WESTERN HORIZONS LIVING CENTERS: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- WESTERN HORIZONS LIVING CENTERS (EIN 26-0794602)
- Tax period
- 2014-04-01 to 2015-03-31
- Filed
- 2016-02-15
- IRS object ID
- 201620469349301607
- 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 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 | 260794602 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTERN HORIZONS LIVING CENTERS | BusinessNameLine1Txt |
| 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 | $4,092,801 | 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 | 2007 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | TO ASSIST OUR NEIGHBORS IN ACHIEVING AND MAINTAINING THEIR HIGHEST LEVEL OF INDEPENDENCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 92 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $88,766 | PYContributionsGrantsAmt |
| CY Contributions Grants | $58,475 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,913,771 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,034,326 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,356 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,004,893 | PYTotalRevenueAmt |
| CY Total Revenue | $4,092,801 | 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 | $2,483,391 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,824,420 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,474,581 | PYOtherExpensesAmt |
| CY Other Expenses | $1,151,404 | CYOtherExpensesAmt |
| PY Total Expenses | $3,957,972 | PYTotalExpensesAmt |
| CY Total Expenses | $3,975,824 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $46,921 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $116,977 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,411,763 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,476,208 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,600,963 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,548,431 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,189,200 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,072,223 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF WESTERN HORIZONS LIVING CENTERS IS TO ASSIST OUR NEIGHBORS IN ACHIEVING AND MAINTAINING THEIR HIGHEST LEVEL OF INDEPENDENCE IN A CARING AND RESPECTFUL ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,230,800 | ExpenseAmt |
| Revenue | $3,578,810 | RevenueAmt |
| Desc | WESTERN HORIZONS LIVING CENTERS (WHLC) BEGAN ITS OPERATIONS OF LONG-TERM CARE SERVICES ON SEPTEMBER 1, 2007. IT WAS LICENSED BY THE NORTH DAKOTA DEPARTMENT OF HEALTH TO OPERATE 82 SKILLED NURSING BEDS AND 6 BASIC CARE BEDS. EFFECTIVE APRIL 1, 2008, WHLC SOLD 20 OF ITS LICENSED SKILLED NURSING BEDS AND EFFECTIVE OCTOBER 1, 2009, WHLC SOLD 8 ADDITIONAL BEDS. EFFECTIVE JULY 1, 2011, WHLC WAS APPROVED FOR A DECREASE IN NURSING FACILITY BEDS FROM 54 TO 50. IN ADDITION AND ALSO EFFECTIVE JULY 1, 2011, WHLC WAS APPROVED FOR AN INCREASE IN BASIC CARE BEDS FROM 6 TO 10. IN ADDITION TO THE BASIC DAILY ROUTINE CARE, STAFF ALSO PROVIDED PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, ACTIVITIES, AND SOCIAL SERVICES TO ITS CLIENTS. ON AVERAGE, LONG-TERM CARE SERVICES WERE PROVIDED TO 41 RESIDENTS PER MONTH FOR THIS REPORTING PERIOD. THERE WERE 15,170 SKILLED NURSING DAYS WITH 62% OF THOSE DAYS BEING MEDICAID CERTIFIED. THERE WERE 3,445 BASIC CARE DAYS FOR THIS REPORTING PERIOD. THROUGHOUT THE YEAR, WHLC AND COMMUNITY INDIVIDUALS/GROUPS PROVIDED MANY VARIED FORMS OF PROGRAMMING, INCLUDING EXERCISE GROUPS, MUSICAL ENTERTAINMENT, BINGO, VAN TRIPS, COMMUNITY OUTINGS, SOCIAL EVENTS, MONTHLY BIRTHDAY PARTIES, EDUCATIONAL PROGRAMS, MOVIES AND BEDSIDE ACTIVITIES. LOCAL CLERGY AND FACILITY STAFF CONDUCTED REGULAR WORSHIP SERVICES AND BIBLE STUDIES FOR RESIDENTS. A GROUP OF LOCAL LADIES WEEKLY VOLUNTEER THEIR SERVICES IN HAIRDRESSING FOR THE RESIDENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $410,616 | ExpenseAmt |
| Revenue | $437,748 | RevenueAmt |
| Desc | IT WAS ON APRIL 1, 2008 THAT WHLC BEGAN OPERATIONS OF A 16-UNIT ASSISTED LIVING FACILITY KNOWN AS WESTERN HORIZONS ASSISTED LIVING (WHAL). IT PROVIDES HANDICAP ACCESSIBLE BATHROOMS IN THE ROOMS, ELECTRIC DOOR OPENERS THROUGHOUT THE FACILITY, AND IS ALL ON ONE LEVEL TO PROVIDE EASY ACCESSIBILITY TO THE TENANTS. WHAL OPERATES CHARITABLY BY MEETING THE PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, AND SIMILAR NEEDS OF ELDERLY PEOPLE. SOME OF THE ACTIVITIES INCLUDE CARD PLAYING, GARDENING, WEEKLY RELIGIOUS GATHERINGS, AND SOCIAL INTERACTION WITH EACH OTHER OR FAMILY VISITORS. STAFF ALSO PROVIDES OTHER HEALTH-RELATED SERVICES INCLUDING BATHING, HAIR, SKIN AND NAIL CARE, DRESSING, ASSISTANCE WITH MOBILITY, COMMUNICATION AND REMINDERS, MEDICATION MANAGEMENT, HOUSEKEEPING AND LAUNDRY SERVICES, MEAL PLANNING AND PREPARATION, EXERCISE PROGRAM, AND MONITORING BLOOD SUGARS, VITAL SIGNS AND OXYGEN. WHILE THERE HAS BEEN SOME TURNOVER THROUGHOUT THE YEAR DUE TO DEATH AND/OR THE TENANT NEEDING A HIGHER LEVEL OF CARE, WHAL HAS ENJOYED A 95% OCCUPANCY RATE AND HAS A LENGTHY WAITING LIST OF THOSE SEEKING ASSISTED LIVING SERVICES. ASSISTED LIVING SERVICES ARE OPEN TO ANY INDIVIDUAL WHO QUALIFIES FOR CARE. THERE ARE 17 TENANTS CURRENTLY RESIDING AT WHAL. STAFF HAVE CLOSE RELATIONSHIPS WITH REGIONAL AND COUNTY SOCIAL SERVICE WORKERS TO ASSIST IN THE APPLICATION PROCESS FOR MEDICAL ASSISTANCE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,641,416 | 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 | Yes (1) | 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 | 0 | OperateHospitalInd |
