2016-06-23T16:21:57-07:00 2015-12-31 990 2015-01-01 450349152 HOSPICE OF THE RED RIVER VALLEY HOSP 7013561500 1701 38th St S Suite 101 Fargo ND 581034499 Steve Slabik Director of Finance 7013561500 2016-06-23 2015 2016-09-27 15:27:22Z Theresa Capron 1701 38th St S Fargo ND 58103 26572560 0 X www.hrrv.org X 1978 ND To provide hospice care to individuals at the end of their life through medically directed and team-coordinated services to terminally ill patients and their families. 13 13 237 397 0 0 1285470 1123191 21364233 21072167 582000 367384 69133 68853 23300836 22631595 0 0 0 0 10967714 11497462 0 0 407852 10976658 10741768 21944372 22239230 1356464 392365 15481597 14695474 3984721 3152964 11496876 11542510 The organization's mission, as stated in its by-laws, is: The purpose of the Corporation shall be charitable and educational. The mission/purpose of the Corporation is: A good dying and death experience is a basic human desire, a common life experience and a quality of life issue. Hospice of the Red River Valley has an obligation to those we serve to provide the following: 1) a quality end-of-life experience for the individual that is dying; 2) a quality end-of-life experience for the individual's loved ones; 3) a quality workplace environment for the staff and volunteers of Hospice of the Red River Valley; 4) a higher quality of life for the community as community members know they have a place to go where they will find needed support for their own end-of-life experience of a loved one. 0 0 17225282 0 21023221 Hospice care; Medically directed and team-coordinated services to terminally ill patients and their families. Patients and families receive care according to plans personalized to each family's needs, wishes and abilities, enlisting all the skills of the hospice team. This care and services are provided to people throughout a 29-county service area in the greater Red River Valley area of the North Dakota/Minnesota border, and is provided without regard for the patient or family's ability to pay. In 2015, Hospice of the Red River Valley served 1,557 patients from offices in Fargo, Grand Forks, Lisbon, Mayville and Valley City, North Dakota and Detroit Lakes and Thief River Falls, Minnesota. 578011 0 48946 Public education on dying, death, grief and loss, advance directives as well as public support through support groups and classes and other community education events. 0 0 0 17803293 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 24 0 0 237 1 0 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 1 0 0 MN ND X Hospice of the Red River Valley 7013561500 1701 38th St S Suite 101 Fargo ND 581034499 Roberta Young President - HRRV Board 2 0 X X 0 0 0 Jane Kelly Vice President, HRRV Board (through August, 2015) 2 0 X X 0 0 0 Jon Benson Vice President, HRRV Board 2 0 X X 0 0 0 Jeff Sandgren Scretary/Treasurer, HRRV Board 2 0 X X 0 0 0 Dan Thorson Past President, HRRV Board - through April, 2015 2 0 X X 0 0 0 Jenny Amon HRRV Board Member - through September, 2015 2 0 X 0 0 0 Tim Richard HRRV Board Member 2 0 X 0 0 0 Paulette Korsmo Frith HRRV Board Member 2 0 X 0 0 0 Dave Selland HRRV Board Member 2 0 X 0 0 0 Ruth Hanson HRRV Board Member 2 0 X 0 0 0 Tim Haugen HRRV Board Member 2 0 X 0 0 0 Todd Fisher HRRV Board Member 2.0 0 X 0 0 0 James Ferragut HRRV Board Member 2 0 X 0 0 0 Rebecca Nichol HRRV Board Member 2 0 X 0 0 0 Gwen Halaas HRRV Board Member 2 0 X 0 0 0 Ann Malmberg HRRV Board Member 2 0 X 0 0 0 Steve Slabik Director of Finance 40 0 X 136570 0 15914 Theresa Capron Executive Director, HRRV 40 0 X 10985 0 869 Kevin Provost Executive Director (through May, 2015) 40 0 X 112586 0 6710 Tricia Langlois Medical Director 40 0 X 284790 0 13717 Rebecca Svaleson Director of Clinical Operations 40 0 X 108114 0 14226 653045 0 51436 4 0 1 0 WISIAN LLC 1733 Normal Hill Edmond OK 73034 Pharmacy benefit management services 890584 Sanford Healthcare Accessories P O Box 9679 Fargo ND 581069679 Durable medical equipment for patients 606076 Network Center Inc 