2015-02-06T16:07:30-06:00 2014-03-31 460403496 CASEY PETERSON & ASSOC 909 ST JOSEPH ST SUITE 101 RAPID CITY SD 57701 990 2013-04-01 450340688 WEST RIVER HEALTH SERVICES DBA WEST RIVER REGIONAL MEDICAL CENTER WEST 7015674561 1000 HIGHWAY 12 HETTINGER ND 58639 JIM LONG CEO 7015674561 2015-02-03 DEIDRE BUDAHL CPA P01273830 6053481930 2015-02-06 2013 2016-03-07 17:11:31Z JIM K LONG 1000 HIGHWAY 12 HETTINGER ND 58639 25958668 0 X WWW.WRHS.COM X 1977 ND PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO THE RESIDENTS AND VISITORS OF THE REGION. 11 8 330 0 0 0 638092 503166 24390118 24659369 69415 4185 55770 45995 25153395 25212715 2044 0 0 0 10659915 10962676 0 0 32409 13786171 14282993 24448130 25245669 705265 -32954 26931485 27248275 7900868 7786365 19030617 19461910 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 20714370 24598991 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. 20714370 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 51 0 1 330 1 0 0 0 0 0 0 0 0 0 0 X 11 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X NATHAN STADHEIM 7015674561 1000 HIGHWAY 12 HETTINGER ND 58639 ERIC ANDRESS CHAIRMAN 2.00 X X 160 0 0 GARY DEWHIRST SECRETARY/TREASURER 2.00 X X 120 0 0 JONATHON EATON BOARD MEMBER 2.00 X 170 0 0 TRAVIS ELLISON BOARD MEMBER 2.00 X 170 0 0 HALEY EVANS VICE CHAIRMAN 2.00 X X 170 0 0 LARRY JACKSON BOARD MEMBER 2.00 X 180 0 0 CODY JORGENSON PAST CHAIRMAN/WRHS REPRESENTATIVE 2.00 X 270 0 0 ROBERT PARKER BOARD MEMBER 2.00 X 140 0 0 ERVIN SCHNEIDER BOARD MEMBER 2.00 X 110 0 0 CLEVE TESKE BOARD MEMBER 2.00 X 160 0 0 DR JENNIFER SHEFFIELD MEDICAL STAFF LIAISON 2.00 X 0 0 0 JIM LONG CEO 34.00 6.00 X 159574 0 19895 NATHAN STADHEIM CFO 32.00 8.00 X 83211 0 11083 MITCH SCHULTZ PHARMACIST 40.00 X 142709 0 23334 387144 0 54312 2 0 1 0 UNITED CLINICS PHYSICIANS PC 110 HWY 12 HETTINGER ND 58639 PHYSICIAN SERVICES 4416007 DR MARK KRISTY 1000 HWY 12 HETTINGER ND 58639 RADIOLOGY SERVICES 353038 MONDAK IMAGING SERVICES 11 SOUTH 7TH ST MILES CITY MT 59301 MRI SERVICES 200760 NORTHERN PLAINS LABORATORY PO BOX 2036 BISMARCK ND 58501 LABORATORY SERVICES 168731 ALEX OR KATHLEEN THOMPSON 600 2ND AVE N HETTINGER ND 58639 PHYSICAL THERAPY SERVICES 155760 5 142422 360744 503166 PATIENT SERVICE REVENUE 621110 23933505 23933505 AFFILIATION SUPPORT 900099 337499 337499 OTHER 900099 129743 129743 ASSISTED LIVING RENT 621610 99300 99300 CAFETERIA 722210 98944 98944 60378 60378 24659369 24272 24272 60225 14230 45995 45995 45995 704242 7394 731723 0 -27481 7394 -20087 -20087 25212715 24598991 0 110558 X 385494 385494 8564908 5992545 2539954 32409 2012274 1640003 372271 5319 5319 66890 66890 6286173 6144043 142130 98793 98793 51490 41964 9526 548767 447245 101522 217111 147957 69154 243687 243687 1453739 1184797 268942 206951 172848 34103 SUPPLIES - OPERATING 3151962 3022841 129121 REPAIRS & MAINTENANCE 727088 592577 134511 BAD DEBTS 684200 684200 STAFF RECRUITMENT 267381 