WEST RIVER HEALTH SERVICES: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- WEST RIVER HEALTH SERVICES (EIN 45-0340688)
- Tax period
- 2014-04-01 to 2015-03-31
- Filed
- 2016-02-15
- IRS object ID
- 201620469349301532
- Schema version
- 2014v6.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-02-15T11:07:04-06:00 | ReturnTs |
| Tax Period End | 2015-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 460403496 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASEY PETERSON & ASSOC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 ST JOSEPH ST SUITE 101 | AddressLine1Txt |
| City | RAPID CITY | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450340688 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST RIVER HEALTH SERVICES DBA WEST | BusinessNameLine1Txt |
| Business Name Line2 | RIVER REGIONAL MEDICAL CENTER | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WEST | BusinessNameControlTxt |
| Phone | 7015674561 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1Txt |
| City | HETTINGER | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58639 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NATHAN STADHEIM | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7015674561 | PhoneNum |
| Signature | 2016-02-15 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEIDRE BUDAHL CPA | PreparerPersonNm |
| PTIN | P01273830 | PTIN |
| Phone | 6053481930 | PhoneNum |
| Preparation | 2016-02-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM K LONG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1Txt |
| City | HETTINGER | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58639 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,286,481 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WRHS.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO THE RESIDENTS AND VISITORS OF THE REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 325 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $503,166 | PYContributionsGrantsAmt |
| CY Contributions Grants | $342,674 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,659,369 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,501,080 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,185 | PYInvestmentIncomeAmt |
| CY Investment Income | $49,333 | CYInvestmentIncomeAmt |
| PY Other Revenue | $45,995 | PYOtherRevenueAmt |
| CY Other Revenue | $48,267 | CYOtherRevenueAmt |
| PY Total Revenue | $25,212,715 | PYTotalRevenueAmt |
| CY Total Revenue | $25,941,354 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,962,676 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,971,511 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $48,740 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,282,993 | PYOtherExpensesAmt |
| CY Other Expenses | $14,721,674 | CYOtherExpensesAmt |
| PY Total Expenses | $25,245,669 | PYTotalExpensesAmt |
| CY Total Expenses | $25,693,185 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$32,954 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $248,169 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,248,275 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,350,896 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,786,365 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,596,544 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,461,910 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,754,352 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF WEST RIVER HEALTH SERVICES (WRHS) IS TO PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO THE RESIDENTS AND VISITORS OF THE REGION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $21,705,879 | ExpenseAmt |
| Revenue | $25,501,080 | RevenueAmt |
| Desc | WEST RIVER HEALTH SERVICES (WRHS) IS A NATIONALLY-RECOGNIZED RURAL HEALTH CARE DELIVERY SYSTEM INCLUDING HOSPITAL, SWING BED, SURGERY, LAB, RADIOLOGY, EMERGENCY ROOM, SEVEN CLINICS, EYE CLINIC, VISITING NURSE SERVICES, AMBULANCE SERVICE, FAMILY THERAPY, REHABILITATIVE THERAPIES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY, HOME MEDICAL EQUIPMENT STORE, AND WELLNESS/FITNESS SERVICES.IN FY 2015 WRHS PROVIDED ACUTE CARE SERVICES TO 787 PATIENTS FOR A TOTAL OF 3,025 DAYS OF CARE. SWING BED SERVICES WERE PROVIDED TO 67 PATIENTS FOR A TOTAL OF 724 DAYS OF CARE. IN ADDITION, 568 DAYS OF OBSERVATION CARE WERE PROVIDED. THERE WERE 1,733 EMERGENCY ROOM VISITS DURING THE YEAR. THERE WERE 68 BABIES BORN DURING THE YEAR WITH A TOTAL OF 161 DAYS OF CARE PROVIDED. THERE WERE A TOTAL OF 925 SURGICAL CASES DURING THE YEAR, WITH 785 OF THOSE BEING DONE ON AN OUTPATIENT BASIS. THE AMBULANCE CREW MADE 314 AMBULANCE RUNS/TRANSFERS THROUGHOUT THE YEAR. THERE WERE 45,395 CLINIC ENCOUNTERS TO THE SEVEN CLINICS. ANCILLARY SERVICES WERE PROVIDED AS FOLLOWS: 197,539 LAB TESTS; 10,421 RADIOLOGY TESTS; 9,497 RESPIRATORY THERAPY PROCEDURES; 33,314 MEALS TO PATIENTS, VISITORS, AND EMPLOYEES. THROUGHOUT THE YEAR THERE WERE 1,768 RHC NURSE VISITS.IT IS THE POLICY OF THE WRHS TO PROVIDE QUALITY HEALTH CARE SERVICES TO ALL PATIENTS IN THE REGION REGARDLESSS OF RACE, COLOR, CREED OR ABILITY TO PAY. TO THIS END, WRHS OFFERS FREE AND DISCOUNTED SERVICES TO PATIENTS WHO LACK ABILITY TO PAY . THE WRHS CHARITY CARE POLICY, INITIALLY APPROVED IN JUNE OF 2006, ASSURES THAT ALL ELIGIBLE PATIENTS WILL RECEIVE THE CARE THEY DESERVE WITHOUT FINANCIAL WORRY. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS HAS OVERSIGHT OF THE CHARITY CARE PROGRAM, APPROVES ELIGIBILITY CRITERIA, AND EVALUATES PROGRAM EFFECTIVENESS. THE AMOUNT OF CHARITY CARE PROVIDED IN FY '15 FOR ELIGIBLE INDIVIDUALS WAS $127,287. THIS AMOUNT REFLECTS THE AMOUNT OF CHARGES FOREGONE BASED ON ESTABLISHED RATES. | Desc |