| 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 | 0 | 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 | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 92 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | 0 | 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 | 58369 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| STEVE HEDSTROM | ||||||
| WHLC REPRESENTATIVE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ALLEN MCINTYRE | ||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| TERRY HENDERSON | ||||||
| WHLC REPRESENTATIVE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LINDA WEAVER BRAATEN | ||||||
| WHLC REPRESENTATIVE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| KEITH KVANVIG | ||||||
| WHLC REPRESENTATIVE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MAGNUS MEIER | ||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| PASTOR RON NELSON | ||||||
| WHLC REPRESENTATIVE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR STACIE WELLMAN | ||||||
| MEDICAL STAFF LIAISON | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR KENT HOERAUF | ||||||
| MEDICAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| BLANE CHAPMAN | ||||||
| WHLC REPRESENTATIVE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| CAROL FORDAHL | ||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DR JOSEPH MATTSON | ||||||
| FORMER WHLC REPRESENTATIVE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT DROWN | ||||||
| WHLC REPRESENTATIVE | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JIM LONG | ||||||
| ADMINISTRATOR/CEO | 6.00 | $0 | $162,251 | $20,490 | Yes (X) | |
| NATHAN STADHEIM | ||||||
| CFO | 8.00 | $0 | $88,149 | $18,361 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $250,400 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $38,851 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PRIME TIME HEALTHCARE LLC | |||||
| PO BOX 3544 | OMAHA | NE | 681030544 | PROVIDE LOCUM NURSING STAFF | $122,061 |
| US FOODS | |||||
| PO BOX 14489 | GRAND FORKS | ND | 582084489 | PROVIDE FOOD AND DIETARY SUPPLIES | $114,863 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $45,799 | RelatedOrganizationsAmt |
| All Other Contributions | $12,676 | AllOtherContributionsAmt |
| Total Contributions | $58,475 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| RESIDENT SERVICE REVEN | 623000 | $3,578,810 | $3,578,810 | |
| ASSISTED LIVING REVENU | 623000 | $437,748 | $437,748 | |
| MISCELLANEOUS REVENUE | 900099 | $17,768 | $17,768 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,034,326 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,092,801 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,016,558 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $17,768 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,281,882 | TotalAmt |
| Program Services | $2,146,399 | ProgramServicesAmt |
| Management And General | $135,483 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,093 | TotalAmt |
| Program Services | $44,926 | ProgramServicesAmt |
| Management And General | $5,167 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,130 | TotalAmt |
| Program Services | $315,791 | ProgramServicesAmt |
| Management And General | $15,339 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,315 | TotalAmt |
| Program Services | $151,793 | ProgramServicesAmt |
| Management And General | $9,522 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,879 | TotalAmt |
| Management And General | $52,879 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,615 | TotalAmt |
| Management And General | $2,615 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,802 | TotalAmt |
| Management And General | $28,802 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,388 | TotalAmt |
| Program Services | $166,362 | ProgramServicesAmt |
| Management And General | $2,026 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,528 | TotalAmt |
| Management And General | $5,528 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,833 | TotalAmt |
| Management And General | $7,833 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,341 | TotalAmt |
| Management And General | $22,341 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,407 | TotalAmt |
| Program Services | $236,056 | ProgramServicesAmt |
| Management And General | $13,351 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,483 | TotalAmt |
| Program Services | $11,825 | ProgramServicesAmt |
| Management And General | $5,658 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,842 | TotalAmt |
| Program Services | $12,842 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,193 | TotalAmt |
| Program Services | $149,193 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,030 | TotalAmt |
| Program Services | $21,181 | ProgramServicesAmt |
| Management And General | $8,849 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES- MEDICAL & OTH | $285,193 | $282,396 | $2,797 |
