Monument Health

Legal name: Monument Health Rapid City Hospital Inc

Nonprofit profile at a glance

EIN
460319070
IRS 990 coverage
2009–2024
Official website data refreshed
Sep 2026
Forms available
Form 990 2024, Form 990-T 2024
Location
Rapid City, SD, USA
Phone
605.755.1000
Rating
69
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Hospital, General

Official website

Reported finances

Revenue
$1,091,839,091
Expenses
$1,059,820,826
Assets
$1,484,513,220
Liabilities
$532,428,914

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

Leadership & pay

30 people listed

Executive titles in this filing

  • Paulette R Davidson (President & CEO)
  • John Pierce (President Rapid City Hospital and Market)

Highest reported compensation

  • Paulette R Davidson (President & CEO): $2,199,697 total reported compensation
  • Joseph Tuma MD (Physician - Cardiology): $2,029,583 total reported compensation
  • Ethan Levine MD (Physician - Cardiology): $1,673,792 total reported compensation

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

Overview

Mission

Monument Health is a non-profit health care system governed by a Board of Directors. Under the board’s direction, our Chief Executive Officer and the Senior Executive Team manage Monument Health’s operations, fiscal policy and strategic planning to achieve the health system’s mission, vision and values.

What it reported doing in 2024

Monument Health Rapid City Hospital, Inc. (MHRCH) offers both inpatient and outpatient health services. Its tertiary hospital, Rapid City Hospital (RCH), serves Western South Dakota. The nearest larger hospital is in Sioux Falls, SD, more than 350 miles away. As such, the services provided by MHRCH are truly a healthcare safety net for Western South Dakota. MHRCH is a community-based health care system with a mission to make a difference, every day. MHRCH also provides patient care at the Behavioral Health Center, Orthopedic and Specialty Hospital, Family Medicine Residency Clinic, Heart and Vascular Institute, Hospice House, Medical Clinics and Urgent Care locations. The Hospital employs physicians through its residency, cardiology, cardiovascular surgery, medical oncology, psychiatry, neurology, hospitalist, orthopedics and other programs.Monument Health Home Plus, LLC provides home care, hospice, pharmacy, and durable medical equipment services to the communities Monument Health serves.

Operating model

Revenue model
Mixed. Its operating money came from several sources; no one source provided a clear majority.
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.
  • Includes noncash contributions: Reported contributions include donated property or goods.

The verdict

SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. Few specific pay-setting methods are documented in the filing; unanswered boxes are not proof of absence and the filing reports few safeguards for money sent abroad.

Rating breakdown

  • Financial Efficiency: 73
  • Transparency & Controls: 60
  • Accountability: 72
  • Sustainability: 51
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 80.2%; rating input score 80
  • Program expense ratio: 81.5%; rating input score 82
  • Fundraising efficiency: $2.25 raised per $1 spent on fundraising; rating input score 7; 7th percentile among comparable filings

Transparency & Controls

  • Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
  • Pay-setting controls: 0 of 6 controls in place; rating input score 0
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Missing
    • Board or committee approval: Missing
  • Foreign activity oversight: Scored; rating input score 0
  • Grant itemization coverage: 100%; rating input score 100; 77th percentile among comparable filings
  • Major donor itemization: Yes; rating input score 100
  • Related-party transparency: Scored; rating input score 0

Accountability

  • Independent voting board: 60%; rating input score 60; 16th percentile among comparable filings
  • Governance controls: 8 of 9 controls in place; rating input score 89
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Pass
    • Other executive compensation review process: Fail
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: 2.9%; rating input score 47; 47th percentile among comparable filings
  • Total-asset coverage ratio: 1.4; rating input score 51; 51st percentile among comparable filings
  • Liabilities to assets ratio: 0.36; rating input score 50; 50th percentile among comparable filings
  • Officer compensation ratio: 1.4%; rating input score 66; 66th percentile among comparable filings

Growth

  • Program expense growth: 8.8% per year; rating input score 100; 69th percentile among comparable filings
  • Revenue growth: 6.5% per year; rating input score 100; 56th percentile among comparable filings
  • Asset growth: 4.8% per year; rating input score 100; 35th percentile among comparable filings

Details

  • What they do: 4 programs and campaigns described on the official site · 5 operating locations identified
  • Where the money goes: 80.2% of revenue deployed · 81.5% of spending went to programs
  • Governance: 9 of 15 board members independent · 8 of 9 filing controls reported
  • Programs: 1 filed program accomplishment · $864.2M in reported program spending
  • Leadership: top reported pay $2.2M · 30 people listed · 0 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $97.6M reported
  • Consistency: 40 of 40 current checks pass
  • Schedules: 14 filed schedules · includes major donors, foreign activity, grants, executive pay, and related organizations
  • Filing history: 16 filing years from 2009 to 2024
  • Contacts: How to reach this organization
  • Money network: 33 filed money-flow records
  • Related organizations: 20 filed related-organization links
  • 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.

  • High — Transparency & Controls: Pay-setting controls scored 0/100.
  • High — Transparency & Controls: Foreign activity oversight scored 0/100.
  • High — Financial Efficiency: Fundraising efficiency scored 7/100.
  • Moderate — Sustainability: Operating margin scored 47/100.
  • High — Transparency & Controls: Related-party transparency scored 0/100.
  • Review — Accountability: Governance controls: Other executive compensation review process not reported.
  • Review — Sustainability: Total-asset coverage ratio scored 51/100.
  • Review — Sustainability: Liabilities to assets ratio scored 50/100.
  • High — Grant Readiness: Federal audit findings: this organization reported findings in its latest federal Single Audit.