{"success":true,"data":{"_id":450230400,"filings":[{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"To provide quality health care and living services with dignity and individualized care.","primary_activities":"The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individual's ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services, emergency services and ambulance services. To fulfill its mission of community service, the Medical Center provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify for charity care, they are not reported as patient and resident service revenue.The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amounts of charges foregone, based on established rates, were $9,563 and $14,804 for the years ended June 30, 2012 and 2011.Hillsboro Medical Services also operates a skilled nursing facility. The Home provides nursing services, meals, housekeeping, laundry and activities for residents.","year":2011,"name":"HILLSBORO MEDICAL CENTER","phone":"7016363201","website":"www.hillsboromedicalcenter.com","type":"990","principal_officer":"Jac McTaggart","year_formation":1946,"state_legal_domicile":"ND","total_volunteers":30,"tax_period_begin":"2011-07-01T00:00:00","tax_period_end":"2012-06-30T00:00:00","address":"PO BOX 609, HILLSBORO, ND, 58045, USA","city":"HILLSBORO","state":"ND","country":"USA","zip_code":"58045"},"Governance":{"501c3 determination":true,"Number of voting members":10,"Number of independent voting members":10,"Number of employees total":192,"Total Gross UBI":0,"Net unrelated business taxable income":0,"Number of employees":192,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Funds to pay premiums":false,"Premiums Paid":false,"Family or business relationship":false,"Delegation of management duties":true,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":false,"Election of board members":false,"Decisions subject to approval":false,"Minutes of governing body":true,"Local chapters":false,"Form 990 provided to governing body":true,"Document retention policy":true,"Investment in joint venture":false,"Independent audit financial statements":false,"Consolidated audit financial statements":true,"Accountant compile or review":false,"Financial statements audited by independent accountant":true,"Audit committee":true,"Federal grant audit required":false,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":false,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":8138945,"Contributions":{"value":632997,"Other contributions":20345,"Grant revenue":169266,"Related organizations":443386},"Program revenue":{"value":7404562,"Total revenue":{"value":7404562,"VARIOUS":7404562},"Unrelated business revenue":0},"Investment income":{"value":24138,"Investment income total":24138},"Other revenues":{"value":77248,"Net rental income":77248}},"Expenses":{"value":8155257,"Grant expense":{"value":0},"Total professional fundraising expense":{"value":0},"Benefits paid to members":{"value":0},"Salaries":{"value":4163425,"Current officers":126373,"Other salaries and wages":3453000,"Pension plan contributions":65805,"Other employee benefits":214104,"Payroll taxes":304143},"Other expenses":{"value":3991832,"Management services":22460,"Accounting":32359,"Other services":861338,"Advertising":24260,"Office expenses":108467,"Occupancy":194909,"Travel":32635,"Conferences and meetings":19410,"Interest":691173,"Depreciation and depletion":1196047,"Insurance":72576,"Itemized Expenses":{"value":717073,"VARIOUS":717073},"All other expenses":19125}},"Assets":{"value":16039565,"Savings and temp cash investments":1088915,"Accounts receivable":2374912,"Inventories for sale or use":35466,"Prepaid expenses deferred charges":47452,"Land, building, equipment":11071971,"Investments publicly traded":1106796,"Other assets":314053},"Liabilities":{"value":13792723,"Accounts payable, accrued":717282,"Deferred, revenue":94558,"Tax exempt bond liabilities":12595000,"Escrow account liability":15672,"Unsecured notes loans payable":357492,"Other liabilities":12719},"Fund balance":{"value":2246842},"Form990Details":{"program_service_accomplishments":[{"description":"The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individual's ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services, emergency services and ambulance services. To fulfill its mission of community service, the Medical Center provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify for charity care, they are not reported as patient and resident service revenue.The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amounts of charges foregone, based on established rates, were $9,563 and $14,804 for the years ended June 30, 2012 and 2011.Hillsboro Medical Services also operates a skilled nursing facility. The Home provides nursing services, meals, housekeeping, laundry and activities for residents.","expense":7914002,"revenue":7404562}],"program_service_revenue_detail":[{"business_code":"621300","description":"Net Patient & Resident","total_revenue":7368839,"related_or_exempt_function_income":7368839},{"business_code":"900099","description":"Supporting Revenue","total_revenue":35723,"related_or_exempt_function_income":35723}],"functional_expense_allocations":{"current_officers_directors":{"management_and_general":126373,"total":126373},"other_salaries_and_wages":{"program_services":3453000,"total":3453000},"pension_plan_contributions":{"program_services":65805,"total":65805},"other_employee_benefits":{"program_services":214104,"total":214104},"payroll_taxes":{"program_services":304143,"total":304143},"management_fees":{"management_and_general":22460,"total":22460},"accounting_fees":{"management_and_general":32359,"total":32359},"other_service_fees":{"program_services":861338,"total":861338},"advertising":{"management_and_general":24260,"total":24260},"office_expenses":{"program_services":72664,"management_and_general":35803,"total":108467},"occupancy":{"program_services":194909,"total":194909},"travel":{"program_services":32635,"total":32635},"conferences_meetings":{"program_services":19410,"total":19410},"interest":{"program_services":691173,"total":691173},"depreciation_depletion":{"program_services":1196047,"total":1196047},"insurance":{"program_services":72576,"total":72576},"all_other_expenses":{"program_services":19125,"total":19125}},"tax_and_disclosure_flags":{"activities_conducted_through_partnership":false,"foreign_financial_account":false,"backup_withholding_compliance":true,"employment_tax_returns_filed":true,"lobbying_activities":false,"deductible_non_cash_contributions":false,"deductible_contributions_of_art":false,"method_of_accounting_accrual":true,"schedule_o_part_iii":true,"schedule_o_part_vi":true,"schedule_o_part_vii":true,"schedule_o_part_xi":true},"principal_officer_detail":{"person_name":"Jac McTaggart","address_line1":"PO BOX 609","city":"HILLSBORO","state":"ND","zip":"58045"},"audit_financial_statement_detail":{"financial_statement_attached":true,"accountant_compile_or_review":false,"audited_financial_statement_consolidated":true,"federal_grant_audit_required":false},"related_party_due_diligence":{"officer_entity_with_business_relationship":false,"officer_mailing_address":false,"related_entity":true,"related_org_controlled_entity":true,"compensation_from_other_sources":false,"excess_benefit_transaction":false,"annual_disclosure_covered_persons":true},"grant_due_diligence":{"grants_to_organizations":false,"grants_to_individuals":false,"more_than_5000_to_organizations":false,"more_than_5000_to_individuals":false},"books_are_in_care_of":{"phone":"7016363211","business_name_line1":"Darlene Swanson","address_line1":"PO Box 609","city":"Hillsboro","state":"ND","zip":"58045"},"contractor_compensation":[{"business_name_line1":"Sanford Health","compensation":517829,"services_description":"Various Medical Service Contracts and Ma","address_line1":"PO Box 2010","city":"Fargo","state":"ND","zip":"58122","name":"Sanford Health","address":"PO Box 2010, Fargo, ND, 58122"},{"business_name_line1":"DMS Health","compensation":106836,"services_description":"X-Ray Fees","address_line1":"SDS 12-2208 PO Box 86","city":"Minneapolis","state":"MN","zip":"55486","name":"DMS Health","address":"SDS 12-2208 PO Box 86, Minneapolis, MN, 55486"},{"business_name_line1":"Dakota Travel Nurse Inc","compensation":105736,"services_description":"Contracted Nursing Services","address_line1":"502 W Main St","city":"Mandan","state":"ND","zip":"58554","name":"Dakota Travel Nurse Inc","address":"502 W Main St, Mandan, ND, 58554"}],"officers_directors_key_employees":[{"title":"Chair","average_hours_per_week":3.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Vice Chair","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Secretary","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Treasurer","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"CFO","average_hours_per_week":12.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"officer":true},{"title":"CEO/Administrator","average_hours_per_week":40.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"officer":true},{"title":"CEO/Administrator","average_hours_per_week":40.0,"reportable_comp_from_org":87218,"reportable_comp_from_related_orgs":0,"other_compensation":5776,"officer":true}]},"ScheduleA":{"public_charity_status":{"hospital_170b1_aiii":true}},"ScheduleB":{"attached":true,"required":true},"ScheduleD":{"escrow_accounts":{"agent_trustee_etc":false,"included_on_financial_statements":true},"land_buildings_equipment":{"buildings":{"other_cost_or_other_basis":13783374,"book_value":9453598,"depreciation":4329776},"equipment":{"other_cost_or_other_basis":3539464,"book_value":1340309,"depreciation":2199155},"other_land_buildings":{"other_cost_or_other_basis":308617,"book_value":278064,"depreciation":30553},"total_book_value":11071971},"other_liabilities":{"liabilities":[{"description":"Unamortized Bond Premium","amount":12719}],"total_liability":12719},"supplemental_information":[{"form_and_line_reference":"Part IV, Line 2b:","explanation":"The Medical Center holds tenant security deposits from assisted living residents. These funds are included in cash and accounts payable in the consolidated financial statements. Tenant security deposits totaled $15,672 and $14,288 at June 30, 2012 and 2011."