WEST RIVER HEALTH SERVICES: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- WEST RIVER HEALTH SERVICES (EIN 45-0340688)
- Tax period
- 2017-04-01 to 2018-03-31
- Filed
- 2019-02-14
- IRS object ID
- 201920459349301287
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-02-14T13:40:53-06:00 | 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 | 450340688 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST RIVER HEALTH SERVICES | 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 | 2019-02-13 | 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 | 2019-02-14 | 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 | 2019-02-14 | IPDt |
| IP Tm | 13:32:06 | 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
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST RIVER REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| 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 | $26,338,543 | 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 | 1977 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO THE RESIDENTS AND VISITORS OF THE REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 325 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $274,875 | PYContributionsGrantsAmt |
| CY Contributions Grants | $149,516 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,267,675 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,133,949 | CYProgramServiceRevenueAmt |
| PY Investment Income | $166,913 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,008 | CYInvestmentIncomeAmt |
| PY Other Revenue | $56,519 | PYOtherRevenueAmt |
| CY Other Revenue | $50,066 | CYOtherRevenueAmt |
| PY Total Revenue | $25,765,982 | PYTotalRevenueAmt |
| CY Total Revenue | $26,338,539 | 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 | $11,887,706 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,886,850 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $75,088 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,354,591 | PYOtherExpensesAmt |
| CY Other Expenses | $10,641,241 | CYOtherExpensesAmt |
| PY Total Expenses | $26,242,297 | PYTotalExpensesAmt |
| CY Total Expenses | $25,528,091 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$476,315 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $810,448 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,263,958 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,984,440 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,053,209 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,963,243 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,210,749 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,021,197 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF WEST RIVER HEALTH SERVICES (WRHS) IS TO PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO THE RESIDENTS AND VISITORS OF THE REGION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $21,346,382 | ExpenseAmt |
| Revenue | $26,133,949 | RevenueAmt |
| Desc | WEST RIVER HEALTH SERVICES (WRHS) IS A NATIONALLY-RECOGNIZED RURAL HEALTH CARE DELIVERY SYSTEM INCLUDING HOSPITAL, SWING BED, SURGERY, LAB, RADIOLOGY, EMERGENCY ROOM, SEVEN CLINICS, EYE CLINIC, VISITING NURSE SERVICES, AMBULANCE SERVICE, FAMILY THERAPY, REHABILITATIVE THERAPIES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY, HOME MEDICAL EQUIPMENT STORE, AND WELLNESS/FITNESS SERVICES.IN FY 2018 WRHS PROVIDED ACUTE CARE SERVICES TO 619 PATIENTS FOR A TOTAL OF 2,179 DAYS OF CARE. SWING BED SERVICES WERE PROVIDED TO 72 PATIENTS FOR A TOTAL OF 534 DAYS OF CARE. IN ADDITION, 460 DAYS OF OBSERVATION CARE WERE PROVIDED. THERE WERE 1,611 EMERGENCY ROOM VISITS DURING THE YEAR. THERE WERE 83 BABIES BORN DURING THE YEAR WITH A TOTAL OF 183 DAYS OF CARE PROVIDED. THERE WERE A TOTAL OF 770 SURGICAL CASES DURING THE YEAR, WITH 666 OF THOSE BEING DONE ON AN OUTPATIENT BASIS. THE AMBULANCE CREW MADE 248 AMBULANCE RUNS/TRANSFERS THROUGHOUT THE YEAR. THERE WERE 39,362 CLINIC ENCOUNTERS TO THE SEVEN CLINICS. ANCILLARY SERVICES WERE PROVIDED AS FOLLOWS: 186,611 LAB TESTS; 7,958 RADIOLOGY TESTS; 5,238 RESPIRATORY THERAPY PROCEDURES; 25,502 MEALS TO PATIENTS, VISITORS, AND EMPLOYEES. THROUGHOUT THE YEAR THERE WERE 1,633 RHC NURSE VISITS. | Desc |
