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← SHERIDAN MEMORIAL HOSPITAL ASSOCIATION

Form 990 for tax year 2022

Filed by SHERIDAN MEMORIAL HOSPITAL ASSOCIATION.

Totals

Total revenue
$20,091,288
Total expenses
$19,114,895
Contributions and grants received
$796,263
Grants paid
$0
Program service revenue
$19,255,686
Investment income
$26,764
Other revenue
$12,575
Total assets, end of year
$11,846,107
Total liabilities, end of year
$3,858,900
Net assets or fund balances, end of year
$7,987,207
Program services expenses (Part IX)
$15,030,641
Management and general expenses
$4,011,279
Fundraising expenses
$72,975
Program service expenses (Part III)
$15,030,641

Program services were 78.6% 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

    $97,696

  • 1e · Government grants (contributions)

    $674,868

  • 1f · All other contributions, gifts and grants

    $23,699

  • 2a · Program service revenue: PATIENT SERVICE REVENUE

    total $17,566,587 · related or exempt $17,566,587

  • 2b · Program service revenue: 340B REVENUE

    total $835,727 · related or exempt $835,727

  • 2c · Program service revenue: OTHER OPERATING REVENUE

    total $560,625 · related or exempt $560,625

  • 2d · Program service revenue: CONTRACT REVENUE

    total $292,747 · related or exempt $292,747

  • 3 · Investment income

    total $21,764 · excluded $21,764

  • 6a · Gross rents

    real property $12,575

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $12,575

  • 6d · Net rental income or loss

    total $12,575 · excluded $12,575

  • 7a · Gross sales of assets other than inventory

    other assets $5,000

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

    other assets $0

  • 7c · Gain or loss

    other assets $5,000

  • 7d · Net gain or loss

    total $5,000 · excluded $5,000

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $7,277,715 · program services $7,277,715

  • 8 · Pension plan contributions

    total $164,554 · program services $164,554

  • 9 · Other employee benefits

    total $888,024 · program services $888,024

  • 10 · Payroll taxes

    total $503,967 · program services $503,967

  • 11b · Fees: legal

    total $2,980 · program services $2,980

  • 11c · Fees: accounting

    total $36,206 · program services $36,206

  • 11g · Fees: other

    total $5,051,983 · program services $5,017,969 · management and general $34,014

  • 12 · Advertising and promotion

    total $49,963 · fundraising $49,963

  • 13 · Office expenses

    total $98,929 · management and general $98,929

  • 16 · Occupancy

    total $390,014 · management and general $390,014

  • 17 · Travel

    total $21,265 · management and general $21,265

  • 19 · Conferences, conventions and meetings

    total $82,526 · management and general $82,526

  • 20 · Interest

    total $44,067 · management and general $43,017 · fundraising $1,050

  • 22 · Depreciation, depletion and amortization

    total $605,385 · program services $295,407 · management and general $309,978

  • 23 · Insurance

    total $184,148 · management and general $184,148

  • 24a · Other expenses: SUPPLIES

    total $1,757,648 · management and general $1,757,648

  • 24b · Other expenses: BAD DEBT

    total $843,819 · program services $843,819

  • 24c · Other expenses: REPAIRS AND MAINTENANCE

    total $369,215 · management and general $369,215

  • 24d · Other expenses: BED TAX

    total $351,390 · management and general $351,390

  • 24e · All other expenses

    total $391,097 · management and general $369,135 · fundraising $21,962

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,682,418 · end of year $2,878,020

  • 2 · Savings and temporary cash investments

    beginning of year $1,615,550 · end of year $999,712

  • 4 · Accounts receivable

    beginning of year $1,963,619 · end of year $2,287,810

  • 8 · Inventories for sale or use

    beginning of year $256,787 · end of year $250,986

  • 9 · Prepaid expenses and deferred charges

    beginning of year $195,920 · end of year $233,060

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

    $20,520,609

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

    $15,945,511

  • 10c · Land, buildings and equipment, net

    beginning of year $4,585,508 · end of year $4,575,098

  • 15 · Other assets

    beginning of year $433,827 · end of year $621,421

  • 17 · Accounts payable and accrued expenses

    beginning of year $2,041,628 · end of year $2,549,826

  • 19 · Deferred revenue

    beginning of year $562,529 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $671,731 · end of year $728,389

  • 25 · Other liabilities

    beginning of year $446,927 · end of year $580,685

  • 27 · Net assets without donor restrictions

    beginning of year $7,007,614 · end of year $7,987,207

  • 28 · Net assets with donor restrictions

    beginning of year $3,200 · end of year $0

Mission and programs · 2022

Mission

PROVIDING QUALITY CARE TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY WE SERVE, REGARDLESS OF THEIR ABILITY TO PAY.

