Skip to content
Nonprofiteer
← NORTHERN PINES MEDICAL CENTER

Form 990 for tax year 2022

Filed by NORTHERN PINES MEDICAL CENTER.

Totals

Total revenue
$24,766,486
Total expenses
$21,189,428
Contributions and grants received
$221,944
Grants paid
$12,500
Program service revenue
$24,109,996
Investment income
$420,718
Other revenue
$13,828
Total assets, end of year
$29,815,711
Total liabilities, end of year
$7,739,176
Net assets or fund balances, end of year
$22,076,535
Program services expenses (Part IX)
$16,811,097
Management and general expenses
$4,378,331
Fundraising expenses
$0
Program service expenses (Part III)
$16,811,097

Program services were 79.3% 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)

    $219,294

  • 1f · All other contributions, gifts and grants

    $2,650

  • 2a · Program service revenue: PATIENT REVENUE

    total $20,365,532 · related or exempt $20,364,791 · unrelated business $741

  • 2b · Program service revenue: SKILLED NURSING FACILITY REVENUE

    total $3,540,272 · related or exempt $3,540,272

  • 2c · Program service revenue: CENTRAL MN DIAGNOSTICS EQUITY

    total $204,192 · related or exempt $204,192

  • 3 · Investment income

    total $320,559 · excluded $320,559

  • 6a · Gross rents

    real property $1,440

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $1,440

  • 6d · Net rental income or loss

    total $1,440 · excluded $1,440

  • 7a · Gross sales of assets other than inventory

    securities $3,020,793

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

    securities $2,920,634

  • 7c · Gain or loss

    securities $100,159

  • 7d · Net gain or loss

    total $100,159 · excluded $100,159

  • 11a · Other revenue: CAFETERIA REVENUE

    total $12,113 · excluded $12,113

  • 11b · Other revenue: MISCELLANEOUS REVENUE

    total $275 · excluded $275

  • 11e · Other revenue, total

    $12,388

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $12,500 · program services $12,500

  • 5 · Compensation of officers, directors and key employees

    total $330,469 · program services $108,352 · management and general $222,117

  • 7 · Other salaries and wages

    total $9,365,357 · program services $8,440,153 · management and general $925,204

  • 8 · Pension plan contributions

    total $429,908 · program services $399,093 · management and general $30,815

  • 9 · Other employee benefits

    total $1,052,564 · program services $913,953 · management and general $138,611

  • 10 · Payroll taxes

    total $649,939 · program services $567,005 · management and general $82,934

  • 11b · Fees: legal

    total $12,867 · management and general $12,867

  • 11d · Fees: lobbying

    total $340 · management and general $340

  • 11f · Fees: investment management

    total $40,883 · management and general $40,883

  • 11g · Fees: other

    total $1,191,507 · program services $1,044,773 · management and general $146,734

  • 13 · Office expenses

    total $1,357,283 · program services $968,719 · management and general $388,564

  • 14 · Information technology

    total $76,036 · program services $68,524 · management and general $7,512

  • 16 · Occupancy

    total $281,040 · program services $253,276 · management and general $27,764

  • 17 · Travel

    total $39,403 · program services $34,115 · management and general $5,288

  • 19 · Conferences, conventions and meetings

    total $13,310 · program services $11,727 · management and general $1,583

  • 20 · Interest

    total $134,543 · program services $134,543

  • 22 · Depreciation, depletion and amortization

    total $649,979 · program services $585,768 · management and general $64,211

  • 23 · Insurance

    total $110,532 · program services $105,520 · management and general $5,012

  • 24a · Other expenses: AFFILIATE SUPPORT FEES

    total $2,210,424 · program services $1,072,719 · management and general $1,137,705

  • 24b · Other expenses: AFFILIATE EXP & REVENUE

    total $1,296,230 · program services $178,726 · management and general $1,117,504

  • 24c · Other expenses: MEDICAL SUPPLIES

    total $814,152 · program services $814,152

  • 24d · Other expenses: BAD DEBT EXPENSE

    total $702,233 · program services $702,233

  • 24e · All other expenses

    total $417,929 · program services $395,246 · management and general $22,683

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $38,611 · end of year $153,944

