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37480 | Total |
| Management And General | 37480 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64374 | Total |
| Management And General | 64374 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11007 | Total |
| Management And General | 11007 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 690912 | Total |
| Program Services | 684869 | ProgramServices |
| Management And General | 6043 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13060 | Total |
| Program Services | 174 | ProgramServices |
| Management And General | 12886 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 597483 | Total |
| Program Services | 539359 | ProgramServices |
| Management And General | 58124 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29690 | Total |
| Program Services | 29690 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 232976 | Total |
| Program Services | 226215 | ProgramServices |
| Management And General | 6761 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25084 | Total |
| Program Services | 24675 | ProgramServices |
| Management And General | 409 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14351 | Total |
| Program Services | 13149 | ProgramServices |
| Management And General | 1202 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 673217 | Total |
| Program Services | 673217 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1144784 | Total |
| Program Services | 1144784 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85204 | Total |
| Program Services | 85204 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debts | 90736 | 90736 | |
| Collections | 5921 | 5921 | |
| Recognition | 1919 | 891 | 1028 |
| Sales tax | 355 | 355 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12897 | Total |
| Program Services | 9412 | ProgramServices |
| Management And General | 3485 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7367455 | Total |
| Program Services | 6806286 | ProgramServices |
| Management And General | 561169 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500517 | BOY |
| EOY | 842044 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1119419 | BOY |
| EOY | 1045759 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28297 | BOY |
| EOY | 27520 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57501 | BOY |
| EOY | 30796 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 16621830 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4188570 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12200939 | BOY |
| EOY | 12433260 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3214814 | BOY |
| EOY | 1343553 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 324871 | BOY |
| EOY | 432975 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17446358 | BOY |
| EOY | 16155907 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1079545 | BOY |
| EOY | 461788 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128426 | BOY |
| EOY | 117572 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13155000 | BOY |
| EOY | 12975000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12059 | BOY |
| EOY | 3102 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15462 | BOY |
| EOY | 14016 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14390492 | BOY |
| EOY | 13571478 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3055866 | BOY |
| EOY | 2584429 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3055866 | BOY |
| EOY | 2584429 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17446358 | BOY |
| EOY | 16155907 | 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 Consolidated | X | FinancialStatementConsolidated |
| 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
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14046561 | OtherCostOrOtherBasis |
| Depreciation | 3112265 | Depreciation |
| Book Value | 10934296 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 138180 | OtherCostOrOtherBasis |
| Depreciation | 22844 | Depreciation |
| Book Value | 115336 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2437089 | OtherCostOrOtherBasis |
| Depreciation | 1053461 | Depreciation |
| Book Value | 1383628 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 12433260 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Unamortized Bond Premium | Description |
| Amount | $14,016 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 14016 | TotalOfAmounts |
| Total Revenue | 6907724 | TotalRevenue |
| Total Expenses | 7367455 | TotalExpenses |
| Excess Or Deficit For Year | -459731 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -11706 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -11706 | TotalAdjustments |
| Excess Or Deficit Per FS | -471437 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 6896018 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -11706 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -11706 | RevenueNotRptdF990 |
| Revenue Subtotal | 6907724 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 6907724 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7367455 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7367455 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7367455 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | The Medical Center is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center undergoes an annual analysis of its various tax positions, assessing the likelihood of these positions being upheld upon examination with relevant tax authorities, as defined by the accounting principles generally accepted in the United States of America. The Medical Center believes that they are compliant with all IRS tax regulations and as of June 30, 2010 has not recorded a tax liability for a tax uncertainty. The Medical Center will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. Under normal circumstances, the Medical Center is no longer subject to Federal and state tax examinations by tax authorities for years before 2007. | 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 | 0 | FPGReferenceFreeCare |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 0 | 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 | 21230 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 21230 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 