WESTERN HORIZONS LIVING CENTERS: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- WESTERN HORIZONS LIVING CENTERS (EIN 26-0794602)
- Tax period
- 2017-04-01 to 2018-03-31
- Filed
- 2019-02-11
- IRS object ID
- 201920429349301092
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-02-11T16:34:51-06:00 | ReturnTs |
| Tax Period End | 2018-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 460403496 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASEY PETERSON LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 ST JOSEPH ST SUITE 101 | AddressLine1Txt |
| City | RAPID CITY | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260794602 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTERN HORIZONS LIVING CENTERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WEST | BusinessNameControlTxt |
| Phone | 7015674561 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1Txt |
| City | HETTINGER | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58639 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NATHAN STADHEIM | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7015674561 | PhoneNum |
| Signature | 2019-02-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEIDRE BUDAHL CPA | PreparerPersonNm |
| PTIN | P01273830 | PTIN |
| Phone | 6053481930 | PhoneNum |
| Preparation | 2019-02-11 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 65.153.235.186 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-02-11 | IPDt |
| IP Tm | 16:26:38 | IPTm |
| IP Timezone | MS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F816B9D621AD14857E56F1346500FC3E34F8C907 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MATT SHAHAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1Txt |
| City | HETTINGER | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58639 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,703,178 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WRHS.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | TO ASSIST OUR NEIGHBORS IN ACHIEVING AND MAINTAINING THEIR HIGHEST LEVEL OF INDEPENDENCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 88 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $200,297 | PYContributionsGrantsAmt |
| CY Contributions Grants | $37,192 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,984,157 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,665,986 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | -$5,534 | CYInvestmentIncomeAmt |
| PY Other Revenue | $60,411 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,244,865 | PYTotalRevenueAmt |
| CY Total Revenue | $3,697,644 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,618,105 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,295,713 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,543,644 | PYOtherExpensesAmt |
| CY Other Expenses | $1,993,095 | CYOtherExpensesAmt |
| PY Total Expenses | $4,161,749 | PYTotalExpensesAmt |
| CY Total Expenses | $4,288,808 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $83,116 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$591,164 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,021,806 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,037,570 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,167,659 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,774,587 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,145,853 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,737,017 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF WESTERN HORIZONS LIVING CENTERS IS TO ASSIST OUR NEIGHBORS IN ACHIEVING AND MAINTAINING THEIR HIGHEST LEVEL OF INDEPENDENCE IN A CARING AND RESPECTFUL ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,167,893 | ExpenseAmt |
| Revenue | $3,191,509 | RevenueAmt |
| Desc | WESTERN HORIZONS LIVING CENTERS (WHLC) OPERATES A 48 BED SKILLED NURSING FACILITY. IN ADDITION TO THE BASIC DAILY ROUTINE CARE, STAFF ALSO PROVIDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, ACTIVITIES, AND SOCIAL SERVICES TO THE RESIDENTS. ON AVERAGE, LONG-TERM CARE SERVICES WERE PROVIDED TO 41 RESIDENTS FOR THIS REPORTING PERIOD. THERE WERE 15,001 SKILLED NURSING DAYS WITH ABOUT 53% OF THOSE DAYS BEING MEDICAID CERTIFIED. THROUGHOUT THE YEAR, WHLC AND COMMUNITY INDIVIDUALS/GROUPS PROVIDED MANY VARIED FORMS OF PROGRAMMING, INCLUDING EXERCISE GROUPS, MUSICAL ENTERTAINMENT, BINGO, VAN TRIPS, COMMUNITY OUTINGS, SOCIAL EVENTS, MONTHLY BIRTHDAY PARTIES, EDUCATIONAL PROGRAMS, MOVIES AND BEDSIDE ACTIVITIES. LOCAL CLERGY AND FACILITY STAFF CONDUCTED REGULAR WORSHIP SERVICES AND BIBLE STUDIES FOR RESIDENTS. A GROUP OF LOCAL LADIES WEEKLY VOLUNTEER THEIR SERVICES IN HAIRDRESSING FOR THE RESIDENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $462,560 | ExpenseAmt |