| Total Program Service Expenses | $21,705,879 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 61 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 325 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATHAN STADHEIM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7015674561 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1Txt |
| City | HETTINGER | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58639 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GARY DEWHIRST | ||||||||
| VICE CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $230 | $0 | $0 | ||
| JONATHON EATON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $220 | $0 | $0 | |||
| HALEY EVANS | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $180 | $0 | $0 | ||
| LARRY JACKSON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $130 | $0 | $0 | |||
| CODY JORGENSON | ||||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $260 | $0 | $0 | ||
| DR JENNIFER SHEFFIELD | ||||||||
| MEDICAL STAFF LIAISON | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT PARKER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $180 | $0 | $0 | |||
| ERVIN SCHNEIDER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $110 | $0 | $0 | |||
| CLEVE TESKE | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $180 | $0 | $0 | |||
| ANTHONY LARSON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $60 | $0 | $0 | |||
| DR GERALD SAILER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $90 | $0 | $0 | |||
| TRAVIS ELLISON | ||||||||
| FORMER WRHS REPRESENTATIVE | 1.00 | Yes (X) | $110 | $0 | $0 | |||
| ERIC ANDRESS | ||||||||
| FORMER CHAIRMAN | 1.00 | Yes (X) | $120 | $0 | $0 | |||
| JIM LONG | ||||||||
| CEO | 34.00 | Yes (X) | $162,251 | $0 | $20,490 | 6.00 | ||
| NATHAN STADHEIM | ||||||||
| CFO | 32.00 | Yes (X) | $88,149 | $0 | $18,361 | 8.00 | ||
| MITCH SCHULTZ | ||||||||
| PHARMACIST | 40.00 | $127,848 | $0 | $19,010 | Yes (X) | |||
| CAROL CORNELIUS | ||||||||
| PHARMACIST | 40.00 | $114,763 | $0 | $16,727 | Yes (X) | |||
| TERESA NIELSEN | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | $102,197 | $0 | $17,256 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $597,078 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $91,844 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNITED CLINICS PHYSICIANS PC | |||||
| 110 HWY 12 | HETTINGER | ND | 58639 | PHYSICIAN SERVICES | $4,453,201 |
| ALLSTAR RECRUITING LOCUM | |||||
| PO BOX 823424 | PHILADEPHIA | PA | 191823424 | PHYSICIAN SERVICES | $384,357 |
| DR MARK KRISTY | |||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | PROFESSIONAL RADIOLOGY SERVICES | $360,652 |
| ABBOTT LABORATORIES INC | |||||
| PO BOX 96279 | CHICAGO | IL | 606752679 | EQUIPMENT AND EQUIPMENT SERVICE | $310,734 |
| MTX MEDICAL SOLUTIONS INC | |||||
| PO BOX 20403 | BILLINGS | MT | 59104 | INSTALLATION OF X-RAY EQUIPMENT | $289,418 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $25,748 | RelatedOrganizationsAmt |
| All Other Contributions | $316,926 | AllOtherContributionsAmt |
| Total Contributions | $342,674 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $24,796,501 | $24,796,501 |
| AFFILIATION SUPPORT | 900099 | $315,000 | $315,000 |
| OTHER | 900099 | $198,532 | $198,532 |
| CAFETERIA | 722210 | $98,947 | $98,947 |
| ASSISTED LIVING RENT | 621610 | $92,100 | $92,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,501,080 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,455 | TotalRevenueColumnAmt |
| Exclusion | $7,455 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $50,375 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,108 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $48,267 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48,267 | TotalRevenueColumnAmt |
| Exclusion | $48,267 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $355,197 | SecuritiesAmt |
| Other | $29,700 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $342,657 | SecuritiesAmt |
| Other | $362 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,540 | SecuritiesAmt |
| Other | $29,338 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,878 | TotalRevenueColumnAmt |
| Exclusion | $41,878 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,941,354 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,501,080 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $97,600 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,251 | TotalAmt |
| Management And General | $289,251 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,602,693 | TotalAmt |
| Program Services | $6,498,299 | ProgramServicesAmt |
| Management And General | $2,055,654 | ManagementAndGeneralAmt |
| Fundraising | $48,740 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,366 | TotalAmt |
| Program Services | $252,948 | ProgramServicesAmt |
| Management And General | $57,418 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,135,553 | TotalAmt |
| Program Services | $925,476 | ProgramServicesAmt |
| Management And General | $210,077 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $633,648 | TotalAmt |
