2017-01-23T09:16:39-06:00 2016-06-30 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2015-07-01 450408291 Richardton Health Center Inc RICH 7019743304 PO Box H Richardton ND 586520908 Marilyn Rippy CEO/DON 7019743304 2017-01-17 1 LISA CHAFFEE CPA P00193453 7012398500 2017-01-17 2015 2021-01-29 14:40:06Z Marilyn Rippy PO Box H Richardton ND 586520908 2412216 0 X N/A X 1969 ND Building relationships to improve the health and quality of life of those we serve. 7 6 67 7 0 0 269734 787392 2170368 1996728 2 28 19273 -371932 2459377 2412216 76 176 0 0 1400835 1210320 0 0 0 922131 1136959 2323042 2347455 136335 64761 2524636 7670830 224906 5783360 2299730 1887470 Building relationships to improve the health and quality of life of those we serve. 0 0 2041582 176 1996728 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. 2041582 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 1 0 0 0 0 0 0 0 0 0 0 1 10 0 1 67 1 0 0 0 0 0 0 0 0 0 0 X 7 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 Donna Reich Secretary 1.00 X X 0 0 0 Roberta Fandrich Director 0.50 X 0 0 0 Kathy Hueske Director 0.50 X 0 0 0 Steve Maershbecker Director 0.50 X 0 0 0 Bob Brummond Administrator (5/1/15-7/31/15) 40.00 X 0 0 0 Marilyn Rippy Administrator (8/24/15 to present) 40.00 X 0 0 0 0 0 0 0 0 0 0 Health Management Services 1001 S 24th St W 311 Billings MT 59102 Management Fees 134507 Dakota Travel Nurse 1200 Collins Ave Mandan ND 58554 Contracted Nursing 132137 ReadyLink PO Box 1047 Thousand Palms CA 92276 Contracted Nursing 105493 3 147404 639988 787392 Patient Service Revenue 621400 1985439 1985439 Other Revenue 900099 11289 11289 1996728 28 28 Auxiliary Revenue 900099 336 336 Loss on Impairment 900099 -372268 -372268 -371932 2412216 1996728 0 -371904 X 176 176 31814 31814 984568 858290 126278 118638 103898 14740 75300 65945 9355 110205 110205 576 576 20500 20500 444681 444681 4954 119 4835 77098 74529 2569 31284 31284 79000 67000 12000 55773 55773 3029 3029 2580 2580 127309 127309 21179 21179 Medical Supplies 132997 132997 Maintenance and Repairs 8724 8724 Dues/Subscriptions 3397 3397 Auxiliary Expense 2312 2312 11361 6546 4815 2347455 2041582 305873 0 102634 162273 171574 193386 25784 25429 35602 38222 8529851 1546331 1442045 6983520 478997 268000 268000 2524636 7670830 149177 483156 4671 2773 71058 5297431 224906 5783360 X 1820733 1887470 478997 0 2299730 1887470 2524636 7670830 X 64761 -477021 X 0 1 X 1 1 1 X 573823 439362 529764 269734 787392 2600075 1582541 1855294 2140478 2170368 1996728 9745409 2156364 2294656 2670242 2440102 2784120 12345484 0 903580 892644 1028140 1269051 875913 4969328 903580 892644 1028140 1269051 875913 4969328 7376156 117 14 14 2 28 175 117 14 14 2 28 175 36000 16576 96037 19273 167886 2192481 2311246 2766293 2459377 2784148 12513545 0.58950 0.55940 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 3201 336 2312 1225 1 X 1159459 830058 329401 804064 668876 135188 6566328 47397 6518931 6983520 X 2784148 0 2784148 -371932 -371932 2412216 2717411 372268 372268 2345143 2312 2312 2347455 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 $2,773 at June 30, 2016. 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 4b - Other Adjustments: Auxiliary Revenue 336. Loss on Impairment of Property -372,268. Part XII, Line 2d - Other Adjustments: Loss on Impairment of Property in Expenses for Financial Statements 372,268. Part XII, Line 4b - Other Adjustments: Auxiliary Expenses 2,312. Laura Leingang Sister of Donna Reich (Board Member) 31814 Compensation & benefits 0 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 $5,419 for Bob Brummond in salary; Administrator compensation was $17,419 in salary and $961 in other benefits for Marilyn Rippy for the year ended June 30, 2016. 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 11 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 444,681. Management and general expenses 0. Fundraising expenses 0. Total expenses 444,681. Form 990, Part XI, line 9: Change in Auxiliary Assets 1,976. Change in interest in net assets of Richardton Healthcare Foundation -478,997.