| Total Program Service Expenses | $21,346,382 | 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 | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | 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 | 51 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 325 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | 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 | 58639 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JONATHON EATON | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $120 | $0 | $0 | ||
| CLEVE TESKE | ||||||||
| VICE-CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $170 | $0 | $0 | ||
| GWYNNE SMITH | ||||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $130 | $0 | $0 | ||
| CHARIS CAMPBELL | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $40 | $0 | $0 | |||
| ROGER GOODFELLOW | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $60 | $0 | $0 | |||
| DR LISA HENDERSON | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $30 | $0 | $0 | |||
| LARRY JACKSON | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $90 | $0 | $0 | |||
| DR STEVEN KILWEIN | ||||||||
| MEDICAL STAFF LIASISON | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG PETERSON | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $20 | $0 | $0 | |||
| JOSH RANUM | ||||||||
| MEDICAL STAFF LIASISON | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHARLIE REISENAUER | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $40 | $0 | $0 | |||
| ERVIN SCHNEIDER | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $130 | $0 | $0 | |||
| GARY DEWHIRST | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $40 | $0 | $0 | |||
| GERALD SAILER | ||||||||
| REPRESENTATIVE | 1.00 | Yes (X) | $90 | $0 | $0 | |||
| MATT SHAHAN | ||||||||
| CEO | 28.00 | Yes (X) | $178,231 | $0 | $11,277 | 12.00 | ||
| NATHAN STADHEIM | ||||||||
| CFO | 32.00 | Yes (X) | $97,404 | $0 | $16,835 | 8.00 | ||
| MITCH SCHULTZ | ||||||||
| PHARMACY MANAGER | 40.00 | $158,832 | $0 | $27,948 | Yes (X) | |||
| MATTHEW HEFTY | ||||||||
| PHYSICIAN | 40.00 | $289,882 | $0 | $0 | Yes (X) | |||
| KENT HOERAUF | ||||||||
| PHYSICIAN | 40.00 | $151,234 | $13,200 | $21,793 | 2.00 | Yes (X) | ||
| BRIAN WILLOUGHBY | ||||||||
| PHYSICIAN | 40.00 | $143,211 | $0 | $22,356 | Yes (X) | |||
| CATHERINE SHIREK | ||||||||
| PHYSICIAN | 40.00 | $136,825 | $0 | $20,869 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,156,579 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $13,200 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $121,078 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNITED CLINIC PHYSICIANS PC | |||||
| 1110 HWY 12 | HETTINGER | ND | 58639 | PHYSICIAN SERVICES | $1,838,450 |
| CHRISTENSEN ANESTHESIA INC | |||||
| 802 11TH AVE NW | HETTINGER | ND | 58639 | PROFESSIONAL ANESTHESIA SERVICES | $422,475 |
| DR MARK KRISTY | |||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | PROFESSIONAL RADIOLOGY SERVICES | $365,684 |
| SCULL CONSTRUCTION | |||||
| 803 INDUSTRIAL AVE | RAPID CITY | SD | 57702 | PARKING LOT PAVING | $357,763 |
| UNIVERSITY OF NORTH DAKOTA | |||||
| 1301 N COLUMBIA RD STOP 9037 | GRAND FORKS | ND | 58202 | PHYSICIAN SERVICES | $186,760 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $76,186 | RelatedOrganizationsAmt |
| All Other Contributions | $73,330 | AllOtherContributionsAmt |
| Total Contributions | $149,516 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $25,362,208 | $25,362,208 |
| OTHER OPERATING REVENUE | 900099 | $474,862 | $474,862 |
| BAD DEBT RECOVERIES | 900099 | $77,034 | $77,034 |
| ASSISTED LIVING BUILDING RENT | 900002 | $74,850 | $74,850 |
