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Nonprofiteer
← GOOD SAMARITAN HOSPITAL ASSOCIATION

Form 990 for tax year 2023

Filed by GOOD SAMARITAN HOSPITAL ASSOCIATION.

Totals

Total revenue
$33,445,568
Total expenses
$31,320,176
Contributions and grants received
$1,725,570
Grants paid
$0
Program service revenue
$31,217,303
Investment income
$437,575
Other revenue
$65,120
Total assets, end of year
$71,154,311
Total liabilities, end of year
$40,090,165
Net assets or fund balances, end of year
$31,064,146
Program services expenses (Part IX)
$27,473,939
Management and general expenses
$3,846,237
Fundraising expenses
$0
Program service expenses (Part III)
$27,473,939

Program services were 87.7% 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.

  • 1d · Related organizations

    $923,173

  • 1e · Government grants (contributions)

    $753,937

  • 1f · All other contributions, gifts and grants

    $48,460

  • 2a · Program service revenue: Patient Service Revenue

    total $27,743,119 · related or exempt $27,743,119

  • 2b · Program service revenue: Pharmacy Revenue

    total $2,311,424 · related or exempt $2,311,424

  • 2c · Program service revenue: Cafeteria Revenue

    total $213,563 · related or exempt $213,563

  • 2d · Program service revenue: Daycare Services

    total $189,330 · related or exempt $189,330

  • 2f · All other program service revenue

    total $759,867 · related or exempt $759,867

  • 3 · Investment income

    total $454,397 · excluded $454,397

  • 6a · Gross rents

    real property $65,120

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $65,120

  • 6d · Net rental income or loss

    total $65,120 · excluded $65,120

  • 7a · Gross sales of assets other than inventory

    other assets $26,253

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

    other assets $43,075

  • 7c · Gain or loss

    other assets -$16,822

  • 7d · Net gain or loss

    total -$16,822 · excluded -$16,822

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $633,177 · program services $190,784 · management and general $442,393

  • 6 · Compensation of disqualified persons

    total $207,002 · program services $207,002

  • 7 · Other salaries and wages

    total $14,248,582 · program services $12,763,636 · management and general $1,484,946

  • 8 · Pension plan contributions

    total $342,183 · program services $307,293 · management and general $34,890

  • 9 · Other employee benefits

    total $2,172,402 · program services $1,945,561 · management and general $226,841

  • 10 · Payroll taxes

    total $1,031,575 · program services $902,836 · management and general $128,739

  • 11b · Fees: legal

    total $65,871 · management and general $65,871

  • 11c · Fees: accounting

    total $20,936 · management and general $20,936

  • 11g · Fees: other

    total $3,464,788 · program services $3,017,346 · management and general $447,442

  • 12 · Advertising and promotion

    total $47,283 · management and general $47,283

  • 13 · Office expenses

    total $340,713 · program services $194,189 · management and general $146,524

  • 14 · Information technology

    total $31,107 · management and general $31,107

  • 16 · Occupancy

    total $1,335,730 · program services $1,222,244 · management and general $113,486

  • 17 · Travel

    total $75,179 · program services $58,792 · management and general $16,387

  • 19 · Conferences, conventions and meetings

    total $96,589 · program services $48,338 · management and general $48,251

  • 20 · Interest

    total $25,466 · program services $25,466

  • 22 · Depreciation, depletion and amortization

    total $2,085,104 · program services $1,843,688 · management and general $241,416

  • 23 · Insurance

    total $287,940 · management and general $287,940

  • 24a · Other expenses: Medical Supplies

    total $3,582,242 · program services $3,582,242

  • 24b · Other expenses: Repairs & Maintenance

    total $494,949 · program services $494,949

  • 24c · Other expenses: Food

    total $430,126 · program services $430,126

  • 24d · Other expenses: Dues and Subscriptions

    total $54,209 · program services $2,872 · management and general $51,337

  • 24e · All other expenses

    total $247,023 · program services $236,575 · management and general $10,448

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $7,624,770 · end of year $8,398,455

