Skip to content
Nonprofiteer
← TIOGA MEDICAL CENTER

Form 990 for tax year 2022

Filed by TIOGA MEDICAL CENTER.

Totals

Total revenue
$20,573,775
Total expenses
$16,963,918
Contributions and grants received
$3,991,674
Grants paid
$4,500
Program service revenue
$16,239,621
Investment income
$21,166
Other revenue
$321,314
Total assets, end of year
$25,723,240
Total liabilities, end of year
$7,192,435
Net assets or fund balances, end of year
$18,530,805
Program services expenses (Part IX)
$13,712,529
Management and general expenses
$3,251,389
Fundraising expenses
$0
Program service expenses (Part III)
$13,712,529

Program services were 80.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $3,945,019

  • 1f · All other contributions, gifts and grants

    $46,655

  • 2a · Program service revenue: Patient & Resident Revenue

    total $15,574,608 · related or exempt $15,574,608

  • 2b · Program service revenue: 340B Pharmacy

    total $495,945 · related or exempt $495,945

  • 2c · Program service revenue: Other Revenue

    total $169,068 · related or exempt $169,068

  • 3 · Investment income

    total $27,242 · excluded $27,242

  • 5 · Royalties

    total $327,263 · excluded $327,263

  • 6a · Gross rents

    real property $9,468

  • 6b · Less rental expenses

    real property $15,417

  • 6c · Rental income or loss

    real property -$5,949

  • 6d · Net rental income or loss

    total -$5,949 · excluded -$5,949

  • 7a · Gross sales of assets other than inventory

    other assets $6,080

  • 7b · Less cost or other basis and sales expenses

    securities $12,156 · other assets $0

  • 7c · Gain or loss

    securities -$12,156 · other assets $6,080

  • 7d · Net gain or loss

    total -$6,076 · excluded -$6,076

Functional expenses

Part IX, the statement of functional expenses.

  • 2 · Grants to domestic individuals

    total $4,500 · program services $4,500

  • 5 · Compensation of officers, directors and key employees

    total $323,006 · management and general $323,006

  • 6 · Compensation of disqualified persons

    total $302,309 · program services $302,309

  • 7 · Other salaries and wages

    total $6,911,103 · program services $5,620,881 · management and general $1,290,222

  • 8 · Pension plan contributions

    total $262,232 · program services $211,763 · management and general $50,469

  • 9 · Other employee benefits

    total $756,175 · program services $600,974 · management and general $155,201

  • 10 · Payroll taxes

    total $497,980 · program services $392,101 · management and general $105,879

  • 11b · Fees: legal

    total $7,153 · management and general $7,153

  • 11c · Fees: accounting

    total $423,841 · management and general $423,841

  • 11f · Fees: investment management

    total $5,910 · management and general $5,910

  • 11g · Fees: other

    total $2,491,556 · program services $2,491,556

  • 12 · Advertising and promotion

    total $40,369 · management and general $40,369

  • 13 · Office expenses

    total $500,018 · program services $388,698 · management and general $111,320

  • 14 · Information technology

    total $465,039 · management and general $465,039

  • 16 · Occupancy

    total $406,800 · program services $403,779 · management and general $3,021

  • 17 · Travel

    total $44,247 · program services $16,870 · management and general $27,377

  • 19 · Conferences, conventions and meetings

    total $28,026 · program services $14,436 · management and general $13,590

  • 20 · Interest

    total $122,486 · program services $122,486

  • 22 · Depreciation, depletion and amortization

    total $1,164,775 · program services $1,114,326 · management and general $50,449

  • 23 · Insurance

    total $94,709 · program services $94,709

  • 24a · Other expenses: Medical Supplies

    total $1,347,257 · program services $1,347,257

  • 24b · Other expenses: Repairs and Maintenance

    total $309,492 · program services $268,719 · management and general $40,773

  • 24c · Other expenses: Food

    total $236,580 · program services $236,580

  • 24d · Other expenses: Dues and Subscriptions

    total $26,566 · management and general $26,566

  • 24e · All other expenses

    total $191,789 · program services $80,585 · management and general $111,204

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $5,653,523 · end of year $4,592,196

