WRAY COMMUNITY DISTRICT HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
WRAY COMMUNITY DISTRICT HOSPITAL (EIN 46-3225995)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-09-07
IRS object ID
202142509349300144
Schema version
2020v4.0
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)
Return2021-09-07T12:20:50-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

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 Begin2020-01-01TaxPeriodBeginDt

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
Signature2021-08-31SignatureDt
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
Preparation2021-09-07PreparationDt
FieldValueIRS element (for citing)
Tax2020TaxYr
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$4,780,374GrossReceiptsAmt
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 Employee113TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$660,092PYContributionsGrantsAmt
CY Contributions Grants$146,750CYContributionsGrantsAmt
PY Program Service Revenue$4,870,254PYProgramServiceRevenueAmt
CY Program Service Revenue$4,596,592CYProgramServiceRevenueAmt
PY Investment Income-$1,045PYInvestmentIncomeAmt
CY Investment Income$1,566CYInvestmentIncomeAmt
PY Other Revenue$8,527PYOtherRevenueAmt
CY Other Revenue$35,466CYOtherRevenueAmt
PY Total Revenue$5,537,828PYTotalRevenueAmt
CY Total Revenue$4,780,374CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,085,132PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,299,740CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,320,952PYOtherExpensesAmt
CY Other Expenses$1,893,876CYOtherExpensesAmt
PY Total Expenses$5,406,084PYTotalExpensesAmt
CY Total Expenses$5,193,616CYTotalExpensesAmt
PY Revenues Less Expenses$131,744PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$413,242CYRevenuesLessExpensesAmt
Total Assets BOY$4,881,735TotalAssetsBOYAmt
Total Assets EOY$5,527,624TotalAssetsEOYAmt
Total Liabilities BOY$2,278,937TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,810,811TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,602,798NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,716,813NetAssetsOrFundBalancesEOYAmt
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$4,623,311ExpenseAmt
Revenue$4,596,592RevenueAmt
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 79 RESIDENTS AND PROVIDED 18,851 DAYS OF RESIDENT SERVICES TO AGING ADULTS DURING THE YEAR.Desc
Total Program Service Expenses$4,623,311TotalProgramServiceExpensesAmt
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 Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee113EmployeeCnt
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 EmployeeKeyEmployeeInd
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$175,445$4,89039.00
TOBY STULTS
CFO1.00Yes (X)$0$120,384$13,29839.00
JENNIFER KRAMER
CMO1.00$0$151,332$14,16439.00Yes (X)
GINGER WILLIAMS
ADMINISTRATO40.00Yes (X)$105,671$0$00.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$105,671TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$447,161TotReportableCompRltdOrgAmt
Total Other Compensation$32,352TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PRIME TIME HEALTHCAREBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3544AddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP68103ZIPCd
FieldValueIRS element (for citing)
ServicesNURSINGServicesDesc
Compensation$429,386CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$4,557RelatedOrganizationsAmt
Government Grants$27,415GovernmentGrantsAmt
All Other Contributions$114,778AllOtherContributionsAmt
Total Contributions$146,750TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET RESIDENT SERVICE REVENUE623000$4,592,143$4,592,143
OTHER PROGRAM REVENUE623000$4,449$4,449
FieldValueIRS element (for citing)
Total Program Service Revenue$4,596,592TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,566TotalRevenueColumnAmt
Exclusion$1,566ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
OTHER900099$32,505$32,505
GIFT SHOP900099$1,531$1,531
MEALS900099$1,430$1,430
FieldValueIRS element (for citing)
Other Revenue Total$35,466OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,780,374TotalRevenueColumnAmt
Related Or Exempt Func Income$4,596,592RelatedOrExemptFuncIncomeAmt
Exclusion$37,032ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$105,671TotalAmt
Management And General$105,671ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,517,978TotalAmt
Program Services$2,378,847ProgramServicesAmt
Management And General$139,131ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$401,996TotalAmt
Program Services$364,520ProgramServicesAmt
Management And General$37,476ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$274,095TotalAmt
Program Services$248,542ProgramServicesAmt
Management And General$25,553ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,276TotalAmt
Management And General$23,276ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$722,041TotalAmt
Program Services$579,922ProgramServicesAmt
Management And General$142,119ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,301TotalAmt
Program Services$1,264ProgramServicesAmt
Management And General$22,037ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$78,030TotalAmt
Program Services$38,468ProgramServicesAmt
Management And General$39,562ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$35,242TotalAmt
Program Services$35,242ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$95,201TotalAmt
Program Services$93,217ProgramServicesAmt
Management And General$1,984ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,639TotalAmt
Program Services$3,550ProgramServicesAmt
Management And General$89ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$12,731TotalAmt
Program Services$2,432ProgramServicesAmt
Management And General$10,299ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$63,587TotalAmt
Program Services$62,233ProgramServicesAmt
Management And General$1,354ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$271,331TotalAmt
Program Services$265,773ProgramServicesAmt
Management And General$5,558ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$74,496TotalAmt
Program Services$74,496ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DIETARY SUPPLIES$168,827$168,827
MEDICAL SUPPLIES & DRUGS$134,115$134,115
REPAIRS & MAINTENANCE$24,003$23,523$480

