WRAY COMMUNITY DISTRICT HOSPITAL: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
WRAY COMMUNITY DISTRICT HOSPITAL (EIN 46-3225995)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-10-13
IRS object ID
202232869349301913
Schema version
2021v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-10-13T17:39:12-04:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN200079326PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DINGUS ZARECOR & ASSOCIATES PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line112015 E MAIN AVEAddressLine1Txt
CitySPOKANE VALLEYCityNm
State AbbreviationWAStateAbbreviationCd
ZIP99206ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN463225995EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WRAY COMMUNITY LONG TERM CARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWRAYBusinessNameControlTxt
Phone9703324856PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 CANYON RIDGE DRIVEAddressLine1Txt
CityWRAYCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80758ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN HARTPersonNm
Person TitleCEOPersonTitleTxt
Phone9703324856PhoneNum
Signature2022-10-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastHARTPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS DINGUSPreparerPersonNm
PTINP00951009PTIN
Phone5092420874PhoneNum
Preparation2022-10-13PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HILLCREST CARE CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJOHN HARTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11017 W 7TH STREETAddressLine1Txt
CityWRAYCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80758ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,845,794GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://HILLCRESTCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2013FormationYr
Legal Domicile StateCOLegalDomicileStateCd
Activity Or MissionTO PROMOTE AN ELDER-CENTERED CARE COMMUNITY WHERE RESIDENTS FEEL LOVED, SECURE AND CONTENT WHILE MAINTAINING INDEPENDENCE AND CHOICE IN DAILY LIFE.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee105TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$146,750PYContributionsGrantsAmt
CY Contributions Grants$1,135,164CYContributionsGrantsAmt
PY Program Service Revenue$4,596,592PYProgramServiceRevenueAmt
CY Program Service Revenue$3,651,466CYProgramServiceRevenueAmt
PY Investment Income$1,566PYInvestmentIncomeAmt
CY Investment Income$280CYInvestmentIncomeAmt
PY Other Revenue$35,466PYOtherRevenueAmt
CY Other Revenue$58,884CYOtherRevenueAmt
PY Total Revenue$4,780,374PYTotalRevenueAmt
CY Total Revenue$4,845,794CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,299,740PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,321,589CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,893,876PYOtherExpensesAmt
CY Other Expenses$1,496,396CYOtherExpensesAmt
PY Total Expenses$5,193,616PYTotalExpensesAmt
CY Total Expenses$4,817,985CYTotalExpensesAmt
PY Revenues Less Expenses-$413,242PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$27,809CYRevenuesLessExpensesAmt
Total Assets BOY$5,527,624TotalAssetsBOYAmt
Total Assets EOY$5,174,146TotalAssetsEOYAmt
Total Liabilities BOY$2,810,811TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,429,524TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,716,813NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,744,622NetAssetsOrFundBalancesEOYAmt
MissionTO PROMOTE HEALTHIER SENIOR LIVING THROUGH COMPASSIONATE, QUALITY, PERSON DIRECTED CARE...FAMILY CARE WITH A FAMILY TOUCH.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$4,261,554ExpenseAmt
Revenue$3,651,466RevenueAmt
DescWRAY COMMUNITY LONG TERM CARE, INC. D/B/A HILLCREST CARE CENTER AND THE TOWERS OPERATES A 45-BED SKILLED NURSING FACILITY AND A 24-UNIT ASSISTED LIVING FACILITY. THE PURPOSE OF HILLCREST CARE CENTER IS TO MAINTAIN AN ENVIRONMENT THAT WILL BE RESPONSIVE TO THE NEEDS OF OUR RESIDENTS AND THEIR FAMILIES, THUS ALLOWING PEOPLE TO BE IN THIS COMMUNITY AND TO LIVE WHERE FAMILIES AND FRIENDS CAN VISIT WITHOUT HAVING TO TRAVEL A LONG DISTANCE. HILLCREST CARE CENTER AND THE TOWERS SERVED 75 RESIDENTS AND PROVIDED 14,610 DAYS OF RESIDENT SERVICES TO AGING ADULTS DURING THE YEAR.Desc
Total Program Service Expenses$4,261,554TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document23IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee105EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTOBY STULTSPersonNm
Phone9703324856PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11017 W 7TH STREETAddressLine1Txt
CityWRAYCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80758ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
REBECCA LENZ
CHAIR1.00Yes (X)Yes (X)$0$0$0
CRAIG SOEHNER
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
JAMES HENDRIX
SECRETARY/TR1.00Yes (X)Yes (X)$0$0$0
PHILIP RIGGLEMAN
MEMBER1.00Yes (X)$0$0$0
JEFFREY WINGFIELD
MEMBER1.00Yes (X)$0$0$0
JOHN HART
CEO1.00Yes (X)$0$218,000$8,20039.00
TOBY STULTS
CFO1.00Yes (X)$0$138,691$16,67639.00
JENNIFER KRAMER
CMO1.00$0$162,916$19,04839.00Yes (X)
GINGER WILLIAMS
ADMINISTRATO40.00$119,426$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$119,426TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$519,607TotReportableCompRltdOrgAmt
Total Other Compensation$43,924TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PRIME TIME HEALTHCARE
PO BOX 3544OMAHANE68103NURSING$227,239
HAYNES MECHANICAL SYSTEMS
PO BOX 561389DENVERCO80256REPAIR & MAINT$105,524
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$1,089,580GovernmentGrantsAmt
All Other Contributions$45,584AllOtherContributionsAmt
Total Contributions$1,135,164TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET RESIDENT SERVICE REVENUE623000$3,648,622$3,648,622
OTHER PROGRAM REVENUE623000$2,844$2,844
FieldValueIRS element (for citing)
Total Program Service Revenue$3,651,466TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$280TotalRevenueColumnAmt
Exclusion$280ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
OTHER900099$55,999$55,999
GIFT SHOP900099$2,222$2,222
MEALS900099$663$663
FieldValueIRS element (for citing)
Other Revenue Total$58,884OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,845,794TotalRevenueColumnAmt
Related Or Exempt Func Income$3,651,466RelatedOrExemptFuncIncomeAmt
Exclusion$59,164ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,629,911TotalAmt
Program Services$2,356,197ProgramServicesAmt
Management And General$273,714ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$421,567TotalAmt
Program Services$377,694ProgramServicesAmt
Management And General$43,873ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$270,111TotalAmt
Program Services$242,000ProgramServicesAmt
Management And General$28,111ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$19,464TotalAmt
Management And General$19,464ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$336,508TotalAmt
Program Services$247,803ProgramServicesAmt
Management And General$88,705ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$29,892TotalAmt
Program Services$1,117ProgramServicesAmt
Management And General$28,775ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$63,713TotalAmt
Program Services$25,686ProgramServicesAmt
Management And General$38,027ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$40,650TotalAmt
Program Services$40,650ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$103,045TotalAmt
Program Services$100,898ProgramServicesAmt
Management And General$2,147ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$5,678TotalAmt
Program Services$5,508ProgramServicesAmt
Management And General$170ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$19,718TotalAmt
Program Services$9,333ProgramServicesAmt
Management And General$10,385ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$60,674TotalAmt
Program Services$59,382ProgramServicesAmt
Management And General$1,292ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$278,132TotalAmt
Program Services$272,298ProgramServicesAmt
Management And General$5,834ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$63,030TotalAmt
Program Services$63,030ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DIETARY SUPPLIES$149,972$149,972
MEDICAL SUPPLIES & DRUGS$99,547$99,547
REPAIRS & MAINTENANCE$57,244$56,104$1,140

