2025-02-17T12:52:15-06:00 2024-03-31 460403496 CASEY PETERSON LTD 909 ST JOSEPH ST STE 101 RAPID CITY SD 57701 990 2023-04-01 450340688 WEST RIVER HEALTH SERVICES WEST 7015674561 1000 HIGHWAY 12 HETTINGER ND 58639 NATHAN STADHEIM CFO 7015674561 2025-02-17 1 1 KAYLA GIESEY CPA P01874520 6053481930 2025-02-17 2023 2025-03-06 01:10:19Z WEST RIVER REGIONAL MEDICAL CENTER ALYSON KORNELE 1000 HIGHWAY 12 HETTINGER ND 58639 29922210 0 X WWW.WRHS.COM X 1977 ND PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO THE RESIDENTS AND VISITORS OF THE REGION. 8 4 284 0 0 0 901450 563552 27488775 28622382 291512 681033 106465 54710 28788202 29921677 15119 21500 0 0 16663770 16640773 0 0 130653 12853666 13267504 29532555 29929777 -744353 -8100 33170524 34769157 2424132 4026533 30746392 30742624 X THE MISSION OF WEST RIVER HEALTH SERVICES (WRHS) IS TO PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO THE RESIDENTS AND VISITORS OF THE REGION. 0 0 27109500 21500 28622382 WEST RIVER HEALTH SERVICES (WRHS) IS A NATIONALLY-RECOGNIZED RURAL HEALTH CARE DELIVERY SYSTEM INCLUDING A CRITICAL ACCESS HOSPITAL THAT PROVIDES MANY DIFFERENT SERVICES INCLUDING ACUTE INPATIENT SERVICES, SWING BED, SURGERY, LAB, RADIOLOGY, EMERGENCY ROOM, SIX MEDICAL CLINICS, EYE CLINIC, VISITING NURSE SERVICES, AMBULANCE SERVICE, COUNSELING, AND REHABILITATIVE THERAPIES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY.IN FY 2024 WRHS PROVIDED ACUTE CARE SERVICES TO 361 PATIENTS FOR A TOTAL OF 1,399 DAYS OF CARE. SWING BED SERVICES WERE PROVIDED TO 65 PATIENTS FOR A TOTAL OF 764 DAYS OF CARE. IN ADDITION, 464 EQUIVALENT DAYS OF OBSERVATION CARE WERE PROVIDED. THERE WERE 1,734 EMERGENCY ROOM VISITS DURING THE YEAR. THERE WERE 19 BABIES BORN DURING THE YEAR WITH A TOTAL OF 32 DAYS OF CARE PROVIDED. THERE WERE A TOTAL OF 668 SURGICAL CASES DURING THE YEAR, WITH 605 OF THOSE BEING DONE ON AN OUTPATIENT BASIS. THE AMBULANCE CREW MADE 244 AMBULANCE RUNS/TRANSFERS THROUGHOUT THE YEAR. THERE WERE 34,024 CLINIC ENCOUNTERS TO THE SIX MEDICAL CLINICS. ANCILLARY SERVICES WERE PROVIDED AS FOLLOWS: 7,127 RADIOLOGY TESTS; 249 RESPIRATORY THERAPY PROCEDURES; 24,272 MEALS TO PATIENTS, VISITORS, AND EMPLOYEES. THROUGHOUT THE YEAR THERE WERE 4,279 HOME VISITS BY REGISTERED NURSES. 27109500 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 92 0 1 284 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 ND X THE ORGANIZATION 7015674561 1000 HIGHWAY 12 HETTINGER ND 58639 JONATHON EATON CHAIRMAN 1.00 X X 170 0 0 BRETT HENDERSON VICE CHAIRMAN 1.00 1.00 X X 180 0 0 DAVE ERICKSON SECRETARY/TREASURER 1.00 X X 180 0 0 KELLY PIERCE FORMER SECRETARY/TREASURER 1.00 X X 30 0 0 LYNN BROWN REPRESENTATIVE 1.00 X 180 0 0 MICHELLE ENGRAF