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$164,056TotalAmt
Program Services$148,340ProgramServicesAmt
Management And General$15,716ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,193,616TotalAmt
Program Services$4,623,311ProgramServicesAmt
Management And General$570,305ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$334,877BOYAmt
EOY$152,472EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$52,466BOYAmt
EOY$1,130,572EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$261,857BOYAmt
EOY$188,081EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,709,203LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,652,704LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,232,535BOYAmt
EOY$4,056,499EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,881,735BOYAmt
EOY$5,527,624EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$304,657BOYAmt
EOY$408,847EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$469,895EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$3,724BOYAmt
EOY$6,641EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,970,556BOYAmt
EOY$1,925,428EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,278,937BOYAmt
EOY$2,810,811EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,602,798BOYAmt
EOY$2,716,813EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,602,798BOYAmt
EOY$2,716,813EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,881,735BOYAmt
EOY$5,527,624EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$413,242ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$527,257NetUnrlzdGainsLossesInvstAmt
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 RequiredfalseFederalGrantAuditRequiredInd

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$1,586,876CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$174,444CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$841,760CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$660,092CurrentTaxYearMinus1YearAmt
Current Tax Year$146,750CurrentTaxYearAmt
Total$3,409,922TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,640,075CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,440,387CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,230,987CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,870,254CurrentTaxYearMinus1YearAmt
Current Tax Year$4,596,592CurrentTaxYearAmt
Total$22,778,295TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,226,951CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,614,831CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,072,747CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,530,346CurrentTaxYearMinus1YearAmt
Current Tax Year$4,743,342CurrentTaxYearAmt
Total$26,188,217TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$866,488CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,279,200CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,480,809CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,257,131CurrentTaxYearMinus1YearAmt
Current Tax Year$1,656,436CurrentTaxYearAmt
Total$6,540,064TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$866,488CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,279,200CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,480,809CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,257,131CurrentTaxYearMinus1YearAmt
Current Tax Year$1,656,436CurrentTaxYearAmt
Total$6,540,064TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$19,648,153PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$64CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$72CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$89CurrentTaxYearMinus1YearAmt
Current Tax Year$1,566CurrentTaxYearAmt
Total$1,821TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$64CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$72CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$89CurrentTaxYearMinus1YearAmt
Current Tax Year$1,566CurrentTaxYearAmt
Total$1,821TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,062CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,216CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$55,672CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,527CurrentTaxYearMinus1YearAmt
Current Tax Year$35,466CurrentTaxYearAmt
Total$125,943TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,240,043CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,628,111CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,128,491CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,538,962CurrentTaxYearMinus1YearAmt
Current Tax Year$4,780,374CurrentTaxYearAmt
Total$26,315,981TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.74660PublicSupportCY509Pct
Public Support PY5090.74840PublicSupportPY509Pct
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 33,000 GIFT SHOP REVENUE 14,273 OTHER REVENUE 78,670ExplanationTxt

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$5,126,523OtherCostOrOtherBasisAmt
Depreciation$1,253,606DepreciationAmt
Book Value$3,872,917BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$569,503OtherCostOrOtherBasisAmt
Depreciation$399,098DepreciationAmt
Book Value$170,405BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,056,499TotalBookValueLandBuildingsAmt
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 6,897 AT DECEMBER 2020.
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 (2 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
JOHN HART
CEO$175,445$4,597$293$180,335
JENNIFER KRAMER
CMO$151,332$4,571$9,593$165,496

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 LONG 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 (8 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.
FORM 990, PART IX, LINE 11GNURSING SERVICES 459,802 0 0 PROFESSIONAL CONSULTANTS 11,997 7,424 0 MEDICARE BILLING SERVICES 0 70,925 0 MEDICAL DIRECTOR SERVICES 20,004 0 0 OTHER PROFESSIONAL SERVICES 88,119 63,770 0 TOTAL 579,922 142,119 0

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$447,161InvolvedAmt
Method Of Amount DeterminationGAAPMethodOfAmountDeterminationTxt

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