| CAFETERIA | 722514 | $72,505 | $72,505 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72,490 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $72,490 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,133,949 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,008 | TotalRevenueColumnAmt |
| Exclusion | $5,008 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $50,070 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $50,066 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,066 | TotalRevenueColumnAmt |
| Exclusion | $50,066 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,338,539 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,133,949 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $55,074 | 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 | $304,707 | TotalAmt |
| Management And General | $304,707 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,041,071 | TotalAmt |
| Program Services | $9,649,604 | ProgramServicesAmt |
| Management And General | $2,316,379 | ManagementAndGeneralAmt |
| Fundraising | $75,088 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,180 | TotalAmt |
| Program Services | $342,795 | ProgramServicesAmt |
| Management And General | $55,385 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,276,673 | TotalAmt |
| Program Services | $1,092,086 | ProgramServicesAmt |
| Management And General | $184,587 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $866,219 | TotalAmt |
| Program Services | $729,857 | ProgramServicesAmt |
| Management And General | $136,362 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,695 | TotalAmt |
| Management And General | $4,695 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,870 | TotalAmt |
| Management And General | $34,870 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,096,521 | TotalAmt |
| Program Services | $2,888,422 | ProgramServicesAmt |
| Management And General | $208,099 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,269 | TotalAmt |
| Management And General | $86,269 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,517 | TotalAmt |
| Program Services | $49,305 | ProgramServicesAmt |
| Management And General | $9,212 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $562,809 | TotalAmt |
| Program Services | $474,211 | ProgramServicesAmt |
| Management And General | $88,598 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,736 | TotalAmt |
| Program Services | $99,239 | ProgramServicesAmt |
| Management And General | $30,497 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,203 | TotalAmt |
| Program Services | $62,082 | ProgramServicesAmt |
| Management And General | $11,121 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,485 | TotalAmt |
| Program Services | $19,485 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,800,902 | TotalAmt |
| Program Services | $1,517,401 | ProgramServicesAmt |
| Management And General | $283,501 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,488 | TotalAmt |
| Program Services | $269,180 | ProgramServicesAmt |
| Management And General | $28,308 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES - MEDICAL AND | $3,217,544 | $3,154,446 | $63,098 |
| REPAIRS & MAINTENANCE | $891,642 | $751,278 | $140,364 |
| OTHER MISCELLANEOUS EXP | $301,607 | $225,128 | $76,479 |
| RECRUITMENT | $65,953 | $21,863 | $44,090 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,528,091 | TotalAmt |
| Program Services | $21,346,382 | ProgramServicesAmt |
| Management And General | $4,106,621 | ManagementAndGeneralAmt |
| Fundraising | $75,088 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,779,877 | BOYAmt |
| EOY | $3,827,983 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,363,414 | BOYAmt |
| EOY | $4,029,263 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,639 | BOYAmt |