REPRESENTATIVE 1.00 X 130 0 0 KEVIN ERDAHL REPRESENTATIVE 1.00 X 60 0 0 TROY MOSBRUCKER REPRESENTATIVE 1.00 X 120 0 0 WILLIAM GION REPRESENTATIVE 1.00 X 30 0 0 BRAD DERSCHAN REPRESENTATIVE 1.00 X 30 0 0 DR MARK KRISTY MEDICAL STAFF LIAISON (TERM JAN 2024) 40.00 X 267469 0 35941 DR STACIE WELLMAN MEDICAL STAFF LIAISON (BEG JAN 2024) 40.00 X 220791 0 26024 STEWART NEILSEN REPRESENTATIVE 1.00 X 0 0 0 ALYSON KORNELE CEO 35.00 5.00 X 180308 0 22808 NATHAN STADHEIM CFO 32.00 8.00 X 146717 0 30602 CATHERINE SHIREK PHYSICIAN 40.00 X 513349 0 35832 KAREN ANDRES PHYSICIAN 40.00 X 315206 0 39072 STEVE KILWEIN PHYSICIAN 40.00 X 294566 0 42918 JOSHUA RANUM PHYSICIAN 139.00 1.00 X 420329 0 18480 TAMMY GROSULAK CRNA 40.00 X 266599 0 18186 2626444 0 269863 27 0 1 0 VIDDAL MD PLLC 3672 E BOOT TRACK TRL GILBERT AZ 85296 LOCUM MEDICAL PROVIDER 560146 UNITIMED RECRUITING RESOURCES LLC 2800 JACKSON BLVD STE 2 RAPID CITY SD 57702 LOCUM STAFFING 511533 AMERICAN HEALTHCARE STAFFING ASSOC PO BOX 670529 DALLAS TX 752670529 LOCUM STAFFING 422901 AUREUS RADIOLOGY LLC 1010 N 102ND ST 300 OMAHA NE 68114 LOCUM RADIOLOGY SERVICES 420344 MARCO TECHNOLOGIES LLC 4510 HEATHERWOOD RD SAINT CLOUD MN 56301 INFORMATION TECHNOLOGY SERVICES 245387 17 303974 257878 1700 563552 PATIENT SERVICE REVENUE 621110 27949583 27949583 OTHER OPERATING REVENUE 621110 508677 508677 ASSISTED LIVING BUILDING RENT 900002 92100 92100 CAFETERIA 722514 72022 72022 28622382 681033 681033 55243 533 54710 54710 54710 29921677 28622382 0 735743 X 21500 21500 930658 550223 380435 13126363 12248351 773533 104479 391376 360708 27587 3081 1259412 1190833 58424 10155 932964 852324 73648 6992 2333 2333 40023 40023 653 653 4930492 4833263 96476 753 93943 93943 63532 58782 4338 412 489496 448796 39291 1409 100280 97576 2702 2 75870 51836 24031 3 5045 5045 1493191 1214158 276535 2498 358094 335586 21835 673 SUPPLIES - MEDICAL AND 3495025 3484142 10779 104 REPAIRS & MAINTENANCE 1321755 623415 698283 57 BAD DEBT EXPENSE 580578 580578 DUES 85756 65493 20263 131438 86891 44512 35 29929777 27109500 2689624 130653 7044579 11720483 4982372 4252595 593575 643610 319045 312417 40997902 30753462 10926895 10244440 6790102 7107035 2513956 488577 33170524 34769157 1690309 1862144 25657 25657 708166 592593 0 1546139 2424132 4026533 X 30746392 30742624 30746392 30742624 33170524 34769157 -8100 3861 471 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18000 90113 108113 1998206 21432042 16014383 7415865 36171 16277181 13921739 2391613 1146189 817340 328849 10244440 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1546139 1546139 X 29344840 3861 -580578 -576717 29921557 653 -533 120 29921677 29349079 533 533 29348546 653 580578 581231 29929777 PART X, LINE 2: AS OF MARCH 31, 2024, 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 2021. 