},{"form_and_line_reference":"Part X:","explanation":"The Medical Center and the Foundation are organized as North Dakota nonprofit corporations and have been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center and the Foundation are required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS annually. In addition, the Medical Center and the Foundation are subject to income tax on any net income that is derived from business activities that are unrelated to its exempt purpose. The Medical Center and the Foundation believe they have appropriate support for any tax positions taken affecting the annual filing requirements for the Medical Center and the Foundation, and as such, do not have any uncertain tax positions that are material to the consolidated financial statements. The Medical Center and the Foundation would recognize future accrued interest and penalties related to unrecognized tax liabilities in income tax expense if such interest and penalties are incurred."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":false,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":false,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":false},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":121077,"bad_debt_expense_attributable_to_financial_assistance":90808,"reimbursed_by_medicare":1628321,"cost_of_care_reimbursed_by_medicare":1612199,"medicare_surplus_or_shortfall":16122,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":false},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":11000,"net_community_benefit_expense":11000,"total_expense_percentage":0.0014},"unreimbursed_medicaid":{"total_community_benefit_expense":2052708,"direct_offsetting_revenue":2044119,"net_community_benefit_expense":8589,"total_expense_percentage":0.0011},"total_financial_assistance":{"total_community_benefit_expense":2063708,"direct_offsetting_revenue":2044119,"net_community_benefit_expense":19589,"total_expense_percentage":0.0025},"community_health_services":{"total_community_benefit_expense":500,"net_community_benefit_expense":500,"total_expense_percentage":0.0001},"subsidized_health_services":{"total_community_benefit_expense":420869,"direct_offsetting_revenue":274537,"net_community_benefit_expense":146332,"total_expense_percentage":0.0182},"total_other_benefits":{"total_community_benefit_expense":421369,"direct_offsetting_revenue":274537,"net_community_benefit_expense":146832,"total_expense_percentage":0.0183},"total_community_benefits":{"total_community_benefit_expense":2485077,"direct_offsetting_revenue":2318656,"net_community_benefit_expense":166421,"total_expense_percentage":0.0208}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Hillsboro Medical Center","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","licensed_hospital":true,"general_medical_and_surgical":true,"critical_access_hospital":true,"emergency_room_24_hours":true,"other_description":"Ambulance","name":"Hillsboro Medical Center","address":"12 3rd St SE, Hillsboro, ND, 58045"}],"facility_policies":[{"business_name_line1":"Hillsboro Medical Center","facility_number":1,"chna_conducted":false,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":false,"fpg_used_determine_discounted_care":false,"income_level_criteria":true,"asset_level_criteria":true,"medical_indigency_criteria":true,"insurance_status_criteria":true,"basis_explained":true,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_request_no_charge":true,"other_publicity":true,"fap_actions_on_nonpayment":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"amounts_generally_billed":false,"gross_charges":false,"name":"Hillsboro Medical Center"}],"other_health_care_facility_count":2,"other_health_care_facilities":[{"business_name_line1":"Hillsboro Medical Center Nursing Home","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","facility_type":"Skilled Nursing","name":"Hillsboro Medical Center Nursing Home","address":"12 3rd St SE, Hillsboro, ND, 58045"},{"business_name_line1":"Comstock Corner","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","facility_type":"Assisted Living","name":"Comstock Corner","address":"12 3rd St SE, Hillsboro, ND, 58045"}],"supplemental_information":[{"explanation":"Part I, Line 3c: Throughout the payment and collection process, the business office staff attempt to identify to the extent possible, patients who may be eligible for charity care considerations. Individuals with accounts to be considered for charity reductions are asked to complete a financial statement form, which provides pertinent financial information necessary to determine financial need. The charity care application asks for items such as employment information, current income, current expenses, assets owned as well as other miscellaneous items. Credit reports are also used to verify and assist in the decision process. This information is also compared against the federal poverty guidelines. Review of potential charity requests are performed monthly by the Business Manager and certain recommendations are forwarded to the Administrator. The Administrator reviews all information in the charity care application and bases a decision for charity care on all factors included in the application."},{"explanation":"Part I, Line 7: An average ratio of cost to gross charges, which addresses all patient segments, was used to determine the amount of Financial Assistance at cost on Part I, line 7a. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Subsidized health services on line 7g was calculated using the cost report. Community health improvement services, line 7e, were calculated based on estimated costs."},{"explanation":"Part I, L7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $121,077."},{"explanation":"Part II: n/a"},{"explanation":"Part III, Line 4: Financial Statement Bad Debt Expense Footnote:The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients, residents, and third-party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write-off and recovery information in determining the estimated bad debt provision.All discounts and payments on a patient's account are accounted for prior to determining bad debt expense. Hillsboro Medical Center reports amounts as bad debt once they are 120 days overdue and have been turned over to a collection agency. Historically, almost all of these amounts remain unpaid as the patient does not have sufficient resources and likely would qualify for the Charity Care Program. Based on this assumption, 75% of the bad debt amount is considered charity care."},{"explanation":"Part III, Line 8: Medicare allowable costs of care are based on the Medicare Cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services."},{"explanation":"Part III, Line 9b: As of 6/30/12, the collection policy did not contain specific written provisions on collection practices to be followed for patients who are known to qualify for financial assistance. However in practice, when it is appropriate, a review is done to determine if a patient qualifies for charity care (all patients are evaluated on an individual basis). This can be discussed with the patient during the phone call prior to sending to collections. All collection efforts are reversed if a patient is determined to be eligible for financial assistance."},{"explanation":"The Organization began re-writing some of their policies during the year in order to be in compliance with IRC 501(r). This process was halted because the Organization was in the process of becoming affiliated with Sanford Health and knew that when the affiliation was official they would adopt the policies and procedures of Sanford Health. The Organization will become part of Sanford Health as of January 1st, 2013."},{"explanation":"Part V, Section B, Line 9: We have a charity care application available requesting financial and employment information. Items requested include but are not limited to, household income, household expense, insurance benefits, and assets. Administration reviews the application and bases a decision for charity care on all factors and compares data to federal poverty guidelines. Notes are made on the statements informing patients that charity care applications are available if they are unable to pay."},{"explanation":"Part V, Section B, Line 10: No discounted care was provided during the fiscal year."},{"explanation":"Part V, Section B, Line 13g: The Organization informs patients about the Charity Care Policy during the collection process and indicates which pertinent information is needed in order to determine financial need. As of the fiscal year end, the Organization is working on making the Charity Care Policy more widely available to the public in order to be in compliance with IRC 501(r)."},{"explanation":"Part V, Section B, Line 19d: During the fiscal year, individuals who were eligible for charity care received a 100% write off applied to the gross charges on their bill. There were no other lesser discounts offered.Effective January 2013, the Organization will be affiliated with Sanford Health. They will adopt the amounts generally billed calculations currently in use by Sanford Health. The minimum discount for those that qualify will be calculated by using the weighted average of the contractual adjustments provided to the three largest commercial insurance companies during the prior calendar year."