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$169,129TotalAmt
Program Services$154,335ProgramServicesAmt
Management And General$14,794ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,817,985TotalAmt
Program Services$4,261,554ProgramServicesAmt
Management And General$556,431ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$152,472BOYAmt
EOY$430,168EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,130,572BOYAmt
EOY$539,111EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$188,081BOYAmt
EOY$230,484EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$81,936EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,823,282LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,930,835LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,056,499BOYAmt
EOY$3,892,447EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,527,624BOYAmt
EOY$5,174,146EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$408,847BOYAmt
EOY$407,980EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$469,895BOYAmt
EOY$96,550EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$6,641BOYAmt
EOY$4,966EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,925,428BOYAmt
EOY$1,920,028EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,810,811BOYAmt
EOY$2,429,524EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,716,813BOYAmt
EOY$2,744,622EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,716,813BOYAmt
EOY$2,744,622EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,527,624BOYAmt
EOY$5,174,146EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$27,809ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$174,444CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$841,760CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$660,092CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$146,750CurrentTaxYearMinus1YearAmt
Current Tax Year$1,135,164CurrentTaxYearAmt
Total$2,958,210TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,440,387CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,230,987CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,870,254CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,596,592CurrentTaxYearMinus1YearAmt
Current Tax Year$3,651,466CurrentTaxYearAmt
Total$21,789,686TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,614,831CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,072,747CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,530,346CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,743,342CurrentTaxYearMinus1YearAmt
Current Tax Year$4,786,630CurrentTaxYearAmt
Total$24,747,896TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,279,200CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,480,809CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,257,131CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,656,436CurrentTaxYearMinus1YearAmt
Current Tax Year$1,360,902CurrentTaxYearAmt
Total$7,034,478TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,279,200CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,480,809CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,257,131CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,656,436CurrentTaxYearMinus1YearAmt
Current Tax Year$1,360,902CurrentTaxYearAmt
Total$7,034,478TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$17,713,418PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$64CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$72CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$89CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,566CurrentTaxYearMinus1YearAmt
Current Tax Year$280CurrentTaxYearAmt
Total$2,071TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$64CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$72CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$89CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,566CurrentTaxYearMinus1YearAmt
Current Tax Year$280CurrentTaxYearAmt
Total$2,071TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,216CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$55,672CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,527CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$35,466CurrentTaxYearMinus1YearAmt
Current Tax Year$58,884CurrentTaxYearAmt
Total$171,765TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,628,111CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,128,491CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,538,962CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,780,374CurrentTaxYearMinus1YearAmt
Current Tax Year$4,845,794CurrentTaxYearAmt
Total$24,921,732TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.71080PublicSupportCY509Pct
Public Support PY5090.74660PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART III, LINE 12FormAndLineReferenceDesc
ExplanationMEAL INCOME 25,220 GIFT SHOP REVENUE 11,876 OTHER REVENUE 134,669ExplanationTxt