| EOY | $612,203 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $281,868 | BOYAmt |
| EOY | $321,805 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,402,892 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,905,341 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,441,824 | BOYAmt |
| EOY | $12,497,551 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $774,336 | BOYAmt |
| EOY | $695,635 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,263,958 | BOYAmt |
| EOY | $21,984,440 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,564,580 | BOYAmt |
| EOY | $1,450,847 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,172 | BOYAmt |
| EOY | $12,543 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $793,939 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613,518 | BOYAmt |
| EOY | $499,853 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,053,209 | BOYAmt |
| EOY | $1,963,243 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,210,749 | BOYAmt |
| EOY | $20,021,197 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,210,749 | BOYAmt |
| EOY | $20,021,197 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,263,958 | BOYAmt |
| EOY | $21,984,440 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $810,448 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $10,895 | BeginningBalanceAmt |
| Additions During Year | $10,867 | AdditionsDuringYearAmt |
| Distributions During Year | $9,520 | DistributionsDuringYearAmt |
| Ending Balance | $12,242 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $18,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $90,113 | OtherCostOrOtherBasisAmt |
| Book Value | $108,113 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,981,026 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $19,063,622 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,809,022 | DepreciationAmt |
| Book Value | $9,235,626 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $26,263 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $13,118,281 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,598,559 | DepreciationAmt |
| Book Value | $2,545,985 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,105,587 | OtherCostOrOtherBasisAmt |
| Depreciation | $497,760 | DepreciationAmt |
| Book Value | $607,827 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,497,551 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,338,543 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,338,543 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$4 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$4 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $26,338,539 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,528,095 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $4 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $4 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,528,091 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,528,091 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | THE HOSPITAL HAS AN AUXILIARY THAT OPERATES UNDER THEIR EIN. THESE FUNDS ARE CONTROLLED BY THE AUXILIARY BOARD MEMBERS. |
| PART X, LINE 2: | AS OF MARCH 31, 2018, WRHS HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. WRHS' INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. WRHS IS NO LONGER SUBJECT TO FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR FISCAL YEARS BEFORE 2015. MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATION, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW, AND NEW AUTHORITATIVE RULINGS. WRHS 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. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -4. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 4. |
| PART XI LINE 4B | EXPENSES RELATED TO RENTAL PROPERTY ARE INCLUDED IN EXPENSES FOR PURPOSES OF THE AUDITED FINANCIAL STATEMENTS; HOWEVER, THESE EXPENSES ARE NETTED AGAINST THE GROSS RENT IN REVENUE FOR 990 PRESENTATION. |