Activities or mission (Part I)

PROVIDE QUALITY CARE TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY WE SERVE.

  • SHERIDAN MEMORIAL HOSPITAL ASSOCIATION OPERATES A 19-BED CRITICAL ACCESS HOSPITAL, A 45-BED LONG-TERM CARE FACILITY, AND A RURAL HEALTH CLINIC THAT BENEFIT THE PEOPLE IN THE SURROUNDING AREA. SMHA IS THE ONLY MEDICAL FACILITY IN SHERIDAN COUNTY, WHICH HAS A POPULATION OF APPROXIMATELY 3,500 RESIDENTS. HIGHLIGHTS OF THE ORGANIZATION'S ACCOMPLISHMENTS DURING FY23 ARE INCLUDED BELOW:SMHA INCREASED ITS CAPACITY TO PATIENTS IN THE RHC BY 15.6% IN FY23. THIS WAS ACCOMPLISHED BY INSTITUTING PRODUCTIVITY REQUIREMENTS FOR PROVIDERS, HIRING QUALIFIED AND HARD-WORKING PROVIDERS AND UPDATING PATIENT WORKFLOWS. SMHA CONTINUED TO UPDATE ITS DIAGNOSTIC CAPABILITIES, ALLOWING FOR IMPROVED IDENTIFICATION OF AILMENTS AND HEALTH ISSUES. THIS IN-TURN HAS ALLOWED SMHA TO HAVE PATIENTS SEEN AT THE CORRECT LEVEL OF CARE FOR THEIR NEEDS AND HELPED SMHA PROVIDERS TREAT PATIENTS LOCALLY RATHER THAN HAVING TO REFER OR TRANSFER TO A HIGHER LEVEL OF CARE. THIS IS EVIDENT IN THE INCREASE IN PATIENTS SEEN IN OUR CLINIC AND UTILIZATION OF OUR ANCILLARY SERVICES.VOLUME INDICATORS FOR THE FISCAL YEAR ARE AS FOLLOWS: ACUTE CARE INPATIENT ADMISSIONS - 90ED VISITS - 977SKILLED SWING BED PATIENTS - 49LONG-TERM CARE ADMISSIONS - 17HOME CARE VISITS - 2,320HOSPICE - 283CLINIC VISITS - 9,036

    Expenses $15,030,641 · Revenue $19,255,686

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

Listed in Part VII

  • Don Benson

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Myrnette Miller

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Joan Tommerup

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Nancy Jensen

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Bev Johnson

    DIRECTOR (THRU 2/2023)

    Total calculated
    $0
    Hours/week
    1

  • Paul Hanson

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Chris Weins

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Cory Sampsen

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Kody Nelson

    CEO

    Total calculated
    $0
    Hours/week
    40

  • Sivash Shahbodaghi

    PHYSCIAN

    Total calculated
    $474,989
    From this org
    $474,989
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $346,771
    Bonus
    $90,718
    Other
    $37,500
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $474,989

  • Brit Nyby

    APP

    Total calculated
    $161,375
    From this org
    $156,010
    From related orgs
    $0
    Other
    $5,365
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $145,227
    Bonus
    $10,783
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $5,365
    Filer's total
    $161,375

  • Carlos Trevino

    PHYSCIAN

    Total calculated
    $155,702
    From this org
    $152,828
    From related orgs
    $0
    Other
    $2,874
    Hours/week
    20

    Schedule J breakdown matched by us

    Base
    $152,774
    Bonus
    $54
    Other
    $0
    Deferred
    $2,498
    Nontaxable benefits
    $376
    Filer's total
    $155,702

  • Linda Ator

    RN

    Total calculated
    $126,900
    From this org
    $123,205
    From related orgs
    $0
    Other
    $3,695
    Hours/week
    36

  • Archana Kayastha

    APP

    Total calculated
    $126,222
    From this org
    $114,334
    From related orgs
    $0
    Other
    $11,888
    Hours/week
    40

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

None.

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
2022
Filed
11 April 2024
IRS schema version
2022v5.0
Source object
202431319349302853

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