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 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -580,578. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -533. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 533. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 580,578. 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. 1 1 X 1 X 1 X 0 1 0 0 44523 44523 0.00150 2602872 1662772 940100 0.03200 2647395 1662772 984623 0.03350 29129 0 29129 0.00100 7269385 5971074 1298311 0.04420 7298514 5971074 1327440 0.04520 9945909 7633846 2312063 0.07870 4727 4727 0.00020 91012 91012 0.00310 95739 95739 0.00330 1 580578 0 13507441 13969453 -462012 X 1 1 1 1 WEST RIVER HEALTH SERVICES 1000 HIGHWAY 12 HETTINGER ND 58639 WRHS.COM X X X X X CLINIC & 5 RHC'S - ALL PROVIDER BASED WEST RIVER HEALTH SERVICES 1 0 0 1 X X X X X X X X X 23 1 0 0 1 X HTTP://WWW.WRHS.COM X 1 23 1 HTTPS://WWW.WRHS.COM/IMAGES/PDF/CHNA-HETTINGER-2024_UPDATEDIP.PDF 0 1 X 100.000000000000 200.000000000000 1 1 X X X 1 X WRHS.COM X WRHS.COM X WRHS.COM X X X X 1 X 0 X X 1 X 0 0 WEST RIVER HEALTH SERVICES PART V, SECTION B, LINE 5: THE CENTER FOR RURAL HEALTH (CRH), IN PARTNERSHIP WITH WEST RIVER HEALTH SERVICES (WRHS) AND SOUTHWESTERN DISTRICT HEALTH UNIT (SDHU), FACILITATED THE CHNA PROCESS. COMMUNITY REPRESENTATIVES MET REGULARLY IN-PERSON, BY TELEPHONE CONFERENCE, AND EMAIL. A CHNA LIAISON WAS SELECTED LOCALLY, WHO SERVED AS THE MAIN POINT OF CONTACT BETWEEN CRH AND WRHS. A STEERING COMMITTEE CONSISTING OF SEVEN WRHS EMPLOYEES WAS FORMED THAT WAS RESPONSIBLE FOR PLANNING AND IMPLEMENTING THE PROCESS LOCALLY. REPRESENTATIVES FROM CRH MET AND CORRESPONDED REGULARLY BY VIDEOCONFERENCE AND/OR VIA THE ETOOLKIT WITH THE CHNA LIAISON. THE COMMUNITY GROUP CONSISTING OF 13 COMMUNITY MEMBERS PROVIDED IN-DEPTH INFORMATION AND INFORMED THE ASSESSMENT PROCESS IN TERMS OF COMMUNITY PERCEPTIONS, COMMUNITY RESOURCES, COMMUNITY NEEDS, AND IDEAS FOR IMPROVING THE HEALTH OF THE POPULATION AND HEALTHCARE SERVICES. THE COMMUNITY GROUP, REPRESENTING A CROSS SECTION DEMOGRAPHICALLY, ATTENDED THE INITIAL FOCUS GROUP MEETING IN OCTOBER 2023. THE MEETING WAS HIGHLY INTERACTIVE WITH GOOD PARTICIPATION. WRHS STAFF AND BOARD MEMBERS WERE IN ATTENDANCE AS WELL BUT LARGELY PLAYED A ROLE OF LISTENING AND LEARNING. GROUP MEMBERS WERE INTRODUCED TO THE NEEDS ASSESSMENT PROCESS, REVIEWED BASIC DEMOGRAPHIC INFORMATION ABOUT THE COMMUNITY, AND SERVED AS A FOCUS GROUP. FOCUS GROUP TOPICS INCLUDED COMMUNITY ASSETS AND CHALLENGES, THE GENERAL HEALTH NEEDS OF THE COMMUNITY, COMMUNITY CONCERNS, AND SUGGESTIONS FOR IMPROVING THE COMMUNITY'S HEALTH.ONE-ON-ONE