WEST RIVER HEALTH SERVICES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- WEST RIVER HEALTH SERVICES (EIN 45-0340688)
- Tax period
- 2013-04-01 to 2014-03-31
- Filed
- 2015-02-06
- IRS object ID
- 201530379349301308
- Schema version
- 2013v4.0
- 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 K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-02-06T16:07:30-06:00 | ReturnTs |
| Tax Period End | 2014-03-31 | 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 & ASSOC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 ST JOSEPH ST SUITE 101 | AddressLine1 |
| City | RAPID CITY | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-04-01 | 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 DBA WEST | BusinessNameLine1 |
| Business Name Line2 | RIVER REGIONAL MEDICAL CENTER | BusinessNameLine2 |
| 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 | AddressLine1 |
| City | HETTINGER | City |
| State | ND | State |
| ZIP Code | 58639 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JIM LONG | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7015674561 | PhoneNum |
| Signature | 2015-02-03 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEIDRE BUDAHL CPA | PreparerPersonNm |
| PTIN | P01273830 | PTIN |
| Phone | 6053481930 | PhoneNum |
| Preparation | 2015-02-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM K LONG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1 |
| City | HETTINGER | City |
| State | ND | State |
| ZIP Code | 58639 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,958,668 | 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 | 8 | VotingMembersIndependentCnt |
| Total Employee | 330 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $638,092 | PYContributionsGrantsAmt |
| CY Contributions Grants | $503,166 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,390,118 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,659,369 | CYProgramServiceRevenueAmt |
| PY Investment Income | $69,415 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,185 | CYInvestmentIncomeAmt |
| PY Other Revenue | $55,770 | PYOtherRevenueAmt |
| CY Other Revenue | $45,995 | CYOtherRevenueAmt |
| PY Total Revenue | $25,153,395 | PYTotalRevenueAmt |
| CY Total Revenue | $25,212,715 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,044 | 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 | $10,659,915 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,962,676 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $32,409 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,786,171 | PYOtherExpensesAmt |
| CY Other Expenses | $14,282,993 | CYOtherExpensesAmt |
| PY Total Expenses | $24,448,130 | PYTotalExpensesAmt |
| CY Total Expenses | $25,245,669 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $705,265 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$32,954 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,931,485 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,248,275 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,900,868 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,786,365 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,030,617 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,461,910 | 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 | $20,714,370 | ExpenseAmt |
| Revenue | $24,598,991 | 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 2014 WRHS PROVIDED ACUTE CARE SERVICES TO 858 PATIENTS FOR A TOTAL OF 3,152 DAYS OF CARE. SWING BED SERVICES WERE PROVIDED TO 77 PATIENTS FOR A TOTAL OF 618 DAYS OF CARE. IN ADDITION, 690 DAYS OF OBSERVATION CARE WERE PROVIDED. THERE WERE 1,736 EMERGENCY ROOM VISITS DURING THE YEAR. THERE WERE 102 BABIES BORN DURING THE YEAR WITH A TOTAL OF 258 DAYS OF CARE PROVIDED. THERE WERE A TOTAL OF 985 SURGICAL CASES DURING THE YEAR, WITH 782 OF THOSE BEING DONE ON AN OUTPATIENT BASIS. THE AMBULANCE CREW MADE 168 AMBULANCE RUNS AND 122 TRANSFERS THROUGHOUT THE YEAR. THERE WERE 42,384 CLINIC ENCOUNTERS TO THE SEVEN CLINICS. ANCILLARY SERVICES WERE PROVIDED AS FOLLOWS: 40,774 LAB TESTS; 9,928 RADIOLOGY TESTS; 7,354 RESPIRATORY THERAPY TESTS; 33,890 MEALS TO PATIENTS, VISITORS, AND EMPLOYEES; AND THERE WERE 1,708 VISITING NURSE VISITS.IT IS THE POLICY OF THE WRHS TO PROVIDE QUALITY HEALTH CARE SERVICES TO ALL PATIENTS IN THE REGION REGARDLESSS OF RACE, COLOR, CREED OR ABILITY TO PAY. TO THIS END, WRHS OFFERS FREE AND DISCOUNTED SERVICES TO PATIENTS WHO LACK ABILITY TO PAY. THE WRHS CHARITY CARE POLICY, INITIALLY APPROVED IN JUNE OF 2006 AND REVISED IN 2011, ASSURES THAT ALL ELIGIBLE PATIENTS WILL RECEIVE THE CARE THEY DESERVE WITHOUT FINANCIAL WORRY. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS HAS OVERSIGHT OF THE CHARITY CARE PROGRAM, APPROVES ELIGIBILITY CRITERIA, AND EVALUATES PROGRAM EFFECTIVENESS. THE AMOUNT OF CHARITY CARE PROVIDED IN FY '14 FOR ELIGIBLE INDIVIDUALS WAS $262,797. THIS AMOUNT REFLECTS THE AMOUNT OF CHARGES FOREGONE BASED ON ESTABLISHED RATES. | Desc |
| Total Program Service Expenses | $20,714,370 | 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 | Yes (1) | 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 | 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 | 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 | 330 | 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 | 8 | 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 | NATHAN STADHEIM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7015674561 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1 |
