2025-10-23T09:37:03-05:00 2024-12-31 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2024-01-01 450232743 PR Health Corporation PRHE 7012847500 115 Vivian St Park River ND 582700708 Marcus Lewis CEO 7012847500 2025-10-23 1 1 Lisa Chaffee CPA P00193453 7012551091 2025-10-23 2024 2025-03-06 01:10:19Z First Care Health Center Marcus Lewis 115 Vivian St Park River ND 582700708 22480469 0 X www.firstcarehc.com X 1952 ND Acute care hospital serving the healthcare needs of individuals residing in the Park River, ND area. 10 10 160 40 0 0 1193851 478475 19440632 21310390 270859 677983 119863 -33792 21025205 22433056 13313 12875 0 0 8947375 10170854 0 0 0 10083079 12091965 19043767 22275694 1981438 157362 29767436 29959687 5399423 5445350 24368013 24514337 X To continue the healing mission of Jesus in a rural setting. We are committed to: A respect for each person; A caring, Christian environment; Professional excellence; Promoting healthy communities; Personal service; and an Innovative spirit. 0 0 19467022 12875 21310390 First Care Health Center is dedicated to carrying out the healing mission of Jesus. In calendar year 2024, First Care Health Center provided acute care to 262 patients. This constituted 910 days of care. The swing-bed program at the health center provides skilled nursing care for the elderly. This program provided service to 138 patients, accounting for 1,921 days of care.First Care Health Center provides health care to the community in the form of outpatient services. In calendar year 2024, outpatient visits totaling 24,768 were provided to the community. In addition, there were 11,415 visits to First Care Rural Health Clinic. As part of the mission of First Care Health Center, we provide health care to persons who are unable to pay for the services that they receive. First Care Health Center will not deny care to anyone based on their ability to pay. Charity care, based on charges foregone, in the amount of $122,074, was written off for qualified individuals.Gross revenue from Medicare and Medicaid patients for calendar year 2024 was $14,262,101. Due to the limited reimbursement from these programs, the cost of these services to the hospital is not fully reimbursed. 19467022 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 35 0 1 160 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 X Nina Hollingsworth CFO 7012844580 115 Vivian St Park River ND 58270 Dennis Markusen Board Chair (Jan-Mar) 2.00 X X 0 0 0 Patty Dahlen Vice Chair (Jan-Mar)/Chair (Apr-Dec) 2.00 X X 0 0 0 Eugene Bossert - Director (Jan-Mar)/Vice Chair (Apr-Dec) 1.00 X X 0 0 0 Ian Myrdal Secretary 1.00 X X 0 0 0 Gale Beneda Director 1.00 X 0 0 0 Nicholas Beneda DDS Director 1.00 X 0 0 0 Mark Helgeson OD Director (Jan-Mar) 1.00 X 0 0 0 Katherine Hall Director 1.00 X 0 0 0 Kirk Ham Director (Jan-Sept) 1.00 X 0 0 0 Brenda Nilson Director 1.00 X 0 0 0 Diana Hahn Director 1.00 X 0 0 0 Dori Carlson Director (Apr-Dec) 1.00 X 0 0 0 Casey Wollangk Director (Apr-Dec) 1.00 X 0 0 0 Marcus Lewis CEO 40.00 X 232611 0 31580 Nina Hollingsworth CFO 40.00 X 115296 0 15454 Lori Seim CNO 40.00 X 159730 0 9256 Tamara Clemetson PA-C/Clinic Manager 40.00 X 221241 0 30305 Mirza Baig Gastroenterologist 27.00 X 424816 0 32105 Lindsey Gillespie RN/Care Coordinator 40.00 X 154682 0 19051 Michael Bittles Surgeon 8.00 X 188334 0 5650 Amy Burianek RN/Care Coordinator 40.00 X 140141 0 24502 1636851 0 167903 15 0 1 0 Triage LLC PO Box 773328 Chicago IL 60677 Staffing Agency 1882637 Joel J Johnson 115 Vivian St Park River ND 58270 Family Physician 1476964 Psychiatric Medical Care PO Box 734606 Dallas TX 75373 Behavioral Health 602788 DMS Health Technologies PO Box 670747 Dallas TX 75267 Mobile Imaging 381328 Independent Radiology PO Box 2746 Fargo ND 58108 Imaging Reads 246816 10 170576 249592 58307 31258 478475 Patient Service Revenue 621110 21110402 21110402 Supporting Revenue 900099 186395 186395 Auxiliary Revenue 900099 13593 13593 21310390 671983 671983 6000 0 6000 6000 6000 13621 170576 47413 -33792 -33792 22433056 21310390 0 644191 X 12875 12875 569585 11964 557621 7313437 6968102 345335 310542 300542 10000 1435705 1313857 121848 541585 483774 57811 18060 18060 141689 141689 5930874 5817509 113365 272639 3108 269531 1225014 450661 774353 387921 354842 33079 250655 125722 124933 126617 115832 10785 1121166 1025665 95501 162736 148874 13862 Medical Supplies 2291980 2291980 Auxiliary Expenses 2555 2555 160059 39160 120899 22275694 19467022 2808672 0 10642096 4741774 2390023 3059933 0 522709 7090 24794 473190 535302 210880 314599 22496764 14853127 7678749 7643637 7361786 13004283 1003622 112656 29767436 29959687 2269806 1845447 2978806 2755576 150811 844327 5399423 5445350 X 22512588 22409320 1855425 2105017 24368013 24514337 29767436 29959687 X 157362 -11038 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 