| Program Services | $516,423 | ProgramServicesAmt |
| Management And General | $117,225 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,979 | TotalAmt |
| Management And General | $3,979 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,740 | TotalAmt |
| Management And General | $45,740 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,587,560 | TotalAmt |
| Program Services | $6,415,250 | ProgramServicesAmt |
| Management And General | $172,310 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,076 | TotalAmt |
| Management And General | $81,076 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,291 | TotalAmt |
| Program Services | $48,322 | ProgramServicesAmt |
| Management And General | $10,969 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $567,031 | TotalAmt |
| Program Services | $462,130 | ProgramServicesAmt |
| Management And General | $104,901 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,188 | TotalAmt |
| Program Services | $111,517 | ProgramServicesAmt |
| Management And General | $32,671 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,174 | TotalAmt |
| Program Services | $22,525 | ProgramServicesAmt |
| Management And General | $16,649 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,778 | TotalAmt |
| Program Services | $235,778 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,527,782 | TotalAmt |
| Program Services | $1,245,142 | ProgramServicesAmt |
| Management And General | $282,640 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,329 | TotalAmt |
| Program Services | $178,160 | ProgramServicesAmt |
| Management And General | $34,169 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,257,803 | $3,142,337 | $115,466 |
| REPAIRS AND MAINTENANCE | $750,434 | $611,604 | $138,830 |
| BAD DEBTS | $613,705 | $613,705 | |
| RECRUITMENT | $330,095 | $250,452 | $79,643 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,709 | TotalAmt |
| Program Services | $175,811 | ProgramServicesAmt |
| Management And General | $89,898 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,693,185 | TotalAmt |
| Program Services | $21,705,879 | ProgramServicesAmt |
| Management And General | $3,938,566 | ManagementAndGeneralAmt |
| Fundraising | $48,740 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,682,106 | BOYAmt |
| EOY | $5,021,481 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,194,732 | BOYAmt |
| EOY | $5,756,120 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $581,419 | BOYAmt |
| EOY | $661,650 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,545 | BOYAmt |
| EOY | $236,261 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,909,028 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $20,795,886 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,717,753 | BOYAmt |
| EOY | $13,113,142 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,493,067 | BOYAmt |
| EOY | $2,551,831 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,346,653 | BOYAmt |
| EOY | $1,010,411 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,248,275 | BOYAmt |
| EOY | $28,350,896 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,060,808 | BOYAmt |
| EOY | $3,148,569 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,348 | BOYAmt |
| EOY | $30,348 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,700,042 | BOYAmt |
| EOY | $4,544,454 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $995,167 | BOYAmt |
| EOY | $873,173 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,786,365 | BOYAmt |
| EOY | $8,596,544 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,461,910 | BOYAmt |
| EOY | $19,754,352 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,461,910 | BOYAmt |
| EOY | $19,754,352 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,248,275 | BOYAmt |
| EOY | $28,350,896 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $248,169 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $44,273 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $9,584 | BeginningBalanceAmt |
| Additions During Year | $8,590 | AdditionsDuringYearAmt |
| Distributions During Year | $12,071 | DistributionsDuringYearAmt |
| Ending Balance | $6,103 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $18,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $90,113 | OtherCostOrOtherBasisAmt |
| Book Value | $108,113 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,941,458 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $17,093,431 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,835,267 | DepreciationAmt |
| Book Value | $9,199,622 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $30,107 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $13,544,841 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,564,750 | DepreciationAmt |
| Book Value | $3,010,198 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,191,078 | OtherCostOrOtherBasisAmt |
| Depreciation | $395,869 | DepreciationAmt |
| Book Value | $795,209 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,113,142 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $25,374,030 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $44,273 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$613,705 | OtherRevenueAmt |