| PART XII LINE 2D | RENTAL EXPENSES ARE NETTED AGAINST THE GROSS RENT REVENUE FOR PURPOSES OF THE 990, BUT ARE REPORTED IN EXPENSES IN THE AUDITED FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $221,805 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $221,805 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,214,103 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $927,028 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $287,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01120 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,435,908 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $927,028 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $508,880 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01990 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,778 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $33,278 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,039,866 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $643,526 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $396,340 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01550 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,084,644 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $655,026 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $429,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01680 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,520,552 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,582,054 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $938,498 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03670 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,708 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,452 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $65,452 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $95,160 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $95,160 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,839,548 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,283,193 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$443,645 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST RIVER HEALTH SERVICES | BusinessNameLine1Txt |
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) |
|---|---|---|
| Website Address | WRHS.COM | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | CLINIC & 5 RHC'S - ALL PROVIDER BASED | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST RIVER HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.WRHS.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.WRHS.COM | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WRHS.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WRHS.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WRHS.COM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 5: AS PART OF THE CHNA PROCESS, DATA WAS COLLECTED USING A SURVEY OF AREA RESIDENTS, ONE-ON-ONE KEY INFORMANT INTERVIEWS WITH COMMUNITY LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, A COMMUNITY MEETING TO DISCUSS HEALTH NEEDS AND THE ASSESSMENT PROCESS, AS WELL AS A WIDE RANGE OF SECONDARY DATA SOURCES. THROUGH ONE OR MORE OF THE ABOVE METHODS, INPUT WAS GATHERED FROM THE BOARDS OF DIRECTORS OF THE HEALTH SYSTEM, PHYSICIANS, EMERGENCY MEDICAL PERSONNEL, FITNESS PROVIDERS, HOME CARE PROVIDERS, QUALITY MANAGEMENT PERSONNEL, ECONOMIC DEVELOPMENT AND CHAMBER OF COMMERCE LEADERS, LONG-TERM CARE PROVIDERS, EDUCATIONAL SYSTEM REPRESENTATIVES, CLERGY REPRESENTATIVES, PHARMACISTS, AS WELL AS PUBLIC HEALTH AND SOCIAL SERVICES PERSONNEL. |
