2020-10-02T16:02:45-05:00 2019-12-31 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2019-01-01 463225995 WRAY COMMUNITY LONG TERM CARE INC % TOBY STULTS WRAY 9703324856 360 CANYON RIDGE DRIVE WRAY CO 80758 JOHN HART CEO 9703324811 2020-09-29 true Adam R Smith CPA P00958966 7194714290 167.68.126.162 84022720202765000000 2020-10-02 P 26C3A9CF11B26F9C2D280370FFBE8B4C03C04303 2CA45E37415201352F759B3DAE2F163B407DB0E3 2019 2021-01-29 14:40:06Z HILLCREST CARE CENTER JOHN HART 1017 W 7TH ST WRAY CO 80758 5538962 false X WWW.HILLCRESTCARE.ORG X 2013 CO HILLCREST CARE CENTER PROMOTES AN ELDER-CENTERED CARE COMMUNITY WHERE RESIDENTS FEEL LOVED, SECURE AND CONTENT WHILE MAINTAINING INDEPENDENCE AND CHOICE IN DAILY LIFE. 5 5 125 35 0 841760 660092 4220530 4870254 72 -1045 66129 8527 5128491 5537828 0 0 0 0 3204296 3085132 0 0 0 2014557 2320952 5218853 5406084 -90362 131744 5108096 4881735 2637042 2278937 2471054 2602798 X TO PROMOTE HEALTHIER SENIOR LIVING THROUGH COMPASSIONATE, QUALITY, PERSON-DIRECTED CARE...FAMILY CARE WITH A FAMILY TOUCH. false true 5032056 4870254 WRAY 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. 5032056 true true false false false false false false true false true false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 7 0 true 125 true false false false false false false false false false false false false X 5 5 false false false false true true false true true false false true true false true true true false false false X TOBY STULTS 9703324811 1017 W 7TH ST WRAY CO 80758 JOHN S HART CEO 1.0 39.0 X 0 177787 1913 JENNIFER S KRAMER CCO 1.0 39.0 X 0 136288 17458 TOBY D STULTS CFO 1.0 39.0 X 0 122235 14313 GINGER M WILLIAMS ADMINISTRATOR 40.0 0.0 X 90839 0 35 BRYAN BECKNER CHAIR 1.0 1.0 X X 0 0 0 CRAIG SOEHNER VICE CHAIR 1.0 1.0 X X 0 0 0 REBECCA LENZ SECRETARY/TREASURER 1.0 1.0 X X 0 0 0 DUSTIN DUNN DC MEMBER 1.0 1.0 X 0 0 0 PHILIP RIGGLEMAN MEMBER 1.0 1.0 X 0 0 0 90839 436310 33719 1 false true false BKD LLP 910 E St Louis St Ste 200 SPRINGFIELD MH 65801 Billing & Support 104844 Prime Time Healthcare LLC PO Box 3544 OMAHA NE 68103 Contract Nursing 263831 STAT Staffing LLC PO Box 45 OSHKOSH NE 69154 Contract Nursing 188746 Trustaff Travel Nurses PO Box 63-8231 CINCINNATI OH 45263 Contract Nursing 188094 4 653997 6095 660092 Hillcrest Resident Revenue 623000 3851390 3851390 Towers Resident Revenue 623000 667727 667727 Provider Fee 900099 343650 343650 OTHER PROGRAM REVENUE 900099 7487 7487 4870254 89 89 0 0 0 0 0 1134 -1134 -1134 -1134 0 0 0 0 0 0 0 0 0 Meal Income 900099 6192 6192 Gift Shop Revenue 900099 2310 2310 MISCELLANEOUS INCOME 900099 25 25 8527 5537828 4870254 7482 X 0 0 0 0 90874 90874 0 2403167 2309921 93246 0 390278 390278 200813 200813 0 0 26159 26159 0 0 0 888931 825921 63010 9383 9383 71072 71072 0 0 138578 138578 6957 5022 1935 0 8788 1448 7340 64427 64427 0 307872 307872 153908 153908 Medical Supplies 353540 353385 155 Food Supplies 201980 201980 Repair & Maintenance 14823 14823 Other - less than 5% of total 74534 63680 10854 0 5406084 5032056 374028 0 145183 334877 43541 52466 0 0 377580 261857 0 0 0 0 0 0 0 0 0 0 5613908 1381373 4541792 4232535 0 0 0 0 0 0 0 0 0 0 5108096 4881735 589769 304657 0 0 0 0 0 0 3064 3724 0 0 2044209 1970556 0 0 0 0 2637042 2278937 X 0 0 0 0 2471054 2602798 2471054 2602798 5108096 4881735 131744 X false true X true false X 31653 1586876 174444 841760 660092 3294825 4627605 4640075 4440387 4230987 4870254 22809308 0 0 0 4659258 6226951 4614831 5072747 5530346 26104133 0 1615018 866488 1279200 1480809 1257131 6498646 1615018 866488 1279200 1480809 1257131 6498646 19605487 20 30 64 72 89 275 0 20 30 64 72 89 275 0 13062 13216 55672 8527 90477 4659278 6240043 4628111 5128491 5538962 26194885 0.74845 0.76200 0.00001 0.00002 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true 13177 13177 5126523 1012835 4113688 474208 368538 105670 4232535 SCHEDULE D, PART IV, LINE 2B ARRANGEMENT 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 $34,199.12 JAN-DEC 2019. SCHEDULE D, PART X, LINE 2 Uncertain Tax Position: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X false false false false false false false false false JOHN S HART CEO 0 177787 0 0 0 0 0 0 0 1913 0 179700 JENNIFER S KRAMER CCO 0 136288 0 0 0 0 0 4717 0 12741 0 153746 Schedule J, Part I, Line 3 Compensation 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. FORM 990, PART III, LINE 3 CHANGES IN PROGRAM SERVICES: WE REDUCED THE NUMBER OF SNF BEDS FROM 58 TO 45. WE NO LONGER PROVIDE SECURED MEMORY CARE SERVICES, ALLOWING US TO SERVE THE LARGER COMMUNITY AT A GREATER CAPACITY BASED ON COMMUNITY NEEDS DATA. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS AND MEMBER RIGHTS: FOR 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, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND ADMINISTRATOR BEFORE BEING PRESENTED TO THE BOARD FOR REVIEW AND THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY PROCESS: TO 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 AN ADMINISTRATOR, THE CFO. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC: THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION B, LINES 15A & 15B REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION: 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. FORM 990 PART IX LINE 11G DESCRIPTION:NURSING SERVICES TOTAL FEES:651535 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL CONSULTANTS TOTAL FEES:63010 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL SERVICES TOTAL FEES:48662 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICARE BILLING SERVICES TOTAL FEES:100320 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL DIRECTOR SERVICES TOTAL FEES:25404 WRAY COMMUNITY DISTRICT HOSPITAL 1017 WEST 7TH STREET WRAY CO 80758 463225995 HOSPITAL CO 501(A) NA false false false true false false false false false false false false false true true true true false false true