| Revenue | $466,008 | RevenueAmt |
| Desc | IN ADDITION TO THE SKILLED NURSING FACILITY, WHLC OPERATED 16-UNIT ASSISTED LIVING FACILITY KNOWN AS WESTERN HORIZONS ASSISTED LIVING (WHAL). IT PROVIDES HANDICAP ACCESSIBLE BATHROOMS IN THE ROOMS, ELECTRIC DOOR OPENERS THROUGHOUT THE FACILITY, AND IS ALL ON ONE LEVEL TO PROVIDE EASY ACCESSIBILITY TO THE TENANTS. WHAL OPERATES CHARITABLY BY MEETING THE PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, AND SIMILAR NEEDS OF ELDERLY PEOPLE. SOME OF THE ACTIVITIES INCLUDE CARD PLAYING, GARDENING, WEEKLY RELIGIOUS GATHERINGS, AND SOCIAL INTERACTION WITH EACH OTHER OR FAMILY VISITORS. STAFF ALSO PROVIDES OTHER HEALTH-RELATED SERVICES INCLUDING BATHING, HAIR, SKIN AND NAIL CARE, DRESSING, ASSISTANCE WITH MOBILITY, COMMUNICATION AND REMINDERS, MEDICATION MANAGEMENT, HOUSEKEEPING AND LAUNDRY SERVICES, MEAL PLANNING AND PREPARATION, EXERCISE PROGRAM, AND MONITORING BLOOD SUGARS, VITAL SIGNS AND OXYGEN. WHILE THERE HAS BEEN SOME TURNOVER THROUGHOUT THE YEAR DUE TO DEATH AND/OR THE TENANT NEEDING A HIGHER LEVEL OF CARE, WHAL HAS ENJOYED A VERY HIGH OCCUPANCY RATE AND HAS A WAITING LIST OF THOSE SEEKING ASSISTED LIVING SERVICES. ASSISTED LIVING SERVICES ARE OPEN TO ANY INDIVIDUAL WHO QUALIFIES FOR CARE. STAFF HAVE CLOSE RELATIONSHIPS WITH REGIONAL AND COUNTY SOCIAL SERVICE WORKERS TO ASSIST IN THE APPLICATION PROCESS FOR MEDICAL ASSISTANCE IF THE NEED ARISES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,630,453 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 88 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ND | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATHAN STADHEIM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7015674561 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1Txt |
| City | HETTINGER | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58369 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|
| TERRY HENDERSON | |||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KATHY VLIEM | |||||||
| VICE-CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LINDA WEAVER | |||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BLANE CHAPMAN | |||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE HEDSTROM | |||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR KENT HEORAUF | |||||||
| MEDICAL LIASON | 2.00 | Yes (X) | $13,200 | $151,234 | $21,793 | 40.00 | |
| BETTYNA JOHNSON | |||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE MCFARLAND | |||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALLEN MCINTYRE | |||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT PARKER | |||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SETH SKOGEN | |||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT SHAHAN | |||||||
| PRESIDENT, CEO | 11.00 | Yes (X) | $0 | $178,231 | $11,277 | 29.00 | |
| NATHAN STADHEIM | |||||||
| CFO | 7.00 | Yes (X) | $0 | $97,404 | $16,835 | 33.00 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $13,200 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $426,869 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $49,905 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WEST RIVER REGIONAL MEDICAL CENTER | |||||
| 1000 HIGHWAY 12 | HETTINGER | ND | 58639 | STAFFING & HEALTHCARE SERVICES, MANAGEME | $256,965 |
| PRIME TIME HEALTHCARE LLC | |||||
| PO BOX 3544 | OMAHA | NE | 68103 | AGENCY NURSING STAFF | $256,518 |
| DAKOTA TRAVEL NURSE INC | |||||
| 1200 COLLINS AVE | MANDAN | ND | 58554 | AGENCY NURSING STAFF | $151,600 |
| GUARDIAN HEALTHCARE PROVIDERS | |||||
| 105 WESTPARK DRIVE SUITE 100 | BRENTWOOD | TN | 370275062 | AGENCY NURSING STAFF | $101,668 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $25,888 | RelatedOrganizationsAmt |
| All Other Contributions | $11,304 | AllOtherContributionsAmt |
| Noncash Contributions | $9,291 | NoncashContributionsAmt |
| Total Contributions | $37,192 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| RESIDENT SERVICE REVEN | 623000 | $3,191,509 | $3,191,509 | |
| ASSISTED LIVING REVENU | 623000 | $466,008 | $466,008 | |
