Marshall County Healthcare Center

Nonprofit profile at a glance

EIN
460380552
IRS 990 coverage
2009–2024
Forms available
Form 990 2024
Location
Britton, SD, USA
Phone
6054482253
Rating
77
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Hospital, General

Reported finances

Revenue
$13,194,933
Expenses
$13,013,408
Assets
$18,009,697
Liabilities
$974,879

Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.

Leadership & pay

16 people listed

Executive titles in this filing

  • ADRIAN HEITMANN (PRESIDENT)
  • BILL HAYWOOD (VICE PRESIDENT)
  • NICK FOSNESS (CEO)

Highest reported compensation

  • NICK FOSNESS (CEO): $227,459 total reported compensation
  • SARA RAABE (NURSE PRACTIONER): $214,637 total reported compensation
  • AMANDA SCHMIEG (NURSE PRACTIONER): $207,828 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.

Overview

Mission

The mission of marshall county healthcare center is to oversee that the full continuum of quality healthcare services is made available to the people in its region.

What it reported doing in 2024

Marshall county healthcare center operates a 20 bed acute care hospital, a 25 unit assisted & independent living facility, and a provider based rural health clinic located in britton, sd. Health care services include acute inpatient care, swing bed care and outpatient & clinic services. For year ended june 30, 2025, the amounts and types of care provided were: 445 acute patient days; 346 swing bed days; 5,427 clinic visits; and 4,160 assisted & independent living days.mchc provides healthcare services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since mchc does not pursue collection of these amounts, they are not reported as patient service revenue.the estimated cost of providing these services was $20,000 for the year ended june 30, 2025, calculated by multiplying the ratio of cost to gross charges for mchc by the gross uncompensated charges associated with providing charity care to its patients.

Operating model

Revenue model
Other-operating. 97% of the money available for current operations came from other operating revenue.
Distribution model
Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.

The verdict

SUPPORTED - A large share of available resources goes toward mission work and most voting board members are independent. Expenses are high relative to revenue and total assets are small relative to annual expenses; liquid coverage is unknown.

Rating breakdown

  • Financial Efficiency: 75
  • Transparency & Controls: 66
  • Accountability: 100
  • Sustainability: 45
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 84.1%; rating input score 84
  • Program expense ratio: 84.2%; rating input score 84
  • Fundraising efficiency: Limited

Transparency & Controls

  • Consistency checks: 100%; rating input score 100; 62nd percentile among comparable filings
  • Pay-setting controls: 1 of 6 controls in place; rating input score 17
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Missing
    • Board or committee approval: Pass
  • Foreign activity oversight: Limited
  • Grant itemization coverage: Limited
  • Major donor itemization: Limited
  • Related-party transparency: Limited

Accountability

  • Independent voting board: 100%; rating input score 100; 66th percentile among comparable filings
  • Governance controls: 9 of 9 controls in place; rating input score 100
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Pass
    • Other executive compensation review process: Pass
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: 1.4%; rating input score 39; 39th percentile among comparable filings
  • Total-asset coverage ratio: 1.38; rating input score 48; 48th percentile among comparable filings
  • Liabilities to assets ratio: 0.05; rating input score 82; 82nd percentile among comparable filings
  • Officer compensation ratio: 9.6%; rating input score 22; 22nd percentile among comparable filings

Growth

  • Program expense growth: 7.2% per year; rating input score 100; 57th percentile among comparable filings
  • Revenue growth: 7% per year; rating input score 100; 59th percentile among comparable filings
  • Asset growth: 7.5% per year; rating input score 100; 51st percentile among comparable filings

Details

  • Where the money goes: 84.1% of revenue deployed · 84.2% of spending went to programs
  • Governance: 8 of 8 board members independent · 9 of 9 filing controls reported
  • Programs: 1 filed program accomplishment · $11M in reported program spending
  • Leadership: top reported pay $227K · 16 people listed · 1 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $2.7M reported
  • Consistency: 32 of 32 current checks pass
  • Schedules: 5 filed schedules · includes executive pay
  • Filing history: 16 filing years from 2009 to 2024
  • Contacts: How to reach this organization
  • Money network: 7 filed money-flow records
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

Grant-readiness screening is separate from the live rating, not a measure of program quality. Review the source records before making a grant decision.

  • Moderate — Sustainability: Operating margin scored 39/100.
  • Moderate — Sustainability: Total-asset coverage ratio scored 48/100.
  • High — Sustainability: Officer compensation ratio scored 22/100.
  • High — Grant Readiness: Federal audit findings: this organization reported findings in its latest federal Single Audit.