2017-11-08T10:27:56-06:00 2017-06-30 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2016-07-01 450408291 Richardton Health Center Inc RICH 7019743304 8885 Highway 10 Richardton ND 58652 Marilyn Rippy Administrator 7019743304 2017-11-06 1 LISA CHAFFEE CPA P00193453 7012398500 2017-11-06 199.116.173.12 2017-11-06 11:16:28 CS P 66CC91E6B7F11C4783FFFA5645E675327CB67316 385FD7544B689D76E9DA9F221308BA92DD4DD75D 2016 2018-03-14 21:41:22Z X Marilyn Rippy 8885 Highway 10 Richardton ND 58652 3071802 0 X N/A X 1969 ND Building relationships to improve the health and quality of life of those we serve. 6 6 56 8 0 0 787392 398587 1996728 2765350 28 16 -371932 -92151 2412216 3071802 176 120 0 0 1210320 1320586 0 0 0 1136959 1922794 2347455 3243500 64761 -171698 7670830 7287961 5783360 5572481 1887470 1715480 Building relationships to improve the health and quality of life of those we serve. 0 0 2843203 120 2772255 Richardton Health Center provides high quality clinic healthcare and skilled nursing care services to Richardton and the surrounding area. This includes respite care, acute inpatient care, cardiac rehab, restorative therapy, PT, OT, ST, a free standing rural health clinic, and long-term care facilities. 2843203 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16 0 1 56 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X Marilyn Rippy 7019743304 PO Box H Richardton ND 58652 X Clare Messmer President 1.00 X X 0 0 0 Michael Taffe OSB Vice President 1.00 X X 0 0 0 Vickie Solemsaas Treasurer 1.00 X X 0 0 0 Roberta Fandrich Secretary 1.00 X X 0 0 0 Kathy Hueske Director 0.50 X 0 0 0 Steve Maershbecker Director 0.50 X 0 0 0 Marilyn Rippy Administrator 40.00 X 0 0 0 0 0 0 0 0 0 0 Dakota Travel Nurse 1200 Collins Ave Mandan ND 58554 Contracted Nursing 382161 Health Management Services 1001 S 24th St W 311 Billings MT 59102 Management Fees 144504 Prime Time Healthcare PO Box 3544 Omaha NE 681030544 Contracted Nursing 122334 3 86277 312310 398587 Patient Service Revenu 621400 2756391 2756391 Other Revenue 900099 8959 8959 2765350 16 16 Debt Forgiveness 900009 6905 6905 Auxiliary Revenue 900099 944 944 Loss on Impairment 900009 -100000 -100000 -92151 3071802 2772255 0 -99040 X 120 120 1090223 958464 131759 150141 131996 18145 80222 70527 9695 139376 139376 538 538 27151 27151 548649 548649 2290 106 2184 87583 84645 2938 28821 28821 94788 82788 12000 64626 64626 2851 2851 188409 188409 456019 456019 34189 34189 Medical Supplies 169960 169960 Maintenance and Repairs 4724 4724 Dues/Subscriptions 3411 3411 Auxiliary Expense 652 652 68757 12246 56511 3243500 2843203 400297 0 162273 219528 193386 219121 25429 27192 38222 18703 8141016 1805599 6983520 6335417 268000 468000 7670830 7287961 483156 218808 2773 9940 5297431 5343733 5783360 5572481 X 1887470 1715480 1887470 1715480 7670830 7287961 X -171698 -292 X 0 1 X 1 0 X 439362 529764 269734 787392 398587 2424839 1855294 2140478 2170368 1996728 2765350 10928218 2294656 2670242 2440102 2784120 3163937 13353057 0 892644 1028140 1269051 875913 1293781 5359529 892644 1028140 1269051 875913 1293781 5359529 7993528 14 14 2 28 16 74 14 14 2 28 16 74 16576 96037 19273 336 944 133166 2311246 2766293 2459377 2784484 3164897 13486297 0.59270 0.58950 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1225 944 652 1517 1 X 6143719 954809 5188910 1133595 732527 401068 863702 118263 745439 6335417 Bed Licenses 268000 Assets Held For Resale 200000 468000 X 3050445 -20413 -20413 3070858 944 944 3071802 3222435 -20413 -20413 3242848 652 652 3243500 Part IV, Line 1b: Richardton Health Center Auxiliary is operating under the EIN of Richardton Health Center, however, the financial statements are not included in the audited financial statements of Richardton Health Center. Part IV, Line 2b: Richardton Health Center acts as custodian for the funds of the nursing facility residents. These funds are included in cash and accounts payable in the financial statements. Resident trust funds totaled $9,940 at June 30, 2017. Part X, Line 2: The Health Center is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Health Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Health Center is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Health Center has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Health Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Health Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Expenses related to assets held for resale -20,413. Part XI, Line 4b - Other Adjustments: Auxiliary Revenue 944. Part XII, Line 2d - Other Adjustments: Expenses related to assets held for resale -20,413. Part XII, Line 4b - Other Adjustments: Auxiliary Expenses 652. Form 990, Part VI, Section A, line 3 The Health Center has engaged Health Management Services (HMS) to provide management and administrative services. Administrative and management services include administrator compensation, along with other management and support service fees. Expenses recognized in relation to this agreement for Part VII: Administrator compensation was $33,925 and $1,122 in other benefits for Marilyn Rippy for the year ended June 30, 2017. Form 990, Part VI, Section A, line 8b There are no committees authorized to act on behalf of the governing board. Form 990, Part VI, Section B, line 11b The Administrator and Board of Directors reviewed the Form 990 prior to the filing of the return. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers the board, employees and contractors alike. The Administrator reviews and determines if conflicts exist with employees and contractors. The board reviews and determines if conflicts exist with a board member. The board is responsible for monitoring its members and the board in regards to this policy. If needed, they will seek legal consultation. If a conflict is determined that individual will abstain from voting. Form 990, Part VI, Section B, line 15 In December 2011 the Organization contracted an unrelated management company, HMS, to provide the Administrator management services. HMS set the Administrator compensation based on comparability data. The Board reviews and approves the contract with HMS. Form 990, Part VI, Section C, line 19 The governing documents and conflict of interest policy are available to the public upon request. Form 990, Part IX, line 11g Contracted Services: Program service expenses 548,349. Management and general expenses 0. Fundraising expenses 0. Total expenses 548,349. Mainenance Monitoring Contract: Program service expenses 300. Management and general expenses 0. Fundraising expenses 0. Total expenses 300. Form 990, Part XI, line 9: Change in Auxiliary Assets -292.