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

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,177OtherCostOrOtherBasisAmt
Book Value$13,177BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,233,402OtherCostOrOtherBasisAmt
Depreciation$1,496,644DepreciationAmt
Book Value$3,736,758BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$569,503OtherCostOrOtherBasisAmt
Depreciation$434,191DepreciationAmt
Book Value$135,312BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,200OtherCostOrOtherBasisAmt
Book Value$7,200BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,892,447TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART IV, LINE 2BARRANGEMENT FOR CUSTODIAL ACCOUNT LIABILITY: HILLCREST ACTS AS CUSTODIAN FOR THE FUNDS OF THE NURSING FACILITY RESIDENTS. THESE FUNDS ARE INCLUDED IN CASH AND CASH EQUIVALENTS AND ACCOUNTS PAYABLE IN THE BALANCE SHEET. RESIDENT TRUST TOTALED 5,065 AT DECEMBER 2021.
SCHEDULE D, PAGE 3, PART XHILLCREST IS A COLORADO NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3).

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
JOHN HART
CEO$218,000$6,286$1,914$226,200
TOBY STULTS
CFO$138,691$4,332$12,344$155,367
JENNIFER KRAMER
CMO$162,916$5,195$13,853$181,964

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PAGE 1, PART I, LINE 3FormAndLineReferenceDesc
ExplanationCOMPENSATION IS PAID BY A RELATED ORGANIZATION. THE SHARED BOARD OF WRAY DISTRICT HOSPITAL AND WRAY COMMUNITY LONT TERM CARE REVIEWS COMPARATIVE DATA FROM SIMILAR ORGANIZATIONS BEFORE APPROVING THE COMPENSATION OF THE CEO AND ADMINISTRATOR. THIS PROCESS AND DECISION REACHED ARE DOCUMENTED IN THE BOARD MINUTES AND PERSONNEL FILES.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 6FOR FORM 990 PURPOSES, WRAY COMMUNITY HOSPITAL DISTRICT IS A MEMBER OF WRAY COMMUNITY LONG TERM CARE. WRAY COMMUNITY HOSPITAL DISTRICT'S BOARD OF DIRECTORS SERVE AS THE GOVERNING BODY OF WRAY COMMUNITY LONG TERM CARE.
FORM 990, PAGE 6, PART VI, LINE 7AAT ALL TIMES, THE MEMBERS OF THE BOARD OF DIRECTORS SHALL HOLD OFFICE FOR A TERM CONCURRENT WITH THEIR TERM ON THE BOARD OF WRAY COMMUNITY HOSPITAL DISTRICT.
FORM 990, PAGE 6, PART VI, LINE 11BA COPY OF THE 990 IS PROVIDED TO THE CEO, CFO, AND ADMINISTRATOR WHO REVIEW THE FORM, SCHEDULES, AND RELATED ATTACHEMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS THEN APPROVED BY THE BOARD. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12CTO PROTECT THE IMPARTIAL DECISION MAKING AND REPUTATION OF BOTH THE ORGANIZATION AND THOSE INVOLVED WITH IT, TRANSACTIONS WITH RELATED PARTIES WHERE A POTENTIAL CONFLICT OF INTERESTS EXISTS OR MAY APPEAR TO EXIST ARE REVIEWED BY THE CFO. IF A CONFLICT IS DEEMED TO EXIST, THE INDIVIDUAL WILL RECUSE THEMSELVES FROM VOTING OR DISCUSSING THOSE PARTICULAR MATTERS.
FORM 990, PAGE 6, PART VI, LINE 15ATHE SHARED BOARD OF WRAY DISTRICT HOSPITAL AND WRAY COMMUNITY LONG TERM CARE REVIEW COMPARATIVE DATA FROM SIMILAR ORGANIZATIONS BEFORE APPROVING THE COMPENSATION OF THE CEO AND ADMINISTRATOR. THIS PROCESS AND DECISION REACHED ARE DOCUMENTED IN THE BOARD MINUTES AND PERSONNEL FILES.
FORM 990, PAGE 6, PART VI, LINE 15BSEE IRS FORM 990, PART VI, LINE 15A.
FORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION MAKES IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1WRAY COMMUNITY DISTRICT HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11017 WEST 7TH STREETAddressLine1Txt
CityWRAYCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80758ZIPCd
FieldValueIRS element (for citing)
EIN840370617EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateCOLegalDomicileStateCd
Exempt Code SectionGOVExemptCodeSectionTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1WRAY COMMUNITY DISTRICT HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeOTransactionTypeTxt
Involved$519,607InvolvedAmt
Method Of Amount DeterminationGAAPMethodOfAmountDeterminationTxt

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