| MISCELLANEOUS REVENUE | 900099 | $8,469 | $8,469 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,665,986 | TotalProgramServiceRevenueAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,534 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$5,534 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,534 | TotalRevenueColumnAmt |
| Exclusion | -$5,534 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,697,644 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,657,517 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,935 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,200 | TotalAmt |
| Management And General | $13,200 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,796,814 | TotalAmt |
| Program Services | $1,743,782 | ProgramServicesAmt |
| Management And General | $53,032 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,117 | TotalAmt |
| Program Services | $42,075 | ProgramServicesAmt |
| Management And General | $3,042 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,221 | TotalAmt |
| Program Services | $304,294 | ProgramServicesAmt |
| Management And General | $9,927 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,361 | TotalAmt |
| Program Services | $120,808 | ProgramServicesAmt |
| Management And General | $5,553 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,894 | TotalAmt |
| Management And General | $101,894 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,650 | TotalAmt |
| Management And General | $35,650 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,752 | TotalAmt |
| Management And General | $18,752 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $841,882 | TotalAmt |
| Program Services | $759,567 | ProgramServicesAmt |
| Management And General | $82,315 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,058 | TotalAmt |
| Management And General | $1,058 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,865 | TotalAmt |
| Management And General | $6,865 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,610 | TotalAmt |
| Management And General | $32,610 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,360 | TotalAmt |
| Program Services | $198,706 | ProgramServicesAmt |
| Management And General | $15,654 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,167 | TotalAmt |
| Program Services | $6,551 | ProgramServicesAmt |
| Management And General | $5,616 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,030 | TotalAmt |
| Program Services | $14,030 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,477 | TotalAmt |
| Program Services | $119,477 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,580 | TotalAmt |
| Program Services | $18,042 | ProgramServicesAmt |
| Management And General | $9,538 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES- MEDICAL & OTH | $241,910 | $238,742 | $3,168 |
| MEDICARE PENALTY FEES | $192,705 | $192,705 | |
| BAD DEBT EXPENSE | $44,105 | $44,105 | |
| MAINTENANCE | $31,917 | $31,496 | $421 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,133 | TotalAmt |
| Program Services | $32,883 | ProgramServicesAmt |
| Management And General | $23,250 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,288,808 | TotalAmt |
| Program Services | $3,630,453 | ProgramServicesAmt |
| Management And General | $658,355 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,517 | BOYAmt |
| EOY | $67,813 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,173 | BOYAmt |
| EOY | $309,994 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,961 | BOYAmt |
| EOY | $14,173 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,438 | BOYAmt |
| EOY | $8,786 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,451,775 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,814,971 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $705,717 | BOYAmt |
| EOY | $636,804 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,021,806 | BOYAmt |
| EOY | $1,037,570 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $230,656 | BOYAmt |
| EOY | $286,164 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $391,808 | BOYAmt |
| EOY | $325,286 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,188 | BOYAmt |
| EOY | $22,358 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,344 | BOYAmt |
| EOY | $418,673 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,464,663 | BOYAmt |
| EOY | $1,722,106 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,167,659 | BOYAmt |
| EOY | $2,774,587 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,145,853 | BOYAmt |