| City | HETTINGER | City |
| State | ND | State |
| ZIP Code | 58639 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 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 |
|---|---|---|---|---|---|---|---|---|
| ERIC ANDRESS | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $160 | $0 | $0 | ||
| GARY DEWHIRST | ||||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $120 | $0 | $0 | ||
| JONATHON EATON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $170 | $0 | $0 | |||
| TRAVIS ELLISON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $170 | $0 | $0 | |||
| HALEY EVANS | ||||||||
| VICE CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $170 | $0 | $0 | ||
| LARRY JACKSON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $180 | $0 | $0 | |||
| CODY JORGENSON | ||||||||
| PAST CHAIRMAN/WRHS REPRESENTATIVE | 2.00 | Yes (X) | $270 | $0 | $0 | |||
| ROBERT PARKER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $140 | $0 | $0 | |||
| ERVIN SCHNEIDER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $110 | $0 | $0 | |||
| CLEVE TESKE | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $160 | $0 | $0 | |||
| DR JENNIFER SHEFFIELD | ||||||||
| MEDICAL STAFF LIAISON | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JIM LONG | ||||||||
| CEO | 34.00 | Yes (X) | $159,574 | $0 | $19,895 | 6.00 | ||
| NATHAN STADHEIM | ||||||||
| CFO | 32.00 | Yes (X) | $83,211 | $0 | $11,083 | 8.00 | ||
| MITCH SCHULTZ | ||||||||
| PHARMACIST | 40.00 | $142,709 | $0 | $23,334 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $387,144 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $54,312 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNITED CLINICS PHYSICIANS PC | |||||
| 110 HWY 12 | HETTINGER | ND | 58639 | PHYSICIAN SERVICES | $4,416,007 |
| DR MARK KRISTY | |||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | RADIOLOGY SERVICES | $353,038 |
| MONDAK IMAGING SERVICES | |||||
| 11 SOUTH 7TH ST | MILES CITY | MT | 59301 | MRI SERVICES | $200,760 |
| NORTHERN PLAINS LABORATORY | |||||
| PO BOX 2036 | BISMARCK | ND | 58501 | LABORATORY SERVICES | $168,731 |
| ALEX OR KATHLEEN THOMPSON | |||||
| 600 2ND AVE N | HETTINGER | ND | 58639 | PHYSICAL THERAPY SERVICES | $155,760 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $142,422 | RelatedOrganizationsAmt |
| All Other Contributions | $360,744 | AllOtherContributionsAmt |
| Total Contributions | $503,166 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $23,933,505 | $23,933,505 |
| AFFILIATION SUPPORT | 900099 | $337,499 | $337,499 |
| OTHER | 900099 | $129,743 | $129,743 |
| ASSISTED LIVING RENT | 621610 | $99,300 | $99,300 |
| CAFETERIA | 722210 | $98,944 | $98,944 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60,378 | TotalRevenueColumnAmt |
| Exclusion | $60,378 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,659,369 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,272 | TotalRevenueColumnAmt |
| Exclusion | $24,272 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $60,225 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,230 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $45,995 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,995 | TotalRevenueColumnAmt |
| Exclusion | $45,995 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $704,242 | SecuritiesAmt |
| Other | $7,394 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $731,723 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$27,481 | SecuritiesAmt |
| Other | $7,394 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$20,087 | TotalRevenueColumnAmt |
| Exclusion | -$20,087 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,212,715 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,598,991 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $110,558 | 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 | $385,494 | TotalAmt |
| Management And General | $385,494 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,564,908 | TotalAmt |
| Program Services | $5,992,545 | ProgramServicesAmt |
| Management And General | $2,539,954 | ManagementAndGeneralAmt |
| Fundraising | $32,409 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,012,274 | TotalAmt |
| Program Services | $1,640,003 | ProgramServicesAmt |
| Management And General | $372,271 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,319 | TotalAmt |
| Management And General | $5,319 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,890 | TotalAmt |
| Management And General | $66,890 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,286,173 | TotalAmt |
| Program Services | $6,144,043 | ProgramServicesAmt |
| Management And General | $142,130 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,793 | TotalAmt |
| Management And General | $98,793 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,490 | TotalAmt |
| Program Services | $41,964 | ProgramServicesAmt |
| Management And General | $9,526 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,767 | TotalAmt |
| Program Services | $447,245 | ProgramServicesAmt |
| Management And General | $101,522 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,111 | TotalAmt |
| Program Services | $147,957 | ProgramServicesAmt |
| Management And General | $69,154 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,687 | TotalAmt |
| Program Services | $243,687 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,453,739 | TotalAmt |
| Program Services | $1,184,797 | ProgramServicesAmt |