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 11: THE TOP FIVE ISSUES IDENTIFIED AS PART OF THE ASSESSMENT PROCESS WERE OBESITY, AVAILABILITY OF SUBSTANCE ABUSE/TREATMENT SERVICES, CANCER, ATTRACTING AND RETAINING YOUNG FAMILIES, AND ADULT ALCOHOL USE AND ABUSE.IN AN EFFORT TO ADDRESS OBESITY, WRHS HAS ADDED AN IDEAL PROTEIN PROGRAM WHICH IS A KETOGENIC WEIGHT LOSS AND WEIGHT MANAGEMENT PROTOCOL. THIS PROGRAM IS A MEDICALLY DEVELOPED 4 PHASE PROTOCOL CONTAINING 2 KEY COMPONENTS - WEIGHT LOSS AND A HEALTHIER LIFESTYLE EDUCATION SO THAT PATIENTS ARE EMPOWERED TO SUSTAIN THEIR WEIGHT LOSS RESULTS OVER THEIR LIFE COURSE.TO BOLSTER AVAILABILITY OF BEHAVIORAL HEALTH SERVICES IN RESPONSE TO SEVERAL OF THE NEEDS IDENTIFIED, WRHS ADDED A FULL-TIME PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER TO SERVE ALL AGES. WE BELIEVE THIS WILL ASSIST IN ADDRESSING SEVERAL OF THE NEEDS IDENTIFIED. WRHS IS ALSO RESEARCHING ALL REFERRAL AVENUES FOR SUBSTANCE ABUSE/TREATMENT SERVICES THAT ARE CURRENTLY AVAILABLE IN THE AREA. WHILE ADDING A SERVICE LINE TO HELP IN ADDRESSING THIS IS NOT COMPLETELY OUT OF THE QUESTION, WE BELIEVE THE SERVICES ARE AVAILABLE BUT NOT BEING UTILIZED TO THEIR FULL EXTENT AT THIS TIME.WRHS IS CONSIDERING WAYS IT CAN HELP IN ADDRESSING CANCER CONCERNS. CERTAINLY CANCER HAS IMPACTED NEARLY ALL OF THE RESIDENTS OF OUR SERVICE AREA IN ONE WAY OR ANOTHER. WHILE THIS ORGANIZATION IS NOT EQUIPPED WITH THE RESOURCES TO RESEARCH A CURE, WE BELIEVE IT MAY BE POSSIBLE TO OFFER MORE TREATMENT SERVICES CLOSER TO OUR PATIENTS' HOMES. CURRENTLY, MANY OF THE TREATMENTS ARE RECEIVED 150 MILES AWAY. THROUGH COLLABORATIVE AGREEMENTS, WE BELIEVE THERE MAY BE WAYS TO PROVIDE SOME OF THOSE SERVICES HERE. FINDING A PARTNER HAS BEEN DIFFICULT UP TO THIS POINT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - WEST RIVER EYE CENTER | ||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | CLINIC |
| 2 - WEST RIVER FOOT & ANKLE CENTER | ||||
| 683 STATE AVENUE SUITE E | DICKINSON | ND | 58601 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE DECLINING AND AGING POPULATION IS OF GREAT CONCERN FOR RURAL AMERICA AND ESPECIALLY THE WRHS SERVICE AREA. THE ACTIVITIES CONDUCTED ARE DESIGNED TO PROVIDE THE YOUNGER POPULATION WITH GOOD EXPERIENCES TO HELP THEM SEE THE VALUE OF LIVING AND RAISING FAMILIES IN A SMALL COMMUNITY. IN ADDITION, YOUNG FAMILIES NEED A WAY TO EARN A LIVING. THE SCRUBS CAMP HELD ANNUALLY IS DESIGNED TO INTRODUCE YOUNG ADULTS TO THE POTENTIAL HEALTHCARE CAREERS THAT ARE AVAILABLE RIGHT HERE AT HOME. |
| PART III, LINE 2: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 3: | PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER EVERY EFFORT IS MADE TO COLLECT THE BALANCE AND PATIENTS ARE GIVEN OPPORTUNITIES TO COMPLETE CHARITY CARE APPLICATIONS OR SET UP PAYMENT PLANS. ALL DISCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE APPLIED TO ACCOUNTS BEFORE THEY ARE WRITTEN OFF TO BAD DEBT. CURRENT PAYMENTS ON ACCOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT REDUCES BAD DEBT EXPENSE.THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE PROGRAM WAS BASED ON THE PERCENTAGE OF CHARITY CARE TO GROSS CHARGES TIMES THE STATED BAD DEBT EXPENSE. |
| 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 THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | FOR THOSE PATIENTS WHO RECEIVE DISCOUNTED CARE UNDER THE FAP, THE REMAINING SELF-PAY PORTION FALLS UNDER THE SAME COLLECTIONS POLICY AS ALL OTHER PATIENT ACCOUNTS. THE HOSPITAL POLICY IS TO SEND THE UNPAID AMOUNTS TO COLLECTIONS 120 DAYS AFTER THE FIRST STATEMENT; HOWEVER THE HOSPITAL MAKES ALL EFFORTS TO WORK WITH THE PATIENTS TO COLLECT THE UNPAID AMOUNT BEFORE THEY ACTUALLY SEND IT TO COLLECTIONS. THE PATIENT ACCOUNT MANAGER MAKES SEVERAL ATTEMPTS TO MAKE PAYMENT ARRANGEMENTS THROUGH PHONE CONVERSATIONS AND PERSONAL CONTACT WITH THE PATIENT. |