INTERVIEWS WITH FOUR KEY INFORMANTS WERE CONDUCTED IN PERSON IN HETTINGER ON OCTOBER 4, 2023. TWO ADDITIONAL KEY INFORMANT INTERVIEWS WERE CONDUCTED OVER THE PHONE IN OCTOBER OF 2023. A REPRESENTATIVE FROM CRH CONDUCTED THE INTERVIEWS. INTERVIEWS WERE HELD WITH SELECTED MEMBERS OF THE COMMUNITY WHO COULD PROVIDE INSIGHTS INTO THE COMMUNITY'S HEALTH NEEDS. INCLUDED AMONG THE INFORMANTS WERE PUBLIC HEALTH PROFESSIONALS WITH SPECIAL KNOWLEDGE IN PUBLIC HEALTH, ACQUIRED THROUGH SEVERAL YEARS OF DIRECT EXPERIENCE IN THE COMMUNITY, INCLUDING WORKING WITH MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS AS WELL AS WITH POPULATIONS WITH CHRONIC DISEASES. TOPICS COVERED DURING THE INTERVIEWS INCLUDED THE GENERAL HEALTH NEEDS OF THE COMMUNITY, THE GENERAL HEALTH OF THE COMMUNITY, COMMUNITY CONCERNS, DELIVERY OF HEALTHCARE BY LOCAL PROVIDERS, AWARENESS OF HEALTH SERVICES OFFERED LOCALLY, BARRIERS TO RECEIVING HEALTH SERVICES, AND SUGGESTIONS FOR IMPROVING COLLABORATION WITHIN THE COMMUNITY. A SURVEY WAS DISTRIBUTED TO SOLICIT FEEDBACK FROM THE COMMUNITY AND WAS NOT INTENDED TO BE A SCIENTIFIC OR STATISTICALLY VALID SAMPLING OF THE POPULATION. IT WAS DESIGNED TO BE AN ADDITIONAL TOOL FOR COLLECTING QUALITATIVE DATA FROM THE COMMUNITY AT LARGE SPECIFICALLY, INFORMATION RELATED TO COMMUNITY-PERCEIVED HEALTH NEEDS. TO PROMOTE AWARENESS OF THE ASSESSMENT PROCESS, THE SURVEY WAS ADVERTISED VIA A WRHS BLOG, FACEBOOK PAGE, INSTAGRAM, AND WEBSITE. EMAILS WERE ALSO SENT OUT. PRINT ADS WERE PUT IN THE LOCAL PAPER AS WELL AS RADIO ADVERTISEMENTS.APPROXIMATELY 50 COMMUNITY MEMBER SURVEYS WERE AVAILABLE FOR DISTRIBUTION IN THE WRHS SERVICE AREA AND WERE AVAILABLE AT WRHS CLINICS IN SCRANTON, NEW ENGLAND, MOTT, HETTINGER, AND LEMMON. TO HELP ENSURE ANONYMITY, INCLUDED WITH EACH SURVEY WAS A POSTAGE-PAID RETURN ENVELOPE TO CRH. IN ADDITION, TO HELP MAKE THE SURVEY AS WIDELY AVAILABLE AS POSSIBLE, RESIDENTS ALSO COULD REQUEST A SURVEY BY CALLING WRHS OR SDHU. THE SURVEY PERIOD RAN FROM OCTOBER 1, 2023, TO OCTOBER 15, 2023. TWO COMPLETED PAPER SURVEYS WERE RETURNED. AREA RESIDENTS WERE ALSO GIVEN THE OPTION OF COMPLETING AN ONLINE VERSION OF THE SURVEY, WHICH WAS PUBLICIZED IN THE NEWSPAPER, EMAILED, AND INCLUDED IN THE WRHS BLOG, FACEBOOK, INSTAGRAM, AND WEBSITE. NINETY-NINE ONLINE SURVEYS WERE COMPLETED. SIX OF THOSE ONLINE RESPONDENTS USED THE QR CODE TO COMPLETE THE SURVEY. IN TOTAL, COUNTING BOTH PAPER AND ONLINE SURVEYS, 101 COMMUNITY MEMBER SURVEYS WERE COMPLETED, EQUATING TO A 10.4% RESPONSE RATE. THIS RESPONSE RATE IS LOW FOR THIS TYPE OF UNSOLICITED SURVEY METHODOLOGY. WEST RIVER HEALTH SERVICES PART V, SECTION B, LINE 11: ATTRACTING AND RETAINING YOUNG FAMILIES: SINCE IMPLEMENTING