| Management And General | $268,942 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,951 | TotalAmt |
| Program Services | $172,848 | ProgramServicesAmt |
| Management And General | $34,103 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES - OPERATING | $3,151,962 | $3,022,841 | $129,121 |
| REPAIRS & MAINTENANCE | $727,088 | $592,577 | $134,511 |
| BAD DEBTS | $684,200 | $684,200 | |
| STAFF RECRUITMENT | $267,381 | $201,800 | $65,581 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,442 | TotalAmt |
| Program Services | $197,863 | ProgramServicesAmt |
| Management And General | $75,579 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,245,669 | TotalAmt |
| Program Services | $20,714,370 | ProgramServicesAmt |
| Management And General | $4,498,890 | ManagementAndGeneralAmt |
| Fundraising | $32,409 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,457,254 | BOYAmt |
| EOY | $3,682,106 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,462,194 | BOYAmt |
| EOY | $5,194,732 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $557,143 | BOYAmt |
| EOY | $581,419 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $230,064 | BOYAmt |
| EOY | $232,545 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $32,118,483 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,400,730 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,359,865 | BOYAmt |
| EOY | $12,717,753 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,422,057 | BOYAmt |
| EOY | $2,493,067 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,442,908 | BOYAmt |
| EOY | $2,346,653 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,931,485 | BOYAmt |
| EOY | $27,248,275 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,771,123 | BOYAmt |
| EOY | $2,060,808 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $30,348 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,848,841 | BOYAmt |
| EOY | $4,700,042 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,106,008 | BOYAmt |
| EOY | $995,167 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,896 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,900,868 | BOYAmt |
| EOY | $7,786,365 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,030,617 | BOYAmt |
| EOY | $19,461,910 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,030,617 | BOYAmt |
| EOY | $19,461,910 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,931,485 | BOYAmt |
| EOY | $27,248,275 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$32,954 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $80,719 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $383,528 | PriorPeriodAdjustmentsAmt |
| 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $8,114 | BeginningBalanceAmt |
| Additions During Year | $13,078 | AdditionsDuringYearAmt |
| Distributions During Year | $11,608 | DistributionsDuringYearAmt |
| Ending Balance | $9,584 | 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 | $1,941,458 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $17,007,445 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,191,533 | DepreciationAmt |
| Book Value | $9,757,370 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $30,107 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $12,186,915 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,835,470 | DepreciationAmt |
| Book Value | $2,381,552 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $844,445 | OtherCostOrOtherBasisAmt |
| Depreciation | $373,727 | DepreciationAmt |
| Book Value | $470,718 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,717,753 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED FINANCING COSTS | $85,273 |
| RELATED PARTY RECEIVABLES | $1,133,883 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $1,127,497 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,346,653 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $24,623,464 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $80,719 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$684,200 | OtherRevenueAmt |
| Revenue Not Reported | -$603,481 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,226,945 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$14,230 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$14,230 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $25,212,715 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $24,575,699 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $14,230 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $14,230 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,561,469 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $684,200 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $684,200 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,245,669 | 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: | WEST RIVER HEALTH SERVICES (WRHS) IS ORGANIZED AS A NORTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE 501(C)(3). WRHS IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, WRHS IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. WRHS HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESSS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. WRHS BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. WRHS WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED WITH REVENUE ON AUDIT -684,200. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | REAL ESTATE TAXES NETTED AGAINST REVENUE ON 990 -14,230. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | REAL ESTATE TAXES NETTED AGAINST REVENUE ON 990 14,230. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED WITH REVENUE ON AUDIT 684,200. |