},{"explanation":"Part VI, Line 2: The Assistant Director of Nursing and the Medical Providers at Hillsboro Medical Center assess the needs of outpatient services utilized by the community. We re-evaluate the services we provide and have added multiple needed outpatient treatments. These services enhanced patient care and provided services within our community instead of needing to travel outside the Hillsboro area for these services. The Organization began planning a Community Health Needs Assessment during the year as well to help assess the needs of the community. We will continue to review the needs of the community and the services that we offer."},{"explanation":"Part VI, Line 3: During the collection process for outstanding bills, Hillsboro Medical Center (HMC) informs the patients that they do have a Charity Care Policy and they will send out a financial statement form, which will provide pertinent patient financial information necessary to determine financial need. Also, HMC discusses with the patients that they could apply with the county for Medicaid assistance. The final determination for Charity Care is approved by the Administrator after reviewing all pertinent factors."},{"explanation":"Part VI, Line 4: Hillsboro Medical Center is a 16-bed acute care hospital, a 36-bed nursing facility, and a 16-unit assisted living facility located in Hillsboro, North Dakota. Hillsboro has a population of approximately 1,603 per the 2010 Census data. Per the 2007-2011 American Community Survey's 5 year estimates, the median income for a household in the city was $43,629 and the median income for a family was $56,719. Males (working year-round and full-time) had a median income of $43,182 versus $30,655 for females. The per capita income for the city was $20,791. About 4.2% of families and 8.4% of the population were below the poverty line, including 7.6% of those under age 18 and 11.2% of those age 65 or over. Sanford-Mayville Hospital is another hospital that serves the community in an 18 mile radius."},{"explanation":"Part VI, Line 5: The mission of the Hillsboro Medical Center is to provide quality health care and living services with dignity and individualized care. Hillsboro Medical Center provides community meetings about CPR, Advance Directives, Child Passenger Safety, Alzheimer's, etc. to promote information and well-being to people in our community. Hillsboro Medical Center also provides a room for Hospice and UND Journal Club free of charge so they can conduct their meetings for the care of people in the community and surrounding areas. The majority of the organization's governing body is comprised of individuals who reside in the primary service area. These individuals are not employees, nor contractors or family members of the organization. The organization extends medical staff privileges to qualified physicians in the community. Surplus funds, if available, are re-invested in the facility to improve patient care."},{"explanation":"Part VI, Line 6: n/a"}]},"ScheduleK":{"bond_issues":[{"issuer_ein":456002246,"business_name_line1":"Traill County","cusip_number":"892846AQ9","date_issued":"2007-05-22T00:00:00","issue_price":13341133,"purpose":"Exp of facility; new Asst Lvg and LT Care bldgs, 80% rmdl of Hospital","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"Traill County"}],"bond_proceeds":[{"total_proceeds":13341133,"gross_proceeds_in_reserve_funds":893789,"capitalized_interest":658284,"issuance_costs_from_proceeds":239850,"capital_expenditures":11549210,"amount_retired":730000,"substantial_completion_year":2009,"current_refunding":false,"advance_refunding":false,"final_allocation_made":false,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":false,"management_contract":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":363542187,"business_name_line1":"Hillsboro Medical Center Foundation","primary_activities":"Fundraising","exempt_code_section":"501(c)(3)","public_charity_status":"7","controlled_organization":true,"legal_domicile_state":"ND","direct_controlling_business_name_line1":"Hillsboro Medical Center","address_line1":"PO Box 609","city":"Hillsboro","state":"ND","zip":"58045","name":"Hillsboro Medical Center Foundation","address":"PO Box 609, Hillsboro, ND, 58045"}],"transaction_flags":{"gift_grant_or_capital_contribution_from_other_org":true,"gift_grant_or_capital_contribution_to_other_org":false,"loans_or_guarantees_from_other_org":false,"loans_or_guarantees_to_other_org":false,"performance_of_services_by_other_orgs":true,"performance_of_services_for_other_orgs":false,"sharing_of_facilities":true,"sharing_of_paid_employees":true,"reimbursement_paid_by_other_org":true,"reimbursement_paid_to_other_org":false,"rental_of_facilities_from_other_orgs":false,"rental_of_facilities_to_other_orgs":false,"purchase_of_assets_from_other_org":false,"sale_of_assets_to_other_org":false,"exchange_of_assets":false,"receipt_of_interest_annuities_rents_royalties":false,"other_transfer_from_other_org":false,"other_transfer_to_other_org":false},"transactions":[{"business_name_line1":"Hillsboro Medical Center Foundation","amount_involved":443386,"method_of_amount_determination":"General Ledger","transaction_type":"C","name":"Hillsboro Medical Center Foundation"}]},"source_xml":"201311279349300966_public.xml"},{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"To provide quality health care and living services with dignity and individualized care.","primary_activities":"The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individuals ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services,emergency services and ambulance services. Charity care provided for fiscal year ended June 30, 2010, based on charges foregone was $22,074.Hillsboro Medical Services also operates a skilled nursing facility. 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been recognized by the Internal Revenue Service as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center undergoes an annual analysis of its various tax positions, assessing the likelihood of these positions being upheld upon examination with relevant tax authorities, as defined by the accounting principles generally accepted in the United States of America. The Medical Center believes that they are compliant with all IRS tax regulations and as of June 30, 2010 has not recorded a tax liability for a tax uncertainty. The Medical Center will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. Under normal circumstances, the Medical Center is no longer subject to Federal and state tax examinations by tax authorities for years before 2007."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":false,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":false,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":false},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":87265,"bad_debt_expense_attributable_to_financial_assistance":65449,"reimbursed_by_medicare":1858076,"cost_of_care_reimbursed_by_medicare":1849866,"medicare_surplus_or_shortfall":8210,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":21230,"net_community_benefit_expense":21230,"total_expense_percentage":0.0029},"unreimbursed_medicaid":{"total_community_benefit_expense":82086,"direct_offsetting_revenue":82086},"total_financial_assistance":{"total_community_benefit_expense":103316,"direct_offsetting_revenue":82086,"net_community_benefit_expense":21230,"total_expense_percentage":0.0029},"community_health_services":{"total_community_benefit_expense":1427,"net_community_benefit_expense":1427,"total_expense_percentage":0.0002},"subsidized_health_services":{"total_community_benefit_expense":311149,"direct_offsetting_revenue":281253,"net_community_benefit_expense":29896,"total_expense_percentage":0.0041},"total_other_benefits":{"total_community_benefit_expense":312576,"direct_offsetting_revenue":281253,"net_community_benefit_expense":31323,"total_expense_percentage":0.0043},"total_community_benefits":{"total_community_benefit_expense":415892,"direct_offsetting_revenue":363339,"net_community_benefit_expense":52553,"total_expense_percentage":0.0072}},"hospital_facilities":[{"business_name_line1":"Hillsboro Medical Center","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","licensed_hospital":true,"general_medical_and_surgical":true,"critical_access_hospital":true,"emergency_room_24_hours":true,"other_description":"LT Care, Assisted Living, Ambulance","name":"Hillsboro Medical Center","address":"12 3rd St SE, Hillsboro, ND, 58045"}],"part_vi_explanations":{"affiliated_health_care_system":"Part VI, Line 7: n/a","bad_debt_footnote":"Part III, Line 4: Financial Statement Bad Debt Expense Footnote:Patient and resident receivables are uncollateralized receivables and third-party payor obligations. Payments of patient and resident receivables are allocated to the specific claims identified on the remittance advice or, if unspecified, are applied to the earliest unpaid claim.The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients, residents, and third-party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write-off and recovery information in determining the estimated bad debt provision.Bad debt expense was converted to cost using the ratio of patient care cost to charges calculated using Worksheet 2.All discounts and payments on a patient's account are accounted for prior to determining bad debt expense. Hillsboro Medical Center reports amounts as bad debt once they are 120 days overdue and have been turned over to a collection agency. Historically, almost all of these amounts remain unpaid as the patient does not have sufficient resources and likely would qualify for the Charity Care Program. Based on this assumption, 75% of the bad debt amount is considered