| Revenue Not Reported | -$569,432 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,943,462 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$2,108 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$2,108 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $25,941,354 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,081,588 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,108 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,108 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,079,480 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $613,705 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $613,705 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,693,185 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | THE HOSPITAL HAS AN AUXILIARY THAT OPERATES UNDER THEIR EIN. THESE FUNDS ARE CONTROLLED BY THE AUXILIARY BOARD MEMBERS. |
| PART X, LINE 2: | WEST RIVER HEALTH SERVICES (WRHS) 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 501(C)(3). WRHS IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, WRHS IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. WRHS HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESSS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. WRHS 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. WRHS 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: | BAD DEBTS -613,705. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -2,108. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 2,108. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBTS 613,705. |
| PART XI LINE 2D | BAD DEBTS ARE NETTED AGAINST REVENUE FOR FINANCIAL STATEMENT PURPOSES, HOWEVER, THEY ARE INCLUDED IN THE FUNCTIONAL EXPENSES FOR THE 990 PRESENTATION. |
| PART XI LINE 4B | EXPENSES RELATED TO RENTAL PROPERTY IS INCLUDED IN EXPENSES FOR PURPOSES OF THE AUDITED FINANCIAL STATEMENTS, HOWEVER, THESE EXPENSES ARE NETTED AGAINST THE GROSS RENT IN REVENUE FOR 990 PRESENTATION. |
| PART XII LINE 2D | RENTAL EXPENSES ARE NETTED AGAINST THE GROSS RENT REVENUE FOR PURPOSES OF THE 990, BUT ARE REPORTED IN EXPENSES IN THE AUDITED FINANCIAL STATEMENTS. |
| PART XII LINE 4B | BAD DEBTS ARE INCLUDED IN THE FUNCTIONAL EXPENSE ALLOCATION FOR PURPOSES OF THE 990, HOWEVER, THEY ARE NETTED AGAINST REVENUES FOR FINANCIAL STATEMENT PURPOSES. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,533 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $89,533 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $450,996 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $352,567 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $98,429 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $540,529 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $352,567 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $187,962 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,147 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,621 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,526 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,174,550 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $903,710 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $270,840 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01080 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,099 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,099 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,215,796 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $913,331 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $302,465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01200 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,756,325 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,265,898 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $490,427 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01950 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,455 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,455 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $284,443 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $284,443 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $293,898 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $293,898 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01170 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $613,705 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,400,907 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,175,922 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$775,015 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST RIVER HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HIGHWAY 12 | AddressLine1Txt |
| City | HETTINGER | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58639 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WRHS.COM | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | CLINIC & 5 RHC'S - ALL PROVIDER BASED | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST RIVER HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.WRHS.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.WRHS.COM | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WRHS.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WRHS.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WRHS.COM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 5: WEST RIVER HEALTH SERVICES CONTRACTED TO HAVE THE CHNA PERFORMED. THE CONTRACTOR HAD PARTICIPATION FROM THE FOLLOWING GROUPS: BOARDS OF DIRECTORS OF THE HEALTH SYSTEM, INDEPENDENT HEALTH PROVIDERS, EMERGENCY MEDICAL SYSTEM PERSONNEL, FITNESS PROVIDERS, HOSPICE AND HOME CARE PROVIDERS, QUALITY MANAGMENT PERSONNEL, ECONOMIC DEVELOPMENT LEADERS, LONG TERM CARE PROVIDERS, PRIMARY CARE PROVIDERS, POLITICAL LEADERS, EDUCATIONAL REPRESENTATIVE, PUBLIC HEALTH AND SOCIAL SERVICES PROVIDERS, CLERGY REPRESENTATIVES, AND PHARMACISTS. |
