COAL COUNTRY COMMUNITY HEALTH CENTER: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
COAL COUNTRY COMMUNITY HEALTH CENTER (EIN 11-3686120)
Tax period
2023-05-01 to 2024-04-30
Filed
2024-12-11
IRS object ID
202403469349300410
Schema version
2023v5.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2024-12-11T08:28:07-06:00ReturnTs
Tax Period End2024-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14585 Coleman St Ste 200AddressLine1Txt
CityBismarckCityNm
State AbbreviationNDStateAbbreviationCd
ZIP58503ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN113686120EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Coal Country Community Health CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOALBusinessNameControlTxt
Phone7018737788PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11312 Highway 49 NAddressLine1Txt
CityBeulahCityNm
State AbbreviationNDStateAbbreviationCd
ZIP585236038ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKurt WaldbillingPersonNm
Person TitleCEOPersonTitleTxt
Phone7018737788PhoneNum
Signature2024-12-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLisa Chaffee CPAPreparerPersonNm
PTINP00193453PTIN
Phone7012551091PhoneNum
Preparation2024-12-11PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-10-15 13:58:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKurt WaldbillingPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11312 Highway 49 NAddressLine1Txt
CityBeulahCityNm
State AbbreviationNDStateAbbreviationCd
ZIP585236038ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$16,026,803GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.coalcountryhealth.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateNDLegalDomicileStateCd
Activity Or MissionCCCHC provides and promotes quality health care to the medically underserved population in the North Dakota counties of Mercer, Dunn, and Oliver.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee153TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,741,649PYContributionsGrantsAmt
CY Contributions Grants$3,326,081CYContributionsGrantsAmt
PY Program Service Revenue$11,567,539PYProgramServiceRevenueAmt
CY Program Service Revenue$12,633,404CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$64,168PYOtherRevenueAmt
CY Other Revenue$67,318CYOtherRevenueAmt
PY Total Revenue$16,373,356PYTotalRevenueAmt
CY Total Revenue$16,026,803CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,045,033PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,934,400CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,050,015PYOtherExpensesAmt
CY Other Expenses$6,462,047CYOtherExpensesAmt
PY Total Expenses$16,095,048PYTotalExpensesAmt
CY Total Expenses$17,396,447CYTotalExpensesAmt
PY Revenues Less Expenses$278,308PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,369,644CYRevenuesLessExpensesAmt
Total Assets BOY$17,189,852TotalAssetsBOYAmt
Total Assets EOY$15,618,101TotalAssetsEOYAmt
Total Liabilities BOY$4,661,229TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,459,122TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,528,623NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,158,979NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWorking together as partners to enhance the lives of area residents by providing a neighborhood of patient centered healthcare services that promote wellness, prevention and care coordination.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$14,713,873ExpenseAmt
Revenue$12,633,404RevenueAmt
DescCoal Country Community Health Center is part of a family of over 1,400 health centers nationally that provide care to more than 32 million people in the United States. Community health centers are local, non-profit health care providers serving low income and medically underserved communities. Also known as Federally-Qualified Health Centers (FQHCs), they are located in areas where care is needed, and improve access to care for millions of Americans. Their costs of care rank among the lowest, and their focus on prevention reduces the need for more expensive in-patient and specialty care, saving billions of dollars for taxpayers. (Continued on Schedule O)The focus of the care we provide can be summed up in one word - community. Coal Country is governed by a board of members from the communities we serve, and every decision they make has the best interest of the community in mind. Our medical staff and support staff are also your neighbors, helping us truly understand you and the health care issues that are important to you.The team of providers delivers primary care for the entire community. Funded by a federal grant, our sliding fee scale allows patients to pay according to their individual ability. This and other efforts ensure that no one in the community goes without proper health care services. That's what we're all about.Coal Country Community Health Center has clinics in Beulah, Center, Hazen, and Killdeer. Furthermore, Coal Country remains a member of health care networks in the region.At Coal Country Community Health Center, our top priority is to provide complete health care services for the entire community.With a background in every area of medicine, our primary care physicians provide continuing and comprehensive care, from preventative care to diagnosis and treatment of health conditions. A full list of services provided by Coal Country Community Health Center can be obtained at www.coalcountryhealth.comCCCHC opened a seasonal school medical clinic located in Killdeer and Hazen School Districts. Services began in the Spring 2023 and will continue annually September through May indefinitely.Desc