PAID COMMUNITY BENEFIT TIME FOR ITS EMPLOYEES, WRHS'S INVOLVEMENT WITH COMMUNITY EVENTS HAS INCREASED. SIGN-ON BONUSES, RELOCATION ASSISTANCE, AND A COMPREHENSIVE BENEFIT PACKAGE IS OFFERED TO NEW HIRES. IN COOPERATION WITH THE LOCAL CHAMBER OF COMMERCE A "TUESDAY NIGHT LIGHTS" EVENT IS HELD IN THE MONTH OF SEPTEMBER, WHICH IS A MINI MARKET WITH FOOD, GAMES, AND LOCALS SELLING THEIR GOODS. THIS EVENT HAS DRAWN A FEW YOUNGER FAMILIES OUT. SUPPORT OF THE NEW COMMUNITY INDOOR POOL HAS BEEN BENEFICIAL WHEN RECRUITING PEOPLE TO THE COMMUNITY. WRHS LOOKS FORWARD TO LOOKING INTO WAYS TO PROMOTE AND HELP FUND THIS POOL IN THE FUTURE TO PROVIDE OPEN SWIMS, NEW SWIM EQUIPMENT, AND WHATEVER SAFETY DEVICES ARE NEEDED. DEPRESSION/ANXIETY: IN ADDITION TO HAVING CLINICAL COUNSELING STAFF AVAILABLE AT WRHS THAT ACCEPT ALL MAJOR INSURANCES AS WELL AS PROVIDING SERVICES ON A SLIDING FEE SCALE, THOSE BEHAVIORAL HEALTH STAFF PARTICIPATE IN ORGANIZING FREE COMMUNITY EVENTS TO CALL ATTENTION TO MANY ISSUES THAT CONTRIBUTE TO DEPRESSION AND ANXIETY, HOW TO COPE WITH THOSE ISSUES, AND BUILD COMMUNITY AWARENESS ON RESOURCES AVAILABLE TO ASSIST.INCREASING YOUTH PHYSICAL ACTIVITY: SEVERAL EMPLOYEES OF WRHS ORGANIZE AND COACH YOUTH ATHLETIC TEAMS AND ARE PAID COMMUNITY BENEFIT TIME TO DO SO. IN ADDITION, WRHS FINANCIALLY SUPPORTS YOUTH ACTIVITIES ACROSS ITS SERVICE AREA. 1 1 - WEST RIVER EYE CENTER 1000 HWY 12 HETTINGER ND 58639 CLINIC PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 580,578. 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. PART III, LINE 2: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGES 15 - 16 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 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGES 15 - 16 OF THE ATTACHED FINANCIAL STATEMENTS. 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: THE BOARD OF DIRECTORS AND MOST OF THE EMPLOYEES ARE MEMBERS OF THE SERVICE AREA. ATTENTION IS GIVEN TO THE MAKEUP OF THE BOARD ESPECIALLY, ATTEMPTING TO HAVE A REPRESENTATIVE FROM EACH RURAL COMMUNITY WITHIN THE SERVICE AREA. IN ADDITION TO OPEN LINES OF COMMUNICATION FOR EMPLOYEES TO VOICE CONCERNS OR IDEAS ON SERVICES AVAILABLE, EACH MONTH THE BOARD HAS A STANDING AGENDA ITEM TO DISCUSS SERVICES CURRENTLY PROVIDED THAT MAY HAVE REDUCED OR LIMITED NEEDS AS WELL AS NEEDS WITHIN THE COMMUNITIES THAT ARE NOT BEING MET. PART VI, LINE 3: THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED AT ALL PATIENT INTAKE LOCATIONS, IS DISCUSSED AS PART OF ALL INTERACTIONS BETWEEN PATIENTS AND FINANCIAL COUNSELING STAFF, IS DESCRIBED BRIEFLY ON OUR NORMAL PATIENT STATEMENTS, AND THE FULL POLICY IS DISCLOSED ON OUR WEBSITE AND IS AVAILABLE FOR PICKUP AT ALL LOCATIONS. AS