| WEST RIVER HEALTH SERVICES | PART V, SECTION B, LINE 11: THE TOP THREE NEEDS IDENTIFIED IN THE MOST RECENT CHNA WERE: 1) ACCESS TO A COMPREHENSIVE RANGE MENTAL HEALTH SERVICES, 2) INCREASE THE COMMUNITY'S COMMITMENT TO HEALTHY LIFESTYLES, 3) PROVIDE LOCAL AVAILABILITY TO MORE SPECIALIZED SERVICES SUCH AS MINIMALLY INVASIVE SURGERY. WRHS PLANS TO HIRE A LICENSED CLINICAL SOCIAL WORKER AND IS RESEARCHING TELEHEALTH OPTIONS TO PROVIDE OUR PATIENTS WITH A MORE COMPREHENSIVE RANGE OF MENTAL HEALTH SERVICES. BOTH OF THESE ITEMS ARE PLANNED FOR COMPLETION IN THE NEXT COUPLE OF YEARS. THE COMMUNITY WELLNESS COORDINATOR ALONG WITH MANY OTHER WRHS STAFF MEMBERS CONTINUE TO PROVIDE COMMUNITY MEMBERS OPPORTUNITIES TO TAKE AN ACTIVE ROLE IN THEIR HEALTH. THIS IS ACCOMPLISHED THROUGH MONTHLY RADIO SPOTS ON HEALTHY LIVING, PARTICIPATION IN COMMUNITY GROUPS AIMED AT INCREASING ACCESS TO EXERCISE FACILITIES AND CONTINUED OPERATION OF THE WELLNESS CENTER DESPITE FINANCIAL BURDEN. RECRUITMENT OF NEW PROVIDERS IS A CONTINUED FOCUS OF WRHS. THE RESIDENCY PROGRAM IS SCHEDULED TO START IN JULY 2015. STUDIES HAVE PROVEN THAT PHYSICIANS ARE MORE LIKELY TO PRACTICE IN AN AREA CLOSER IN PROXIMITY TO WHERE THEIR RESIDENCIES WERE COMPLETED. IN ADDITION, THE PHYSICIAN RECRUITMENT COMMITTEE CONTINUES TO EVALUATE ANY POTENTIAL LEADS ON SURGICAL CANDIDATES. IN ADDITION TO THE FULL-TIME PROVIDERS, WRHS INVITES SPECIALISTS FROM THE MORE URBAN AREAS TO SPEND A LIMITED AMOUNT OF TIME IN ONE OR MORE OF OUR RURAL LOCATIONS TO ALLOW MORE COMPREHENSIVE CARE, CLOSER TO THE PATIENTS' HOMES. NO STRATEGIES WERE DEVELOPED TO "PREPARE FOR THE OIL PATCH". UP TO THIS POINT, WE HAVE SEEN A VERY LIMITED INCREASE IN PATIENT BASE RELATED TO THE OIL PATCH. WHILE THERE IS ANTICIPATION OF THE BOOM REACHING THE HEART OF THE WRHS SERVICE AREA AT SOME POINT IN THE FUTURE, PREPARING FOR WHAT OTHER PARTS OF OUR STATE HAVE EXPERIENCED IS COST PROHIBITIVE WITHOUT THE INCREASED PATIENT BASE AND SUCH NEED IS PURELY SPECULATION AT THIS POINT IN TIME. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| WEST RIVER HEALTH SERVICES PART V, SECTION B, LINE 16A WEBSITE: | WRHS.COM |
| WEST RIVER HEALTH SERVICES PART V, SECTION B, LINE 16B WEBSITE: | WRHS.COM |
| WEST RIVER HEALTH SERVICES PART V, SECTION B, LINE 16C WEBSITE: | WRHS.COM |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| WEST RIVER EYE CENTER | ||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | CLINIC |
| WEST RIVER FOOT & ANKLE CENTER | ||||
| 683 STATE AVENUE SUITE E | DICKINSON | ND | 58601 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 613,705. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WEST RIVER HEALTH SERVICES IS A NOT-FOR-PROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPREHENSIVE HEATLH AND WELLNESS SERVICES TO RESIDENTS AND VISITORS OF THE REGION. WE DO THIS BY REINVESTING OUR PROFITS BACK INTO THE COMMUNITIES THROUGH VARIOUS PROGRAMS AND SERVICES; MAKING SURE THAT CARE IS AVAILABLE TO EVERYONE REGARDLESS OF ABILITY TO PAY; OFFERING CARE WITH COMPASSION TO ALL PATIENTS; AND PROVIDING A WIDE RANGE OF SPECIAL BENEFITS TO EACH COMMUNITY, SUCH AS PROGRAMS TO MANAGE CARE FOR PERSONS WITH CHRONIC DISEASES, HEALTH EDUCATION AND DISEASE PREVENTION INITIATVES, OUTREACH FOR THE ELDERLY, AND CARE FOR PERSONS WHO ARE POOR OR UNINSURED.WEST RIVER HEALTH SERVICES WORKS WITH MANY COMMUNITY PROGRAMS EACH YEAR, OFTEN PARTNERING WITH OTHER ORGANIZATIONS THROUGHOUT THE SERVICE AREA. THE ORGANIZATION WAS INSTRUMENTAL IN THE APPLICATION TO AND AWARD OF A SOUTHWESTERN AREA HEALTHCARE EDUCATION CONSORTIUM, AN OUTREACH EFFORT ENCOMPASSING THE WESTERN HALF OF NORTH DAKOTA. THE GOAL OF THE SWAHEC IS TO ASSIST HEALTH CARE PROVIDERS IN THEIR RECUITMENT AND RETENTION OF HEALTH CARE WORKERS THROUGHOUT WESTERN NORTH DAKOTA. QUITE THE CONTRAST TO OTHER PARTS OF THE NATION, NORTH DAKOTA IS FACING SEVERE SHORTAGE OF WORKERS IN MANY INDUSTRIES, INCLUDING HEALTH CARE. MEMBERS FROM THE MANAGEMENT TEAM STAY CONNECTED TO THE COMMUNITIES THROUGH THEIR INVOLVEMENT WITH OTHER COMMUNITY ORGANIZATIONS, INCLUDING MEMBERSHIP ON NUMEROUS COMMUNITY BOARDS AND COMMITTEES. DOING SO GIVES THE ORGANIZATION A VOICE AND INPUT INTO LOCAL ACTIVITIES, AS WELL AS SERVES AS REPRESENTATION OF HEALTH ACTIVITIES INTO EACH OF THE COMMUNITIES. THE BOARD REPRESENTS MEMBERS FROM THE COMMUNITY THAT ARE NEITHER EMPLOYEES, NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. WRHS EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. WEST RIVER HEALTH SERVICES HAS A POLICY OF USING ANY OF ITS SURPLUS FUNDS FOR IMPROVEMENTS THAT PRMOTE A HIGHER LEVEL OF QUALITY PATIENT CARE. |