Total Program Service Expenses$14,713,873TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document34IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee153EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Victoria OberlanderBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7018737788PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11312 Hwy 49 NAddressLine1Txt
CityBeulahCityNm
State AbbreviationNDStateAbbreviationCd
ZIP585236038ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Aaron Garman MD
Physician40.00Yes (X)$343,920$0$51,168
Michelle Placke
Physician40.00Yes (X)$301,570$0$48,826
Jacinta-Jon Klindworth MD
Physician40.00Yes (X)$288,401$0$51,361
Ann Ruffo
Physician40.00Yes (X)$250,165$0$43,628
Kelsey Wiseman
Physician40.00Yes (X)$249,509$0$38,649
Brian Williams
CEO (Admin Leave May-Aug)40.00$219,575$0$35,827Yes (X)
Darrold Bertsch
Interim CEO40.00$173,805$0$0Yes (X)
Victoria Oberlander
CFO40.00$128,958$0$32,736Yes (X)
Kurt Waldbillig
CEO (Oct-April)40.00$57,172$0$10,905Yes (X)
Dr DJ Erickson
Chair1.00$0$0$0Yes (X)Yes (X)
Kathy Kelsch
Vice Chair1.00$0$0$0Yes (X)Yes (X)
Heidi Moore
Secretary/Treasurer1.00$0$0$0Yes (X)Yes (X)
Fred Stern
Director1.00$0$0$0Yes (X)
Anna Mae Batke
Director1.00$0$0$0Yes (X)
Myria Perry
Director1.00$0$0$0Yes (X)
Wayne Hoffner
Director1.00$0$0$0Yes (X)
Sharon Rud
Director1.00$0$0$0Yes (X)
Sarah Duttenhefner
Director1.00$0$0$0Yes (X)
William Suter
Director1.00$0$0$0Yes (X)
Brian Nolan
Director (Began June 2023)1.00$0$0$0Yes (X)
Carl Blackhurst
Director (Until May 2023)1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,013,075TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$313,100TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K23IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Beulah Drug
147 W MainBeulahND58523Contract Pharmacy Dispensing Fees$1,146,763
Comstock Construction Inc
PO Box 1145WhapetonND58074Construction General Contractor$877,034
Sakakawea Medical Center
510 8th Avenue NEHazenND58545Rent for Hazen Clinic, Shared Staff: HR,$367,861
Altru Health System
PO Box 6002Grand ForksND582066002Software Subscription & Support$251,352
Trisha Walker DBA A Fresh Start LLC
639 S Main AveDickinsonND58601Housekeeping Services$170,344
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Government Grants$3,158,181GovernmentGrantsAmt
All Other Contributions$167,900AllOtherContributionsAmt
Total Contributions$3,326,081TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue621110$8,359,513$8,359,513
340B Program Revenue621110$3,718,303$3,718,303
Other Program Revenue621110$555,588$555,588
FieldValueIRS element (for citing)
Total Program Service Revenue$12,633,404TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$67,318RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$67,318RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$67,318TotalRevenueColumnAmt
Exclusion$67,318ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,026,803TotalRevenueColumnAmt
Related Or Exempt Func Income$12,633,404RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$67,318ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$444,835TotalAmt
Management And General$444,835ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$56,533TotalAmt
Program Services$56,533ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,417,891TotalAmt
Program Services$7,825,199ProgramServicesAmt
Management And General$592,692ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$310,471TotalAmt
Program Services$235,519ProgramServicesAmt
Management And General$74,952ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,092,619TotalAmt
Program Services$859,038ProgramServicesAmt
Management And General$233,581ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$612,051TotalAmt
Program Services$434,758ProgramServicesAmt
Management And General$177,293ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$14,694TotalAmt
Management And General$14,694ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$71,868TotalAmt
Management And General$71,868ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,184,089TotalAmt
Program Services$1,966,613ProgramServicesAmt
Management And General$217,476ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$74,071TotalAmt
Management And General$74,071ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$673,693TotalAmt
Program Services$563,007ProgramServicesAmt
Management And General$110,686ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$709,656TotalAmt
Program Services$535,575ProgramServicesAmt
Management And General$174,081ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$105,056TotalAmt