| MAINTENANCE | $41,949 | $41,949 | |
| EQUIPMENT | $39,447 | $36,839 | $2,608 |
| STAFF RECRUITMENT | $21,740 | $21,412 | $328 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,734 | TotalAmt |
| Program Services | $2,452 | ProgramServicesAmt |
| Management And General | $13,282 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,975,824 | TotalAmt |
| Program Services | $3,641,416 | ProgramServicesAmt |
| Management And General | $334,408 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,310 | BOYAmt |
| EOY | $223,108 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,585 | BOYAmt |
| EOY | $380,601 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,455 | BOYAmt |
| EOY | $20,083 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,981 | BOYAmt |
| EOY | $11,774 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,215,805 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,375,163 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $870,432 | BOYAmt |
| EOY | $840,642 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,411,763 | BOYAmt |
| EOY | $1,476,208 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,419 | BOYAmt |
| EOY | $339,672 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $589,157 | BOYAmt |
| EOY | $524,121 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,347 | BOYAmt |
| EOY | $23,639 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,535 | BOYAmt |
| EOY | $152,052 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,509,505 | BOYAmt |
| EOY | $1,508,947 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,600,963 | BOYAmt |
| EOY | $2,548,431 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,189,200 | BOYAmt |
| EOY | -$1,072,223 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,189,200 | BOYAmt |
| EOY | -$1,072,223 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,411,763 | BOYAmt |
| EOY | $1,476,208 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $116,977 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,677 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,243 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,179 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $88,766 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $59,696 | CurrentTaxYearAmt |
| Total | $186,561 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,564,539 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,943,022 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,826,515 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,913,771 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,034,326 | CurrentTaxYearAmt |
| Total | $19,282,173 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,666 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,515 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,022 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,356 | CurrentTaxYearMinus1YearAmt |
| Total | $39,559 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,569,882 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,991,780 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,847,716 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,004,893 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,094,022 | CurrentTaxYearAmt |
| Total | $19,508,293 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $19,508,293 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15 | CurrentTaxYearMinus4YearsAmt |
| Total | $15 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15 | CurrentTaxYearMinus4YearsAmt |
| Total | $15 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,569,897 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,991,780 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,847,716 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,004,893 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,094,022 | CurrentTaxYearAmt |
| Total | $19,508,308 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $122,647 | OtherCostOrOtherBasisAmt |
| Book Value | $122,647 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,379,912 | OtherCostOrOtherBasisAmt |
| Depreciation | $865,752 | DepreciationAmt |
| Book Value | $514,160 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $573,806 | OtherCostOrOtherBasisAmt |
| Depreciation | $462,089 | DepreciationAmt |
| Book Value | $111,717 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $139,440 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,322 | DepreciationAmt |
| Book Value | $92,118 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $840,642 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTY | $308,947 |
| NOTE PAYABLE TO WEST RIVER HEALTH SERVICES FOUNDATION | $600,000 |
| NOTE PAYABLE TO WEST RIVER HEALTH SERVICES | $600,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,508,947 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,092,801 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,092,801 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,092,801 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,975,824 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,975,824 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,975,824 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | WESTERN HORIZONS LIVING CENTERS ACT AS CUSTODIAN FOR THE FUNDS OF THE NURSING FACILITY RESIDENTS AND HOLDS SECURITY DEPOSITS FOR RESIDENTS OF THE ASSISTED LIVING FACILITIES. THESE FUNDS ARE INCLUDED IN CASH AND ACCOUNTS PAYABLE IN THE FINANCIAL STATEMENTS. RESIDENT TRUST FUNDS AND SECURITY DEPOSITS TOTALED $23,639 AND $20,347 AT MARCH 31, 2015 AND 2014. |