| PART III, LINE 2: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 3: | PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER EVERY EFFORT IS MADE TO COLLECT THE BALANCE AND PATEIENTS ARE GIVEN OPPORTUNITIES TO COMPLETE CHARITY CARE APPLICATIONS OR SET UP PAYMENT PLANS. ALL DISCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE APPLIED TO ACCOUNTS BEFORE THEY ARE WRITTEN OFF TO BAD DEBT. CURRENT PAYMENTS ON ACCOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT REDUCES BAD DEBT EXPENSE.THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATEIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE PROGRAM WAS BASED ON THE PERCENTAGE OF CHARITY CARE TO GROSS CHARGES TIMES THE STATED BAD DEBT EXPENSE. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS OF CARE ARE BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | FOR THOSE PATIENTS THAT RECEIVE DISCOUNTED CARE UNDER THE FAP THE REMAINING SELF-PAY PORTION FALLS UNDER THE SAME COLLECTIONS POLICY AS ALL OTHER PATIENT ACCOUNTS. THE HOSPITAL POLICY IS TO SEND THE UNPAID AMOUNTS TO COLLECTIONS 45 DAYS AFTER THIS INITIAL LETTER; HOWEVER THE HOSPITAL MAKES ALL EFFORTS TO WORK WITH THE PATIENTS TO COLLECT THE UNPAID AMOUNT BEFORE THEY ACTUALLY SEND IT TO COLLECTIONS. THE PATIENT ACCOUNT MANAGER MAKES SEVERAL ATTEMPTS TO MAKE PAYMENT ARRANGEMENTS THROUGH PHONE CONVERSATIONS AND PERSONAL CONTACT WITH THE PATIENT. |
| PART VI, LINE 2: | BOARD MEMBERS FROM ALL AFFILIATED BOARDS (WRHSF, WRHS, WHLC) AS WELL AS WRHS MEDICAL STAFF MET TOGETHER AT THE ANNUAL BOARD RETREAT IN JANUARY OF 2015 AT WHICH TIME RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN JULY OF 2014 WERE REVIEWED AND DISCUSSED. THE NEEDS ASSESSMENT SERVED AS THE BASIS FOR HEALTH CARE STRATEGIC AND LONG-RANGE PLANNING TO DEVELOP HEALTHY POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS, AND COLLABORATE WITH OTHER COMMUNITY HEALTH CARE PROVIDERS. THERE IS A WIDE REPRESENTATION FROM ACROSS THE MULTI-COUNTY REGION ON THE WRHS BOARD OF DIRECTORS. BOARD MEMBERS ROUTINELY PROVIDE FEEDBACK TO ADMINISTRATION AND THE BOARD OF PERCEIVED HEALTH CARE NEEDS BASED ON DISCUSSION WITH PATIENTS IN THEIR RESPECTIVE COMMUNITIES. ALTHOUGH ALL MEMBERS OF THE 14-MEMBER PHYSICIAN GROUP WITH WHOM WRHS CONTRACTS FOR PROFESSIONAL MEDICAL SERVICES RESIDE IN HETTINGER, THEY TRAVEL DAILY/WEEKLY TO COMMUNITY CLINICS WITHIN THE REGION. THEY HAVE BECOME ADVOCATES FOR EACH OF THESE COMMUNITIES AND REPRESENT THE COMMUNITY NEEDS TO ADMINISTRATION AND BOARD OF DIRECTORS.WRHS CONDUCTS REGULAR SATISFACTION SURVEYS WITH PATIENTS WHO HAVE RECEIVED HOSPITAL/CLINIC SERVICES FROM WRHS. AS PART OF THOSE SURVEYS, PATIENTS ARE ASKED FOR THEIR INPUT FOR IMPROVEMENT AND/OR TO SUGGEST OTHER NEEDED SERVICES. WRHS FURTHER IDENTITIES UNMET COMMUNITY HEALTH NEEDS BY PARTICIPATING IN COMMUNITY COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, ADVISORY GROUPS, AND PANELS LOCALLY AND WITHIN THE REGION.BASED ON THE ABOVE-NOTED ASSESSMENT MEASURES, THE MAJOR COMMUNITY NEEDS IDENTIFIED FOR 2014 WERE THE NEED TO INCREASE ACCESS TO QUALITY HEALTH CARE, ESPECIALLY FOR CHILDREN, PREGNANT WOMEN, AND UNINSURED ADULTS AND SENIORS; THE NEED TO OBTAIN MEDICAL CARE FOR THE UNDERSERVED BY ENROLLING ELIGIBLE RESIDENTS IN MEDICAID, SCHIP, AND OTHER INSURANCE PROGRAMS; THE NEED TO ENHANCE AND STRENGTHEN MENTAL HEALTH SERVICES WITHIN THE REGION BY RECRUITING ADDITIONAL MENTAL HEALTH PROVIDERS; THE NEED FOR ADDITIONAL ASSISTED LIVING CENTERS; THE NEED TO RECRUIT ADDITIONAL QUALIFIED PHYSICIANS TO THIS UNDERSERVED AREA; THE NEED TO SERVE THE TRANSIENT POPULATIONS AS A RESULT OF THE ECONOMIC BOOM OCCURRING IN NORTH DAKOTA; AND THE NEED TO PROVIDE HEALTH EDUCATION, DISEASE PREVENTION AND CHRONIC DISEASE MANAGEMENT (INCLUDING OBESITY) PROGRAMS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITES SERVED. |
| PART VI, LINE 3: | IT IS THE MISSION OF WEST RIVER HEALTH SERVICES (WRHS) TO PROVIDE COMPREHENSIVE HEALTH AND WELLNESS SERVICES TO ALL RESIDENTS AND VISITORS IN THE REGION IT SERVES. THESE SERVICES ARE OFFERED TO ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED OR ABILITY TO PAY. WE ARE COMMITTED TO PROVIDE QUALITY HEALTH CARE SERVICES WITH COMPASSION AND RESPECT, PARTICULARLY THE UNDERINSURED AND UNINSURED POPULATION. IT IS THE POLICY OF WRHS TO PROVIDE EFFECTIVE COMMUNICATION WITH PATIENTS REGARDING HOSPITAL BILLS, TO MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS, TO OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS, TO ASSIST LOW-INCOME PATIENTS IN A CONSISTENT MANNER AND TO MAINTAIN FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONS. IT IS NORMALLY AT THE POINT OF ADMISSION THAT THE PATIENT'S ABILITY TO PAY IS ASSSESSED. PATIENTS WHO ARE UNINSURED AND BELIEVED TO HAVE LIMITED RESOURCES ARE REFERRED TO THE WRHS FINANCIAL COUNSELOR WHO WILL DETERMINE PATIENT'S ELIGIBILITY FOR CHARITY CARE AND/OR OTHER FINANCIAL ASSISTANCE PROGRAMS. THE FINANCIAL COUNSELOR WILL ALSO DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENTAL PROGRAMS, INCLUDING MEDICAID OR OTHER STATE-FUNDED PROGRAMS. WHERE APPROPRIATE, THE FINANCIAL COUNSELOR WILL ASSIST THE PATIENT WITH QUALIFICATION AND /OR APPLICATION TO SUCH PROGRAMS.PATIENTS UNABLE TO PAY THEIR MEDICAL BILLS ARE INVITIED TO SUBMIT AN APPLICATION TO THE CHARITY CARE PROGRAM. BOTH THE FINANCIAL COUNSELOR AND THE PATIENT FINCANCIAL SERVICES MANAGER ARE READILY AVAILABLE TO VISIT WITH CANDIDATES TO THIS PROGRAM AND TO ASSIST IN THE APPLICATION PROCESS, AS APPROPRIATE. WRHS INFORMS PATIENTS OF ITS FINANCIAL ASSISTANCE PROGRAMS THROUGH THE WRHS WESITE, BROCHURES AVIALABLE AT POINTS OF ADMISSION AND THE PATIENT CARE HANDBOOK LOCATED IN EACH PATIENT ROOM. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBLITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE. WRHS HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. WRHS MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTEN MANNER. WRHS EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ON THE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. THE FINANCIAL COUNSELOR IS GIVEN MORE IN-DEPTH TRAINING ON HANDLING FINANCIAL ASSISTANCE REQUESTS, PROCESSING OF APPLICATIONS, AND MANAGING OUTCOMES. |