2240 13593 2555 13278 0 154334 5717 5717 154334 154334 2370 2370 154334 154334 345 345 154334 154334 347 347 154334 154334 308 308 154334 0.00000 1.00000 0.00000 0 0 62063 62063 11558248 8135956 3422292 10045829 6385498 3660331 830624 331673 498951 7643637 Finance Lease 117033 Estimated third-party payor settlements 324558 Split-dollar life insurance obligations 402736 844327 X 22419463 0 22419463 13593 13593 22433056 22267422 0 22267422 8272 8272 22275694 Part IV, Line 1b: The organization holds assets on behalf of the First Care Health Center Auxiliary. Part V, Line 4: Investments are to be held in perpetuity, and the income from the investments is expendable to support various health care services. Part X, Line 2: The Health Center 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. The Health Center 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 4b - Other Adjustments: Income from Auxiliary Operations 13,593. Part XII, Line 4b - Other Adjustments: Expenses from Auxiliary Operations 2,555. Endowment Expenditures Recorded in Net Assets 5,717. Harvest Fest 136847 129897 6950 28704 150 5500 1300 Golf Tournament 47350 40679 6671 500 4588 3690 2484 497 184197 170576 13621 500 33292 3840 7984 1300 497 47413 -33792 1 1 X 1 X 1 X 1 1 1 0 0 84000 84000 0.00380 1038148 661555 376593 0.01690 1122148 661555 460593 0.02070 31422 2500 28922 0.00130 27572 5552 22020 0.00100 17275 17275 0.00080 76269 8052 68217 0.00310 1198417 669607 528810 0.02380 2277 2277 0.00010 189 189 0.00000 7786 7786 0.00030 12204 12204 0.00050 22456 22456 0.00090 0 146690 71715 11065061 11170567 -105506 X 1 1 1 1 First Care Health Center 115 Vivian Street PO Box I Park River ND 582700708 www.firstcarehc.com 5042 X X X First Care Health Center 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X See Part V, Page 8 X 1 22 1 firstcarehc.com/community-health-needs-assessment 0 1 X 100.000000000000 300.000000000000 X 1 1 X X X X 1 X firstcarehc.com/insurance-assistance X firstcarehc.com/insurance-assistance X firstcarehc.com/insurance-assistance X X X X X 1 X 0 X X X X 1 X 0 0 First Care Health Center Part V, Section B, Line 5: Administrator of Walsh County Public Health was a member of our steering committee as well as a key informant during the interview phase. They were present at planning meetings throughout the CHNA process and assisted with the implementation of the surveys throughout the county. We also included various community members that would have knowledge and expertise related to health needs of medically underserved, low-income, and minority populations including school staff, local pastors, law enforcement, medical providers, human service center providers, social workers, and population health nurses. First Care Health Center Part V, Section B, Line 6a: Unity Medical Center located in Grafton, ND. First Care Health Center Part V, Section B, Line 6b: Walsh County Health District First Care Health Center Part V, Section B, Line 11: The needs identified in the latest CHNA were, in descending order, the availability of mental health and disorder treatment services, the availability of resources to help the elderly stay in their homes, the availability of transportation resources, and having enough child daycare services. The actions taken in the current year to address the needs identified are as follows:1. Hired a full time Psychologist to provide behavioral health services both virtually and in person. Continued to provide Senior Life Solutions, telepsychiatry, and an e-emergency solution to coordinate behavioral health care in the ED to support behavioral health within the community. Continued to provide space for UND Psychology students to provide services free of charge.2. Continued to provide transportation for patients free of charge.3. Continued to participate in the Walsh County Substance Abuse Coalition.4. Attended quarterly Walsh County Behavioral Health meetings to collaborate with other resources within the community.5. Continued to employ an outpatient care coordinator to assist high risk patients.6. Continued to provide Powerful Tools for Caregivers course throughout the year.7. Started a daycare to address the severe daycare shortage within the area. First Care Health Center Part V, Section B, Line 13b: The Hospital provides free care and discounted care up to 300% of the Federal Poverty Income guidelines. In addition to the FPGs, the hospital requires proof of Medicaid/Medicaid expansion denial, most recent tax return copy, current wage verification, and a completed financial assistance application. Schedule H, Part V, Line 7a: firstcarehc.com/community-health-needs-assessment 1 1 - First Care Rural Health Clinic 115 Vivian Street Park River ND 58270 Rural Health Clinic Part I, Line 3c: The Hospital provides free care and discounted care up to 300% of the