  • 4 · Accounts receivable

    beginning of year $2,665,542 · end of year $3,164,270

  • 8 · Inventories for sale or use

    beginning of year $233,578 · end of year $201,683

  • 9 · Prepaid expenses and deferred charges

    beginning of year $319,007 · end of year $334,709

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

    $59,730,795

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

    $14,022,863

  • 10c · Land, buildings and equipment, net

    beginning of year $10,696,721 · end of year $45,707,932

  • 11 · Investments: publicly traded securities

    beginning of year $139,693 · end of year $1,695,356

  • 13 · Investments: program-related

    beginning of year $114,222 · end of year $177,248

  • 15 · Other assets

    beginning of year $12,260,717 · end of year $11,474,658

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,698,588 · end of year $7,847,988

  • 21 · Escrow or custodial account liability

    beginning of year $16,892 · end of year $17,269

  • 23 · Secured mortgages and notes payable

    end of year $31,289,626

  • 25 · Other liabilities

    beginning of year $1,444,084 · end of year $935,282

  • 27 · Net assets without donor restrictions

    beginning of year $23,669,988 · end of year $25,774,368

  • 28 · Net assets with donor restrictions

    beginning of year $5,224,698 · end of year $5,289,778

Mission and programs · 2023

Mission

To deliver compassionate care by advancing the physical and spiritual well-being of the communities we serve through smart medicine and exceptional service.

Activities or mission (Part I)

Provide quality medical care based on the needs and demographics of north central North Dakota.

  • Good Samaritan Hospital Association (GSHA) is a nonprofit healthcare organization owned by 20 local churches representing all Christian denominations in the area. Each year, these churches elect a board of trustees at an annual meeting, and this board serves as the legal governing body responsible for the Association. GSHA is dedicated to providing comprehensive healthcare services to the community of Rugby, ND, and its surrounding areas.GSHA operates a 25-bed licensed acute/swing bed critical access hospital, three rural health clinics (located in Rugby, Dunseith, and Maddock), a surgery department, a provider-based surgical clinic and (Continued on Schedule O)pain clinic, 18 skilled nursing home beds, 60 basic care beds, and 37 assisted living apartments. Additionally, we offer a robust hospital-based hospice program, serving the community with compassionate end-of-life care.In response to the current economic challenges and the lingering effects of COVID-19, we have seen an increase in the need for charity care. To address this, GSHA provided an estimated $244,000 in charity care services for the year ending March 31, 2024 (calculated by multiplying the ratio of costs to gross charges for the Organization by the gross uncompensated charges associated with providing charity care to its patients). Our CEO has actively engaged the community through numerous health updates on the radio, educating the public about new initiatives and changes from CMS.GSHA also offers a variety of community and social programs, including reduced-fee flu shot clinics, a diabetic education program, chronic care management, and public healthcare educational initiatives. We participate in health shows and community events, provide ambulance volunteers, and offer EMT courses. Our educational outreach extends to local schools, senior citizen meals through the Meals on Wheels Program, free blood pressure checks, physical therapy services, and wellness programs. Additionally, we provide meeting space for various organizations and churches, and offer CPR training.Furthermore, we have established strong relationships with CNA, LPN, and RN school programs through a consortium of facilities and colleges, supporting the education and training of future healthcare professionals.GSHA remains committed to improving the health and well-being of our community through comprehensive and compassionate care.Our Diabetes Education program offers various nutrition classes focused on maintaining and controlling diabetes. Through our 340b program, patients can request free test strips from our DME department, ensuring they have the necessary supplies for effective diabetes management. Furthermore, we host a monthly diabetes support group to assist patients and their families in managing the condition through shared experiences and expert advice.The Ambulance Service is operated by GSHA after the community was unable to sustain it as a volunteer service. We staff the ambulance 24/7, respond to all 911 calls in our area, and provide community services such as home blood draws for those unable to make it to the hospital. The operation of the ambulance service is subsidized through a mill levy and a state grant.