| EOY | -$1,737,017 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,145,853 | BOYAmt |
| EOY | -$1,737,017 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,021,806 | BOYAmt |
| EOY | $1,037,570 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$591,164 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $88,766 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $59,696 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,116 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $200,297 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,192 | CurrentTaxYearAmt |
| Total | $418,067 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,913,771 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,034,326 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,004,819 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,984,157 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,665,986 | CurrentTaxYearAmt |
| Total | $19,603,059 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,356 | CurrentTaxYearMinus4YearsAmt |
| Total | $2,356 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,004,893 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,094,022 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,036,935 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,184,454 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,703,178 | CurrentTaxYearAmt |
| Total | $20,023,482 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $128,489 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $222,374 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $319,490 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $404,371 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $541,699 | CurrentTaxYearAmt |
| Total | $1,616,423 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $128,489 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $222,374 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $319,490 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $404,371 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $541,699 | CurrentTaxYearAmt |
| Total | $1,616,423 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $18,407,059 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,004,893 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,094,022 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,036,935 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,184,454 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,703,178 | CurrentTaxYearAmt |
| Total | $20,023,482 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.91930 | PublicSupportCY509Pct |
| Public Support PY509 | 0.91520 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $122,647 | OtherCostOrOtherBasisAmt |
| Book Value | $122,647 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,657,498 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,245,396 | DepreciationAmt |
| Book Value | $412,102 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $609,569 | OtherCostOrOtherBasisAmt |
| Depreciation | $516,942 | DepreciationAmt |
| Book Value | $92,627 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $62,061 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,633 | DepreciationAmt |
| Book Value | $9,428 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $636,804 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTY | $279,651 |
| NOTE PAYABLE TO WEST RIVER HEALTH SERVICES FOUNDATION | $600,000 |
| NOTE PAYABLE TO WEST RIVER HEALTH SERVICES | $650,000 |
| PENALTY PAYABLE TO MEDICARE | $192,455 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,722,106 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,697,644 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,697,644 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,697,644 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,288,808 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,288,808 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,288,808 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | WESTERN HORIZONS LIVING CENTERS ACT AS CUSTODIAN FOR THE FUNDS OF THE NURSING FACILITY RESIDENTS AND HOLDS SECURITY DEPOSITS FOR RESIDENTS OF THE ASSISTED LIVING FACILITIES. THESE FUNDS ARE INCLUDED IN CASH AND ACCOUNTS PAYABLE IN THE FINANCIAL STATEMENTS. RESIDENT TRUST FUNDS AND SECURITY DEPOSITS TOTALED $25,188 AND $22,358 AT MARCH 31, 2017 AND 2018. |