82086 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 82086 | DirectOffsettingRevenue |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 103316 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 82086 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 21230 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1427 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1427 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 311149 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 281253 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 29896 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 312576 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 281253 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 31323 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 415892 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 363339 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 52553 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00720 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $87,265 | BadDebtExpenseAmount |
| Amount Attributable To | 65449 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 1858076 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 1849866 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 8210 | 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 | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hillsboro Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12 3rd St SE | AddressLine1 |
| City | Hillsboro | City |
| State | ND | State |
| ZIP Code | 58045 | 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 |
| Other | LT Care, Assisted Living, Ambulance | Other |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: Throughout the payment and collection process, the business office staff attempt to identify to the extent possible, patients which are worthy and appropriate for charity care considerations. Those accounts to be considered for charity reductions are asked to complete a financial statement form, which provides pertinent financial information necessary to determine financial need. The charity care application asks for items such as employment information, current income, current expenses, assets owned as well as other miscellaneous items. Credit reports can be used to verify and assist in the decision process. Review of potential charity requests are performed monthly by the Business Manager and certain recommendations are forwarded to the Administrator. The administrator makes the final decision if someone is eligible for free or discounted care. The decision for free or discounted care is strictly done on a case by case basis as the administrator reviews information provided in the charity care application. | IncomeBasedCriteria |
| Costing Method Used | Part I, Line 7: The organization used Worksheet 2 to determine the cost for Part I, Line 7, Rows a and b. The cost in Part I, line 7, Row e was determined based on the wages that were paid to individuals providing the services while on hospital time and it was also based on the cost of supplies (such as printed materials) used in the activities. The cost in Part I, line 7, row g was determined from the Medicare Cost report. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: The amount of bad debt expense removed from the denominator is $90,736. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Financial Statement Bad Debt Expense Footnote:Patient and resident receivables are uncollateralized receivables and third-party payor obligations. Payments of patient and resident receivables are allocated to the specific claims identified on the remittance advice or, if unspecified, are applied to the earliest unpaid claim.The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's 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 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 and residents due to bad debts. Management considers historical write-off and recovery information in determining the estimated bad debt provision.Bad debt expense was converted to cost using the ratio of patient care cost to charges calculated using Worksheet 2.All discounts and payments on a patient's account are accounted for prior to determining bad debt expense. Hillsboro Medical Center reports amounts as bad debt once they are 120 days overdue and have been turned over to a collection agency. Historically, almost all of these amounts remain unpaid as the patient does not have sufficient resources and likely would qualify for the Charity Care Program. Based on this assumption, 75% of the bad debt amount is considered charity care. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Medicare allowable costs were obtained from the 2009 Medicare Cost Report. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: If a patient bill is unpaid after 120 days, a phone call is made to the patient. If they do not hear from the patient and there is no response to the phone call, the bill is sent to collections. The final approval for sending the account to collections is signed by the administrator. When it is appropriate, a review is done to determine if a patient might qualify for charity care. This can also be discussed when the phone call is made to the patient prior to sending the bill to collections. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: The Assistant Director of Nursing and the Medical Providers at Hillsboro Medical Center assess the needs of outpatient services utilized by the community. We re-evaluate the services we provide and have added multiple needed outpatient treatments. These services enhanced patient care and provided services within our community instead of needing to travel outside the Hillsboro area for these services. We will continue to review the needs of the community and the services that we offer. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Hillsboro Medical Center (HMC) does not post its charity care policy. During the collection process for outstanding bills, HMC informs the patients that we do have a Charity Care Policy and we will send out a financial statement form, which will provide pertinent patient financial information necessary to determine financial need. Also, HMC discusses with the patients that they could apply with the county for Medicaid assistance. The final determination for Charity Care is approved by the administrator. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Hillsboro has a population of approximately 1,600. Per the 2000 census, the median income for a household in the city was $33,516 and the median income for a family was $42,357. Males had a median income of $30,607 versus $19,769 for females. The per capita income for the city was $17,976. About 6.6% of families and 9.2% of the population were below the poverty line, including 9.4% of those under age 18 and 15.0% of those age 65 or over. Approximately 15% of the city's population are Medicaid recipients. Sanford-Mayville Hospital is another hospital that serves the community in an 18 mile radius. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: n/a | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: The mission of the Hillsboro Medical Center is to provide quality health care and living services with dignity and individualized care. Hillsboro Medical Center provides community meetings about CPR, Advance Directives, Child Passenger Safety, Alzheimer's, etc. to promote information and well-being to people in our community. Hillsboro Medical Center also provides a room for Hospice and UND Journal Club free of charge so they can conduct their meetings for the care of people in the community and surrounding areas. The majority of the organization's governing body is comprised of individuals who reside in the primary service area. These individuals are not employees, nor contractors or family members of the organization. The organization extends medical staff privileges to qualified physicians in the community. Surplus funds, if available, are re-invested in the facility to improve patient care. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: n/a | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Patricia Dirk | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Base Compensation Filing Org | 84400 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 5099 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 5089 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 94588 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | Schedule J Part I Line 3 methods of establishing compensation: The CEO, Patricia Dirk, is compensated by Sanford Health an unrelated entity. The compensation amounts included in Part II for Patricia Dirk indicate the types and amount of compensation that she was paid by Sanford Health. Sanford Health used one or more of these methods in establishing her compensation. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Traill County | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 456002246 | IssuerEIN |
| CUSIP Number | 892846AQ9 | CUSIPNumber |
| Date Issued | 2007-05-22 | DateIssued |
| Issue Price | 13341133 | IssuePrice |
| Description Of Purpose | Exp of facility; new Asst Lvg and LT Care bldgs, 80% rmdl of Hospital | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 13341133 | TotalProceeds |
| Amount In Reserve Fund | 893789 | AmountInReserveFund |
| Issuance Costs From Proceeds | 339850 | IssuanceCostsFromProceeds |
| Capital Expenditures | 12107494 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | 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 |
| Bond Counsel Routinely Engaged | 0 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 0 | 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 | 1 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | Jeff McInnes and Chris McInnes had a family relationship. |
| Form 990, Part VI, Section A, line 3 | The CEO/administrator is employed through a management agreement with Sanford Health, an unrelated party. |
| Form 990, Part VI, Section A, line 4 | Candidates for the position of Chairperson, Vice-Chairperson, Secretary and Treasurer are presented to the board of trustees for a majority vote after being nominated by the Nominating Committee, rather than being nominated by the Nominating Committee. |
| Form 990, Part VI, Section B, line 11 | The chief executive officer/administrator will review a draft of the Form 990. The board reviewed the 990 prior to it being filed and approved the 990 at the December 2010 board meeting. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy covers the board of directors. In December board members are asked to disclose any possible conflicts. The chief executive officer/administrator reviews the disclosures and determines if there are any conflicts. Any board member with a conflict is asked to abstain from voting on that issue. The conflict of interest for the CEO is covered by the management contract with Sanford Health. The CFO is not covered by the conflict of interest policy. |
| Form 990, Part VI, Section B, line 15 | Salary range for CEO is determined by Sanford Health and presented to Hillsboro Medical Center board of trustees for approval. Other officer's salaries are reviewed on an annual basis with comparative data. Market adjustments as well as annual increases are approved by the board. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy and financial statements are available upon request. |
| Form 990, Part VI, line 1 | The organization has an Executive Committee which has the power to transact all regular business of the organization during the interim between meetings of the Board of Directors, provided that any action taken does not conflict with the policies and expressed wishes of the Board and that the Executive Committee refers all matters of major importance to the full Board. The Executive Committee consists of the Chairperson, Vice Chairperson, Corporation CEO/Administrator, Treasurer and Secretary. The Executive Committee is chaired by the Chairperson and meets on call of the Chairperson of the Board or Corporation CEO/Administrator. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hillsboro Medical Center Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 609 | AddressLine1 |
| City | Hillsboro | City |
| State | ND | State |
| ZIP Code | 58045 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363542187 | EIN |
| Primary Activities | Fundraising | PrimaryActivities |
| Legal Domicile State | ND | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 7 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hillsboro Medical Center Foundation | BusinessNameLine1 |
Comments