Program Services$63,355ProgramServicesAmt
Management And General$41,701ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$37,613TotalAmt
Program Services$9,156ProgramServicesAmt
Management And General$28,457ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$30,664TotalAmt
Program Services$30,664ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$991,999TotalAmt
Program Services$925,502ProgramServicesAmt
Management And General$66,497ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$68,641TotalAmt
Program Services-$6,000ProgramServicesAmt
Management And General$74,641ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$1,142,199$1,142,199
Dues & Subscriptions$54,121$10,296$43,825
Licenses$37,449$36,235$1,214

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$266,234TotalAmt
Program Services$26,224ProgramServicesAmt
Management And General$240,010ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,396,447TotalAmt
Program Services$14,713,873ProgramServicesAmt
Management And General$2,682,574ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,726,159BOYAmt
EOY$6,243,818EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,663,867BOYAmt
EOY$1,577,364EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$12,963BOYAmt
EOY$9,711EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$83,307BOYAmt
EOY$97,529EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$240,426BOYAmt
EOY$166,269EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,636,407LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,306,475LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,993,781BOYAmt
EOY$7,329,932EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$469,349BOYAmt
EOY$193,478EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,189,852BOYAmt
EOY$15,618,101EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,232,718BOYAmt
EOY$1,345,802EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,428,511BOYAmt
EOY$3,113,320EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,661,229BOYAmt
EOY$4,459,122EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,528,623BOYAmt
EOY$11,158,979EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,528,623BOYAmt
EOY$11,158,979EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,189,852BOYAmt
EOY$15,618,101EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,369,644ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,925,137CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,431,566CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,190,746CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,741,649CurrentTaxYearMinus1YearAmt
Current Tax Year$3,326,081CurrentTaxYearAmt
Total$20,615,179TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,925,137CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,431,566CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,190,746CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,741,649CurrentTaxYearMinus1YearAmt
Current Tax Year$3,326,081CurrentTaxYearAmt
Total$20,615,179TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$20,615,179PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$66,860CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$65,968CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$66,368CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$64,168CurrentTaxYearMinus1YearAmt
Current Tax Year$67,318CurrentTaxYearAmt
Total$330,682TotalAmt
FieldValueIRS element (for citing)
Total Support$20,945,861TotalSupportAmt
Gross Receipts Rltd Activities$54,991,580GrossReceiptsRltdActivitiesAmt
Public Support CY1700.98420PublicSupportCY170Pct
Public Support PY1700.98540PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,406,970OtherCostOrOtherBasisAmt
Depreciation$3,719,868DepreciationAmt
Book Value$6,687,102BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,136OtherCostOrOtherBasisAmt
Depreciation$22,848DepreciationAmt
Book Value$10,288BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,957,050OtherCostOrOtherBasisAmt
Depreciation$1,360,068DepreciationAmt
Book Value$596,982BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$239,251OtherCostOrOtherBasisAmt
Depreciation$203,691DepreciationAmt
Book Value$35,560BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,329,932TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$16,026,803TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$16,026,803RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$16,026,803TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$17,396,447TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$17,396,447ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$17,396,447TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Aaron Garman MD
Physician$282,850$0$59,828$0$1,242$0$11,146$0$41,442$0$396,508$0$0$0
Michelle Placke
Physician$237,318$0$63,648$0$604$0$12,305$0$37,940$0$351,815$0$0$0
Jacinta-Jon Klindworth MD
Physician$233,269$0$53,890$0$1,242$0$11,257$0$41,523$0$341,181$0$0$0
Ann Ruffo
Physician$209,314$0$33,164$0$7,687$0$9,103$0$35,841$0$295,109$0$0$0
Kelsey Wiseman
Physician$202,850$0$46,299$0$360$0$8,739$0$31,225$0$289,473$0$0$0