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 | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $216,307 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $216,307 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $669,033 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $523,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $145,367 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00590 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $885,340 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $523,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $361,674 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,539 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,796 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,743 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $899,707 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $550,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $349,476 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01420 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,405 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,405 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $946,651 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $572,027 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $374,624 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01530 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,831,991 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,095,693 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $736,298 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,388 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,388 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,581 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $65,581 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,969 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $75,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $684,200 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,324,056 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,529,804 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$205,748 | 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 | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1 |
| City | HETTINGER | City |
| State | ND | State |
| ZIP Code | 58639 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WRHS.COM | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 11 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.WRHS.COM | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | Yes (1) | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 3: TWO VERSIONS OF A SURVEY TOOL WERE DISTRIBUTED TO TWO DIFFERENT AUDIENCES:1. COMMUNITY MEMBERS - THE COMMUNITY MEMBER SURVEY WAS DISTRIBUTED TO RESIDENTS OF THE CORE SERVICES AREA OF THE ORGANIZATION AND WAS DESIGNED TO GAIN AN UNDERSTANDING OF COMMUNITY AWARENESS ABOUT SERVICES PROVIDED BY WRHS AND WHETHER CONSUMERS ARE USING THOSE SERVICES, THE COMMUNITY'S NEED FOR SERVICES AND CONCERNS ABOUT THE DELIVERY OF HEALTH CARE IN THE COMMUNITY, SOLICIT SUGGESTIONS AND HELP IDENTIFY ANY GAPS IN SERVICES, AND DETERMINE PREFERENCES FOR USING LOCAL HEALTHCARE VERSUS TRAVELING TO OTHER FACILITIES.2. HEALTH CARE PROFESSIONALS - THE HEALTH CARE PROFESSIONAL SURVEY WAS DISTRIBUTED TO 300 EMPLOYEES OF WRHS. THIS SURVEY COVERED THE SAME TOPICS AS THE CONSUMER SURVEY, ALTHOUGH IT SOUGHT LESS DEMOGRAPHIC INFORMATION AND EXCLUDED QUESTIONS REGARDING THE AWARENESS OF SERVICES OFFERED BY WRHS.ONE-ON-ONE INTERVIEWS WITH "KEY INFORMANTS" IDENTIFIED BY WRHS ADMINISTRATORS WERE PERFORMED TO GATHER INFORMATION FROM CITIZENS CONSIDERED TO BE COMMUNITY LEADERS AND WERE BELIEVED TO REPRESENT THE BROAD INTERESTS OF THE HEALTH COMMUNITY, BUSINESS COMMUNITY, FAITH COMMUNITY, SOCIAL SERVICES, NONPROFIT AGENCIES, AND PUBLIC HEALTH.THE INFORMATION GATHERED THROUGH THE PROCESSES OUTLINED ABOVE ALONG WITH DEMOGRAPHIC INFORMATION FROM THE 2010 CENSUS WAS USED BY THE ORGANIZATION IN PRIORITIZING AND DRAFTING AN ACTION PLAN TO ADDRESS IDENTIFIED NEEDS. |
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 14G: THE HOSPITAL PROVIDES A SUMMARY IN PLAIN LANGUAGE ON THE HOSPITAL WEBSITE, EMERGENCY AND WAITING ROOMS, ADMISSIONS OFFICE, UPON ADMISSION TO THE HOSPITAL, AND IN PACKETS PROVIDED IN EACH PATIENT ROOM. THE PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON WHERE THE PATIENT CAN OBTAIN ACCESS TO THE POLICY. |
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 80% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 20%. THE HOSPITAL WILL REVIEW THE PROPOSED METHODS TO DETERMINE AMOUNTS GENERALLY BILLED TO DETERMINE ITS DISCOUNT UNDER THE FINANCIAL ASSISTANCE POLICY MEETS THE REQUIREMENTS OF 501(R). |
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 21: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO DETERMINE AMOUNTS GENERALLY BILLED TO ENSURE IT IS IN COMPLIANCE WITH SECTION 501(R). |
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 22: ALL INDIVIDUALS ELIGIBLE UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY ARE PROVIDED A DISCOUNT FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. THE FINANCIAL ASSISTANCE POLICY DOES NOT APPLY TO ELECTIVE PROCEDURES. THEREFORE, FAP-ELIGIBLE PATIENTS WITHOUT INSURANCE MAY BE CHARGED GROSS CHARGES ON ELECTIVE PROCEDURES. |