| PART VI, LINE 4: | HETTINGER IS LOCATED IN SOUTHWESTERN NORTH DAKOTA AND BORDERS THE STATES OF SOUTH DAKOTA AND MONTANA. THE CITY HAS A POPULATION OF 1,236 WITH A TOTAL POPULATION OF 2,384 IN ADAMS COUNTY. IN ADDITION TO THE HOSPITAL AND CLINIC SERVICES LOCATED IN HETTINGER, THERE ARE ALSO RURAL CLINICS LOCATED IN NEW ENGLAND (HETTINGER COUNTY) BOWMAN AND SCRANTON (BOWMAN COUNTY), AND MOTT (HETTINGER COUNTY), ALL IN SOUTHWESTERN NORTH DAKOTA. ANOTHER CLINIC IS LOCATED IN LEMMON, SOUTH DAKOTA (PERKINS COUNTY). IN TOTAL, WEST RIVER HEALTH SERVICS PROVIDES HEALTH CARE TO APPROXIMATELY 13,000 INDIVIDUALS OVER 25,000 SQUARE MILES INCLUSIVE OF THE COUNTIES NAMED. THE MEDIAN HOUSEHOLD INCOME FOR THESE COUNTIES IS $55,064, WHICH IS CONSIDERABLY BELOW THE NORTH DAKOTA AVERAGE OF $59,276.TWENTY-THREE PERCENT OF THE POPULATION IN ALL COUNTIES SERVED IS 65 YEARS OF AGE OR OLDER. FOUR HUNDRED THIRTY-EIGHT FAMILIES WITHIN THE SERVICE AREA FALL BELOW THE FEDERAL POVERTY GUIDLINES FOR AN AVERAGE OF 11.4%. THE NORTH DAKOTA AVERAGE FOR FAMILIES FALLING BELOW POVERTY LEVELS IS 9.6%. NOT INCLUDED TO THE ABOVE DEMOGRAPHICS IS THE CITY OF DICKINSON, 75 MILES FROM HETTINGER AND LOCATED IN STARK COUNTY. IT IS HERE THAT WRHS OPERATES A WEEKLY FOOT AND ANKLE CENTER. WITH THE EXCEPTION OF DICKINSON, ALL OTHER SITES HAVE BEEN DESIGNATED AS MEDICALLY UNDERSERVED AREAS. HEALTH CARE IS AN IMPORTANT PART OF THE ECONOMY AND, AS SUCH, THE HOSPITAL AND CLINICS HAVE BECOME ONE OF THE TOP EMPLOYERS IN THE REGION. APPROXIMATELY 3.5% OF ALL PATIENTS SERVED ARE MEDICAID RECIPIENTS AND 7.6% OF ALL PATIENTS ARE UNINSURED. THERE IS ANOTHER HOSPITAL AND CLINIC IN BOWMAN, LOCATED 40 MILES WEST OF HETTINGER. THERE IS ALSO A HOSPITAL AND SEVERAL OTHER CLINICS IN DICKINSON, LOCATED 75 MILES NORTHWEST OF HETTINGER. TERTIARY REFERRAL CENTERS ARE LOCATED 150 MILES AWAY IN BISMARCK, NORTH DAKOTA, AND 180 MILES AWAY IN RAPID CITY, SOUTH DAKOTA. |
| PART VI, LINE 5: | THE ORGANIZATION HAS LONG BEEN A PROMOTER OF MEDICAL EDUCATION AND HAS ENJOYED A LONGSTANDING RELATIONSHIP WITH THE UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE IN PROVIDING ROTATION SITES FOR MEDICAL STUDENTS. PHYSICIANS WITHIN THE ORGNAIZATION GRACIOUSLY PRECEPTOR THESE STUDENTS. WITH THE SUPPORT, ENDORSEMNT, AND APPROVAL OF UND'S ADVISORY COUNCIL, THE STATE BOARD OF HIGHER EDUCATION, AND THE UND SCHOOL OF MEDICINE AND HEALTH SCIENCES, THE NORTH DAKOTA STATE LEGISLATURE APPROVED THE INITAL FUNDING FOR AN EXPANSION OF GRADUATE MEDICAL EDUCATION RESIDENCIES WITH THE STATE. WEST RIVER REGIONAL MEDICAL CENTER OF HETTINGER WAS INCLUDED TO THE FUNDING PROPOSAL AND WILL PARTNER WITH THE BISMARCK CENTER FOR FAMILY MEDICINE TO OFFER RESIDENCIES TO YEAR TWO AND THREE RESIDENTS IN A RURAL SETTING. THIS IS A COLLBORATIVE EFFORT BETWEEN ALL ENTITIES TO ENSURE AN ADEQUATE SUPPLY OF PROFESSIONALS FOR THE FUTURE, ESPECIALLY PRIMARY CARE PROVIDERS AND PARTICULARLY TO RURAL AREAS. THIS PARTNERSHIP WILL BE INVALUABLE AS IT WILL HELP ADDRESS THE THIRD CONCERN IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, THAT OF A CRITICAL SHORTAGE OF HEALTHCARE PROVIDERS. IN ADDITION TO TOTAL UNCOMPENSATED CARE FOR FY '15 OF $157,778, WRHS ALSO PROVIDES MANY OTHER SERVICES AS IN-KIND SUPPORT TO BENEFIT THE HEALTH OF THE COMMUNITIES AND REGIONS IT SERVES. THESE COMMUNITY BENEFITS INCLUDE OFFERING CPR AND FIRST AID PROGRAMS TO THE GENERAL PUBLIC, GUIDING TOURS OF THE HOSPITAL/CLINIC TO AREA SCHOOL CHILDREN, PROVIDING HEALTH AND WELLNESS EDUCATION CLASSES TO THE PUBLIC AND EDUCATING/TRAINING PARAMEDICS/EMTS IN ALL OUTREACH COMMUNITIES.HETTINGER HAS A LOCALLY-OWNED RADIO STATION. THIS STATION HAS A PROGRAM CALLED TTO (THIS, THAT, AND OTHER THINGS). THIS PROGRAM AIRS DAILY (M-F). WRHS HAS A DESIGNATED TWO HOURS PER MONTH TO SHARE INFORMATION ABOUT HEALTHY HAPPENINGS AND PROMOTE GENERAL HEALTH AND WELL-BEING. WRHS COSTS SHOWN WERE STAFF TIME TO PREPARE AND PARTICIPATE IN THE TALK SHOW.TWO EMPLOYEES OF WRHS ANNUALLY TEACH FOURTH, FIFTH, AND SIXTH GRADERS AT THE PUBLIC SCHOOL ABOUT PUBERTY AND ITS CHANGES FOR BOTH BOYS AND GIRLS. HYGIENE, HORMONAL CHANGES, AND BODY DEVELOPMENT PHASES ARE A MAJOR PART OF THIS CURRICULUM.WEST RIVER HEALTH SERVICES AND CLINICS IT OPERATES ARE LOCATED IN A VERY SPARSELY POPULATED RURAL AREA. TRANSPORTATION FOR SENIORS TO/FROM CLINIC APPOINTMENTS IS DIFFICULT AND EXPENSIVE. MANY SENIORS OFTEN OPT TO NOT COME FOR THEIR APPOINTMENT IN LIGHT OF THE COST AND INCONVENIENCE OF GETTING TO THE CLINIC. RECOGNIZING THE IMPORTANCE OF THESE PATIENTS TO KEEP THEIR APPOINTMENTS AND MAINTAIN OPTIMAL HEALTH, WRHS IS SHARING IN THE COST FOR SENIORS TO TRAVEL TO/FROM CLINICS. LOCALLY-ESTABLISHED SENIOR VANS ARE USED FOR THIS SERVICE AND WRHS REIMBURSES ONE-HALF THE COST OF THE TRANSPORTATION IN GETTING PATIENTS TO/FROM CLINIC AND/OR HOSPITAL SERVICES. FOR MORE INFORMATION ABOUT WRHS, VISIT WWW.WRHS.COM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JIM LONG | ||||||||||||||
| CEO | $162,251 | $0 | $0 | $0 | $0 | $0 | $10,903 | $0 | $9,587 | $0 | $182,741 | $0 | $0 | $0 |
| MITCH SCHULTZ | ||||||||||||||
| PHARMACIST | $127,848 | $0 | $0 | $0 | $0 | $0 | $3,566 | $0 | $15,444 | $0 | $146,858 | $0 | $0 | $0 |