    Expenses $27,473,939 · Revenue $31,217,303

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Wayne Trottier

    President

    Total calculated
    $0
    Hours/week
    1

  • Michael Graner

    Vice Chair

    Total calculated
    $0
    Hours/week
    1

  • Craig Zachmeier

    Trustee

    Total calculated
    $0
    Hours/week
    1

  • Kolin Johnson

    Trustee

    Total calculated
    $0
    Hours/week
    1

  • Kim Bott

    Trustee

    Total calculated
    $0
    Hours/week
    1

  • Tanner Johnson

    Trustee

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Will Griffin

    Trustee

    Total calculated
    $0
    Hours/week
    1

  • Travis Maddock

    Trustee

    Total calculated
    $0
    Hours/week
    1

  • Lisa Thorp

    Trustee

    Total calculated
    $0
    Hours/week
    1

  • Erik Christenson

    Secretary - CEO

    Total calculated
    $197,411
    From this org
    $153,379
    From related orgs
    $0
    Other
    $44,032
    Hours/week
    58 + 2 related

    Schedule J breakdown matched by us

    Base
    $153,379
    Bonus
    $0
    Other
    $0
    Deferred
    $3,726
    Nontaxable benefits
    $41,815
    Filer's total
    $198,920

  • Melissa Shepard

    Treasurer - CFO

    Total calculated
    $153,104
    From this org
    $137,138
    From related orgs
    $0
    Other
    $15,966
    Hours/week
    58 + 2 related

    Schedule J breakdown matched by us

    Base
    $134,584
    Bonus
    $2,554
    Other
    $0
    Deferred
    $3,444
    Nontaxable benefits
    $13,000
    Filer's total
    $153,582

  • Dustin Hager

    COO & Provider

    Total calculated
    $247,590
    From this org
    $201,996
    From related orgs
    $0
    Other
    $45,594
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $198,196
    Bonus
    $3,800
    Other
    $0
    Deferred
    $5,287
    Nontaxable benefits
    $41,883
    Filer's total
    $249,166

  • Ronald Skipper MD

    Surgeon

    Total calculated
    $418,282
    From this org
    $375,294
    From related orgs
    $0
    Other
    $42,988
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $375,186
    Bonus
    $108
    Other
    $0
    Deferred
    $8,250
    Nontaxable benefits
    $37,584
    Filer's total
    $421,128

  • Cammy Kelsch FNP-C

    ER Provider

    Total calculated
    $322,005
    From this org
    $276,302
    From related orgs
    $0
    Other
    $45,703
    Hours/week
    66.5

    Schedule J breakdown matched by us

    Base
    $276,302
    Bonus
    $0
    Other
    $0
    Deferred
    $7,102
    Nontaxable benefits
    $41,166
    Filer's total
    $324,570

  • Josalynne Hoff Rue MD

    Physician

    Total calculated
    $363,311
    From this org
    $317,795
    From related orgs
    $0
    Other
    $45,516
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $309,008
    Bonus
    $7,155
    Other
    $1,632
    Deferred
    $6,678
    Nontaxable benefits
    $39,690
    Filer's total
    $364,163

  • Steven Schoneberg MD

    Physician

    Total calculated
    $323,853
    From this org
    $284,605
    From related orgs
    $0
    Other
    $39,248
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $277,184
    Bonus
    $7,421
    Other
    $0
    Deferred
    $7,148
    Nontaxable benefits
    $34,723
    Filer's total
    $326,476

  • Chelsey Wyatt

    CRNA

    Total calculated
    $346,061
    From this org
    $298,617
    From related orgs
    $0
    Other
    $47,444
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $296,008
    Bonus
    $54
    Other
    $2,555
    Deferred
    $7,138
    Nontaxable benefits
    $43,153
    Filer's total
    $348,908

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 · 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

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
2023
Filed
23 September 2024
IRS schema version
2023v5.1
Source object
202402689349300820

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