2025-12-23T11:18:22-06:00 2024-06-30 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-07-01 450227753 Cooperstown Medical Center COOP 7017861700 107 12th St S Cooperstown ND 584254501 Nicole Lindsey CEO/Administrator 7017861700 2025-12-23 1 1 Lisa Chaffee CPA P00193453 7012551091 2025-12-22 2023 2025-03-06 01:10:19Z Dakota Regional Medical Center Nicole Lindsey 107 12th St S Cooperstown ND 584254501 8796430 0 X https://www.dakotaregional.com/ X 1946 ND Provide health care services to the residents including the elderly in the Cooperstown, North Dakota and surrounding communities regardless of the ability to pay. 4 4 77 5 0 0 1565677 1450986 5804332 6917599 -468367 -38681 1870 2040 6903512 8331944 5890 5753 0 0 3970275 4285430 0 0 0 2462019 4161998 6438184 8453181 465328 -121237 27832409 27345540 23706194 23340562 4126215 4004978 Cooperstown Medical Center is dedicated to providing high quality healthcare services in a personalized, compassionate, and professional manner. 0 0 6877999 5753 6917599 A 9-bed critical access hospital. Helping to relieve the added stress of extended travel, the organization is able to provide locally many of the services found at large hospitals. Through strong affiliations with major medical organizations, Cooperstown Medical Center is able to provide: 24-hour emergency services, occupational therapy, x-ray and laboratory services, electrocardiography, respiratory therapy, incontinence management, therapy, physical therapy, speech therapy, cardiac monitoring/telemetry, chemotherapy, swing bed, respite and hospice care. 6877999 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 5 0 1 77 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Judy Monson 7017972221 107 12th St S Cooperstown ND 584254501 Barry Getz President 1.00 0.00 X X 0 0 0 Gerald Stokka Vice President 1.00 0.00 X X 0 0 0 Benjamin Halvorson Secretary/Treasurer 1.00 0.00 X X 0 0 0 James Halvorson Director (Until Oct 23) 1.00 1.00 X 0 0 0 Larry Grandalen Director 1.00 0.00 X 0 0 0 Nicole Lindsey CEO - Administrator 12.00 1.00 X 57824 0 11754 Judy Monson CFO 28.00 1.00 X 74321 0 34028 Barbara Anderson CFO (Until Aug 23) 28.00 1.00 X 73635 0 0 Steven Barlow Provider 40.00 0.00 X 348322 0 56262 Lanette Harr-Isakson Nurse 40.00 0.00 X 103361 0 8790 Liza Ystaas Provider 40.00 0.00 X 143145 0 32608 Kali Manz Provider 40.00 0.00 X 146005 0 22523 Debra Middleton NP (Until Oct 23) 40.00 0.00 X 156225 0 25097 1102838 0 191062 5 0 1 1 Altru Health System 1200 S Columbia Road Grand Forks ND 58201 Therapy and Software Services 386560 Netcenter Technologies 2536 Main Ave W West Fargo ND 58078 IT Services 161416 RTG Medical 4611 E 22nd Street Freemont NE 68025 Radiology Services 145556 National Medical Resources 2792 E Broadway Ave Bismarck ND 58501 Provider Locums 133935 4 1040000 410986 1450986 Net Patient and Resident Revenue 623000 6296088 6296088 Assisted Living Rental 623000 197115 197115 424396 424396 6917599 425805 425805 2040 0 2040 2040 2040 464486 -464486 -464486 -464486 8331944 6917599 0 -36641 X 5753 5753 238732 238732 67194 67194 3392395 2950137 442258 48817 40109 8708 287345 264270 23075 250947 206185 44762 28076 151 27925 58124 58124 1547859 1223244 324615 13296 214 13082 40026 19342 20684 245504 202169 43335 26006 22659 3347 24139 15191 8948 609982 532331 77651 825284 757388 67896 108000 108000 Medical Supplies 473361 473361 Dues and Subscriptions 76922 14448 62474 Repairs and Maintenance 32974 32839 135 52445 10208 42237 8453181 6877999 1575182 0 921614 2396 400000 1063892 1518168 90954 88542 99028 123229 18727849 5106319 13701589 13621530 1495737 529586 10459595 11062089 27832409 27345540 783539 550167 25900 26880 22765536 22417475 131219 346040 23706194 23340562 X 4126215 4004978 4126215 4004978 27832409 27345540 -121237 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 234 0 0 0 234 0 Part II-B, Line 1: The Organization is a member of several organizations that take part in lobbying. A portion of the dues paid to the various organizations is for lobbying costs. These various organizations advocate on behalf of their members by supporting legislation that is in their collective interests. 