| CAROL CORNELIUS | ||||||||||||||
| PHARMACIST | $114,763 | $0 | $0 | $0 | $0 | $0 | $2,001 | $0 | $14,726 | $0 | $131,490 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF HETTINGER NORTH DAKOTA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 456002094 | BondIssuerEIN |
| CUSIP | NONEAVAIL | CUSIPNum |
| Bond Issued | 2008-01-31 | BondIssuedDt |
| Issue Price | $5,275,000 | IssuePriceAmt |
| Purpose | EXPAND AND RENOVATE HOSPITAL | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $730,546 | RetiredAmt |
| Total Proceeds | $5,275,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $105,500 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $5,169,500 | CapitalExpendituresAmt |
| Substantial Completion | 2010 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2 | FormAndLineReferenceDesc |
| Explanation | WEST RIVER HEALTH SERVICES HAS DETERMINED THAT A REBATE COMPUTATION WAS NOT WARRANTED DUE TO THE TAX EXEMPT BOND BEING A DRAW DOWN BOND THAT DID NOT HAVE INVESTED PROCEEDS. ALL FUNDS WERE SPENT WITHIN THE ALLOTTED TIME PERIOD. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JENIFER LONG | |||
| SPOUSE OF JIM LONG, CEO | $41,881 | COMPENSATION | 0 |
| KYLEE STADHEIM | |||
| SPOUSE OF NATHAN STADHEIM, CFO | $14,508 | COMPENSATION | 0 |
| DANA ANDRESS | |||
| SPOUSE OF ERIC ANDRESS, FORMER DIRECTOR | $49,322 | COMPENSATION | 0 |
| TARA JORGENSON | |||
| SPOUSE OF CODY JORGENSON, DIRECTOR | $68,397 | COMPENSATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THERE IS AN EXECUTIVE COMMITTEE THAT HAS AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS. MINUTES OF THE EXECUTIVE COMMITTEE SHALL BE SUBMITTED TO THE BOARD AND ITS ACTION SHALL BE SUBJECT TO THE APPROVAL OR DISAPPROVAL AT THE NEXT REGULAR BOARD MEETING. THIS COMMITTEE WILL MEET WHEN CALLED BY THE CHAIRMAN. THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIRMAN, VICE CHAIR, SECRETARY/TREASURER, PAST CHAIRMAN, MEDICAL STAFF REPRESENTATIVE OF THE BOARD, AND TWO OTHER BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 6 | WEST RIVER HEALTH SERVICES FOUNDATION IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER, WRHS FOUNDATION APPOINTS THE BOARD MEMBERS OF WRHS. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS A SOLE MEMBER, WRHS FOUNDATION APPROVES ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS, DETERMINES APPROVED DEBT LEVELS AND APPROVES INDIVIDUAL DEBT TRANSACTIONS THAT EXCEED THE APPROVED DEBT LEVELS, APPROVES DISSOLUTION OR MERGER OF THE ORGANIZATION, AND APPROVES THE SALE OR TRANSFER OF ANY CAPITAL ASSETS HAVING A PURCHASE PRICE OR MARKET VALUE GREATER THAN $100,000. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CFO AND CEO WILL REVIEW THE FORM 990 PRIOR TO THE COMPLETED FORM 990 BEING DISTRIBUTED ELECTRONICALLY TO THE BOARD MEMBERS FOR THEIR REVIEW AND COMMENTS. THE FORM 990 IS ALSO REVIEWED AND DISCUSSED AT A BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEDICAL STAFF, EMPLOYEES, AND BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS. POTENTIAL CONFLICTS ARE REVIEWED BY THE CEO. INDIVIDUALS WITH CONFLICTS ABSTAIN FROM VOTING, AND THIS ACTION IS NOTED BY BOARD MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15A | CEO: EACH BOARD AND MEDICAL STAFF MEMBER ANNUALLY COMPLETE AN EVALUATION FORM ON THE CEO'S PERFORMANCE. THE CHAIRMAN OF EXECUTIVE COMMITTEE TABULATES THE RESULTS AND REVIEWS THEM WITH THE OTHER MEMBERS OF THE EXECUTIVE COMMITTEE. THE RESULTS ARE PRESENTED TO THE FULL BOARD OF DIRECTORS WHO HAVE FINAL AUTHORITY IN DETERMINING COMPENSATION. COMPARABILITY DATA FROM THE STATE HOSPITAL ASSOCIATION, AS WELL AS OTHER COMPARATIVE INDUSTRY INFORMATION, IS USED IN DETERMINING COMPENSATION. CFO: THE CEO REVIEWS THE CFO'S PERFORMANCE AND USES COMPARABILITY DATA IN DETERMINING COMPENSATION. ALL OTHER EMPLOYEES: THE ADMINISTRATIVE STAFF USES COMPARABLE DATA IN SETTING COMPENSATION FOR EACH LEVEL OF EMPLOYEE. COMPENSATION IS REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | ADMINISTRATIVE REPRESENTATIVES OF THE ORGANIZATION WILL PROVIDE THE GOVERNING BOARD DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS UPON WRITTEN OR VERBAL REQUEST TO ADMINISTRATIVE REPRESENTATIVES OF THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,415,250. MANAGEMENT AND GENERAL EXPENSES 172,310. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,587,560. |
| FORM 990, PART XII, LINE 2C: | THIS PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WESTERN HORIZONS LIVING CENTER | ||||||||||
| 1104 HIGHWAY 12 | HETTINGER | SD | 58369 | 260794602 | LONG-TERM CARE/ASSISTED LIVING FACILITY | ND | 501C | LINE 9 | WEST RIVER HEALTH SERVICES FOUNDATION | 0 |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||||||||||
| 1000 HIGHWAY 12 | HETTINGER | SD | 58369 | 450411825 | FUNDRAISING | ND | 501C | LINE 11C, III-F1 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| C | $25,748 | CASH PAID |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| D | $56,676 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| D | $872,990 | CASH PAID |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| O | $48,740 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| J | $92,100 | LEASE AGREEMENT |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| Q | $77,723 | CASH PAID |
| WESTERN HORIZONS LIVING CENTER | ||
| Q | $52,879 | CASH PAID |
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