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Nonprofiteer
← PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION

Form 990 for tax year 2023

Filed by PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION.

Totals

Total revenue
$21,422,108
Total expenses
$20,531,614
Contributions and grants received
$271,830
Grants paid
$0
Program service revenue
$20,951,579
Investment income
$138,514
Other revenue
$60,185
Total assets, end of year
$22,126,648
Total liabilities, end of year
$2,825,858
Net assets or fund balances, end of year
$19,300,790
Program services expenses (Part IX)
$18,037,752
Management and general expenses
$2,387,893
Fundraising expenses
$105,969
Program service expenses (Part III)
$18,037,752

Program services were 87.9% 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)

    $61,838

  • 1f · All other contributions, gifts and grants

    $209,992

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $18,134,697 · related or exempt $18,134,697

  • 2b · Program service revenue: 340B REVENUE

    total $2,624,796 · related or exempt $2,624,796

  • 2c · Program service revenue: ANCILLARY REVENUES

    total $192,086 · related or exempt $192,086

  • 3 · Investment income

    total $138,514 · excluded $138,514

  • 6a · Gross rents

    real property $15,991

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $15,991

  • 6d · Net rental income or loss

    total $15,991 · excluded $15,991

  • 11a · Other revenue: OTHER INCOME

    total $44,194 · excluded $44,194

  • 11e · Other revenue, total

    $44,194

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $746,750 · management and general $746,750

  • 7 · Other salaries and wages

    total $7,687,661 · program services $6,803,271 · management and general $823,294 · fundraising $61,096

  • 8 · Pension plan contributions

    total $115,926 · program services $104,199 · management and general $10,609 · fundraising $1,118

  • 9 · Other employee benefits

    total $834,518 · program services $750,100 · management and general $76,373 · fundraising $8,045

  • 10 · Payroll taxes

    total $554,944 · program services $498,807 · management and general $50,787 · fundraising $5,350

  • 11b · Fees: legal

    total $5,083 · management and general $5,083

  • 11c · Fees: accounting

    total $81,581 · management and general $81,581

  • 11d · Fees: lobbying

    total $2,040 · management and general $2,040

  • 11g · Fees: other

    total $4,742,945 · program services $4,589,768 · management and general $147,060 · fundraising $6,117

  • 12 · Advertising and promotion

    total $56,018 · program services $11,916 · management and general $41,321 · fundraising $2,781

  • 13 · Office expenses

    total $218,146 · program services $211,010 · management and general $6,855 · fundraising $281

  • 16 · Occupancy

    total $397,049 · program services $322,627 · management and general $74,422

  • 20 · Interest

    total $28,689 · program services $28,689

  • 22 · Depreciation, depletion and amortization

    total $803,296 · program services $803,296

  • 23 · Insurance

    total $146,980 · program services $31,265 · management and general $108,418 · fundraising $7,297

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $3,422,876 · program services $3,422,876

  • 24b · Other expenses: EQUIPMENT RENTAL & REPA

    total $249,666 · program services $242,650 · management and general $7,016 · fundraising $0

  • 24c · Other expenses: FOOD EXPENSE

    total $195,702 · program services $41,628 · management and general $144,358 · fundraising $9,716

  • 24d · Other expenses: PROVISION FOR BAD DEBT

    total $149,054 · program services $149,054

  • 24e · All other expenses

    total $92,690 · program services $26,596 · management and general $61,926 · fundraising $4,168

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $10,350 · end of year $10,358

  • 2 · Savings and temporary cash investments

    beginning of year $8,504,127 · end of year $6,970,236

  • 4 · Accounts receivable

    beginning of year $2,950,713 · end of year $3,049,472

  • 8 · Inventories for sale or use

    beginning of year $318,566 · end of year $209,387

  • 9 · Prepaid expenses and deferred charges

    beginning of year $142,400 · end of year $228,963

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

    $27,221,673

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

    $17,301,197

  • 10c · Land, buildings and equipment, net

    beginning of year $7,249,451 · end of year $9,920,476

  • 11 · Investments: publicly traded securities

    beginning of year $1,603,189 · end of year $1,169,092

  • 15 · Other assets

    beginning of year $0 · end of year $568,664

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,647,912 · end of year $2,230,515

  • 19 · Deferred revenue

    beginning of year $24,906 · end of year $10,001

  • 21 · Escrow or custodial account liability

    beginning of year $13,310 · end of year $13,310

  • 23 · Secured mortgages and notes payable

    beginning of year $259,304 · end of year $219,778

  • 24 · Unsecured notes and loans payable

    beginning of year $267,434 · end of year $231,777

  • 25 · Other liabilities

    beginning of year $155,634 · end of year $120,477

  • 27 · Net assets without donor restrictions

    beginning of year $18,410,296 · end of year $19,300,790

Mission and programs · 2023

Mission

THE MISSION OF PEMBINA COUNTY MEMORIAL HOSPITAL AND WEDGEWOOD MANOR IS TO PROVIDE A FAMILY CENTERED APPROACH TO THE DELIVERY OF HEALTH SERVICES AND TO PROMOTE A HEALTHY LIFESTYLE TO THOSE WE SERVE IN CAVALIER AND THE SURROUNDING COMMUNITIES. THE VISION THAT GUIDES PEMBINA COUNTY MEMORIAL HOSPITAL AND WEDGEWOOD MANOR IS TO DEVELOP A FAMILY CENTERED INTEGRATED HEALTHCARE ORGANIZATION WHICH PROVIDES SERVICES THAT MEET THE NEEDS OF THE REGION, THEREBY MAKING US THEIR PROVIDER OF CHOICE.