charity care.","community_building_activities":"Part VI, Line 5: n/a","community_information":"Part VI, Line 4: Hillsboro has a population of approximately 1,600. Per the 2000 census, the median income for a household in the city was $33,516 and the median income for a family was $42,357. Males had a median income of $30,607 versus $19,769 for females. The per capita income for the city was $17,976. About 6.6% of families and 9.2% of the population were below the poverty line, including 9.4% of those under age 18 and 15.0% of those age 65 or over. Approximately 15% of the city's population are Medicaid recipients. Sanford-Mayville Hospital is another hospital that serves the community in an 18 mile radius.","costing_method_used":"Part I, Line 7: The organization used Worksheet 2 to determine the cost for Part I, Line 7, Rows a and b. The cost in Part I, line 7, Row e was determined based on the wages that were paid to individuals providing the services while on hospital time and it was also based on the cost of supplies (such as printed materials) used in the activities. The cost in Part I, line 7, row g was determined from the Medicare Cost report.","debt_collection_policy":"Part III, Line 9b: If a patient bill is unpaid after 120 days, a phone call is made to the patient. If they do not hear from the patient and there is no response to the phone call, the bill is sent to collections. The final approval for sending the account to collections is signed by the administrator. When it is appropriate, a review is done to determine if a patient might qualify for charity care. This can also be discussed when the phone call is made to the patient prior to sending the bill to collections.","income_based_criteria":"Part I, Line 3c: Throughout the payment and collection process, the business office staff attempt to identify to the extent possible, patients which are worthy and appropriate for charity care considerations. Those accounts to be considered for charity reductions are asked to complete a financial statement form, which provides pertinent financial information necessary to determine financial need. The charity care application asks for items such as employment information, current income, current expenses, assets owned as well as other miscellaneous items. Credit reports can be used to verify and assist in the decision process. Review of potential charity requests are performed monthly by the Business Manager and certain recommendations are forwarded to the Administrator. The administrator makes the final decision if someone is eligible for free or discounted care. The decision for free or discounted care is strictly done on a case by case basis as the administrator reviews information provided in the charity care application.","needs_assessment":"Part VI, Line 2: The Assistant Director of Nursing and the Medical Providers at Hillsboro Medical Center assess the needs of outpatient services utilized by the community. We re-evaluate the services we provide and have added multiple needed outpatient treatments. These services enhanced patient care and provided services within our community instead of needing to travel outside the Hillsboro area for these services. We will continue to review the needs of the community and the services that we offer.","other_information":"Part VI, Line 6: The mission of the Hillsboro Medical Center is to provide quality health care and living services with dignity and individualized care. Hillsboro Medical Center provides community meetings about CPR, Advance Directives, Child Passenger Safety, Alzheimer's, etc. to promote information and well-being to people in our community. Hillsboro Medical Center also provides a room for Hospice and UND Journal Club free of charge so they can conduct their meetings for the care of people in the community and surrounding areas. The majority of the organization's governing body is comprised of individuals who reside in the primary service area. These individuals are not employees, nor contractors or family members of the organization. The organization extends medical staff privileges to qualified physicians in the community. Surplus funds, if available, are re-invested in the facility to improve patient care.","patient_education_assistance":"Part VI, Line 3: Hillsboro Medical Center (HMC) does not post its charity care policy. During the collection process for outstanding bills, HMC informs the patients that we do have a Charity Care Policy and we will send out a financial statement form, which will provide pertinent patient financial information necessary to determine financial need. Also, HMC discusses with the patients that they could apply with the county for Medicaid assistance. The final determination for Charity Care is approved by the administrator.","percent_of_total_expense":"Part I, Line 7f: The amount of bad debt expense removed from the denominator is $90,736.","shortfall_as_community_benefit":"Part III, Line 8: Medicare allowable costs were obtained from the 2009 Medicare Cost Report."}},"ScheduleJ":{"compensation_process":{"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":false,"equity_based_compensation_arrangement":false},"compensation":[{"business_name_line1":"Patricia Dirk","base_compensation_filing_org":84400,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":5099,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":5089,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":94588,"total_compensation_related_orgs":0,"name":"Patricia Dirk"}],"supplemental_information":[{"identifier":"Supplemental Information","form_and_line_reference":"Part III","explanation":"Schedule J Part I Line 3 methods of establishing compensation: The CEO, Patricia Dirk, is compensated by Sanford Health an unrelated entity. The compensation amounts included in Part II for Patricia Dirk indicate the types and amount of compensation that she was paid by Sanford Health. Sanford Health used one or more of these methods in establishing her compensation."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":456002246,"business_name_line1":"Traill County","cusip_number":"892846AQ9","date_issued":"2007-05-22T00:00:00","issue_price":13341133,"purpose":"Exp of facility; new Asst Lvg and LT Care bldgs, 80% rmdl of Hospital","defeased":false,"on_behalf_of_issuer":false,"name":"Traill County"}],"bond_proceeds":[{"total_proceeds":13341133,"gross_proceeds_in_reserve_funds":893789,"issuance_costs_from_proceeds":339850,"capital_expenditures":12107494,"substantial_completion_year":2008,"current_refunding":false,"advance_refunding":false,"final_allocation_made":false,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":false,"management_contract":false,"bond_counsel_routinely_engaged":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":true,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":363542187,"business_name_line1":"Hillsboro Medical Center Foundation","primary_activities":"Fundraising","exempt_code_section":"501(c)(3)","public_charity_status":"7","legal_domicile_state":"ND","address_line1":"PO Box 609","city":"Hillsboro","state":"ND","zip":"58045","name":"Hillsboro Medical Center Foundation","address":"PO Box 609, Hillsboro, ND, 58045"}],"transaction_flags":{"gift_grant_or_capital_contribution_from_other_org":true,"gift_grant_or_capital_contribution_to_other_org":false,"loans_or_guarantees_from_other_org":false,"loans_or_guarantees_to_other_org":false,"performance_of_services_by_other_orgs":true,"performance_of_services_for_other_orgs":false,"sharing_of_facilities":true,"sharing_of_paid_employees":true,"reimbursement_paid_by_other_org":true,"reimbursement_paid_to_other_org":false,"rental_of_facilities_from_other_orgs":false,"rental_of_facilities_to_other_orgs":false,"purchase_of_assets_from_other_org":false,"sale_of_assets_to_other_org":false,"exchange_of_assets":false,"receipt_of_interest_annuities_rents_royalties":false,"other_transfer_from_other_org":false,"other_transfer_to_other_org":false},"transactions":[{"business_name_line1":"Hillsboro Medical Center Foundation","name":"Hillsboro Medical Center Foundation"}]},"source_xml":"201130129349300828_public.xml"},{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"To provide quality health care and living services with dignity and individualized care.","primary_activities":"The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individuals ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services,emergency services and ambulance services. To fulfill its mission of community service, the Medical Center provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify for charity care, they are not reported as patient and resident service revenue.The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amounts of charges foregone, based on established rates, were $14,804 and $22,074 for the years ended June 30, 2011 and 2010.Hillsboro Medical Services also operates a skilled nursing facility. The Home provides nursing services, meals, housekeeping, laundry and activities for residents.","year":2010,"name":"HILLSBORO MEDICAL CENTER","phone":"7016363201","website":"www.hillsboromedicalcenter.com","type":"990","principal_officer":"Jac McTaggart","year_formation":1946,"state_legal_domicile":"ND","total_volunteers":90,"tax_period_begin":"2010-07-01T00:00:00","tax_period_end":"2011-06-30T00:00:00","address":"PO BOX 609, HILLSBORO, ND, 58045, USA","city":"HILLSBORO","state":"ND","country":"USA","zip_code":"58045"},"Governance":{"501c3 determination":true,"Number of voting members":10,"Number of independent voting members":10,"Number of employees total":189,"Total Gross UBI":0,"Net unrelated business taxable income":0,"Number of employees":189,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Funds to pay premiums":false,"Premiums