  • 3 · Pledges and grants receivable

    end of year $10,695

  • 4 · Accounts receivable

    beginning of year $2,866,507 · end of year $2,910,059

  • 8 · Inventories for sale or use

    beginning of year $107,275 · end of year $94,179

  • 9 · Prepaid expenses and deferred charges

    beginning of year $105,837 · end of year $133,955

  • 10a · Land, buildings and equipment: cost or other basis

    $26,667,458

  • 10b · Land, buildings and equipment: accumulated depreciation

    $15,684,242

  • 10c · Land, buildings and equipment, net

    beginning of year $11,814,927 · end of year $10,983,216

  • 11 · Investments: publicly traded securities

    beginning of year $1,853,054 · end of year $3,167,735

  • 15 · Other assets

    beginning of year $205,871 · end of year $3,831,205

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,187,645 · end of year $934,659

  • 19 · Deferred revenue

    beginning of year $333,831

  • 21 · Escrow or custodial account liability

    beginning of year $11,075 · end of year $10,125

  • 23 · Secured mortgages and notes payable

    beginning of year $6,190,509 · end of year $5,889,561

  • 25 · Other liabilities

    beginning of year $0 · end of year $358,090

  • 27 · Net assets without donor restrictions

    beginning of year $14,877,434 · end of year $18,524,305

  • 28 · Net assets with donor restrictions

    beginning of year $6,500 · end of year $6,500

Mission and programs · 2022

Mission

The mission of Tioga Medical Center is to address the health care needs of the community through providing quality health care and promoting education and wellness.

Activities or mission (Part I)

Health care and nursing care services

  • Tioga Medical Center provides delivery of healthcare services over eastern Williams county, Burke County and western Mountrail county of the state of North Dakota.Requirements of the IRS community benefit standard for tax-exempt organizations are integral to Tioga Medical Center's larger charitable mission of improving health and quality of life. Specifically, an independent board including community leaders, business experts and consumer representatives governs Tioga Medical Center. The Board has a history of commitment to acting with the highest integrity. For example:-Policies on confidentiality of patient and corporate information are reviewed annually as a component of mandatory education, and a confidentiality statement is signed and/or reviewed annually by all employees and board members.-Board members and key employees review and sign a conflict of interest statement annually.-Tioga Medical Center's code of conduct is published in its employee handbook and included in general orientation of all new employees and volunteers.Tioga Medical Center also makes medical care accessible to the entire community it serves. Tioga Medical Center operates a 24 hour emergency room and provides emergency care regardless of ability to pay. Tioga Medical Center had 1,944 emergency room visits during the past fiscal year. Tioga Medical Center provides clinical services needed to operate the emergency room.In addition, Tioga Medical Center provides non-emergency services to the community it serves. It makes these services accessible to the community through participation in government programs like Medicare and Medicaid and by offering assistance through the Tioga Medical Center's uncompensated care program.Tioga Medical Center's uncompensated care (charity care) program provides free services to patients who lack the resources to be fully responsible for the health care they receive. The uncompensated care program is designed to ensure the entire community served by Tioga Medical Center has access to needed healthcare services. The Tioga Medical Center administration oversees services delivered under the uncompensated care program, including assessing community needs, approving eligibility criteria and monitoring the effectiveness of the program in providing community access to medical care.Tioga Medical Center maintains records to identify and monitor the level of care provided under the uncompensated care program. These records include the amount of charges foregone for services and supplies furnished under its charity care program. Tioga Medical Center had costs for charity care for the year ended June 30, 2023 of approximately $29,000.Tioga Medical Center takes its mission to improve the health and quality of life of the people it serves a step further by reaching out to meet the broad needs of the community. It strives to identify the community needs beyond basic healthcare, and then respond to them, aiming to make a positive, life-enhancing difference in the community. For example, many employees and Board members of Tioga Medical Center are actively involved in volunteer organizations that serve to protect the community, such as the Tioga Fire & Ambulance Department. As a small community, it is vital for people to come to the aid, as volunteers, when people are in need of assistance. Tioga Medical Center allows its employees to leave the workplace to tend to the emergency needs of the community we serve.The Tioga Medical Center, located at Tioga, North Dakota, is a provider of integrated healthcare delivery services consisting of a 25 bed Medicare designated Critical Access Hospital (CAH). The Tioga Medical Center CAH is a Level V designated trauma center. Within the CAH, acute care services are provided, along with swing bed services.

    Expenses $7,695,052 · Grants $4,500 · Revenue $10,145,520

  • Attached to the CAH is a 30 bed skilled nursing facility. This facility provides skilled and long term care services to its residents.

    Expenses $3,167,766 · Revenue $3,727,846

  • The Medical Center also operates three clinics located in Tioga, Ray, and Powers Lake. These clinics are Medicare and Medicaid designated provider-based rural health clinics. Within the clinics, they employ one Family Medicine Physician, two Physician Assistants and two Family Nurse Practitioners. These practitioners provide physician related services at these clinics, as well as to the CAH and SNF.