| PART VI, LINE 2: | AT LEAST ANNUALLY, THE BOARD OF DIRECTORS, PROVIDERS, AND ADMINISTRATION GATHER TO DISCUSS THE NEEDS OF OUR PATIENTS ALONG WITH THE STRATEGIC DIRECTION OF THE ORGANIZATION. THE PROVIDERS ARE SEEING MANY PATIENTS ON A DAILY BASIS AND SEE THE HEALTHCARE NEEDS OF OUR PATIENTS. THIS, COUPLED WITH THE INPUT FROM THE BOARD WHICH IS MADE UP OF COMMUNITY MEMBERS FROM ACROSS THE GEOGRAPHICAL AREA WE SERVE AND LEADERSHIP OF THE ORGANIZATION PROVIDES MUCH INSIGHT INTO THE NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | WRHS ATTEMPTS TO INFORM ALL PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON OUR WEBSITE, AVAILABLE IN ALL PUBLIC LOCATIONS WITHIN OUR FACILITY, IS DISTRIBUTED TO PATIENTS UPON ADMISSION AND/OR DISCHARGE. THE POLICY IS PROVIDED FREE OF CHARGE UPON REQUEST FROM ANYONE. THE EXISTENCE OF THE POLICY AND THE DIRECT URL IS LISTED ON OUR STATEMENTS. INFORMATION SHEETS SUMMARIZING THE POLICY IS PROVIDED TO PUBLIC AGENCIES AND OTHER NONPROFIT ORGANIZATIONS WITHIN OUR SERVICE AREA IN AN EFFORT TO INFORM ALL POTENTIAL PATIENTS OF ITS EXISTENCE. IN ADDITION, WE HAVE TWO FINANCIAL COUNSELORS THAT WORK WITH PATIENTS DURING THE PREAUTHORIZATION, REGISTRATION, AND BILLING PROCESSES TO ENSURE THE AVAILABILITY OF ASSISTANCE IS COMMUNICATED ALONG WITH HELP OF THE APPLICATION IS OFFERED.IN ADDITION TO OFFERING INTERNAL FINANCIAL ASSISTANCE, WE REACH OUT TO PATIENTS DURING THE OPEN ENROLLMENT PROCESS TO REMIND THEM OF ASSISTANCE AVAILABLE THROUGH HEALTHCARE.GOV. AS PART OF THE APPLICATION PROCESS FOR INTERNAL FINANCIAL ASSISTANCE, WE ALSO DIRECT THEM TO THEIR COUNTY SOCIAL SERVICES OFFICE TO LEARN MORE ABOUT AND APPLY FOR MEDICAID. |
| PART VI, LINE 4: | THE COMMUNITY SERVED BY WRHS IS MADE UP OF SEVERAL TOWNS INCLUDING BOWMAN, BUCYRUS, DICKINSON, HAYNES, HETTINGER, MOTT, NEW ENGLAND, REEDER IN NORTH DAKOTA AND LEMMON, SOUTH DAKOTA. THE CORE SERVICE AREA IS COMPRISED OF SIX COUNTIES ACROSS NORTH DAKOTA AND SOUTH DAKOTA. THESE COUNTIES INCLUDE 10,000 SQUARE MILES WITH A POPULATION OF APPROXIMATELY 13,000 PEOPLE. FARMING AND RANCHING IS THE PRIMARY ECONOMIC DRIVER IN THE AREA. THE POPULATION IS DECLINING AND GETTING OLDER AS TIME GOES ON. |
| PART VI, LINE 5: | THE BOARD OF DIRECTORS IS COMPRISED OF MEMBERS FROM ACROSS OUR SERVICE AREA WHICH SPANS NUMEROUS COMMUNITIES. THIS ALLOWS LEADERS FROM EACH OF THOSE COMMUNITIES TO COME TOGETHER TO PROVIDE INPUT ON SERVICES PROVIDED BY THE ORGANIZATION, NEEDS OF THEIR COMMUNITIES, AS WELL AS POSITIVE EXPERIENCES FROM THEIR COMMUNITIES. THESE EXPERIENCES ARE NOT ONLY RELATED TO HEALTHCARE, BUT SMALL TOWN LIFE IN GENERAL. THE ORGANIZATION EMPLOYS MANY INDIVIDUALS WITHIN OUR SERVICE AREA CONTRIBUTING TO THE LOCAL ECONOMIES. THE LARGEST ISSUE FACING RURAL AMERICA IS THE LOSS OF POPULATION, ESPECIALLY WORKING AGE FAMILIES. ANY LOCAL BUSINESSES CONTRIBUTE GREATLY TO THE HEALTH OF RURAL COMMUNITIES THROUGH THE ECONOMIC IMPACT. IN REVIEWING POTENTIAL CONTRACTS AND SERVICES PROVIDERS, PREFERENCE IS GIVEN TO LOCAL VENDORS WHICH IS VITAL TO KEEPING OUR COMMUNITIES ALIVE.FOR MORE INFORMATION ABOUT WRHS, VISIT WWW.WRHS.COM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATT SHAHAN | ||||||||||||||
| CEO | $178,231 | $0 | $0 | $0 | $0 | $0 | $5,497 | $0 | $5,780 | $0 | $189,508 | $0 | $0 | $0 |
| MITCH SCHULTZ | ||||||||||||||
| PHARMACY MANAGER | $158,832 | $0 | $0 | $0 | $0 | $0 | $5,177 | $0 | $22,771 | $0 | $186,780 | $0 | $0 | $0 |
| MATTHEW HEFTY | ||||||||||||||
| PHYSICIAN | $289,882 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $289,882 | $0 | $0 | $0 |
| KENT HOERAUF | ||||||||||||||
| PHYSICIAN | $151,234 | $13,200 | $0 | $0 | $0 | $0 | $4,770 | $0 | $17,023 | $0 | $173,027 | $13,200 | $0 | $0 |
| BRIAN WILLOUGHBY | ||||||||||||||
| PHYSICIAN | $143,211 | $0 | $0 | $0 | $0 | $0 | $4,428 | $0 | $17,928 | $0 | $165,567 | $0 | $0 | $0 |
| CATHERINE SHIREK | ||||||||||||||
| PHYSICIAN | $136,825 | $0 | $0 | $0 | $0 | $0 | $4,105 | $0 | $16,764 | $0 | $157,694 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| TARA JORGENSON | |||
| SPOUSE OF CODY JORGENSON, DIRECTOR | $73,670 | COMPENSATION | 0 |
| LANI SCHULTZ | |||
| SPOUSE OF MITCH SCHULTZ, PHARMACY MANAGER | $58,372 | COMPENSATION | 0 |
| KYLEE STADHEIM | |||
| SPOUSE OF NATHAN STADHEIM, CFO | $12,444 | COMPENSATION | 0 |