Paid":false,"Family or business relationship":false,"Delegation of management duties":true,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":false,"Election of board members":false,"Decisions subject to approval":false,"Minutes of governing body":true,"Local chapters":false,"Form 990 provided to governing body":true,"Document retention policy":true,"Investment in joint venture":false,"Independent audit financial statements":false,"Consolidated audit financial statements":true,"Accountant compile or review":false,"Financial statements audited by independent accountant":true,"Audit committee":true,"Federal grant audit required":false,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":false,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":7625458,"Contributions":{"value":396438,"Other contributions":7159,"Grant revenue":151733,"Related organizations":237546},"Program revenue":{"value":7095839,"Total revenue":{"value":7095839,"VARIOUS":7095839},"Unrelated business revenue":0},"Investment income":{"value":57162,"Investment income total":57162},"Other revenues":{"value":76019,"Net rental income":76019}},"Expenses":{"value":7868525,"Grant expense":{"value":0},"Total professional fundraising expense":{"value":0},"Benefits paid to members":{"value":0},"Salaries":{"value":4008975,"Current officers":176568,"Other salaries and wages":3290490,"Pension plan contributions":51813,"Other employee benefits":209312,"Payroll taxes":280792},"Other expenses":{"value":3859550,"Management services":12195,"Legal":2590,"Accounting":44696,"Other services":708286,"Advertising":20898,"Office expenses":662020,"Information technology":18418,"Occupancy":220650,"Travel":27078,"Conferences and meetings":18052,"Interest":703357,"Depreciation and depletion":1204893,"Insurance":57328,"Itemized Expenses":{"value":136405,"VARIOUS":136405},"All other expenses":22684}},"Assets":{"value":15718023,"Savings and temp cash investments":1204470,"Accounts receivable":1315958,"Inventories for sale or use":29715,"Prepaid expenses deferred charges":45787,"Land, building, equipment":11562769,"Investments publicly traded":1145364,"Other assets":413960},"Liabilities":{"value":13412557,"Accounts payable, accrued":514992,"Deferred, revenue":79914,"Tax exempt bond liabilities":12790000,"Escrow account liability":14288,"Other liabilities":13363},"Fund balance":{"value":2305466},"Form990Details":{"program_service_accomplishments":[{"description":"The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individuals ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services,emergency services and ambulance services. 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Bond Premium","amount":13363}],"total_liability":13363},"supplemental_information":[{"form_and_line_reference":"Part IV, Line 2b:","explanation":"The Medical Center holds tenant security deposits from assisted living residents. These funds are included in cash and accounts payable in the consolidated financial statements. Tenant security deposits totaled $14,288 and $12,378 at June 30, 2011 and 2010."},{"form_and_line_reference":"Part X:","explanation":"Hillsboro Medical Center believes they have appropriate support for any tax positions taken affecting the annual filing requirements for Hillsboro Medical Center, and as such, does not have any uncertain tax positions that are material to the financial statements. Hillsboro Medical Center would recognize future accrued interest and penalties related to unrecognized tax liabilities in income tax expense if such interest and penalties are incurred."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":false,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":false,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":false},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":138209,"bad_debt_expense_attributable_to_financial_assistance":103657,"reimbursed_by_medicare":1809086,"cost_of_care_reimbursed_by_medicare":1784306,"medicare_surplus_or_shortfall":24780,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":false},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":15367,"net_community_benefit_expense":15367,"total_expense_percentage":0.002},"unreimbursed_medicaid":{"total_community_benefit_expense":68949,"direct_offsetting_revenue":68949},"total_financial_assistance":{"total_community_benefit_expense":84316,"direct_offsetting_revenue":68949,"net_community_benefit_expense":15367,"total_expense_percentage":0.002},"community_health_services":{"total_community_benefit_expense":2725,"net_community_benefit_expense":2725,"total_expense_percentage":0.0004},"subsidized_health_services":{"total_community_benefit_expense":150965,"direct_offsetting_revenue":109334,"net_community_benefit_expense":41631,"total_expense_percentage":0.0054},"total_other_benefits":{"total_community_benefit_expense":153690,"direct_offsetting_revenue":109334,"net_community_benefit_expense":44356,"total_expense_percentage":0.0058},"total_community_benefits":{"total_community_benefit_expense":238006,"direct_offsetting_revenue":178283,"net_community_benefit_expense":59723,"total_expense_percentage":0.0078}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Hillsboro Medical Center","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","licensed_hospital":true,"general_medical_and_surgical":true,"critical_access_hospital":true,"emergency_room_24_hours":true,"other_description":"Ambulance","name":"Hillsboro Medical Center","address":"12 3rd St SE, Hillsboro, ND, 58045"}],"facility_policies":[{"business_name_line1":"Not Required","facility_number":1,"name":"Not Required"}],"other_health_care_facility_count":2,"other_health_care_facilities":[{"business_name_line1":"Hillsboro Medical Center Nursing Home","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","facility_type":"Skilled Nursing","name":"Hillsboro Medical Center Nursing Home","address":"12 3rd St SE, Hillsboro, ND, 58045"},{"business_name_line1":"Comstock Corner","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","facility_type":"Assisted Living","name":"Comstock Corner","address":"12 3rd St SE, Hillsboro, ND, 58045"}],"supplemental_information":[{"explanation":"Part I, Line 3c: Throughout the payment and collection process, the business office staff attempt to identify to the extent possible, patients which are worthy and appropriate for charity care considerations. Those accounts to be considered for charity reductions are asked to complete a financial statement form, which provides pertinent financial information necessary to determine financial need. The charity care application asks for items such as employment information, current income, current expenses, assets owned as well as other miscellaneous items. Credit reports can be used to verify and assist in the decision process. Review of potential charity requests are performed monthly by the Business Manager and certain recommendations are forwarded to the Administrator. The Administrator makes the final decision if someone is eligible for free or discounted care. The decision for free or discounted care is strictly done on a case by case basis as the Administrator reviews information provided in the charity care application."},{"explanation":"Part I, Line 7: The cost-to-charge ratio derived from Worksheet 2 was used to determine charity care, line 7a, and subsidized health services, line 7g. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, were calculated based on actual estimated costs."},{"explanation":"Part I, L7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $133,145."},{"explanation":"Part II: n/a"},{"explanation":"Part III, Line 4: Financial Statement Bad Debt Expense Footnote:The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients, residents, and third-party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write-off and recovery information in determining the estimated bad debt provision.Bad debt expense was converted to cost using the ratio of patient care cost to charges calculated using Worksheet 2.All discounts and payments on a patient's account are accounted for prior to determining bad debt expense. Hillsboro Medical Center reports amounts as bad debt once they are 120 days overdue and have been turned over to a collection agency. Historically, almost all of these amounts remain unpaid as the patient does not have sufficient resources and likely would qualify for the Charity Care Program. Based on this assumption, 75% of the bad debt amount is considered charity care."},{"explanation":"Part III, Line 8: Medicare allowable costs of care are based on the Medicare Cost report. The Medicare cost report is completed based on the rules and regulations set forth by CMS."},{"explanation":"Part VI, Line 2: The Assistant Director of Nursing and the Medical Providers at Hillsboro Medical Center assess the needs of outpatient services utilized by the community. We re-evaluate the services we provide and have added multiple needed outpatient treatments. These services enhanced patient care and provided services within our community instead of needing to travel outside the Hillsboro area for these services. We will continue to review the needs of the community and the services that we offer."},{"explanation":"Part VI, Line 3: Hillsboro Medical Center (HMC) does not post its charity care policy. During the collection process for outstanding bills, HMC informs the patients that we do have a Charity Care Policy and we will send out a financial statement form, which will provide pertinent patient financial information necessary to determine financial need. Also, HMC discusses with the patients that they could apply with the county for Medicaid assistance. The final determination for Charity Care is approved by the Administrator."