Federal Poverty Income guidelines. In addition to the FPGs, the hospital requires proof of Medicaid/Medicaid expansion denial, most recent tax return copy, current wage verification, and a completed financial assistance application. Part I, Line 7: The Organization calculated the cost for providing financial assistance reported in Part I, line 7a by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. Medicaidon line 7b and subsidized health services on line 7g are reported according to costs allocated to the relevant costs centers on the Medicare Cost Report. The Organization used actual expenses to determine the cost for Community Health Improvement Services and Caontributions, lines 7e and 7i. Part II, Community Building Activities: Employees participate in meetings, events, and committees to assist new businesses, develop housing projects, improve access to care, and address other concerns to help the community. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: The estimated amount of implicit price concessions attributable to patients eligible for charity care of is determined by taking the percentage of applications that were denied due to lack of information or unwillingness to complete the applications. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 13 and 14 of the attached audited financial statements. Part III, Line 8: One hundred percent of any shortfall should be treated as community benefit. A facility must be able to recover its costs in order to continue to provide quality care to Medicare patients and the community as a whole. Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall, if any, is considered a community benefit.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 Centers for Medicare and Medicaid Services.Hospital services reimbursed on a fee schedule are not included in the Medicare calculation per the 990 instructions. Had this been reported the Hospital would have had a greater loss from Medicare services of $189,867.Medicare fee schedule revenue $207,201Medicare estimated costs of care relating to payments $(397,068)Net Surplus (Shortage) $(189,867) Part III, Line 9b: If a patient hasn't made a payment on their bill 30 days after they receive it, they receive a letter reminding them to pay it. A patient continues to receive letters up to 120 days after they receive their bill if they haven't made any payments, stating that their account could be turned over to bad debt or turn in a financial assistance application. The patient has up to 240 days to turn in their financial assistance application from the time of their first bill. If a patient applies for financial assistance within 240 days of the date of the first invoice the patient charges are pulled from collections as the Hospital works with the patient to complete the application. Part VI, Line 2: First Care Health Center utilizes patient satisfaction surveys and assessment surveys to get feedback on the services offered and to find out what services are desired by the people we serve. Most recently, the surveys focused on wellness and outreach to the surrounding communities. Part VI, Line 3: First Care Health Center posts its charity care policy, or a summary thereof, and financial assistance contact information (1) in admissions areas, emergency rooms, and other areas of the Organization's facilities in which eligible patients are likely to be present;(2) provides a copy of the policy, or a verbal summary thereof, and financial assistance contact information to patients as part of the intake process; (3) provides a copy of the policy, or a verbal summary thereof, and financial assistance contact information to patients with discharge materials; (4) may include the policy, or a summary thereof, along with financial assistance contact information, in patient bills; and/or (5) discusses with the patient the availability of various government benefits, such as Medicaid or state programs, and assists the patient with qualification for such programs, where applicable. In addition, the charity care policy, application and plain language summary are posted on the facility web site. Part VI, Line 4: First Care Health Center (FCHC) serves a rural geographical area in NE North Dakota which includes portions of six counties. The total population served is estimated at 19,500. The median household income of the service area is $51,181 with 11.0% of the population below the federal poverty level. Almost 15 percent of the communities' patients are uninsured or on Medicaid. The main county, in which the Health Center is located, is a federally-designated primary care HPSA due to low income. FCHC is located in Park River, which is a federally-designated medically underserved area. The unemployment rate of the service area is 6.1%. Nearly 21.0% of the area population is over 65 years