0 1 X 395017 395017 14068298 3340089 10728209 3699855 1645702 2054153 564679 120528 444151 13621530 Estimated Third Party Payors 890000 Right of Use Assets 313180 Investment in Sales-Type Lease 9858909 11062089 Related Party Payable 210 Interest Payable 30167 Lease Liability 315663 346040 X 8331944 0 8331944 0 8331944 8453181 0 8453181 0 8453181 Part IV, Line 2b: Security deposits advanced by tenants of the assisted living units are held in trust by the Organization. These funds are included in cash and cash equivalents and accounts payable in the consolidated financial statements. Tenant security deposits totaled $26,880 and $25,900 at June 30, 2024 and 2023. Part X, Line 2: The Medical Center believes that they have appropriate support for any tax positions taken affecting their annual filing requirements, and as such, do not have any uncertain tax positions that are material to the consolidated financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 0 0 18000 18000 0.00210 417178 392217 24961 0.00300 435178 392217 42961 0.00510 1261391 814145 447246 0.05290 1261391 814145 447246 0.05290 1696569 1206362 490207 0.05800 1 501465 167155 3307807 3337168 -29361 X 1 1 1 1 Cooperstown Medical Center DBA DRMC 107 12th St S Cooperstown ND 58425 www.dakotaregional.com 5010 X X X Cooperstown Medical Center 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V, Page 8 X 1 21 1 See Part V, Page 8 0 1 X 100.000000000000 200.000000000000 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X 1 X 0 X X X X 1 X 0 0 Cooperstown Medical Center Part V, Section B, Line 5: To gather feedback from the community, residents of the area were given the opportunity to participate in a survey. Seventy-five CMC service area residents completed the survey. Additional information was collected through five key informant interviews with community members. The input from the residents, who primarily reside in Griggs County, represented the broad interests of the communities in the service area. Together with secondary data gathered from a wide range of sources, the survey presents a snapshot of the health needs and concerns in the community. A community group met on March 28, 2022. Twelve community members attended the meeting. Cooperstown Medical Center Part V, Section B, Line 11: The community members voted on the needs identified to determine the ones deemed most significant. The needs were ranked as follows:1. Attracting and retaining young families2. Having enough child daycare services3. Not enough affordable housing4. Availability of mental health services5. Depression and anxiety for all agesFrom those top five priorities, each person voted on the one concern they felt was the most important. The rankings were: 1. Attracting and retaining young families (3 votes) 2. Having enough child daycare services (2 votes) 3. Availability of mental health services (2 votes) 4. Depression and anxiety for all ages (2 votes)The Hospital will not address the following health needs identified in the CHNA due to limited resources and the need to allocate significant resources to the two priority health needs identified above: 1. Attracting and retaining young families. 2. Adequate childcare services.In fiscal year 2024, the following actions were taken to address the needs of the latest CHNA:We added two mental health professionals, so we now have mental health services available two times a week with varying services. A couple of service providers are able to prescribe medicine and one provides therapy. Because childcare services were identified as a need on the assessment, internal and external conversations occurred on the possibility of addressing this need but did not work out. In FY24, the Chief Nursing Officer continued to attended parent teacher conferences and other events at the school promoting suicide prevention and mental health awareness. The CNO also worked with the school paramedic on educational presentations as well as suicide prevention. Part V, Section B, Line 7a and 10a: https://www.dakotaregional.com/about-7 Part V, Section B, Line 16a-c: Line 16a: https://www.dakotaregional.com/about-7Line 16b: https://www.dakotaregional.com/about-7Line 16c: https://www.dakotaregional.com/payment-policy Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part II, Community Building Activities: The Organization participates in community building activities, however, the activities are too difficult to quantify and are not tracked. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 3: CMC used the percentage of charity care/financial assistance applications that were denied due to lack of sufficient information or were never returned to determine the amount of implicit price concessions that is attributable to patients who would likely qualify for charity. For FY 2024 approximately 33% of applications lacked information or were never returned after patient was given an application to complete. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 13 and 14 of the attached audited financial statements. Part III, Line 8: Hospital services remibursed on a fee schedule are not included in the Medicare calculations per the 990 instructions. Had this been reported the Hospital would have had a greater loss from Medicare services of $59,813.$39,819 - Medicare fee schedule revenue($99,632) - Medicare estimated costs of care relating to payment($59,813) - Net (shortage) Part III, Line 9b: When patients are known to qualify for financial assistance, they are requested to fill out a financial assistance application and collection actions are stopped. If an application is returned with insufficient information a telephone call and/or a letter is sent indicating what is still needed to process the application. If no response is received, the application will be reviewed by the Financial Assistance/Community Care Program committee to determine if collection proceedings should resume or if presumptive charity care be allowed. Patients will be notified when the facility determines the amount of financial assistance approved. Part VI, Line 2: The Organization typically offers wellness screenings once a year at no cost to the public. The wellness screenings help the Organization to assess health needs of the community. Included are blood pressure checks, diabetes screenings, pulmonary and respiratory screenings, and education on good health. This often results in follow-up care after results of screenings are reviewed. A community health needs assessment was also conducted during the 6/30/25 fiscal year end to help assess needs in the community. Part VI, Line 3: Patients receive charity care information through the business office. The Organization mails brochures regarding the program in past due statements. The Organization also gives the brochure to people in the community known to the Organization that do not have insurance upon arrival for a visit. The charity care information is part of the intake process. Part VI, Line 4: As of the census of 2020, there were 2,306 people and 946 households residing in the county. The population density was 3.4 people per square mile. There were 1,378 housing units. The racial makeup of the county was 95.70% White, 0.30% Asian, 0.40% Black, 0.6% American Indian and Alaska Native persons, and 3.0% from other races. There were 946 households out of which 23.0% had children under the age of 18 living with them, 51.2% were married couples living together, and 24.6% had a female householder with no husband present. The average family size was 3.23.In the county the population was spread out with 23.4% under the age of 19, 4.4% from 20 to 24, 15.6% from 25 to 44, 27.8% from 45 to 64, and 28.8% who were 65 years of age or older. The median age was 50.6 years. The median income for a household in the county was $64,737, and the median income for a family was $92,500. About 10.1% of the population were below the poverty line, including 7.3% of those under age 18 and 14.1% of those ages 65 or over. Part VI, Line 5: The Organization offers a variety of services to the community to assist in taking away the burden of having to travel for medical care. The Organization also assists in accommodating any financial concerns through the charity care program. By doing both, the Organization hopes to better the well-being of the community. The Board of Directors is comprised of persons who reside in the primary service area. Medical staff privileges are given to all qualified physicians in the community. The Organization is affiliated with Emergency Heart Network, St. Paul Ramsey Burn Center, and Life Flight. When available, surplus funds are used to upgrade patient care equipment and facility infrastructure.The organization continued to offer COVID-19 screenings available at no cost to the public, unless a physician visit was required due to the patient's condition. 