2026-05-13T11:13:55-05:00 2025-06-30 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2024-07-01 450227753 Cooperstown Medical Center COOP 7017861700 107 12th St S Cooperstown ND 584254501 Judy Monson CFO 7017861700 2026-05-12 1 1 Lisa Chaffee CPA P00193453 7012551091 2026-05-12 2024 2025-03-06 01:10:19Z Dakota Regional Medical Center Nicole Lindsey 107 12th St S Cooperstown ND 584254501 9989983 0 X https://www.dakotaregional.com/ X 1946 ND Provide health care services to the residents including the elderly in the Cooperstown, North Dakota and surrounding communities regardless of the ability to pay. 5 5 77 6 0 0 1450986 660026 6917599 8918590 -38681 391636 2040 19731 8331944 9989983 5753 735 0 0 4285430 4209785 0 0 0 4161998 5674486 8453181 9885006 -121237 104977 27345540 27459315 23340562 23349360 4004978 4109955 X Cooperstown Medical Center is dedicated to providing high quality healthcare services in a personalized, compassionate, and professional manner. 0 0 8085661 735 8918590 Cooperstown Medical Center is a 9 bed Critical Access Hospital that serves to reduce the need for extended travel by providing essential healthcare services within the local area. Through established affiliations with major medical organizations, the facility is able to deliver a range of clinical capabilities typically associated with larger hospitals. The medical center offers continuous emergency services and maintains access to key diagnostic resources, including x ray, CT imaging, laboratory testing, electrocardiography, and respiratory therapy. Rehabilitation services are available across multiple disciplines, including occupational, physical, and speech therapy, supporting both acute and long term patient needs. Additional specialized services include (continued on Schedule O)cardiac monitoring and telemetry, sleep studies, inpatient hemodialysis, and incontinence management. The organization also provides a continuum of care through swing bed services, respite care, and hospice care, ensuring that patients can receive appropriate support across various stages of treatment and recovery. Overall, Cooperstown Medical Center functions as a comprehensive local healthcare resource, offering a broad scope of services within a rural setting.The organization operates three Rural Health Clinics located in Cooperstown, Lakota, and New Rockford. These clinics collectively serve a primary service area of approximately 1,800 individuals and a secondary service area of an estimated 10,900 individuals. As designated Rural Health Clinics, they provide essential primary and preventive care within underserved rural communities, often functioning as the most accessible point of healthcare for residents. The clinics play a central role in supporting community health by emphasizing preventive medicine and the ongoing management of chronic conditions. Through this focus, they contribute to improved long term health outcomes and help ensure that individuals in rural areas have consistent access to foundational medical services.The twelve assisted living apartments provide a secure, maintenance free residential setting designed to support individuals who require assistance with activities of daily living. Services such as medication management and dressing are available, with additional options including whirlpool bathing and linen services. Residents have access to weekly grocery delivery and benefit from private, accessible living units that promote independence while ensuring appropriate support. Care plans are individualized to address each resident's specific health and functional needs, including assistance with grooming and mobility. Housekeeping services are provided, reducing the responsibilities associated with home maintenance. Residents have access to on site amenities such as dining rooms, exercise spaces, and libraries, along with organized activities, group outings, and communal dining that encourage social engagement and support overall well being. Two meals per day, along with snacks, are provided, and transportation is arranged for medical appointments, shopping, and community events. All assisted living units are two bedroom apartments equipped with full kitchens. They are designed for accessibility and safety, featuring secured common areas, wide doorways, walk in showers, grab bars and safety equipment such as emergency call systems to ensure timely staff response when needed. 8085661 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 11 0 1 77 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Judy Monson 7017972221 107 12th St S Cooperstown ND 584254501 Barry Getz -President thru Dec/Director until May 1.00 X X 0 0 0 Gerald Stokka -Vice President until Dec/President as of Jan 1.00 X X 0 0 0 Brett Salvesen Vice President 1.00 X X 0 0 0 Benjamin Halvorson Secretary/Treasurer 1.00 X X 0 0 0 Larry Grandalen Director 1.00 X 0 0 0 Scott Tranby Director as of May 1.00 X 0 0 0 Nicole Lindsey CEO/Administrator 12.00 1.00 X 61197 0 11732 Judy Monson CFO 28.00 1.00 X 131459 0 29307 Kali Manz Provider/Clinic Manager 40.00 X 126124 0 19601 Lanette Harr-Isakson Nurse 40.00 X 117165 0 7288 Liza Ystaas Provider 40.00 X 137538 0 27494 Steven Barlow Provider 40.00 X 275745 0 34468 849228 0 129890 5 0 1 1 Triage LLC PO Box 773328 Chicago IL 606773328 Traveling Nurses 530997 CGI Staffing LLC 205 Legion Rd Bloomsberg PA 17815 Contract Providers 473305 Altru Health