    Expenses $2,599,310 · Revenue $2,128,972

  • Finally, attached to the Nursing home is a 22 unit independent living unit. The organization also has a Foundation that distributes scholarships.

    Expenses $250,401 · Revenue $237,283

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • James Booth

    Chairman

    Total calculated
    $0
    Hours/week
    1
  • Brodie Odegaard

    Vice Chairman

    Total calculated
    $0
    Hours/week
    0.5
  • Wendy Lenzen

    Secretary/Treasurer

    Total calculated
    $0
    Hours/week
    0.5
  • Nathan Germundson

    Director

    Total calculated
    $0
    Hours/week
    0.5
  • Lee Olson

    Director

    Total calculated
    $0
    Hours/week
    0.5
  • Seth Wisthoff

    Director

    Total calculated
    $0
    Hours/week
    0.5
  • Jeremy Becker

    Director

    Total calculated
    $0
    Hours/week
    0.5
  • Carolyn Eide

    Director thru March 2023

    Total calculated
    $0
    Hours/week
    0.5
  • Brandon Hauge

    Director thru January 2023

    Total calculated
    $0
    Hours/week
    0.5
  • Kristopher Kuehn

    Director as of March 2023

    Total calculated
    $0
    Hours/week
    0.5
  • Patrick Joyce

    Director as of March 2023

    Total calculated
    $0
    Hours/week
    0.5
  • Holly Bryant

    CFO as of February 2023

    Total calculated
    $0
    Hours/week
    40
  • Ryan Mickelsen

    CEO/Pres. thru January 2023

    Total calculated
    $228,377
    From this org
    $189,369
    From related orgs
    $0
    Other
    $39,008
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $187,289
    Bonus
    $2,080
    Other
    $0
    Deferred
    $6,045
    Nontaxable benefits
    $32,963
    Filer's total
    $228,377
  • Jamie Eraas - CFO thru

    Jan 2023/CEO as of Feb 2023

    Total calculated
    $90,506
    From this org
    $87,353
    From related orgs
    $0
    Other
    $3,153
    Hours/week
    40
  • Dr Robert Rotering

    Medical Director/Physician

    Total calculated
    $445,028
    From this org
    $426,056
    From related orgs
    $0
    Other
    $18,972
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $413,976
    Bonus
    $12,080
    Other
    $0
    Deferred
    $9,093
    Nontaxable benefits
    $9,879
    Filer's total
    $445,028
  • Jeffrey Moberg Jr

    Physician Assistant

    Total calculated
    $395,034
    From this org
    $352,844
    From related orgs
    $0
    Other
    $42,190
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $350,764
    Bonus
    $2,080
    Other
    $0
    Deferred
    $9,025
    Nontaxable benefits
    $33,165
    Filer's total
    $395,034
  • Jesse Mitchell

    Nurse Practitioner

    Total calculated
    $237,160
    From this org
    $209,295
    From related orgs
    $0
    Other
    $27,865
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $207,215
    Bonus
    $2,080
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $27,865
    Filer's total
    $237,160
  • Shelby Knox

    Physician Assistant

    Total calculated
    $243,990
    From this org
    $224,668
    From related orgs
    $0
    Other
    $19,322
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $222,588
    Bonus
    $2,080
    Other
    $0
    Deferred
    $6,806
    Nontaxable benefits
    $12,516
    Filer's total
    $243,990
  • Nancy Carlson

    Nurse Practitioner

    Total calculated
    $176,208
    From this org
    $148,818
    From related orgs
    $0
    Other
    $27,390
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $147,154
    Bonus
    $1,664
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $27,390
    Filer's total
    $176,208

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Discretionary spending account
  • 1a · Housing allowance or residence for personal use
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Part I, Line 1a
The spending account is for a continuing medical education allowance. The doctors have an allowance of $4,000 per year for their continuing education. The board provides direction on the CME allowance. Review of the allowance is completed during each recruitment phase. An estimate is determined by the board based on a reasonable estimate provided by the recruiters. Total expenditures per person are reviewed and examined on an industry standard basis. These numbers are reevaluated each time a new doctor is recruited. Dr. Rotering and Jesse Mitchell live in a Tioga Medical Center apartment. The organization did include this as a taxable benefit income on their W-2.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Provenance

Return type
form_990
Tax year
2022
Filed
17 April 2024
IRS schema version
2022v5.0
Source object
202421169349300327

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.