0 0 0 0 0 0 0 0 0 Steven Barlow Provider 348322 0 0 0 0 0 7259 0 50546 0 406127 0 0 0 Debra Middleton NP (Until Oct 23) 156225 0 0 0 0 0 4677 0 21964 0 182866 0 0 0 Liza Ystaas Provider 143145 0 0 0 0 0 0 0 34152 0 177297 0 0 0 Kali Manz Provider 146005 0 0 0 0 0 0 0 24067 0 170072 0 0 0 Nicole Lindsey CEO - Administrator 57824 0 0 0 0 0 2657 0 9561 0 70042 0 0 0 Part I, Line 3 Nicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The amounts reported in Part VII and on schedule J represent 30 percent of her compensation. Darnell Lindsey Husband of CEO, Nicole Lindsey 67194 Compensation 0 Form 990, Part VI, Section A, line 1a An Executive Committee may be appointed or dissolved by a majority vote of the Board of Directors. If so formed, the Executive Committee, in addition to the Chairman of the board and the Administrator, shall consist of the Secretary, the Treasurer, and one (1) additional member of the Board of Directors elected by the board at its first meeting after its election. The Executive Committee shall have power to transact all regular business of the Cooperstown Medical Center during the period between the meetings of the Board of Directors, subject to any prior limitations imposed by the Board and with the understanding that all matters of major importance will be referred to the Board of Directors. Minutes of the Executive Committee meetings shall be submitted to the Board, and its actions shall be subject to approval or disapproval at the next regular Board meeting. Form 990, Part VI, Section A, line 2 Nicole Lindsey and Barbara Anderson have a business relationship. Barbara Anderson and James Halvorson have a family relationship. Gerald Stokka and Barry Getz have a family relationship. Form 990, Part VI, Section A, line 6 The Organization has members consisting of those persons who are 18 years of age or above residing in the area served by Cooperstown Medical Center. Form 990, Part VI, Section A, line 7a The Members elect the Board of Directors. Form 990, Part VI, Section B, line 11b The CFO reviews the Form 990 prior to filing with the Internal Revenue Service. The Board of Directors also receives a copy of the Form 990 by email prior to it being filed with the IRS. Form 990, Part VI, Section B, line 12c Each board member annually and upon hire each corporate officer, executive, department director, supervisor or other individual, duly authorized by the governing body to conduct business on behalf of Cooperstown Medical Center signs a statement which affirms that such person: 1) has received a copy of the conflict of interest policy; 2) has read and understands the policy; 3) has agreed to comply with the policy; 4) understands that the organization is and includes charitable organizations and that in order to maintain its federal tax exemption it must engage primarily in activities which further one or more of its tax-exempt purposes. If a conflict arises, the board will assign a disinterested person to investigate alternatives to the proposed transaction or arrangement. The interested member is to provide information to the board, however not influence the board regarding their decision. Form 990, Part VI, Section B, line 15 Nicole Lindsey, CEO, is an employee of Griggs County Care Center (GCCC), an unrelated organization. Nicole's compensation is determined by an agreement of both the board of directors of GCCC and the Organization. She is paid by GCCC and 30 percent of her compensation is billed by GCCC to the Organization. The CFO's, Judy Monson and Barbara Anderson, were compensated for their services to the Organization as well as for their services to Griggs County Care Center (GCCC) an unrelated organization. Their compensation was determined by an agreement between both the Organization's board of directors and that of GCCC. Thirty percent of their compensation is billed to and reimbursed by GCCC. The amounts reported in part VII represent all of their compensation including the thirty percent that is billed to GCCC. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request and at the annual meeting. Form 990, Part IX, line 11g Professional Fees: Program service expenses 584,352. Management and general expenses 3,631. Fundraising expenses 0. Total expenses 587,983. Purchased Services: Program service expenses 615,873. Management and general expenses 320,984. Fundraising expenses 0. Total expenses 936,857. Consultant Fees: Program service expenses 23,019. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,019. Cooperstown Medical Center Foundation 107 12th St S Cooperstown ND 58425 450450301 To support the programs of the Cooperstown Medical Center ND 501(c)(3) Line 7 Cooperstown Medical Center 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 Cooperstown Medical Center Foundation C 1040000 General Ledger