  • 2 · Savings and temporary cash investments

    beginning of year $3,775,592 · end of year $5,189,692

  • 4 · Accounts receivable

    beginning of year $2,489,417 · end of year $2,981,568

  • 7 · Other notes and loans receivable

    beginning of year $258,711 · end of year $380,213

  • 8 · Inventories for sale or use

    beginning of year $134,369 · end of year $112,713

  • 9 · Prepaid expenses and deferred charges

    beginning of year $25,431 · end of year $18,755

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

    $18,276,644

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

    $12,353,437

  • 10c · Land, buildings and equipment, net

    beginning of year $6,192,939 · end of year $5,923,207

  • 12 · Investments: other securities

    beginning of year $12,953,262 · end of year $14,702,471

  • 15 · Other assets

    beginning of year $663,149 · end of year $353,148

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,685,401 · end of year $1,137,545

  • 19 · Deferred revenue

    beginning of year $100,000 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $6,166,666 · end of year $5,916,455

  • 21 · Escrow or custodial account liability

    beginning of year $15,248 · end of year $16,741

  • 25 · Other liabilities

    beginning of year $964,508 · end of year $668,435

  • 27 · Net assets without donor restrictions

    beginning of year $17,599,658 · end of year $22,076,545

  • 28 · Net assets with donor restrictions

    end of year -$10

Mission and programs · 2022

Mission

WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES.

  • NORTHERN PINES MEDICAL CENTER, DBA ESSENTIA HEALTH NORTHERN PINES, IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES. MORE SPECIFICALLY, ESSENTIA HEALTH NORTHERN PINES IS CREATED AND ORGANIZED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY.ESSENTIA HEALTH NORTHERN PINES HAS A 16-BED CRITICAL ACCESS HOSPITAL AND MULTI-SPECIALTY CLINIC THAT SERVES THE COMMUNITIES OF THE EAST RANGE OF MINNESOTA'S IRON RANGE. THE HOSPITAL'S EMERGENCY DEPARTMENT OFFERS CARE 24 HOURS A DAY, SEVEN DAYS A WEEK. ESSENTIA HEALTH NORTHERN PINES IS A LEVEL IV TRAUMA CENTER.ESSENTIA HEALTH NORTHERN PINES HAS A 33-BED SKILLED NURSING FACILITY CONNECTED TO THE HOSPITAL THAT PROVIDES RESPITE, HOSPICE, AND TRANSITIONAL CARE, REHABILITATION AND THERAPY, THERAPEUTIC ACTIVITIES, AND OTHER SERVICES.ESSENTIA HEALTH NORTHERN PINES EMPLOYS APPROXIMATELY 105 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED OVER 2,000 HOSPITAL PATIENT DAYS AND APPROXIMATELY 16,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2023. THE CLINIC HAD NEARLY 12,000 ENCOUNTERS AND THE SKILLED NURSING FACILITY PROVIDED CLOSE TO 11,000 RESIDENT DAYS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2023, ESSENTIA HEALTH NORTHERN PINES PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $110,000 IN CHARITY CARE, $13,000 IN COMMUNITY SERVICES, AND $3,000 IN HEALTH PROFESSION EDUCATION.

    Expenses $16,811,097 · Grants $12,500 · Revenue $24,109,996

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

Listed in Part VII

  • Thomas Witt MD

    FORMER PHYSICIAN LEADER

    Total calculated
    $760,462
    From this org
    $0
    From related orgs
    $680,647
    Other
    $79,815
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $406,419 related
    Bonus
    $0 + $175,190 related
    Other
    $0 + $99,038 related
    Deferred
    $0 + $64,818 related
    Nontaxable benefits
    $0 + $14,997 related
    Filer's total
    $0 + $760,462 related

  • Krista Skorupa MD

    BOARD DIRECTOR

    Total calculated
    $603,239
    From this org
    $0
    From related orgs
    $533,408
    Other
    $69,831
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $336,583 related
    Bonus
    $0 + $143,215 related
    Other
    $0 + $53,610 related
    Deferred
    $0 + $54,798 related
    Nontaxable benefits
    $0 + $15,033 related
    Filer's total
    $0 + $603,239 related

  • Tammy Kritzer

    SENIOR VICE PRESIDENT, OPERATIONS

    Total calculated
    $533,962
    From this org
    $0
    From related orgs
    $468,127
    Other
    $65,835
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $326,304 related
    Bonus
    $0 + $139,215 related
    Other
    $0 + $2,608 related
    Deferred
    $0 + $50,738 related
    Nontaxable benefits
    $0 + $15,097 related
    Filer's total
    $0 + $533,962 related