System 1200 S Columbia Road Grand Forks ND 58201 Therapies 307709 Grigg County Care Center 107 12th St SE Cooperstown ND 584254501 Laundry/Meals/Admin 173984 Prime Time Healthcare PO Box 3544 Omaha NE 68103 Traveling Nurses 163003 6 592089 67937 660026 Net Patient/Resident R 623000 8129512 8129512 Assisted Living Rental 623000 198922 198922 590156 590156 8918590 391636 391636 19731 0 19731 19731 19731 9989983 8918590 0 411367 X 735 735 245241 245241 86703 13824 72879 3224468 2609305 615163 68153 56615 11538 339161 285813 53348 246059 187734 58325 2648 2648 107956 107956 2676522 2394840 281682 9373 9373 22727 11461 11266 274771 242733 32038 22087 20847 1240 16191 7925 8266 603670 522563 81107 883915 784033 99882 128966 128966 Medical Supplies 767991 767991 Dues and Subscriptions 47618 8809 38809 Repairs and Maintenance 37644 37644 72407 3823 68584 9885006 8085661 1799345 0 2396 2132342 400000 0 1518168 1855359 88542 87275 123229 83798 18760152 5913212 13621530 12846940 529586 302314 11062089 10151287 27345540 27459315 550167 720295 26880 27780 22417475 22060783 346040 540502 23340562 23349360 X 4004978 4109955 4004978 4109955 27345540 27459315 104977 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 606 0 0 0 606 0 Part II-B, Line 1: The Organization is a member of several organizations that take part in lobbying. A portion of the dues paid to the various organizations is for lobbying costs. These various organizations advocate on behalf of their members by supporting legislation that is in their collective interests. 0 1 X 395017 395017 14073806 3761313 10312493 3726650 1995416 1731234 564679 156483 408196 12846940 Estimated Third Party Payors 168000 Right of Use Assets 236157 Investment in Sales-Type Lease 9747130 10151287 Related Party Payable 268184 Interest Payable 29409 Lease Liability 242909 540502 X 9989983 0 9989983 0 9989983 9885006 0 9885006 0 9885006 Part IV, Line 2b: Security deposits advanced by tenants of the assisted living units are held in trust by the Organization. These funds are included in cash and cash equivalents and accounts payable in the consolidated financial statements. Tenant security deposits totaled $27,780 and $26,880 at June 30, 2025 and 2024. Part X, Line 2: The Medical Center believes that they have appropriate support for any tax positions taken affecting their annual filing requirements, and as such, do not have any uncertain tax positions that are material to the consolidated financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 0 0 76000 76000 0.00770 458043 435244 22799 0.00230 534043 435244 98799 0.01000 1511373 1294024 217349 0.02200 1511373 1294024 217349 0.02200 2045416 1729268 316148 0.03200 1 278110 91776 3939347 3960809 -21462 X 1 1 1 1 Cooperstown Medical Center DBA DRMC 107 12th St S Cooperstown ND 58425 www.dakotaregional.com 5010 X X X 3 provider-based clinics Cooperstown Medical Center 1 0 0 1 X X X X X X X X X 24 1 0 1 1 X https://www.dakotaregional.com/about-7 X 1 24 1 https://www.dakotaregional.com/about-7 0 1 X 100.000000000000 200.000000000000 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X 1 X 0 X X X X 1 X 0 0 Cooperstown Medical Center Part V, Section B, Line 5: The Center for Rural Health (CRH), in partnership with DRMC and Nelson-Griggs District Health Unit (NGDHU), facilitated the CHNA process. Community representatives met regularly in-person, by telephone conference, and email. A CHNA liaison was selected locally, who served as the main point of contact between CRH and DRMC. A steering committee was formed that was responsible for planning and implementing the process locally. Representatives from CRH met and corresponded regularly by videoconference and/or via the eToolkit with the CHNA liaison. The community group (described in more detail below) provided in-depth information and informed the assessment process in terms of community perceptions, community resources, community needs, and ideas for improving the health of the population and healthcare services. Nine people, representing a cross section demographically, attended the focus group meeting. The meeting was highly interactive with good participation. DRMC staff and board members were in attendance as well but largely played a role of listening and learning.The original survey tool was developed and used by CRH. In order to revise the original survey tool to ensure the data gathered met the needs of hospitals and public health, CRH worked with the North Dakota Department of Health's public health liaison. CRH representatives also participated in a series of meetings that garnered input from the state's health officer, local North Dakota public health unit professionals, and representatives from North Dakota State University. As part of the assessment's overall collaborative process, CRH spearheaded efforts to collect data for the assessment in a variety of ways: - A survey solicited feedback from area residents - Community leaders representing the broad interests of the community took part in one-on-one key informant interviews - The community group, comprised of community leaders and area residents, was convened to discuss area health needs and inform the assessment process - A wide range of secondary sources of data were examined, providing information on a multitude of measures, including demographics, health conditions, indicators, outcomes, rates of preventive measures, rates of disease, and at-risk