},{"explanation":"Part VI, Line 4: Hillsboro Medical Center is a 16-bed acute care hospital, a 36-bed nursing facility, and a 16-unit assisted living facility located in Hillsboro, North Dakota. Hillsboro has a population of approximately 1,600. Per the 2000 census, the median income for a household in the city was $33,516 and the median income for a family was $42,357. Males had a median income of $30,607 versus $19,769 for females. The per capita income for the city was $17,976. About 6.6% of families and 9.2% of the population were below the poverty line, including 9.4% of those under age 18 and 15.0% of those age 65 or over. Approximately 15% of the city's population are Medicaid recipients. Sanford-Mayville Hospital is another hospital that serves the community in an 18 mile radius."},{"explanation":"Part VI, Line 6: The mission of the Hillsboro Medical Center is to provide quality health care and living services with dignity and individualized care. Hillsboro Medical Center provides community meetings about CPR, Advance Directives, Child Passenger Safety, Alzheimer's, etc. to promote information and well-being to people in our community. Hillsboro Medical Center also provides a room for Hospice and UND Journal Club free of charge so they can conduct their meetings for the care of people in the community and surrounding areas. The majority of the organization's governing body is comprised of individuals who reside in the primary service area. These individuals are not employees, nor contractors or family members of the organization. The organization extends medical staff privileges to qualified physicians in the community. Surplus funds, if available, are re-invested in the facility to improve patient care."},{"explanation":"Part VI, Line 7: n/a"}]},"ScheduleJ":{"compensation_process":{"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":false,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"Patricia Dirk July - Sept","base_compensation_filing_org":75699,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":1444,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":77143,"total_compensation_related_orgs":0,"name":"Patricia Dirk July - Sept"},{"person_name":"John Reike Oct - June","base_compensation_filing_org":20861,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":804,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":21665,"total_compensation_related_orgs":0,"name":"John Reike Oct - June"}],"supplemental_information":[{"identifier":"Supplemental Information","form_and_line_reference":"Part III","explanation":"Schedule J Part I Line 3 methods of establishing compensation: The CEO/Administrators (Patricia Dirk and John Rieke) were compensated by Sanford Health, an unrelated entity. Sanford Health used one or more of the methods in Part I, Question 3 to determine compensation for the CEO/Administrator. Schedule J Part II: The compensation amounts included in Part II indicate the types and amount of compensation that was paid by Sanford Health."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":456002246,"business_name_line1":"Traill County","cusip_number":"892846AQ9","date_issued":"2007-05-22T00:00:00","issue_price":13341133,"purpose":"Exp of facility; new Asst Lvg and LT Care bldgs, 80% rmdl of Hospital","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"Traill County"}],"bond_proceeds":[{"total_proceeds":13341133,"gross_proceeds_in_reserve_funds":893789,"capitalized_interest":658284,"issuance_costs_from_proceeds":239850,"capital_expenditures":11549210,"substantial_completion_year":2009,"current_refunding":false,"advance_refunding":false,"final_allocation_made":false,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":false,"management_contract":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":true,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":363542187,"business_name_line1":"Hillsboro Medical Center Foundation","primary_activities":"Fundraising","exempt_code_section":"501(c)(3)","public_charity_status":"7","controlled_organization":true,"legal_domicile_state":"ND","direct_controlling_business_name_line1":"Hillsboro Medical Center","address_line1":"PO Box 609","city":"Hillsboro","state":"ND","zip":"58045","name":"Hillsboro Medical Center Foundation","address":"PO Box 609, Hillsboro, ND, 58045"}],"transaction_flags":{"gift_grant_or_capital_contribution_from_other_org":true,"gift_grant_or_capital_contribution_to_other_org":false,"loans_or_guarantees_from_other_org":false,"loans_or_guarantees_to_other_org":false,"performance_of_services_by_other_orgs":true,"performance_of_services_for_other_orgs":false,"sharing_of_facilities":true,"sharing_of_paid_employees":true,"reimbursement_paid_by_other_org":true,"reimbursement_paid_to_other_org":false,"rental_of_facilities_from_other_orgs":false,"rental_of_facilities_to_other_orgs":false,"purchase_of_assets_from_other_org":false,"sale_of_assets_to_other_org":false,"exchange_of_assets":false,"receipt_of_interest_annuities_rents_royalties":false,"other_transfer_from_other_org":false,"other_transfer_to_other_org":false},"transactions":[{"business_name_line1":"Hillsboro Medical Center Foundation","amount_involved":237546,"transaction_type":"C","name":"Hillsboro Medical Center Foundation"}]},"source_xml":"201201309349301700_public.xml"}],"Latest":{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"To provide quality health care and living services with dignity and individualized care.","primary_activities":"The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individual's ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services, emergency services and ambulance services. To fulfill its mission of community service, the Medical Center provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify for charity care, they are not reported as patient and resident service revenue.The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amounts of charges foregone, based on established rates, were $9,563 and $14,804 for the years ended June 30, 2012 and 2011.Hillsboro Medical Services also operates a skilled nursing facility. The Home provides nursing services, meals, housekeeping, laundry and activities for residents.","year":2011,"name":"HILLSBORO MEDICAL CENTER","phone":"7016363201","website":"www.hillsboromedicalcenter.com","type":"990","principal_officer":"Jac McTaggart","year_formation":1946,"state_legal_domicile":"ND","total_volunteers":30,"tax_period_begin":"2011-07-01T00:00:00","tax_period_end":"2012-06-30T00:00:00","address":"PO BOX 609, HILLSBORO, ND, 58045, USA","city":"HILLSBORO","state":"ND","country":"USA","zip_code":"58045"},"Governance":{"501c3 determination":true,"Number of voting members":10,"Number of independent voting members":10,"Number of employees total":192,"Total Gross UBI":0,"Net unrelated business taxable income":0,"Number of employees":192,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Funds to pay premiums":false,"Premiums Paid":false,"Family or business relationship":false,"Delegation of management duties":true,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":false,"Election of board members":false,"Decisions subject to approval":false,"Minutes of governing body":true,"Local chapters":false,"Form 990 provided to governing body":true,"Document retention policy":true,"Investment in joint venture":false,"Independent audit financial statements":false,"Consolidated audit financial statements":true,"Accountant compile or review":false,"Financial statements audited by independent accountant":true,"Audit committee":true,"Federal grant audit required":false,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":false,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":8138945,"Contributions":{"value":632997,"Other contributions":20345,"Grant revenue":169266,"Related organizations":443386},"Program revenue":{"value":7404562,"Total revenue":{"value":7404562,"VARIOUS":7404562},"Unrelated business revenue":0},"Investment income":{"value":24138,"Investment income total":24138},"Other revenues":{"value":77248,"Net rental income":77248}},"Expenses":{"value":8155257,"Grant expense":{"value":0},"Total professional fundraising expense":{"value":0},"Benefits paid to members":{"value":0},"Salaries":{"value":4163425,"Current officers":126373,"Other salaries and wages":3453000,"Pension plan contributions":65805,"Other employee benefits":214104,"Payroll taxes":304143},"Other expenses":{"value":3991832,"Management services":22460,"Accounting":32359,"Other services":861338,"Advertising":24260,"Office expenses":108467,"Occupancy":194909,"Travel":32635,"Conferences and meetings":19410,"Interest":691173,"Depreciation and depletion":1196047,"Insurance":72576,"Itemized Expenses":{"value":717073,"VARIOUS":717073},"All other expenses":19125}},"Assets":{"value":16039565,"Savings and temp cash investments":1088915,"Accounts receivable":2374912,"Inventories for sale or use":35466,"Prepaid expenses deferred charges":47452,"Land, building, equipment":11071971,"Investments publicly traded":1106796,"Other assets":314053},"Liabilities":{"value":13792723,"Accounts payable, accrued":717282,"Deferred, revenue":94558,"Tax exempt bond liabilities":12595000,"Escrow account liability":15672,"Unsecured notes loans payable":357492,"Other liabilities":12719},"Fund balance":{"value":2246842},"Form990Details":{"program_service_accomplishments":[{"description":"The Hospital/Home provides medical care to the community and long-term care to the elderly regardless of the individual's ability to pay for the services received.Medical services offered include critical access hospital services, skilled nursing services, emergency services and ambulance services. To fulfill its mission of community service, the Medical Center provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify for charity