PART OF THE APPLICATION FOR FINANCIAL ASSISTANCE, WE REQUIRE PATIENTS TO ALSO WORK WITH THEIR LOCAL SOCIAL SERVICES STAFF TO REVIEW ELIGIBILITY FOR MEDICAID OR MARKETPLACE REBATES. ANNUALLY WE COMMUNICATE WITH OUR PATIENTS REGARDING OPEN ENROLLMENT AND THE EXISTENCE OF BOTH MEDICAID BENEFITS AND THE HEALTH INSURANCE MARKETPLACE. PART VI, LINE 4: HETTINGER IS LOCATED ALONG HIGHWAY 12 IN SOUTHWEST NORTH DAKOTA, FOUR MILES FROM THE SOUTH DAKOTA BORDER AND 60 MILES FROM MONTANA. THE CITY IS LOCATED IN ADAMS COUNTY IN THE HEART OF AGRICULTURE AND RANCH COUNTRY. THIS AREA PROMOTES A STRONG, FAMILY-ORIENTED LIFESTYLE WITH FRIENDLY, HONEST PEOPLE WHO TAKE GREAT PRIDE IN THEIR COMMUNITY. THE PEOPLE OF THE AREA ARE THE BACKBONE OF THE COMMUNITY. HETTINGER HAS TWO SCHOOLS, GRADES PRE-KINDERGARTEN TO HIGH SCHOOL, WHICH HAS 288 STUDENTS ENROLLED. THE MAIN STREET HAS A NUMBER OF BUSINESSES, INCLUDING A COFFEE SHOP, T-SHIRT SHOPS, AND OTHER ESTABLISHMENTS FOR ENTERTAINMENT. HETTINGER IS A POPULAR SPOT FOR HUNTERS TO COME AND SPEND THEIR WEEKENDS HUNTING, FISHING, AND ENJOYING OTHER OUTDOOR ACTIVITIES. WRHS, THROUGH ITS HOSPITAL AND CLINIC IN HETTINGER AND CLINICS IN BOWMAN, SCRANTON, NEW ENGLAND, AND MOTT, NORTH DAKOTA, AND LEMMON, SOUTH DAKOTA, SERVES A LARGE AREA IN SOUTHWESTERN NORTH DAKOTA AND NORTHWESTERN SOUTH DAKOTA. WRHS SERVES A GEOGRAPHIC AREA OF ROUGHLY 10,000 SQUARE MILES WITH A POPULATION OF APPROXIMATELY 13,000 PEOPLE. FARMING AND RANCHING IS THE PRIMARY ECONOMIC DRIVER IN THE AREA. 25% OF THE POPULATION IS 65 YEARS OR OLDER WITH 20% BEING 18 OR YOUNGER AND IS 90% WHITE. THE POPULATION DECREASED 4% BETWEEN THE 2020 CENSUS AND 2022 CENSUS. PART VI, LINE 5: WRHS IS RIGHT IN THE MIDDLE OF WHAT WOULD OTHERWISE BE AN OBSTETRICS DESERT. THE CLOSEST HOSPITAL TO WRHS THAT DELIVERS BABIES IS 75 MILES TO THE NORTH. SOUTH OF HETTINGER, YOU MUST DRIVE OVER TWO HOURS TO FIND THE NEXT HOSPITAL THAT DELIVERS BABIES. WHILE DELIVERY VOLUMES ARE NOT HIGH AT WRHS, WITHOUT THESE SERVICES AND SKILLS EXPECTANT FAMILIES WOULD BE FORCED TO RELOCATE FOR A PERIOD OF TIME TO BE CERTAIN OF SAFE DELIVERY OF THEIR BABIES. THIS IS A SIGNIFICANT FINANCIAL LOSS LEADER BUT OUR BOARD REMAINS COMMITTED TO HAVING THE SERVICES AVAILABLE.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. 1 ABLE INC 1951 1ST STREET WEST DICKINSON ND 58601 450379352 501(C)(3) 20000 0 DONATION TOWARD BUILDING CAMPAIGN FOR INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES 1 0 0 0 0 0 0 0 0 0 CATHERINE SHIREK PHYSICIAN 513349 0 0 0 0 0 9900 0 25932 0 549181 0 0 0 JOSHUA RANUM PHYSICIAN 420329 0 0 0 0 0 9900 0 8580 0 438809 0 0 0 KAREN ANDRES PHYSICIAN 315206 0 0 0 0 0 9700 0 29372 0 354278 0 0 0 STEVE KILWEIN PHYSICIAN 