| 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/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| HETTINGER WEST RIVER EYE CENTER | ||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | CLINIC |
| WEST RIVER FOOT & ANKLE CENTER | ||||
| 683 STATE AVENUE SUITE E | DICKINSON | ND | 58601 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $ 684,200. |
| PART I LINE 7 | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERAL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE WORKSHEET 3. THE ORGANIZATION USED ACUTAL EXPENSES TO DETERMINE THE COST FOR COMMUNITY HEALTH IMPROVEMENT SERVICES ON LINE 7E. THE COST OF SUBSIDIZED HEALTH SERVICES ON LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WEST RIVER HEALTH SERVICES IS A NOT-FOR-PROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO RESIDENTS AND VISITORS OF THE REGION. WE DO THIS BY REINVESTING OUR PROFITS BACK INTO THE COMMUNITIES THROUGH VARIOUS PROGRAMS AND SERVICES; MAKING SURE THAT CARE IS AVAILABLE TO EVERYONE REGARDLESS OF ABILITY TO PAY; OFFERING CARE WITH COMPASSION TO ALL PATIENTS; AND PROVIDING A WIDE RANGE OF SPECIAL BENEFITS TO EACH COMMUNITY, SUCH AS PROGRAMS TO MANAGE CARE FOR PERSONS WITH CHRONIC DISEASES, HEALTH EDUCATION AND DISEASE PREVENTION INITIATVES, OUTREACH FOR THE ELDERLY, AND CARE FOR PERSONS WHO ARE POOR OR UNINSURED.WEST RIVER HEALTH SERVICES WORKS WITH MANY COMMUNITY PROGRAMS EACH YEAR, OFTEN PARTNERING WITH OTHER ORGANIZATIONS THROUGHOUT THE SERVICE AREA. THE ORGANIZATION WAS INSTRUMENTAL IN THE APPLICATION TO AND AWARD OF A SOUTHWESTERN AREA HEALTHCARE EDUCATION CONSORTIUM, AN OUTREACH EFFORT ENCOMPASSING THE WESTERN HALF OF NORTH DAKOTA. THE GOAL OF THE SWAHEC IS TO ASSIST HEALTH CARE PROVIDERS IN THEIR RECUITMENT AND RETENTION OF HEALTH CARE WORKERS THROUGHOUT WESTERN NORTH DAKOTA. QUITE THE CONTRAST TO OTHER PARTS OF THE NATION, NORTH DAKOTA IS FACING SEVERE SHORTAGE OF WORKERS IN MANY INDUSTRIES, INCLUDING HEALTH CARE. MEMBERS FROM THE MANAGEMENT TEAM STAY CONNECTED TO THE COMMUNITIES THROUGH THEIR INVOLVEMENT WITH OTHER COMMUNITY ORGANIZATIONS, INCLUDING MEMBERSHIP ON NUMEROUS COMMUNITY BOARDS AND COMMITTEES. DOING SO GIVES THE ORGANIZATION A VOICE AND INPUT INTO LOCAL ACTIVITIES, AS WELL AS SERVES AS REPRESENTATION OF HEATLH ACTIVITIES IN EACH OF THE COMMUNITIES. THE BOARD REPRESENTS MEMBERS FROM THE COMMUNITY THAT ARE NEITHER EMPLOYEES, NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. WRHS EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. WEST RIVER HEALTH SERVICES HAS A POLICY OF USING ANY OF ITS SURPLUS FUNDS FOR IMPROVEMENTS THAT PRMOTE A HIGHER LEVEL OF QUALITY PATIENT CARE. |
| 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 ORGNIZATION'S BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATIONS CHARITY CARE PROGRAM WAS BASED ON THE PERCENTAGE OF CHARITY CARE TO GROSS CHARGES TIMES THE STATED BAD DEBT EXPENSE. |
| PART II LINES 6-8 | LINE 6 - COALITION BUILDINGSEVERAL OF THE WRHS STAFF ARE MEMBERS OF THE ADAMS COUNTY DISASTER MANAGEMENT TEAM AND, AS SUCH, ARE ALSO REPRESENTED ON THE SOUTHWEST REGION COALITION FOR DISASTER MANAGEMENT. THESE GROUPS HAVE BEEN INSTRUMENTAL IN DEVELOPING DISASTER PLANS WHICH ENCOMPASS A VARIETY OF NATURAL DISASTERS IN A TEAM INVOLVING FIRE, POLICE, RESCUE, AND HOSPITAL PERSONNEL. IN THIS REPORTING PERIOD, $1,289 OF COMMUNITY BENEFIT EXPENSE WAS INCURRED. THERE WAS NO DIRECT OFFSETTING REVENUE TO THE EXPENSE.THREE EMPLOYEES FROM WRHS WERE REPRESENTED ON THE SOUTHWEST REGION INFLUENZA COALITION. THIS COALITION WORKS WITH THE SOUTHWEST DISTRICT HEALTH UNIT TO HELP ENSURE ADEQUATE VACCINATION COVERAGE FOR THE UNDERINSURED AND UNINSURED POPULATION OF THE AREA. THE COALITION WAS ALSO INSTRUMENTAL IN ASSURING AN ADEQUATE AVAILABILITY OF BOTH INFLUENZA AND TDAP VACCINE. THE GROUP MET MONTHLY TO DISCUSS CURRENT PUBLIC HEALTH CONCERNS AND OUTBREAKS. THEY PROVIDED MUCH EDUCATION TO THE PUBLIC ON BENEFITS OF INFLUENZA VACCINATIONS AND OFFERED FLUE CLINICS AT AREA FARM SHOWS AND SCHOOLS. IN THIS REPORTING PERIOD, $1,350 OF COMMUNITY BENEFIT EXPENSE WAS INCURRED. THERE WAS NO DIRECT OFF SETTING REVENUE TO THE EXPENSE.NUMEROUS WRHS STAFF PARTICIPATE IN THE NORTH DAKOTA HOSPITAL ENGAGEMENT NETWORK. REPRESENTATIVES FROM MEMBERS OF HOSPITALS AROUND THE STATE GATHER TO DISCUSS BEST PRACTICES AND LESSONS LEARNED DURING THE CARE OF THEIR PATIENTS. THE TIME COMMITTED TO THIS PROGRAM CAME AT A COST OF $7,749 DURING THE CURRENT YEAR.GRAND TOTAL OF ALL COALITION BUILDING EFFORT WAS $10,388.LINE 8 - WORKFORCE DEVELOPMENTINCLUDED IN THE WRHS HEALTH CARE SYSTEM IS A 25-BED CRITICAL ACCESS HOSPITAL, EIGHT CLINICS (LOCATED IN HETTINGER, BOWMAN, SCRANTON, NEW ENGLAND, DICKINSON, AND MOTT IN NORTH DAKOTA AND LEMMON IN SOUTH DAKOTA), A VISITING NURSE PROGRAM, ADVANCED LIFE SUPPORT AMBULANCE SERVICE, PLUS A WIDE ARRAY OF ANCILLARY SERVICES TO COMPLIMENT THE ENTIRETY OF THE SYSTEM. THE SERVICE AREA COVERS OVER 25,000 SQUARE MILES AND SERVES AN ESTIMATED POPULATION OF 25,000. ONE OF THE BIGGEST CHALLENGES WRHS HAS AND CONTINUES TO FACE IS FINDING A WORKFORCE WILLING TO LOCATE TO THIS SPARSELY-POPULATED AREA. MOST COMMUNITIES WITHIN THE SYSTEM, INCLUDING HETTINGER, HAVE BEEN DESIGNATED MEDICAL SHORTAGE AREAS. WRHS HAS LONG SUPPORTED THE NEED FOR HEALTH CARE SERVICES IN EVEN THE REMOTEST OF AREAS. RECOGNIZING THAT RURAL PEOPLE DESERVE THE SAME QUALITY HEALTH CARE AS DO THEIR URBAN COUNTERPARTS, PHYSICIANS AND MID-LEVELS TRAVEL DAILY TO THESE REMOTE SITES IN ORDER TO PROVIDE THE HEALTH CARE THESE RURAL PEOPLE SO DESPARATELY NEED. GIVEN THE CURRENT SHORTAGE, RECRUITMENT HAS BEEN A MAJOR EXPENSE OVER THE PAST YEAR. EXPENSES HAVE INCLUDED COLLABORATIVE PHYSICIAN RECRUITMENT FEES, EXPENSE TO ATTEND STATEWIDE RECRUITMENT FAIRS, FORGIVENESS OF ACADEMIC LOANS FOR PHYSICIANS, AND EXPENSE TO BRING CANDIDATES ON-SITE TO SEE THE WEST RIVER SYSTEM AND TO INTERVIEW FOR POSITIONS. RECRUITMENT EXPENSE FOR THIS REPORTING PERIOD TOTALED $65,581.GRAND TOTAL OF ALL WORKFORCE DEVELOPMENT ACTIVITIES WAS $65,581. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, WRHS ANALYZES ITS HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, WRHS ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), WRHS RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MAY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.WRHS' PROCESS FOR CALCULATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS HAS NOT SIGNIFICANTLY CHANGED FROM MARCH 31, 2013 TO MARCH 31, 2014. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS INCREASED FROM 82.60 PERCENT OF SELF-PAY ACCOUNTS RECEIVABLE AT MARCH 31, 2013 TO 86.48 PERCENT OF SELF-PAY ACCOUNTS RECEIVABLE AT MARCH 31, 2014 (A $666,000 INCREASE), WHILE BAD DEBT EXPENSE REMAINED CONSISTENT BETWEEN THE TWO YEARS. THE INCREASE IN THE ALLOWANCE IS THE RESULT OF CONTINUED DIFFICULTIES IN COLLECTING AMOUNTS FROM SELF-PAY PATIENTS AND LESS SELF-PAY ACCOUNTS BEING WRITTEN OFF (REMOVED FROM THE PATIENT ACCOUNTS RECEIVABLE LEDGER) AS BEING UNCOLLECTABLE DURING FISCAL YEAR 2014. WRHS DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. |
| 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 THAT 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 45 DAYS AFTER THIS INITIAL LETTER; 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 V SECTION A | WEST RIVER HEALTH SERVICES OPERATES IN HETTINGER CLINIC, A PROVIDER BASED CLINIC. THE HOSPITAL ALSO OPERATES FIVE PROVIDER BASED RURAL HEALTH CLINICS: NEW ENGLAND CLINIC, BOWMAN CLINIC, SCRANTON CLINIC, MOTT CLINIC AND LEMMON CLINIC. |
| PART VI, LINE 2: | BOARD MEMBERS FROM ALL AFFILIATED BOARDS (WRHSF, WRHS, WHLC) AS WELL AS WRHS MEDICAL STAFF MET TOGETHER AT THE ANNUAL BOARD RETREAT IN JANUARY OF 2012 AT WHICH TIME RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN JULY OF 2011 WERE REVIEWED AND DISCUSSED. THE NEEDS ASSESSMENT SERVED AS THE BASIS FOR HEALTH CARE STRATEGIC AND LONG-RANGE PLANNING TO DEVELOP HEALTHY POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS, AND COLLABORATE WITH OTHER COMMUNITY HEALTH CARE PROVIDERS. THERE IS A WIDE REPRESENTATION FROM ACROSS THE MULTI-COUNTY REGION ON THE WRHS BOARD OF DIRECTORS. BOARD MEMBERS ROUTINELY PROVIDE FEEDBACK TO ADMINISTRATION AND TEH BOARD OF PERCEIVED HEALTH CARE NEEDS BASED ON DISCUSSION WITH PATIENTS IN THEIR RESPECTIVE COMMUNITIES. ALTHOUGH ALL MEMBERS OF THE 14-MEMBER PHYSICIAN GROUP WITH WHOM WRHS CONTRACTS FOR PROFESSIONAL MEDICAL SERVICES RESIDE IN HETTINGER, THEY TRAVEL DAILY/WEEKLY TO COMMUNITY CLINICS WITHIN THE REGION. THEY HAVE BECOME ADVOCATES FOR EACH OF THESE COMMUNITIES AND REPRESENT THE COMMUNITY NEEDS TO ADMINISTRATION AND BOARD OF DIRECTORS.WRHS CONDUCTS REGULAR SATISFACTION SURVEYS WITH PATIENTS WHO HAVE RECEIVED HOSPITAL/CLINIC SERVICES FROM WRHS. AS PART OF THOSE SURVEYS, PATIENTS ARE ASKED FOR THEIR INPUT FOR IMPROVEMENT AND/OR TO SUGGEST OTHER NEEDED SERVICES. WRHS FURTHER IDENTITIES UNMET COMMUNITY HEALTH NEEDS BY PARTICIPATING IN COMMUNITY COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, ADVISORY GROUPS, AND PANELS LOCALLY AND WITHIN THE REGION.BASED ON THE ABOVE-NOTED ASSESSMENT MEASURES, THE MAJOR COMMUNITY NEEDS IDENTIFIED FOR 2011 WERE THE NEED TO INCREASE ACCESS TO QUALITY HEALTH CARE, ESPECIALLY FOR CHILDREN, PREGNANT WOMEN, AND UNINSURED ADULTS AND SENIORS; THE NEED TO OBTAIN MEDICAL CARE FOR THE UNDERSERVED BY ENROLLING ELIGIBLE RESIDENTS IN MEDICAID, SCHIP, AND OTHER INSURANCE PROGRAMS; THE NEED TO ENHANCE AND STRENGTHEN MENTAL HEALTH SERVICES WITHIN THE REGION BY RECRUITING ADDITIONAL MENTAL HEALTH PROVIDERS; THE NEED TO CONSIDER THE ADDITION OF ORTHOPEDIC SERVICES; THE NEED TO RECRUIT ADDITIONAL QUALIFIED PHYSICIANS TO THIS UNDERSERVED AREA; AND THE NEED TO PROVIDE HEALTH EDUCATION, DISEASE PREVENTION AND CHRONIC DISEASE MANAGEMENT (INCLUDING OBESITY) PROGRAMS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITES SERVED.DURING 2014, THE ORGANIZATION HIRED HEALTH PLANNING & MANAGEMENT RESOURCES, INC TO UPDATE THE 2012 NEEDS ASSESSMENT AND ASSIST IN THE DEVELOPMENT OF A COLLABORATIVE IMPLEMENTATION PLAN. CORE DATA SUCH AS DEMOGRAPHICS AND HEALTH STATUS HAVE NOT CHANGED. THE HP&MR TEAM MET WITH VARIOUS PERSONS IN THE COMMUNITY TO IDENTIFY HEALTH ISSUES FOR VARIOUS POPULATION COHORTS, RESOURCES NECESSARY TO ADDRESS THE ISSUES, AND RESOURCES CURRENTLY AVAILABLE TO ADDRESS THE ISSUES IDENTIFIED. |