behavior Cooperstown Medical Center Part V, Section B, Line 6b: Nelson-Griggs District Health Unit Cooperstown Medical Center Part V, Section B, Line 11: The organization completed a new CHNA during FY25.The current process did identify one identical common need from 2022. Depression/anxiety was identified in 2022 and 2025. The needs identified in the FY25 CHNA are:1. Attracting and retaining young families2. Availability of resources to help the elderly stay in their homes3. Availability of home health4. Depression/anxiety for all agesTop needs identified in the prior CHNA were:1. Availability of Mental health services2. Bullying/cyberbullying3. Depression/anxiety4. Having enough child daycare servicesDuring the tax year, the facility took actions to address priority needs identified in its 2022 and 2025 Community Health Needs Assessment (CHNA). To promote mental health awareness and access to crisis resources, the facility actively marketed the Suicide Hotline through its social media platforms, increasing visibility and community engagement. To support community development and address the need to attract and retain young families, the facility initiated discussions with city leaders regarding the potential repurposing of former facility properties for housing targeted to young families. Additionally, the facility explored and began implementing telehealth options to expand access to care, particularly for individuals facing barriers to in-person services thus increasing the availability of resources to help the elderly stay in their homes. Part V, Section B, Line 16a-c: Line 16a: https://www.dakotaregional.com/about-7Line 16b: https://www.dakotaregional.com/about-7Line 16c: https://www.dakotaregional.com/payment-policy 1 1 - Park Place Assisted Living 1204 Park Ave Cooperstown ND 58425 Assisted Living Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part II, Community Building Activities: The Organization participates in community building activities, however, the activities are too difficult to quantify and are not tracked. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 3: CMC used the percentage of charity care/financial assistance applications that were denied due to lack of sufficient information or were never returned to determine the amount of implicit price concessions that is attributable to patients who would likely qualify for charity. For FY 2025 approximately 33% of applications lacked information or were never returned after patient was given an application to complete. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 13 and 14 of the attached audited financial statements. Part III, Line 8: Hospital services remibursed on a fee schedule are not included in the Medicare calculations per the 990 instructions. Had this been reported the Hospital would have had a greater loss from Medicare services of $74,260.Medicare fee schedule revenue $45,157Medicare estimated costs of care relating to payment ($119,417) Net surplus (shortage) ($74,260) Part III, Line 9b: When patients are known to qualify for financial assistance, they are requested to fill out a financial assistance application and collection actions are stopped. If an application is returned with insufficient information a telephone call and/or a letter is sent indicating what is still needed to process the application. If no response is received, the application will be reviewed by the Financial Assistance/Community Care Program committee to determine if collection proceedings should resume or if presumptive charity care be allowed. Patients will be notified when the facility determines the amount of financial assistance approved. Part VI, Line 2: The Organization initiated a program to give patients high-quality, coordinated service and health care, improve health outcomes, and manage costs primarily focusing on annual wellness and preventive screenings. We also host an annual breast health awareness day in October. A Community Health Needs Assessment was completed in fiscal year 2025 to help assess needs in the community. Part VI, Line 3: Patients receive charity care information through the business office. The Organization mails brochures regarding the program in past due statements. The Organization also gives the brochure to people in the community known to the Organization that do not have insurance upon arrival for a visit. The charity care information is part of the intake process. Part VI, Line 4: As of the census of 2020, there were 2,306 people and 946 households residing in the county. The population density was 3.4 people per square mile. There were 1,378 housing units. The racial makeup of the county was 95.70% White, 0.30% Asian, 0.40% Black, 0.6% American Indian and Alaska Native persons, and 3.0% from other races. There were 946 households out of which 23.0% had children under the age of 18 living with them, 51.2% were married couples living together, and 24.6% had a female householder with no husband present. The average family size was 3.23.In the county the population was spread out with 23.4% under the age of 19, 4.4% from 20 to 24, 15.6% from 25 to 44, 27.8% from 45 to 64, and 28.8% who were 65 years of age or older. The median age was 50.6 years. The median income for a household in the county was $64,737, and the median income for a family was $92,500. About 10.1% of the population were below the poverty line, including 7.3% of