care, they are not reported as patient and resident service revenue.The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amounts of charges foregone, based on established rates, were $9,563 and $14,804 for the years ended June 30, 2012 and 2011.Hillsboro Medical Services also operates a skilled nursing facility. The Home provides nursing services, meals, housekeeping, laundry and activities for residents.","expense":7914002,"revenue":7404562}],"program_service_revenue_detail":[{"business_code":"621300","description":"Net Patient & Resident","total_revenue":7368839,"related_or_exempt_function_income":7368839},{"business_code":"900099","description":"Supporting Revenue","total_revenue":35723,"related_or_exempt_function_income":35723}],"functional_expense_allocations":{"current_officers_directors":{"management_and_general":126373,"total":126373},"other_salaries_and_wages":{"program_services":3453000,"total":3453000},"pension_plan_contributions":{"program_services":65805,"total":65805},"other_employee_benefits":{"program_services":214104,"total":214104},"payroll_taxes":{"program_services":304143,"total":304143},"management_fees":{"management_and_general":22460,"total":22460},"accounting_fees":{"management_and_general":32359,"total":32359},"other_service_fees":{"program_services":861338,"total":861338},"advertising":{"management_and_general":24260,"total":24260},"office_expenses":{"program_services":72664,"management_and_general":35803,"total":108467},"occupancy":{"program_services":194909,"total":194909},"travel":{"program_services":32635,"total":32635},"conferences_meetings":{"program_services":19410,"total":19410},"interest":{"program_services":691173,"total":691173},"depreciation_depletion":{"program_services":1196047,"total":1196047},"insurance":{"program_services":72576,"total":72576},"all_other_expenses":{"program_services":19125,"total":19125}},"tax_and_disclosure_flags":{"activities_conducted_through_partnership":false,"foreign_financial_account":false,"backup_withholding_compliance":true,"employment_tax_returns_filed":true,"lobbying_activities":false,"deductible_non_cash_contributions":false,"deductible_contributions_of_art":false,"method_of_accounting_accrual":true,"schedule_o_part_iii":true,"schedule_o_part_vi":true,"schedule_o_part_vii":true,"schedule_o_part_xi":true},"principal_officer_detail":{"person_name":"Jac McTaggart","address_line1":"PO BOX 609","city":"HILLSBORO","state":"ND","zip":"58045"},"audit_financial_statement_detail":{"financial_statement_attached":true,"accountant_compile_or_review":false,"audited_financial_statement_consolidated":true,"federal_grant_audit_required":false},"related_party_due_diligence":{"officer_entity_with_business_relationship":false,"officer_mailing_address":false,"related_entity":true,"related_org_controlled_entity":true,"compensation_from_other_sources":false,"excess_benefit_transaction":false,"annual_disclosure_covered_persons":true},"grant_due_diligence":{"grants_to_organizations":false,"grants_to_individuals":false,"more_than_5000_to_organizations":false,"more_than_5000_to_individuals":false},"books_are_in_care_of":{"phone":"7016363211","business_name_line1":"Darlene Swanson","address_line1":"PO Box 609","city":"Hillsboro","state":"ND","zip":"58045"},"contractor_compensation":[{"business_name_line1":"Sanford Health","compensation":517829,"services_description":"Various Medical Service Contracts and Ma","address_line1":"PO Box 2010","city":"Fargo","state":"ND","zip":"58122","name":"Sanford Health","address":"PO Box 2010, Fargo, ND, 58122"},{"business_name_line1":"DMS Health","compensation":106836,"services_description":"X-Ray Fees","address_line1":"SDS 12-2208 PO Box 86","city":"Minneapolis","state":"MN","zip":"55486","name":"DMS Health","address":"SDS 12-2208 PO Box 86, Minneapolis, MN, 55486"},{"business_name_line1":"Dakota Travel Nurse Inc","compensation":105736,"services_description":"Contracted Nursing Services","address_line1":"502 W Main St","city":"Mandan","state":"ND","zip":"58554","name":"Dakota Travel Nurse Inc","address":"502 W Main St, Mandan, ND, 58554"}],"officers_directors_key_employees":[{"title":"Chair","average_hours_per_week":3.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Vice Chair","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Secretary","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Treasurer","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Trustee","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"CFO","average_hours_per_week":12.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"officer":true},{"title":"CEO/Administrator","average_hours_per_week":40.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"officer":true},{"title":"CEO/Administrator","average_hours_per_week":40.0,"reportable_comp_from_org":87218,"reportable_comp_from_related_orgs":0,"other_compensation":5776,"officer":true}]},"ScheduleA":{"public_charity_status":{"hospital_170b1_aiii":true}},"ScheduleB":{"attached":true,"required":true},"ScheduleD":{"escrow_accounts":{"agent_trustee_etc":false,"included_on_financial_statements":true},"land_buildings_equipment":{"buildings":{"other_cost_or_other_basis":13783374,"book_value":9453598,"depreciation":4329776},"equipment":{"other_cost_or_other_basis":3539464,"book_value":1340309,"depreciation":2199155},"other_land_buildings":{"other_cost_or_other_basis":308617,"book_value":278064,"depreciation":30553},"total_book_value":11071971},"other_liabilities":{"liabilities":[{"description":"Unamortized Bond Premium","amount":12719}],"total_liability":12719},"supplemental_information":[{"form_and_line_reference":"Part IV, Line 2b:","explanation":"The Medical Center holds tenant security deposits from assisted living residents. These funds are included in cash and accounts payable in the consolidated financial statements. Tenant security deposits totaled $15,672 and $14,288 at June 30, 2012 and 2011."},{"form_and_line_reference":"Part X:","explanation":"The Medical Center and the Foundation are organized as North Dakota nonprofit corporations and have been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center and the Foundation are required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS annually. In addition, the Medical Center and the Foundation are subject to income tax on any net income that is derived from business activities that are unrelated to its exempt purpose. The Medical Center and the Foundation believe they have appropriate support for any tax positions taken affecting the annual filing requirements for the Medical Center and the Foundation, and as such, do not have any uncertain tax positions that are material to the consolidated financial statements. The Medical Center and the Foundation would recognize future accrued interest and penalties related to unrecognized tax liabilities in income tax expense if such interest and penalties are incurred."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":false,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":false,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":false},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":121077,"bad_debt_expense_attributable_to_financial_assistance":90808,"reimbursed_by_medicare":1628321,"cost_of_care_reimbursed_by_medicare":1612199,"medicare_surplus_or_shortfall":16122,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":false},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":11000,"net_community_benefit_expense":11000,"total_expense_percentage":0.0014},"unreimbursed_medicaid":{"total_community_benefit_expense":2052708,"direct_offsetting_revenue":2044119,"net_community_benefit_expense":8589,"total_expense_percentage":0.0011},"total_financial_assistance":{"total_community_benefit_expense":2063708,"direct_offsetting_revenue":2044119,"net_community_benefit_expense":19589,"total_expense_percentage":0.0025},"community_health_services":{"total_community_benefit_expense":500,"net_community_benefit_expense":500,"total_expense_percentage":0.0001},"subsidized_health_services":{"total_community_benefit_expense":420869,"direct_offsetting_revenue":274537,"net_community_benefit_expense":146332,"total_expense_percentage":0.0182},"total_other_benefits":{"total_community_benefit_expense":421369,"direct_offsetting_revenue":274537,"net_community_benefit_expense":146832,"total_expense_percentage":0.0183},"total_community_benefits":{"total_community_benefit_expense":2485077,"direct_offsetting_revenue":2318656,"net_community_benefit_expense":166421,"total_expense_percentage":0.0208}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Hillsboro Medical Center","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","licensed_hospital":true,"general_medical_and_surgical":true,"critical_access_hospital":true,"emergency_room_24_hours":true,"other_description":"Ambulance","name":"Hillsboro Medical Center","address":"12 3rd St SE, Hillsboro, ND, 58045"}],"facility_policies":[{"business_name_line1":"Hillsboro Medical Center","facility_number":1,"chna_conducted":false,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":false,"fpg_used_determine_discounted_care":false,"income_level_criteria":true,"asset_level_criteria":true,"medical_indigency_criteria":true,"insurance_status_criteria":true,"basis_explained":true,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_request_no_charge":true,"other_publicity":true,"fap_actions_on_nonpayment":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"amounts_generally_billed":false,"gross_charges":false,"name":"Hillsboro Medical Center"}],"other_health_care_facility_count":2,"other_health_care_facilities":[{"business_name_line1":"Hillsboro Medical Center Nursing Home","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","facility_type":"Skilled Nursing","name":"Hillsboro Medical Center Nursing Home","address":"12 3rd St SE, Hillsboro, ND, 58045"},{"business_name_line1":"Comstock Corner","address_line1":"12 3rd St SE","city":"Hillsboro","state":"ND","zip":"58045","facility_type":"Assisted Living","name":"Comstock Corner","address":"12 3rd St SE, Hillsboro, ND, 58045"}],"supplemental_information":[{"explanation":"Part I, Line 3c: Throughout the payment and collection process, the business office staff attempt to identify to the extent possible, patients who may be eligible for charity care considerations. Individuals with accounts to be considered for charity reductions are asked to complete a financial statement form, which provides pertinent financial information necessary to determine financial need. The charity care application asks for items such as employment information, current income, current expenses, assets owned as well as other miscellaneous items. Credit reports are also used to verify and assist in the decision process. This information is also compared against the federal poverty guidelines. Review of potential charity requests are performed monthly by the Business Manager and certain recommendations are forwarded to the Administrator. The Administrator reviews all information in the charity care application and bases a decision for charity care on all factors included in the application."