| PART VI, LINE 3: | IT IS THE MISSION OF WEST RIVER HEALTH SERVICES (WRHS) TO PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO ALL RESIDENTS AND VISITORS IN THE REGION IT SERVES. THESES SERVICES ARE OFFERED TO ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED OR ABILITY TO PAY. WE ARE COMMITTED TO PROVIDE QUALITY HEALTH CARE SERVICES WITH COMPASSION AND RESPECT, PARTICULARLY THE UNDERINSURED AND UNINSURED POPULATION. IT IS THE POLICY OF WRHS TO PROVIDE EFFECTIVE COMMUNICATION WITH PATIENTS REGARDING HOSPITAL BILLS, TO MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS, TO OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS, TO ASSIST LOW-INCOME PATIENTS IN A CONSISTENT MANNER AND TO MAINTAIN FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONS. IT IS NORMALLY AT THE POINT OF ADMISSION THAT THE PATIENT'S ABILITY TO PAY IS ASSSESSED. PATIENTS WHO ARE UNINSURED AND BELIEVED TO HAVE LIMITED RESOURCES ARE REFERRED TO THE WRHS FINANCIAL COUNSELOR WHO WILL DETERMINE PATIENT'S ELIGIBILITY FOR CHARITY CARE AND/OR OTHER FINANCIAL ASSISTANCE PROGRAMS. THE FINANCIAL COUNSELOR WILL ALSO DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENTAL PROGRAMS, INCLUDING MEDICAID OR OTHER STATE-FUNDED PROGRAMS. WHERE APPROPRIATE, THE FINANCIAL COUNSELOR WILL ASSIST THE PATIENT WITH QUALIFICATION AND /OR APPLICATION TO SUCH PROGRAMS.PATIENTS UNABLE TO PAY THEIR MEDICAL BILLS ARE INVITIED TO SUBMIT AN APPLICATION TO THE CHARITY CARE PROGRAM. BOTH THE FINANCIAL COUNSELOR AND THE PATIENT FINCANCIAL SERVICES MANAGER ARE READILY AVAILABLE TO VISIT WITH CANDIDATES TO THIS PROGRAM AND TO ASSIST IN THE APPLICATION PROCESS, AS APPROPRIATE. WRHS INFORMS PATIENTS OF ITS FINANCIAL ASSISTANCE PROGRAMS THROUGH THE WRHS WEBSITE, BROCHURES AVAILABLE AT POINTS OF ADMISSION AND THE PATIENT CARE HANDBOOK LOCATED IN EACH PATIENT ROOM. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBLITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR DURING THE COLLECTION CYCLE. WRHS HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. WRHS MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. WRHS EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ON THE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. THE FINANCIAL COUNSELOR IS GIVEN MORE IN-DEPTH TRAINING ON HANDLING FINANCIAL ASSISTANCE REQUESTS, PROCESING OF APPLICATIONS, AND MANAGING OUTCOMES. |
| PART VI, LINE 4: | HETTINGER IS LOCATED IN SOUTHERWESTERN NORTH DAKOTA AND BORDERS THE STATES OF SOUTH DAKOTA AND MONTANA. THE CITY HAS A POPULATION OF 1,226 WITH A TOTAL POPULATION OF 2,343 IN ADAMS COUNTY. IN ADDITION TO THE HOSPITAL AND CLINIC SERVICES LOCATED IN HETTINGER, THERE ARE ALSO RURAL CLINICS LOCATED IN NEW ENGLAND (SLOPE COUNTY), BOWMAN AND SCRANTON (BOWMAN COUNTY), AND MOTT (HETTINGER COUNTY), ALL IN SOUTHWESTERN NORTH DAKOTA. ANOTHER CLINIC IS LOCATED IN LEMMON, SOUTH DAKOTA (PERKINS COUNTY). IN TOTAL, WEST RIVER HEALTH SERVICS PROVIDES HEALTH CARE TO APPROXIMATELY 37,134 INDIVIDUALS OVER 25,000 SQUARE MILES INCLUSIVE OF THE COUNTIES NAMED. THE MEDIAN HOUSHOLD INCOME FOR THESE COUNTIES IS $38,371, WHICH IS CONSIDERABLY BELOW THE NORTH DAKOTA AVERAGE OF $46,781.TWENTY-THREE PERCENT OF THE POPULATION IN ALL COUNTIES SERVED IS 65 YEARS OF AGE OR OLDER. FOUR HUNDRED THIRTY-NINE FAMILIES WITHIN THE SERVICE AREA FALL BELOW THE FEDERAL POVERTY GUIDLINES FOR AN AVERAGE OF 11.7%. THE NORTH DAKOTA AVERAGE FOR FAMILIES FALLING BELOW POVERTY LEVELS IS 12.3%. NOT INCLUDED IN THE ABOVE DEMOGRAPHICS IS THE CITY OF DICKINSON, 75 MILES FROM HETTINGER AND LOCATED IN STARK COUNTY. IT IS HERE THAT WRHS OPERATES A WEEKLY FOOT AND ANKLE CENTER. WITH THE EXCEPTION OF DICKINSON, ALL OTHER SITES HAVE BEEN DESIGNATED AS MEDICALLY UNDERSERVED AREAS. HEALTH CARE IS AN IMPORTANT PART OF THE ECONOMY AND, AS SUCH, THE HOSPITAL AND CLINICS HAVE BECOME ONE OF THE TOP EMPLOYERS IN THE REGION. APPROXIMATELY 3.5% OF ALL PATIENTS SERVED ARE MEDICAID RECIPIENTS AND 7.6% OF ALL PATIENTS ARE UNINSURED. THERE IS ANOTHER HOSPITAL AND CLINIC IN BOWMAN, LOCATED 40 MILES WEST OF HETTINGER. THERE IS ALSO A HOSPITAL AND SERVERAL OTHER CLINICS IN DICKINSON, LOCATED 75 MILES NORTHWEST OF HETTINGER. TERTIARY REFERRAL CETNERS ARE LOCATED 150 MILES AWAY IN BISMARK, NORTH DAKOTA, AND 180 MILES AWAY IN RAPID CITY, SOUTH DAKOTA. |
| PART VI, LINE 5: | THE ORGANIZATION HAS LONG BEEN A PROMOTER OF MEDICAL EDUCATION AND HAS ENJOYED A LONGSTANDING RELATIONSHIP WITH THE UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE IN PROVIDING ROTATION SITES FOR MEDICAL STUDENTS. PHYSICIANS WITHIN THE ORGANIZATION GRACIOUSLY PRECEPTOR THESE STUDENTS. WITH THE SUPPORT, ENDORSEMNT, AND APPROVAL OF UND'S ADVISORY COUNCIL, THE STATE BOARD OF HIGHER EDUCATION, AND THE UND SCHOOL OF MEDICINE AND HEALTH SCIENCES, THE NORTH DAKOTA STATE LEGISLATURE APPROVED THE INITAL FUNDING FOR AN EXPANSION OF GRADUATE MEDICAL EDUCATION RESIDENCIES WITH THE STATE. WEST RIVER REGIONAL MEDICAL CENTER OF HETTINGER WAS INCLUDED TO THE FUNDING PROPOSAL AND WILL PARTNER WITH THE BISMARK CENTER FOR FAMILY MEDICINE TO OFFER RESIDENCIES TO YEAR TWO AND THREE STUDENTS IN A RURAL SETTING. THIS IS A COLLBORATIVE EFFORT BETWEEN ALL ENTITIES TO ENSURE AN ADEQUATE SUPPLY OF PROFESSIONALS FOR THE FUTURE, ESPECIALLY PRIMARY CARE PROVIDERS AND PARTICULARLY TO RURAL AREAS. THIS PARTNERSHIP WILL BE INVALUABLE AS IT WILL HELP ADDRESS THE NUMBER ONE CONCERN IDETNIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, THAT OF A CRITICAL SHORTAGE OF HEALTHCARE PROVIDERS. IN ADDITION TO TOTAL UNCOMPENSATED CARE FOR FY '14 OF $262,797, WRHS ALSO PROVIDES MANY OTHER SERVICES AS IN-KIND SUPPORT TO BENEFIT THE HEALTH OF THE COMMUNITIES AND REGIONS IT SERVES. THESE COMMUNITY BENEFITS INCLUDE OFFERING CPR AND FIRST AID PROGRAMS TO THE GENERAL PUBLIC, GUIDING TOURS OF THE HOSPITAL/CLINIC TO AREA SCHOOL CHILDREN, PROVIDING HEALTH AND WELNESS EDUCATION CLASSES TO THE PUBLIC AND EDUCATING/TRAINING PARAMEDICS/EMTS IN ALL OUTREACH COMMUNITIES.HETTINGER HAS A LOCALLY-OWNED RADIO STATION. THIS STATION HAS A PROGRAM CALLED TTO (THIS, THAT, AND OTHER THINGS). THIS PROGRAM AIRS DAILY (M-F). WRHS HAS A DESIGNATED HOUR PER MONTH TO SHARE INFORMATION ABOUT HEALTHY HAPPENINGS AND PRMOTE GENERAL HEALTH AND WELL-BEING. DURING THIS REPORTING PERIOD, THE FOLLOWING TOPICS WERE