| KIM SCHALESKY | |||
| DAUGHTER OF LONNIE STIPPICH (WRHSF [RELATED PARTY] BOARD DIRECTOR) | $35,441 | COMPENSATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THERE IS AN EXECUTIVE COMMITTEE THAT HAS AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS. MINUTES OF THE EXECUTIVE COMMITTEE SHALL BE SUBMITTED TO THE BOARD AND ITS ACTION SHALL BE SUBJECT TO THE APPROVAL OR DISAPPROVAL AT THE NEXT REGULAR BOARD MEETING. THIS COMMITTEE WILL MEET WHEN CALLED BY THE CHAIRMAN. THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIRMAN, VICE CHAIR, SECRETARY/TREASURER, PAST CHAIRMAN, MEDICAL STAFF REPRESENTATIVE OF THE BOARD, AND TWO OTHER BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 6 | WEST RIVER HEALTH SERVICES FOUNDATION IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER, WRHS FOUNDATION APPOINTS THE BOARD MEMBERS OF WRHS. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS A SOLE MEMBER, WRHS FOUNDATION APPROVES ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS, DETERMINES APPROVED DEBT LEVELS AND APPROVES INDIVIDUAL DEBT TRANSACTIONS THAT EXCEED THE APPROVED DEBT LEVELS, APPROVES DISSOLUTION OR MERGER OF THE ORGANIZATION, AND APPROVES THE SALE OR TRANSFER OF ANY CAPITAL ASSETS HAVING A PURCHASE PRICE OR 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. INDIVIDUALS WITH CONFLICTS ABSTAIN FROM VOTING, AND THIS ACTION IS NOTED BY BOARD MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15A | CEO: EACH BOARD AND MEDICAL STAFF MEMBER ANNUALLY COMPLETE AN EVALUATION FORM ON THE CEO'S PERFORMANCE. THE CHAIRMAN OF EXECUTIVE COMMITTEE TABULATES THE RESULTS AND REVIEWS THEM WITH THE OTHER MEMBERS OF THE EXECUTIVE COMMITTEE. THE RESULTS ARE PRESENTED TO THE FULL BOARD OF DIRECTORS WHO HAVE FINAL AUTHORITY IN DETERMINING COMPENSATION. COMPARABILITY DATA FROM THE STATE HOSPITAL ASSOCIATION, AS WELL AS OTHER COMPARATIVE INDUSTRY INFORMATION, IS USED IN DETERMINING COMPENSATION. CFO: THE CEO REVIEWS THE CFO'S PERFORMANCE AND USES COMPARABILITY DATA IN DETERMINING COMPENSATION. ALL OTHER EMPLOYEES: THE ADMINISTRATIVE STAFF USES COMPARABLE DATA IN SETTING COMPENSATION FOR EACH LEVEL OF EMPLOYEE. COMPENSATION IS REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | ADMINISTRATIVE REPRESENTATIVES OF THE ORGANIZATION WILL PROVIDE THE GOVERNING BOARD DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS UPON WRITTEN OR VERBAL REQUEST TO ADMINISTRATIVE REPRESENTATIVES OF THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,888,422. MANAGEMENT AND GENERAL EXPENSES 208,099. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,096,521. |
| FORM 990, PART XII, LINE 2C: | PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| WESTERN HORIZONS LIVING CENTER | ||||||||||
| 1104 HIGHWAY 12 | HETTINGER | SD | 58369 | 260794602 | LONG-TERM CARE/ASSISTED LIVING FACILITY | ND | 501C | LINE 10 | WEST RIVER HEALTH SERVICES FOUNDATION | 0 |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||||||||||
| 1000 HIGHWAY 12 | HETTINGER | SD | 58369 | 450411825 | FUNDRAISING | ND | 501C | LINE 12C, 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 | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | 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 | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | 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 (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| C | $76,186 | CASH PAID |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| D | $9,465 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| D | $895,393 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| J | $74,850 | LEASE AGREEMENT |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| Q | $108,302 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| Q | $140,858 | CASH PAID |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| P | $300 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| P | $578 | CASH PAID |