| PART X, LINE 2: | WESTERN HORIZONS LIVING CENTERS (WHLC) IS ORGANIZED AS A NORTH DAKOTA NONPROFIT AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). WHLC IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, WHLC IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. WHLC HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 99T) WITH THE IRS. WHLC 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. WHLC 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JIM LONG | PersonNm |
| Title | ADMINISTRATOR/CEO | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $162,251 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $8,096 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $12,394 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $182,741 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE CEO COMPENSATION IS PAID AND DETERMINED BY A RELATED ORGANIZATION, WEST RIVER HEALTH SERVICES. THE COMPENSATION IS DETERMINED THROUGH THE USE OF: A COMPENSATION COMMITTEE CONSISTING OF THE EXECUTIVE COMMITTEE; COMPENSATION SURVEY OR STUDY; AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. | ExplanationTxt |
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 |
| Bond Issued | 2007-12-03 | BondIssuedDt |
| Issue Price | $900,000 | IssuePriceAmt |
| Purpose | PURCHASE OF NURSING HOME AND EQUIPMENT | 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 | $375,879 | RetiredAmt |
| Total Proceeds | $900,000 | TotalProceedsAmt |
| Other Spent Proceeds | $900,000 | OtherSpentProceedsAmt |
| Substantial Completion | 2007 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | 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 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CAN ACT FOR AND ON BEHALF OF THE FULL BOARD. IT IS COMPRISED OF THE CHAIR, VICE CHAIR, SECRETARY/TREASURER, PAST CHAIR, MEDICAL STAFF REPRESENTATIVE, AND ONE ADDITIONAL MEMBER OF THE WESTERN HORIZONS LIVING CENTER BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | WESTER RIVER HEALTH SERVICES FOUNDATION IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER, WEST RIVER HEALTH SERVICES FOUNDATION ELECTS THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS OF THE BOARD OF DIRECTORS REQUIRE APPROVAL BY THE WEST RIVER HEALTH SERVICES FOUNDATION: 1) CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS; 2) DEBT IN EXCESS OF SET LIMITS; 3) DISSOLUTION OR MERGER OF THE CORPORATION; 4) SALE OR TRANSFER OF ANY CAPITAL ASSESTS WITH A PURCHASE PRICE OR FAIR 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. BOARD MEMBERS WITH CONFLICTS ABSTAIN FROM VOTING, AND THIS ACTION IS NOTED IN BOARD MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | EACH BOARD AND MEDICAL STAFF MEMBER ANNUALLY COMPLETES AN EVALUATION FORM ON THE ADMINISTRATOR'S PERFORMANCE; THE CHAIRMAN OF THE EXECUTIVE COMMITTEE TABULATES THE RESULTS AND REVIEWS WITH THE MEMBERS OF THE EXECUTIVE COMMITTEE; RESULTS ARE PRESENTED TO THE FULL BOARD OF DIRECTORS WHO HAVE FINAL AUTHORITY IN DETERMINING COMPENSATION. COMPARABILITY DATA FROM THE ND LONG TERM CARE ASSOCIATION, AS WELL AS OTHER COMPARATIVE INDUSTRY INFORMATION, IS USED IN DETERMINING COMPENSATION. COMPENSATION PAID TO THE CEO & CFO IS PAID AND DETERMINED BY A RELATED ORGANIZATION, WEST RIVER HEALTH SERVICES (WRHS). THE COMPENSATION PROCEDUTRES USED BY WRHS ARE AS FOLLOWS: CEO: EACH BOARD AND MEDICAL STAFF MEMBER ANNUALLY COMPLETES AN EVALUATION FROM ON THE CEO'S PERFORMANCE; THE CHAIRMAN OF THE EXECUTIVE COMMITTEE TABULATES THE RESULTS AND REVIEWS WITHT HE MEMBERS OF THE EXECUTIVE COMMITTEE; 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 PERFORMANCE AND USES COMPARABILITY DATA IN DETERMINING COMPENSATION. ALL OTHER EMPLOYEES: ADMINISTRATIVE STAFF USE COMPARABILITY DATA IN SETTING COMPESATION FOR EACH LEVEL OF EMPLOYEE. THESE PROCESSES WERE LAST REVIEWED IN APRIL OF 2012. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM PREVIOUS YEARS. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| WEST RIVER HEALTH SERVICES | ||||||||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | 450340688 | HOSPITAL | ND | 501C3 | LINE 3 | WEST RIVER HEALTH SERVICES FOUNDATION | 0 |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||||||||||
| 1000 HWY 12 | HETTINGER | ND | 58639 | 450411825 | FUNDRAISING | ND | 501C3 | LINE 11C, III-FI | 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 | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | 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 | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| C | $45,799 | CASH PAID |
| WEST RIVER HEALTH SERVICES | ||
| E | $600,000 | CASH PAID |
| WEST RIVER HEALTH SERVICES FOUNDATION | ||
| E | $600,000 | CASH PAID |
| WEST RIVER HEALTH SERVICES | ||
| P | $102,510 | CASH PAID |
| WEST RIVER HEALTH SERVICES | ||
| K | $92,100 | LEASE AGREEMENT |