294566 0 0 0 0 0 9080 0 33838 0 337484 0 0 0 DR MARK KRISTY MEDICAL STAFF LIAISON (TERM JAN 2024 267469 0 0 0 0 0 8266 0 27675 0 303410 0 0 0 TAMMY GROSULAK CRNA 266599 0 0 0 0 0 2794 0 15392 0 284785 0 0 0 DR STACIE WELLMAN MEDICAL STAFF LIAISON (BEG JAN 2024) 220791 0 0 0 0 0 6624 0 19400 0 246815 0 0 0 ALYSON KORNELE CEO 180308 0 0 0 0 0 0 0 22808 0 203116 0 0 0 NATHAN STADHEIM CFO 146717 0 0 0 0 0 4868 0 25734 0 177319 0 0 0 PART I, LINE 3 THE WEST RIVER HEALTH SERVICES FOUNDATION (A RELATED ORGANIZATION) BOARD OF DIRECTORS DETERMINES THE CEO'S COMPENSATION VIA COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. COMPENSATION IS PAID BY WEST RIVER HEALTH SERVICES. KYLEE STADHEIM SPOUSE OF NATHAN STADHEIM, CFO 23841 COMPENSATION 0 AMIE HENDERSON SPOUSE OF BRETT HENDERSON, DIRECTOR ON WRHS BOARD 81090 COMPENSATION 0 JACQUELYN HEDSTROM SPOUSE OF STEVE HEDSTROM, DIRECTOR ON WRHSF BOARD (PARENT ORGANIZATION) 129150 COMPENSATION 0 ALAINA STADHEIM-OLSON SISTER OF NATHAN STADHEIM, CFO 158212 COMPENSATION 0 BETHANY ERICKSON DAUGHTER OF DAVE ERICKSON, DIRECTOR ON WRHS BOARD 51941 COMPENSATION 0 AUDREY SKOGEN MOTHER OF SETH SKOGEN, DIRECTOR ON WRHSF BOARD (PARENT ORGANIZATION) 29765 COMPENSATION 0 DANA ANDRESS SISTER OF DAVE ERICKSON, DIRECTOR ON WRHS BOARD 33281 COMPENSATION 0 BRAXTON KORNELE SPOUSE OF ALYSON KORNELE, CEO 14438 COMPENSATION 0 TERESA NIELSEN SPOUSE OF STUART NIELSEN, DIRECTOR ON WRHS BOARD 169634 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1A 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 COMPENSATION FOR THE CEO & CFO IS DETERMINED BY THE BOARD OF DIRECTORS OF WEST RIVER HEALTH SERVICES FOUNDATION (WRHSF), A RELATED ORGANIZATION. THE FOLLOWING PROCEDURES ARE USED BY WRHSF: CEO: EACH BOARD MEMBER AND THE MEDICAL STAFF REPRESENTATIVE FROM EACH BOD ANNUALLY COMPLETES AN EVALUATION FORM ON THE CEO'S PERFORMANCE. THE CHAIRMAN OF WRHSF TABULATES THE RESULTS AND REVIEWS WITH MEMBERS OF THE WRHSF EXECUTIVE COMMITTEE. 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 PERFORMANCE AND USES COMPARABILITY DATA IN DETERMINING COMPENSATION. ALL OTHER EMPLOYEES: THE ADMINISTRATIVE STAFF USES COMPARABILITY 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 4,833,263. MANAGEMENT AND GENERAL EXPENSES 96,476. FUNDRAISING EXPENSES 753. TOTAL EXPENSES 4,930,492. PART XII, LINE 2C PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 WEST RIVER HEALTH SERVICES FOUNDATION C 303974 CASH PAID WEST RIVER HEALTH SERVICES FOUNDATION D 24714 CASH PAID WESTERN HORIZONS LIVING CENTER D 30544 CASH PAID WESTERN HORIZONS LIVING CENTER J 92100 LEASE AGREEMENT WEST RIVER HEALTH SERVICES FOUNDATION Q 162342 CASH PAID WESTERN HORIZONS LIVING CENTER Q 166664 CASH PAID