| PART X, LINE 2: | AS OF MARCH 31, 2018, WHLC HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. WHLC'S INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. WHLC IS NO LONGER SUBJECT TO FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR FISCAL YEARS BEFORE 2014. MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATION, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. WHLC BELIEVES ESTIMATES ARE APPROPRIATE BASED ON CURRENT FACTS AND CIRCUMSTANCES. INTEREST AND PENALTIES ASSESSED BY INCOME TAXING AUTHORITIES, IF ANY, ARE INCLUDED IN INTEREST EXPENSE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR KENT HEORAUF | ||||||||||||||
| MEDICAL LIASON | $13,200 | $151,234 | $0 | $0 | $0 | $0 | $0 | $4,770 | $0 | $17,023 | $13,200 | $173,027 | $0 | $0 |
| MATT SHAHAN | ||||||||||||||
| PRESIDENT, CEO | $0 | $178,231 | $0 | $0 | $0 | $0 | $0 | $5,497 | $0 | $5,780 | $0 | $189,508 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S CEO IS COMPENSATED BY WEST RIVER HEALTH SERVICES (A RELATED PARTY). THE WEST RIVER HEALTH SERVICES BOARD OF DIRECTORS DETERMINES THE CEO'S COMPENSATION VIA COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF HETTINGER NORTH DAKOTA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 456002094 | BondIssuerEIN |
| Bond Issued | 2007-12-03 | BondIssuedDt |
| Issue Price | $900,000 | IssuePriceAmt |
| Purpose | PURCHASE OF NURSING HOME AND EQUIPMENT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $574,714 | RetiredAmt |
| Total Proceeds | $900,000 | TotalProceedsAmt |
| Other Spent Proceeds | $900,000 | OtherSpentProceedsAmt |
| Substantial Completion | 2007 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CAN ACT FOR AND ON BEHALF OF THE FULL BOARD. IT IS COMPRISED OF THE CHAIR, VICE CHAIR, SECRETARY/TREASURER, PAST CHAIR, MEDICAL STAFF REPRESENTATIVE, AND ONE ADDITIONAL MEMBER OF THE WESTERN HORIZONS LIVING CENTER BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | WEST RIVER HEALTH SERVICES FOUNDATION IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER, WEST RIVER HEALTH SERVICES FOUNDATION ELECTS THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS OF THE BOARD OF DIRECTORS REQUIRE APPROVAL BY THE WEST RIVER HEALTH SERVICES FOUNDATION: 1) CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS; 2) DEBT IN EXCESS OF SET LIMITS; 3) DISSOLUTION OR MERGER OF THE CORPORATION; 4) SALE OR TRANSFER OF ANY CAPITAL ASSESTS WITH A PURCHASE PRICE OR FAIR MARKET VALUE GREATER THAN $100,000. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO AND CEO WILL REVIEW THE FORM 990 PRIOR TO THE COMPLETED FORM 990 BEING DISTRIBUTED ELECTRONICALLY TO THE BOARD MEMBERS FOR THEIR REVIEW AND COMMENTS. THE FORM 990 IS ALSO REVIEWED AND DISCUSSED AT A BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEDICAL STAFF, EMPLOYEES, AND BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS. POTENTIAL CONFLICTS ARE REVIEWED BY THE CEO. BOARD MEMBERS WITH CONFLICTS ABSTAIN FROM VOTING, AND THIS ACTION IS NOTED IN BOARD MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | EACH BOARD AND MEDICAL STAFF MEMBER ANNUALLY COMPLETES AN EVALUATION FORM ON THE ADMINISTRATOR'S PERFORMANCE; THE CHAIRMAN OF THE EXECUTIVE COMMITTEE TABULATES THE RESULTS AND REVIEWS WITH THE MEMBERS OF THE EXECUTIVE COMMITTEE; RESULTS ARE PRESENTED TO THE FULL BOARD OF DIRECTORS WHO HAVE FINAL AUTHORITY IN DETERMINING COMPENSATION. COMPARABILITY DATA FROM THE ND LONG TERM CARE ASSOCIATION, AS WELL AS OTHER COMPARATIVE INDUSTRY INFORMATION, IS USED IN DETERMINING COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 759,567. MANAGEMENT AND GENERAL EXPENSES 82,315. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 841,882. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM PREVIOUS YEARS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WEST RIVER HEALTH SERVICES | ||||||||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | 450340688 | HOSPITAL | ND | 501C3 | LINE 3 | WEST RIVER HEALTH SERVICES FOUNDATION | 0 |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||||||||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | 450411825 | FUNDRAISING | ND | 501C3 | LINE 11C, III-FI | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| C | $25,888 | CASH PAID |
| WEST RIVER HEALTH SERVICES | ||
| E | $895,393 | CASH PAID |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| E | $634,356 | CASH PAID |
| WEST RIVER HEALTH SERVICES | ||
| P | $140,856 | CASH PAID |
| WEST RIVER HEALTH SERVICES | ||
| K | $74,850 | LEASE AGREEMENT |
| WEST RIVER HEALTH SERVICES | ||
| Q | $578 | CASH PAID |