  • Michelle Oman MD

    BOARD DIRECTOR

    Total calculated
    $379,323
    From this org
    $0
    From related orgs
    $315,946
    Other
    $63,377
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $315,422 related
    Bonus
    $0
    Other
    $0 + $524 related
    Deferred
    $0 + $24,400 related
    Nontaxable benefits
    $0 + $38,977 related
    Filer's total
    $0 + $379,323 related

  • Laura Ackman

    ADMINISTRATOR

    Total calculated
    $227,278
    From this org
    $213,949
    From related orgs
    $0
    Other
    $13,329
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $201,306
    Bonus
    $0
    Other
    $12,643
    Deferred
    $10,578
    Nontaxable benefits
    $2,751
    Filer's total
    $227,278

  • Jason Lenz

    NURSE PRACTITIONER

    Total calculated
    $219,061
    From this org
    $173,467
    From related orgs
    $0
    Other
    $45,594
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $153,280
    Bonus
    $20,000
    Other
    $187
    Deferred
    $9,114
    Nontaxable benefits
    $36,480
    Filer's total
    $219,061

  • Jessica Linsten

    NURSE PRACTITIONER

    Total calculated
    $199,700
    From this org
    $186,750
    From related orgs
    $0
    Other
    $12,950
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $166,561
    Bonus
    $20,000
    Other
    $189
    Deferred
    $9,434
    Nontaxable benefits
    $3,516
    Filer's total
    $199,700

  • Peter Mattson

    PHARMACY SITE SUPERVISOR

    Total calculated
    $196,380
    From this org
    $162,660
    From related orgs
    $0
    Other
    $33,720
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $161,762
    Bonus
    $0
    Other
    $898
    Deferred
    $8,423
    Nontaxable benefits
    $25,297
    Filer's total
    $196,380

  • Joshua Senger

    FINANCE DIRECTOR

    Total calculated
    $194,011
    From this org
    $0
    From related orgs
    $192,308
    Other
    $1,703
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $192,154 related
    Bonus
    $0
    Other
    $0 + $154 related
    Deferred
    $0 + $684 related
    Nontaxable benefits
    $0 + $1,019 related
    Filer's total
    $0 + $194,011 related

  • Richard Jackson

    MEDICAL LABORATORY TECHNICIAN

    Total calculated
    $186,824
    From this org
    $154,280
    From related orgs
    $0
    Other
    $32,544
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $154,239
    Bonus
    $0
    Other
    $41
    Deferred
    $8,032
    Nontaxable benefits
    $24,512
    Filer's total
    $186,824

  • Susan Stark

    NURSE PRACTITIONER

    Total calculated
    $142,108
    From this org
    $134,606
    From related orgs
    $0
    Other
    $7,502
    Hours/week
    60

  • Steve Feltman

    FORMER SENIOR FINANCE ADVISOR

    Total calculated
    $112,973
    From this org
    $0
    From related orgs
    $101,406
    Other
    $11,567
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $72,884 related
    Bonus
    $0
    Other
    $0 + $28,522 related
    Deferred
    $0 + $5,162 related
    Nontaxable benefits
    $0 + $6,405 related
    Filer's total
    $0 + $112,973 related

  • Richard Hess

    BOARD CHAIR/TREASURER

    Total calculated
    $4,963
    From this org
    $0
    From related orgs
    $4,963
    Other
    $0
    Hours/week
    2

  • Keith Shatava

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    2

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

  • 3 · Compensation committee
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 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
ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH NORTHERN PINES' ADMINISTRATOR'S COMPENSATION: A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: THOMAS WITT, MD $87,616 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: THOMAS WITT, MD $42,735 KRISTA SKORUPA, MD $30,398 TAMMY KRITZER $28,674

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

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • PMC-GATEWAY IMAGING LLC THRU 1132022

    N/A · IMAGING SERVICES · MN

  • HORSESHOE SURGERY CENTER LLC

    N/A · SURGERY CENTER · MN

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • ESSENTIA HEALTH INSURANCE SERVICES SPC LTD

    C · SELF INSURANCE · CJ · controlled entity

  • MID DAKOTA CLINIC INC

    C · CLINIC OPERATIONS CEASED 9/30/22 · ND · controlled entity

Provenance

Return type
form_990
Tax year
2022
Filed
6 May 2024
IRS schema version
2022v5.0
Source object
202441279349303419

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.