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Nonprofiteer
← MOBRIDGE REGIONAL HOSPITAL

Form 990 for tax year 2022

Filed by MOBRIDGE REGIONAL HOSPITAL.

Totals

Total revenue
$27,167,311
Total expenses
$28,184,742
Contributions and grants received
$490,204
Grants paid
$0
Program service revenue
$26,498,946
Investment income
$178,161
Other revenue
$0
Total assets, end of year
$47,667,918
Total liabilities, end of year
$20,957,382
Net assets or fund balances, end of year
$26,710,536
Program services expenses (Part IX)
$24,507,149
Management and general expenses
$3,677,593
Fundraising expenses
$0
Program service expenses (Part III)
$24,507,149

Program services were 87.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DR TRAVIS HENDERSON

    INTERNAL MEDICINE/DIRECTOR

    Total calculated
    $445,250
    From this org
    $386,670
    From related orgs
    $0
    Other
    $58,580
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $386,670
    Bonus
    $0
    Other
    $0
    Deferred
    $27,696
    Nontaxable benefits
    $30,884
    Filer's total
    $445,250

  • DR ROBERT MARCIANO

    FAMILY MD/DIRECTOR

    Total calculated
    $354,736
    From this org
    $322,234
    From related orgs
    $0
    Other
    $32,502
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $322,234
    Bonus
    $0
    Other
    $0
    Deferred
    $12,200
    Nontaxable benefits
    $20,302
    Filer's total
    $354,736

  • BILL BACHMEIER

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    1

  • LORI HEIL

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • PATTI SCHMEICHEL

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • HEIDI ROSHAU

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • ADAM HAYES

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • CHRISTOPHER BOHLANDER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JAKE KRAFT

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • RICHARD GROSS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • LAURIE BAUER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JOSH WUDEL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • RENAE KARST

    CFO

    Total calculated
    $167,071
    From this org
    $130,505
    From related orgs
    $0
    Other
    $36,566
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $130,505
    Bonus
    $0
    Other
    $0
    Deferred
    $5,572
    Nontaxable benefits
    $30,993
    Filer's total
    $167,070

  • JOHN AYOUB

    CEO

    Total calculated
    $0
    Hours/week
    40 + 0.25 related

  • DR DONALD LUCEK

    SURGEON

    Total calculated
    $340,322
    From this org
    $288,382
    From related orgs
    $0
    Other
    $51,940
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $288,382
    Bonus
    $0
    Other
    $0
    Deferred
    $31,639
    Nontaxable benefits
    $20,302
    Filer's total
    $340,323

  • DR MATT SCHAFFER

    PHYSICIAN

    Total calculated
    $403,863
    From this org
    $363,157
    From related orgs
    $0
    Other
    $40,706
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $363,157
    Bonus
    $0
    Other
    $0
    Deferred
    $12,200
    Nontaxable benefits
    $28,506
    Filer's total
    $403,863

  • DR EMILY BODEN

    PHYSICIAN

    Total calculated
    $391,019
    From this org
    $345,121
    From related orgs
    $0
    Other
    $45,898
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $345,121
    Bonus
    $0
    Other
    $0
    Deferred
    $12,200
    Nontaxable benefits
    $33,698
    Filer's total
    $391,019

  • DR JOSH HENDERSON

    INTERNAL MEDICINE

    Total calculated
    $384,669
    From this org
    $343,963
    From related orgs
    $0
    Other
    $40,706
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $343,963
    Bonus
    $0
    Other
    $0
    Deferred
    $12,200
    Nontaxable benefits
    $28,506
    Filer's total
    $384,669

  • DR ALAN LAWRENCE

    SURGEON

    Total calculated
    $407,876
    From this org
    $381,058
    From related orgs
    $0
    Other
    $26,818
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $381,058
    Bonus
    $0
    Other
    $0
    Deferred
    $6,516
    Nontaxable benefits
    $20,302
    Filer's total
    $407,876

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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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 3
THE CEO IS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH CHI ST. ALEXIUS MEDICAL CENTER IN BISMARCK, ND. THE EXECUTIVE COMMITTEE OF MOBRIDGE REGIONAL HOSPITAL REVIEWS THE MANAGEMENT AGREEMENT AND MAKES A DETERMINATION AS TO WHETHER THE COMPENSATION FOR THE CEO'S SERVICES IS REASONABLE.
PART I, LINE 4B
DEFERRALS WERE MADE TO THE 457(B) PLAN (NOT SUBSTANTIALLY VESTED) BY THE FOLLOWING PARTICIPANTS: DR. TRAVIS HENDERSON - $15,496 AND DR. DON LUCEK - $20,500.

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.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
14 August 2024
IRS schema version
2022v5.0
Source object
202422279349303062

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