DISCUSSED ON TTO: INFLUENZA PRECAUTIONS AND INFECTION CONTROL, MEDICATION/PRESCRIPTION CARDS, GENERAL WELLNESS AND FITNESS, DIABETIC EDUCATION, WIC, ASSISTANCE PROVIDED BY WRHS TO THE UNINSURED AND/OR UNDERINSURED, PUBLIC ACCESS TO ELECTRONIC HEALTH INFORMATION, ETC. WRHS COSTS SHOWN WERE STAFF TIME TO PREPARE AND PARTICIPATE IN THE TALK SHOW.TWO OF THE WRHS OB STAFF ANNUALLY TEACH FOURTH, FIFTH, AND SIXTH GRADERS AT THE PUBLIC SCHOOL ABOUT PUBERTY AND ITS CHANGES FOR BOTH BOYS AND GIRLS. HYGIENE, HORMONAL CHANGES, AND BODY DEVELOPMENT PHASES ARE A MAJOR PART OF THIS CURRICULUM.PHYSICIANS, MID-LEVELS, AND NURSES WERE FINDING IT DIFFICULT TO KEEP CURRENT RECORDS ON THE MEDICATIONS AND DOSAGES PATIENTS WERE TAKING. IN REPSONSE TO THIS ISSUE, SEVERAL NURSES AND THE HOSPITAL PHARMACIST MET AND SUBSEQUENTLY DESIGNED MEDICATION CARDS TO BE MASS DISTRIBUTED TO ALL PATIENTS WITHIN THE SERVICE AREA. THE WALLET-SIZE MEDICATION CARD OFFERED IS AN EXCELLENT TOOL FOR PATIENTS TO MANAGE HIS/HER OWN MEDICATIONS AS WELL AS TO INFORM PROVIDERS OF THE MEDS THE PATIENT IS CURRENTLY TAKING. SEVERAL HOURS HAVE BEEN DEVOTED BY STAFF TO HELP IN THE EDUCATION OF THE CARD USE AS WELL AS HOW TO FILL THEM OUT APPROPRIATELY. THE TOOL HAS BEEN HEARTILY RECEIVED BY THE PUBLIC.WEST RIVER HEALTH SERVICES AND CLINICS IT OPERATES ARE LOCATED IN A VERY SPARSELY POPULATED RURAL AREA. TRANSPORTATION FOR SENIORS TO/FROM CLINIC APPOINTMENTS IS DIFFICULT AND EXPENSIVE. MANY SENIORS OFTEN OPT TO NOT COME FOR THIER APPOINTMENT IN LIGHT OF THE COST AND INCONVENIENCE FO GETTING TO THE CLINIC. RECOGNIZING THE IMPORTANCE OF THESE PATIENTS TO KEEP THEIR APPOINTMENTS AND MAINTAIN OPTIMAL HEALTH, WRHS IS SHARING IN THE COST FOR SENIORS TO TRAVEL TO/FROM CLINICS. LOCALLY-ESTABLISHED SENIOR VANS ARE USED FOR THIS SERVICE AND WRHS REMIBURSES ONE-HALF THE COST OF THE TRANSPORTATION IN GETTING PATIENTS TO/FROM CLINIC AND/OR HOSPITAL SERVICES. FOR MORE INFORMATION ABOUT WRHS, VISIT WWW.WRHS.COM. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | ND |
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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JIM LONG | ||||||||||||||
| CEO | $159,574 | $0 | $0 | $0 | $0 | $0 | $10,822 | $0 | $9,073 | $0 | $179,469 | $0 | $0 | $0 |
| MITCH SCHULTZ | ||||||||||||||
| PHARMACIST | $142,709 | $0 | $0 | $0 | $0 | $0 | $4,616 | $0 | $18,718 | $0 | $166,043 | $0 | $0 | $0 |
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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 456002094 | BondIssuerEIN |
| Bond Issued | 2008-01-31 | BondIssuedDt |
| Issue Price | $5,275,000 | IssuePriceAmt |
| Purpose | EXPAND AND RENOVATE HOSPITAL FACILITY | 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 | $574,958 | RetiredAmt |
| Total Proceeds | $5,275,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $105,500 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $5,169,500 | CapitalExpendituresAmt |
| Substantial Completion | 2010 | SubstantialCompletionYr |
| Current Refunding | 0 | 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 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2 | FormAndLineReferenceDesc |
| Explanation | WEST RIVER HEALTH SERVICES HAS DETERMINED THAT A REBATE COMPUTATION WAS NOT WARRANTED DUE TO THE TAX EXEMPT BOND BEING A DRAW DOWN BOND THAT DID NOT HAVE INVESTED PROCEEDS. ALL FUNDS WERE SPENT WITHIN THE ALLOTTED TIME PERIOD. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JENNIFER LONG | |||
| SPOUSE OF JIM LONG, CEO | $41,056 | COMPENSATION | 0 |
| KYLEE STADHEIM | |||
| SPOUSE OF NATHAN STADHEIM, CFO | $12,756 | COMPENSATION | 0 |
| DANA ANDRESS | |||
| SPOUSE OF ERIC ANDRESS, DIRECTOR | $56,955 | COMPENSATION | 0 |
| TARA JORGENSON | |||
| SPOUSE OF CODY JORGENSON, DIRECTOR | $64,715 | COMPENSATION | 0 |
| RIA EATON | |||
| SPOUSE OF JONATHAN EATON, DIRECTOR | $30,007 | COMPENSATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 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 11 | 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 ELL 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. COMPENSATOIN WAS LAST REVIEWED IN APRIL OF 2012. |
| FORM 990, PART VI, SECTION C, LINE 18 | 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 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 | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,144,043. MANAGEMENT AND GENERAL EXPENSES 142,130. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,286,173. |
| FORM 990 PART XII LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WESTERN HORIZONS LIVING CENTER | ||||||||||
| 1104 HIGHWAY 12 | HETTINGER | ND | 58369 | 260794602 | LONG-TERM CARE/ ASSISTED LIVING SERVICES | ND | 501C(3) | LINE 9 | WEST RIVER HEALTH SERVICES FOUNDATION | 0 |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||||||||||
| 1000 HIGHWAY 12 | HETTINGER | ND | 58369 | 450411825 | FUNDRAISING | ND | 501C(3) | 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 | 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 (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WR HEALTH SERVICES FOUNDATION | ||
| C | $142,422 | CASH PAID |
| WR HEALTH SERVICES FOUNDATION | ||
| D | $258,734 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| D | $875,149 | CASH PAID |
| WR HEALTH SERVICES FOUNDATION | ||
| O | $32,409 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| J | $99,300 | LEASE AGREEMENT |
| WR HEALTH SERVICES FOUNDATION | ||
| P | $66,580 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| P | $63,163 | CASH PAID |