},{"explanation":"Part I, Line 7: An average ratio of cost to gross charges, which addresses all patient segments, was used to determine the amount of Financial Assistance at cost on Part I, line 7a. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Subsidized health services on line 7g was calculated using the cost report. Community health improvement services, line 7e, were calculated based on estimated costs."},{"explanation":"Part I, L7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $121,077."},{"explanation":"Part II: n/a"},{"explanation":"Part III, Line 4: Financial Statement Bad Debt Expense Footnote:The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients, residents, and third-party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write-off and recovery information in determining the estimated bad debt provision.All discounts and payments on a patient's account are accounted for prior to determining bad debt expense. Hillsboro Medical Center reports amounts as bad debt once they are 120 days overdue and have been turned over to a collection agency. Historically, almost all of these amounts remain unpaid as the patient does not have sufficient resources and likely would qualify for the Charity Care Program. Based on this assumption, 75% of the bad debt amount is considered charity care."},{"explanation":"Part III, Line 8: Medicare allowable costs of care are based on the Medicare Cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services."},{"explanation":"Part III, Line 9b: As of 6/30/12, the collection policy did not contain specific written provisions on collection practices to be followed for patients who are known to qualify for financial assistance. However in practice, when it is appropriate, a review is done to determine if a patient qualifies for charity care (all patients are evaluated on an individual basis). This can be discussed with the patient during the phone call prior to sending to collections. All collection efforts are reversed if a patient is determined to be eligible for financial assistance."},{"explanation":"The Organization began re-writing some of their policies during the year in order to be in compliance with IRC 501(r). This process was halted because the Organization was in the process of becoming affiliated with Sanford Health and knew that when the affiliation was official they would adopt the policies and procedures of Sanford Health. The Organization will become part of Sanford Health as of January 1st, 2013."},{"explanation":"Part V, Section B, Line 9: We have a charity care application available requesting financial and employment information. Items requested include but are not limited to, household income, household expense, insurance benefits, and assets. Administration reviews the application and bases a decision for charity care on all factors and compares data to federal poverty guidelines. Notes are made on the statements informing patients that charity care applications are available if they are unable to pay."},{"explanation":"Part V, Section B, Line 10: No discounted care was provided during the fiscal year."},{"explanation":"Part V, Section B, Line 13g: The Organization informs patients about the Charity Care Policy during the collection process and indicates which pertinent information is needed in order to determine financial need. As of the fiscal year end, the Organization is working on making the Charity Care Policy more widely available to the public in order to be in compliance with IRC 501(r)."},{"explanation":"Part V, Section B, Line 19d: During the fiscal year, individuals who were eligible for charity care received a 100% write off applied to the gross charges on their bill. There were no other lesser discounts offered.Effective January 2013, the Organization will be affiliated with Sanford Health. They will adopt the amounts generally billed calculations currently in use by Sanford Health. The minimum discount for those that qualify will be calculated by using the weighted average of the contractual adjustments provided to the three largest commercial insurance companies during the prior calendar year."},{"explanation":"Part VI, Line 2: The Assistant Director of Nursing and the Medical Providers at Hillsboro Medical Center assess the needs of outpatient services utilized by the community. We re-evaluate the services we provide and have added multiple needed outpatient treatments. These services enhanced patient care and provided services within our community instead of needing to travel outside the Hillsboro area for these services. The Organization began planning a Community Health Needs Assessment during the year as well to help assess the needs of the community. We will continue to review the needs of the community and the services that we offer."},{"explanation":"Part VI, Line 3: During the collection process for outstanding bills, Hillsboro Medical Center (HMC) informs the patients that they do have a Charity Care Policy and they will send out a financial statement form, which will provide pertinent patient financial information necessary to determine financial need. Also, HMC discusses with the patients that they could apply with the county for Medicaid assistance. The final determination for Charity Care is approved by the Administrator after reviewing all pertinent factors."},{"explanation":"Part VI, Line 4: Hillsboro Medical Center is a 16-bed acute care hospital, a 36-bed nursing facility, and a 16-unit assisted living facility located in Hillsboro, North Dakota. Hillsboro has a population of approximately 1,603 per the 2010 Census data. Per the 2007-2011 American Community Survey's 5 year estimates, the median income for a household in the city was $43,629 and the median income for a family was $56,719. Males (working year-round and full-time) had a median income of $43,182 versus $30,655 for females. The per capita income for the city was $20,791. About 4.2% of families and 8.4% of the population were below the poverty line, including 7.6% of those under age 18 and 11.2% of those age 65 or over. Sanford-Mayville Hospital is another hospital that serves the community in an 18 mile radius."},{"explanation":"Part VI, Line 5: The mission of the Hillsboro Medical Center is to provide quality health care and living services with dignity and individualized care. Hillsboro Medical Center provides community meetings about CPR, Advance Directives, Child Passenger Safety, Alzheimer's, etc. to promote information and well-being to people in our community. Hillsboro Medical Center also provides a room for Hospice and UND Journal Club free of charge so they can conduct their meetings for the care of people in the community and surrounding areas. The majority of the organization's governing body is comprised of individuals who reside in the primary service area. These individuals are not employees, nor contractors or family members of the organization. The organization extends medical staff privileges to qualified physicians in the community. Surplus funds, if available, are re-invested in the facility to improve patient care."},{"explanation":"Part VI, Line 6: n/a"}]},"ScheduleK":{"bond_issues":[{"issuer_ein":456002246,"business_name_line1":"Traill County","cusip_number":"892846AQ9","date_issued":"2007-05-22T00:00:00","issue_price":13341133,"purpose":"Exp of facility; new Asst Lvg and LT Care bldgs, 80% rmdl of Hospital","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"Traill County"}],"bond_proceeds":[{"total_proceeds":13341133,"gross_proceeds_in_reserve_funds":893789,"capitalized_interest":658284,"issuance_costs_from_proceeds":239850,"capital_expenditures":11549210,"amount_retired":730000,"substantial_completion_year":2009,"current_refunding":false,"advance_refunding":false,"final_allocation_made":false,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":false,"management_contract":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":363542187,"business_name_line1":"Hillsboro Medical Center Foundation","primary_activities":"Fundraising","exempt_code_section":"501(c)(3)","public_charity_status":"7","controlled_organization":true,"legal_domicile_state":"ND","direct_controlling_business_name_line1":"Hillsboro Medical Center","address_line1":"PO Box 609","city":"Hillsboro","state":"ND","zip":"58045","name":"Hillsboro Medical Center Foundation","address":"PO Box 609, Hillsboro, ND, 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