of age and just over 22.7% of the area population are children zero to seventeen years of age. Part VI, Line 5: The Organization's governing body is comprised of persons who reside in the Organization's primary service area. The Organization applies any surplus funds to improve the Facility and equipment to improve patient care. The Organization also extends medical staff privileges to other qualified physicians in the community.Educational pamphlets and brochures are available at no cost to patients. FCHC staff assist patients with understanding their Medicare and Medicaid benefits, applying for said benefits, and assist with completing Advanced Medical Directives and Living Wills. The Facility participates in the annual county fair by renting booth space to educate the public on various health issues. First Care Health Center sponsors drives to collect school supplies for the area schools and food donations to the local food pantry. FCHC participates in mentoring medical, pharmacy, nursing, and health careers students. First Care Health Center also provides nail care at a nominal fee by licensed staff. This service serves as a first step in checking for issues in diabetic patients. The fee does not cover the cost of space, salaries, or supplies, but is done more as a service to patients.First Care Health Center provides many other services that benefit the community for which there is little or no reimbursement. The following list provides examples of some of the services and programs offered:*Tours of the hospital to children.*Provide rooms for overnight stay for families of patients.*Training to area vocational high school students.*Provide preceptorships for nurses training.*Provide educational pamphlets and brochures to the community.*Provide free medical advice from registered nurses via telephone.*Provide meals to parents of pediatric patients.*Personnel run errands for patients.*Provide supplies and movies for activities and crafts for swing-bed patients.*Pay for local travel for swing-bed patients. X X X X 0 0 0 0 0 0 0 0 0 Mirza Baig Gastroenterologist 424816 0 0 0 0 0 17250 0 14855 0 456921 0 0 0 Marcus Lewis CEO 232611 0 0 0 0 0 12174 0 21333 0 266118 0 0 0 Tamara Clemetson PA-C/Clinic Manager 221241 0 0 0 0 0 19175 0 13056 0 253472 0 0 0 Michael Bittles Surgeon 188334 0 0 0 0 0 5650 0 0 0 193984 0 0 0 Lindsey Gillespie RN/Care Coordinator 154682 0 0 0 0 0 7922 0 12361 0 174965 0 0 0 Lori Seim CNO 159730 0 0 0 0 0 8056 0 3126 0 170912 0 0 0 Amy Burianek RN/Care Coordinator 140141 0 0 0 0 0 7426 0 18468 0 166035 0 0 0 Marcus Lewis CEO CASD Plan loan X 503420 522709 0 1 1 522709 X Auction Items 32 21735 FMV X Event Prizes 70 9523 FMV 0 0 0 0 Part I, Column (b): Number of items contributed Form 990, Part VI, Section A, line 8b There are no committees that exist that can act on behalf of the governing board. All decisions are made by the governing board. Form 990, Part VI, Section B, line 11b The CFO and Administrator review the Form 990 together. The Form 990 is also provided to the Board of Directors electronically for their review prior to filing the Form 990 with the IRS. Form 990, Part VI, Section B, line 12c The conflict of interst policy covers the Board of Directors and all employees. Annual disclosures by the board members and officers of the organization are reviewed by the CFO after signature. The Board would review any potential conflicts of the CFO. If a board member has a conflict on a particular issue he/she will identify the conflict and he/she must abstain from voting on that issue. Form 990, Part VI, Section B, line 15a The independent Board determines and approves the Administrator's compensation. The board compares the salary with similar organizations, all of which is recorded in the board meeting minutes. The CFO's salary is determined by the Administrator, which is typically a small percentage increase from the prior year. The process for determining compensation for both positions is performed on an annual basis. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part IX, line 11g Medical Professional Fees: Program service expenses 5,775,065. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,775,065. Adm Collection Expense: Program service expenses 0. Management and general expenses 72,634. Fundraising expenses 0. Total expenses 72,634. Admin Professional Fees: Program service expenses 0. Management and general expenses 34,076. Fundraising expenses 0. Total expenses 34,076. Maintenance and housekeeping professional fees: Program service expenses 42,444. Management and general expenses 0. Fundraising expenses 0. Total expenses 42,444. Consulting: Program service expenses 0. Management and general expenses 6,655. Fundraising expenses 0. Total expenses 6,655. Form 990, Part XI, line 9: Net Income From Auxiliary Operations -11,038.