those under age 18 and 14.1% of those ages 65 or over. Part VI, Line 5: The Organization offers a variety of services to the community to assist in taking away the burden of having to travel for medical care. The Organization also assists in accommodating any financial concerns through the charity care program. By doing both, the Organization hopes to better the well-being of the community. The Board of Directors is comprised of persons who reside in the primary service area. Medical staff privileges are given to all qualified physicians in the community. The Organization is affiliated with Emergency Heart Network, St. Paul Ramsey Burn Center, and Life Flight. When available, surplus funds are used to upgrade patient care equipment and facility infrastructure.The organization continued to offer COVID-19 screenings available at no cost to the public, unless a physician visit was required due to the patient's condition. 0 0 0 0 0 0 0 1 0 Steven Barlow Provider 275345 0 400 0 0 0 2496 0 33387 0 311628 0 0 0 Liza Ystaas Provider 137538 0 0 0 0 0 3828 0 25081 0 166447 0 0 0 Judy Monson CFO 126459 0 5000 0 0 0 427 0 30114 0 162000 0 0 0 Nicole Lindsey CEO/Administrator 61197 0 0 0 0 0 2495 0 9661 0 73353 0 0 0 Part I, Line 3 Nicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The amounts reported in Part VII and on schedule J represent 30 percent of her compensation. Part I, Line 7 Completion of special projects bonus was given to the CFO. Darnell Lindsey Husband of CEO, Nicole Lindsey 72879 Compensation 0 Mark Anderson Parent of CEO, Nicole Lindsey 13824 Compensation 0 Form 990, Part VI, Section A, line 1a An Executive Committee may be appointed or dissolved by a majority vote of the Board of Directors. If so formed, the Executive Committee, in addition to the Chairman of the board and the Administrator, shall consist of the Secretary, the Treasurer, and one (1) additional member of the Board of Directors elected by the board at its first meeting after its election. The Executive Committee shall have power to transact all regular business of the Cooperstown Medical Center during the period between the meetings of the Board of Directors, subject to any prior limitations imposed by the Board and with the understanding that all matters of major importance will be referred to the Board of Directors. Minutes of the Executive Committee meetings shall be submitted to the Board, and its actions shall be subject to approval or disapproval at the next regular Board meeting. Form 990, Part VI, Section A, line 2 Gerald Stokka and Barry Getz have a family relationship. Form 990, Part VI, Section A, line 6 The Organization has members consisting of those persons who are 18 years of age or above residing in the area served by Cooperstown Medical Center. Form 990, Part VI, Section A, line 7a The Members elect the Board of Directors. Form 990, Part VI, Section B, line 11b The CFO reviews the Form 990 prior to filing with the Internal Revenue Service. The Board of Directors also receives a copy of the Form 990 by email prior to it being filed with the IRS. Form 990, Part VI, Section B, line 12c Each board member annually and upon hire each corporate officer, executive, department director, supervisor or other individual, duly authorized by the governing body to conduct business on behalf of Cooperstown Medical Center signs a statement which affirms that such person: 1) has received a copy of the conflict of interest policy; 2) has read and understands the policy; 3) has agreed to comply with the policy; 4) understands that the organization is and includes charitable organizations and that in order to maintain its federal tax exemption it must engage primarily in activities which further one or more of its tax-exempt purposes. If a conflict arises, the board will assign a disinterested person to investigate alternatives to the proposed transaction or arrangement. The interested member is to provide information to the board, however not influence the board regarding their decision. Form 990, Part VI, Section B, line 15 Nicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The CFO, Judy Monson, was compensated for services to the Organization as well as for services to Griggs County Care Center (GCCC), an unrelated organization. Her compesnation was determined by an agreement between both the Organization's board of directors and that of GCCC. Thirty percent of Judy's compensation is billed to and reimbursed by GCCC. The amounts reported in part VII represent all of Judy's compensation including the thirty percent that is billed to GCCC. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request and at the annual meeting. Form 990, Part IX, line 11g Professional Fees: Program service expenses 1,663,567. Management and general expenses 8,650. Fundraising expenses 0. Total expenses 1,672,217. Purchased Services: Program service expenses 710,375. Management and general expenses 273,032. Fundraising expenses 0. Total expenses 983,407. Consultant Fees: Program service expenses 20,898. Management and general expenses 0. Fundraising expenses 0. Total expenses 20,898. Cooperstown Medical Center Foundation 107 12th St S Cooperstown ND 58425 450450301 To support the programs of the Cooperstown Medical Center ND 501(c)(3) Line 7 Cooperstown Medical Center 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 Cooperstown Medical Center Foundation C 592089 General Ledger