Activities or mission (Part I)

TO PROVIDE A FAMILY CENTERED APPROACH TO THE DELIVERY OF HEALTH SERVICES AND TO PROMOTE A HEALTHY LIFESTYLE FOR THOSE WE SERVE.

  • PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION IS A 20 BED ACUTE CARE HOSPITAL, 40 BED NURSING HOME, A RURAL HEALTH CLINIC, AND 20 UNIT CONGREGATE HOUSING COMPLEX LOCATED IN CAVALIER, ND. THE FACILITY PROVIDES QUALITY MEDICAL AND LONG-TERM CARE TO THE RESIDENTS OF THE SURROUNDING AREA, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES RECEIVED. A 24 HOUR EMERGENCY ROOM IS AVAILABLE FOR PATIENTS WHO NEED IMMEDIATE TREATMENT, AND TREATMENT IS PROVIDED TO ALL INDIVIDUALS WHO PRESENT, REGARDLESS OF THEIR ABILITY TO PAY. THE ASSOCIATION ALSO SUPPLIES FREE OR REDUCED SERVICES TO PATIENTS WHO MEET ESTABLISHED CRITERIA OUTLINED IN THE FACILITY'S CHARITY CARE POLICY AND PROVIDES HEALTH EDUCATION AND OTHER SERVICES TO THE COMMUNITY.

    Expenses $18,037,752 · Revenue $20,951,579

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

Listed in Part VII

  • Duanne Deraas

    PRESIDENT

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Tom Vaughn

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • George Wright

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Gordon Johnson

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Nicole Safranski

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Susan Thompson

    MEDICAL STAFF PRESIDENT

    Total calculated
    $253,441
    From this org
    $222,533
    From related orgs
    $0
    Other
    $30,908
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $222,533
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $30,908
    Filer's total
    $253,441

  • Darin Otto

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Gretta Beard

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Larae Horgan

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Drew Olafson

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.8 + 0.2 related

  • Lisa Letexier

    CEO

    Total calculated
    $212,412
    From this org
    $189,871
    From related orgs
    $0
    Other
    $22,541
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $189,871
    Bonus
    $0
    Other
    $0
    Deferred
    $6,562
    Nontaxable benefits
    $15,979
    Filer's total
    $212,412

  • Patti Johnson

    NURSING HOME ADMINISTRATOR

    Total calculated
    $147,676
    From this org
    $118,718
    From related orgs
    $0
    Other
    $28,958
    Hours/week
    40

  • Katie Werner

    CFO

    Total calculated
    $133,221
    From this org
    $92,677
    From related orgs
    $0
    Other
    $40,544
    Hours/week
    40

  • Laura Ermer

    PHYSCIANS ASSISTANT

    Total calculated
    $184,311
    From this org
    $175,065
    From related orgs
    $0
    Other
    $9,246
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $175,065
    Bonus
    $0
    Other
    $0
    Deferred
    $7,019
    Nontaxable benefits
    $2,227
    Filer's total
    $184,311

  • Jenna Carpenter

    NURSE PRACTITIONER

    Total calculated
    $178,105
    From this org
    $168,979
    From related orgs
    $0
    Other
    $9,126
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $168,979
    Bonus
    $0
    Other
    $0
    Deferred
    $6,772
    Nontaxable benefits
    $2,354
    Filer's total
    $178,105

  • Kim Ford

    NURSE PRACTITIONER

    Total calculated
    $171,119
    From this org
    $160,688
    From related orgs
    $0
    Other
    $10,431
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $160,688
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $10,431
    Filer's total
    $171,119

  • Heather Snell

    NURSE PRACTITIONER

    Total calculated
    $168,993
    From this org
    $149,054
    From related orgs
    $0
    Other
    $19,939
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $149,054
    Bonus
    $0
    Other
    $0
    Deferred
    $6,150
    Nontaxable benefits
    $13,789
    Filer's total
    $168,993

  • Janae Heuchert

    PHARMACIST

    Total calculated
    $163,195
    From this org
    $127,874
    From related orgs
    $0
    Other
    $35,321
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $127,874
    Bonus
    $0
    Other
    $0
    Deferred
    $5,727
    Nontaxable benefits
    $29,594
    Filer's total
    $163,195

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 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.

Provenance

Return type
form_990
Tax year
2023
Filed
6 November 2024
IRS schema version
2023v5.1
Source object
202443119349302584

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

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