201800 65581 273442 197863 75579 25245669 20714370 4498890 32409 3457254 3682106 4462194 5194732 557143 581419 230064 232545 32118483 19400730 13359865 12717753 2422057 2493067 2442908 2346653 26931485 27248275 1771123 2060808 30348 4848841 4700042 1106008 995167 174896 0 7900868 7786365 X 19030617 19461910 19030617 19461910 26931485 27248275 -32954 80719 383528 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 8114 13078 11608 9584 0 18000 90113 108113 1941458 17007445 9191533 9757370 30107 12186915 9835470 2381552 844445 373727 470718 12717753 DEFERRED FINANCING COSTS 85273 RELATED PARTY RECEIVABLES 1133883 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1127497 2346653 X 24623464 80719 -684200 -603481 25226945 -14230 -14230 25212715 24575699 14230 14230 24561469 684200 684200 25245669 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. 1 1 X 1 X 1 X 0 0 0 216307 216307 0.00880 669033 523666 145367 0.00590 885340 523666 361674 0.01470 40539 21796 18743 0.00080 899707 550231 349476 0.01420 6405 6405 0.00030 946651 572027 374624 0.01530 1831991 1095693 736298 0.03000 10388 10388 0.00040 65581 65581 0.00270 75969 75969 0.00310 1 684200 0 10324056 10529804 -205748 X 1 1 1 1 WEST RIVER HEALTH SERVICES 1000 HIGHWAY 12 HETTINGER ND 58639 WRHS.COM X X X X CLINIC & 5 RHC'S - ALL PROVIDER BASED WEST RIVER HEALTH SERVICES 1 X X X X X X X 11 1 0 1 X WWW.WRHS.COM X X X X X X 1 0 1 1 150.000000000000 1 200.000000000000 1 X X X X X X 1 1 X X X 1 0 X X X X 1 X 1 1 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. 2 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 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 X X X 0 0 0 0 0 0 0 0 0 JIM LONG CEO 159574 0 0 0 0 0 10822 0 9073 0 179469 0 0 0 MITCH SCHULTZ PHARMACIST 142709 0 0 0 0 0 4616 0 18718 0 166043 0 0 0 A CITY OF HETTINGER NORTH DAKOTA 456002094 2008-01-31 5275000 EXPAND AND RENOVATE HOSPITAL FACILITY 0 0 0 A 574958 5275000 105500 5169500 2010 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 1 0 0 0 0 SCHEDULE K, PART IV, LINE 2 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. JENNIFER LONG SPOUSE OF JIM LONG, CEO 41056 COMPENSATION 0 KYLEE STADHEIM SPOUSE OF NATHAN STADHEIM, CFO 12756 COMPENSATION 0 DANA ANDRESS SPOUSE OF ERIC ANDRESS, DIRECTOR 56955 COMPENSATION 0 TARA JORGENSON SPOUSE OF CODY JORGENSON, DIRECTOR 64715 COMPENSATION 0 RIA EATON SPOUSE OF JONATHAN EATON, DIRECTOR 30007 COMPENSATION 0 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. 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 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 WR HEALTH SERVICES FOUNDATION C 142422 CASH PAID WR HEALTH SERVICES FOUNDATION D 258734 CASH PAID WESTERN HORIZONS LIVING CENTER D 875149 CASH PAID WR HEALTH SERVICES FOUNDATION O 32409 CASH PAID WESTERN HORIZONS LIVING CENTER J 99300 LEASE AGREEMENT WR HEALTH SERVICES FOUNDATION P 66580 CASH PAID WESTERN HORIZONS LIVING CENTER P 63163 CASH PAID