Brian Williams
CEO (Admin Leave May-Aug)$212,258$0$6,000$0$1,317$0$8,939$0$27,765$0$256,279$0$0$0
Darrold Bertsch
Interim CEO$173,805$0$0$0$0$0$0$0$0$0$173,805$0$0$0
Victoria Oberlander
CFO$113,738$0$15,000$0$220$0$5,706$0$27,672$0$162,336$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part II:FormAndLineReferenceDesc
ExplanationBrian Williams was an employee of Coal Country Community Health Center (CCCHC) and also provided services to Sakakawea Medical Center (SMC). Brian was paid on administrative leave until August. The compensation reported in Part VII, and Part II of the Schedule J, reflects total compensation Brian received from CCCHC for services to both SMC and CCCHC. 49% of his compensation was reimbursed by SMC as part of a shared services agreement. Darrold Bertsch served as the interim CEO until Kurt Waldbillig took over in October. Darrold and Kurt both also provided services to SMC. The compensation reported in Part VII and Part II of the schedule J, reflects total compensation Darrold and Kurt received from CCCHC for services to both SMC and CCCHC. 49% of Darrold and Kurt's compensation was reimbursed by SMC as part of a similar share services agreement.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonAmber BlackhurstPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSpouse of Board Member, Carl BlackhurstRelationshipDescriptionTxt
Transaction$56,533TransactionAmt
TransactionEmployee Wages and BenefitsTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 2The organization began offering Fluoride treatment application and continuous blood glucose monitoring during the year.
Form 990, Part III, line 3Nutritional Counseling - Registered Dietician resigned.
Form 990, Part VI, Section A, line 1aThe Executive Committee shall consist of at least five (5) voting members, including the Chair, Vice Chair, Secretary, Treasurer, and one (1) at-large member. The Executive Director of the Corporation shall serve without voting powers. The Executive Committee shall have the power to transact all business of the Corporation during the interim between meetings of the Board of Directors, provided that any action so taken shall not conflict with the policies and express wishes of the Board of Directors, and that it shall refer all matters of major importance to the full Board of Directors, including any amendments to the Articles and Bylaws.
Form 990, Part VI, Section B, line 11bThe full copy of the Form 990 is provided to the board via email. The Form 990 is reviewed and approved by the board and signed by the CEO after approval.
Form 990, Part VI, Section B, line 12cThe conflict of interest and compensation disclosure statements are completed annually. All board members and officers of CCCHC are covered by the policy. The annual conflict of interest and compensation disclosure statements obtained from board members and officers of CCCHC are reviewed by the CEO and Administration staff of CCCHC. It is at this review that the determination is made as to whether a conflict exists. Actual conflicts of interest identified are brought before the Board Executive Committee or the entire Board, depending on the situation and circumstances. Board members and officers of CCCHC are required to recuse themselves from voting on issues where it has been determined that a conflict of interest does exist. If the conflict of interest is pervasive, the Board Executive Committee or the entire Board will determine if further actions are needed. In all situations, the Board will document the restrictions imposed or acted upon.
Form 990, Part VI, Section B, line 15aTo determine compensation, the organization uses the following salary surveys for both the CEO and CFO as well as other positions within the organization: National Community Health Center Association (NACHC), Community Healthcare Association of the Mountain Plain States (CHAMPS), Medical Group Management Association (MGMA), and state of ND. The board of directors determines the salary of the CEO. CEO Salary adjustments are documented on a payroll notification form, signed by the board chair and forwarded to the accounting department for entry into the accounting/payroll system. Compensation for the CFO is reviewed and approved by the CEO. The board of directors approves an annual budget to provide guidance for expenditures which includes personnel salaries. In addition, annual salary adjustments are presented to the board for approval through the budgetary process. Personnel salary adjustments are documented on a payroll notification form signed by the CEO or Human Resources and forwarded to the accounting department for entry into the accounting/payroll system. The process for determining compensation is undertaken annually before the new fiscal year in May begins.
Form 990, Part VI, Section C, line 19The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part IX, line 11gOther Medical Service Fees: Program service expenses 1,966,613. Management and general expenses 217,476. Fundraising expenses 0. Total expenses 2,184,089.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.