3487 S University Drive Fargo ND 58104 IT management & support services 271964 Sanford Medical Center Fargo 801 North Broadway Fargo ND 58102 Medical & Hospitalization 193680 4 20620 0 0 0 0 1102571 62336 1123191 Net Patient Service Revenue 621610 21023221 21023221 0 0 Public Grief Support and Other Community Services 624100 48946 48946 0 0 0 0 0 0 21072167 315539 0 0 315539 0 0 0 0 0 0 0 0 61569 0 73217 0 -11648 0 -11648 0 0 -11648 3566295 1415 3490545 25320 75750 -23905 51845 0 0 51845 0 0 0 0 0 0 0 0 0 0 0 0 432384 351883 80501 0 0 80501 0 22631595 21072167 0 436237 0 0 0 0 0 0 0 0 283634 0 283634 0 0 0 0 0 8924559 7104339 1535914 284306 239983 185152 47421 7410 1358711 1048277 268483 41951 690575 532795 136458 21322 0 0 0 0 15420 0 15420 0 66852 0 66852 0 0 0 0 0 0 0 0 0 0 0 32484 20850 11634 0 98810 3045 81260 14505 435540 216373 199537 19630 434373 0 434373 0 0 0 0 0 429088 0 429088 0 473224 402787 67533 2904 0 0 0 0 41575 22925 12540 6110 271 0 271 0 0 0 0 0 313443 16778 296665 0 80517 0 80517 0 Contracted Services 7290197 7290197 0 0 Medical Supplies 882230 882230 0 0 Dues, Licenses & Subscriptions & Miscellaneous 89860 19661 60485 9714 Bad Debt 57884 57884 0 0 0 0 0 0 22239230 17803293 4028085 407852 612 2312 1905257 1530547 2506670 2348818 53101 52363 225071 138152 6497863 2947200 3316481 3550663 6820361 6872619 417488 200000 236556 0 15481597 14695474 1989721 1607579 1995000 1545385 0 0 3984721 3152964 X 9617092 9837320 408897 110617 1470887 1594573 11496876 11542510 15481597 14695474 X 392365 -346733 0 0 0 2 X 0 1 0 0 X 1085175 1189311 1347449 1285470 1123191 6030596 0 0 0 0 0 0 0 0 0 0 1085175 1189311 1347449 1285470 1123191 6030596 6030596 176675 256687 280159 403394 377108 1494023 0 0 0 0 0 0 98698 80290 68783 75434 80501 403706 7928325 101882871 0.76064 0.77798 X Schedule A, Part II, Line 10 Income shown here is primarily net income from Heirlooms, the gift and thrift store operated by Hospice of the Red River Valley in support of its mission. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3038323 326993 -90006 0 138539 0 3136771 2722918 309551 133146 0 127292 0 3038323 2175085 424582 226853 0 103602 0 2722918 1975762 111511 185085 0 97273 0 2175085 1966320 110143 -2393 0 98308 0 1975762 0.464 0.508 0.028 0 0 0 870000 870000 0 2480487 746775 1733712 0 145090 110047 35043 0 2942623 2069370 873253 0 59663 21008 38655 3550663 0 0 X 22913210 0 0 0 425100 425100 22488110 0 143485 143485 22631595 22594651 0 0 0 425100 425100 22169551 0 69679 69679 22239230 Schedule D, Part V, Line 4 The stated purpose of the organization's endowment fund is to fulfill the board of director's policies ensuring the organization's stability through preservation and protection of its assets and to allow for satisfactory total return on all funds. Schedule D, Part X, Line 2 Hospice is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501 (c) (3). Hospice is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, Hospice is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. Hospice has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. Hospice 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. Hospice would recognize future accrued interest and penalties related to unrecognized tax liabilities in income tax expense if such interest and penalties are incurred. Schedule D, Part XI, Line 2d Cost of Goods Sold from in Part VIII line 10b - $351,883 Expenses related to real estate rental - $73,217 TOTAL - $425,100 Schedule D, Part XI, Line 4b Permanently Restricted Donations - $123,686 Temporarily Restricted Donations - $29,357 Release of Restricted Assets - ($237,631) Contributions released for long-lived assets - $72,342 Investment income on restricted net assets - $86,054 Loss on debt refinancing - $69,679 Rounding ($2)TOTAL - $143,485 Schedule D, Part XII, Line 2d Cost of Goods Sold from Part VIII line 10b - $351,883 Expenses related to real estate rental - $73,217 TOTAL - $425,100 Schedule D, Part XII, Line 4b Loss on debt refinancing - $69,679 X X 1 0 0 0 0 0 0 0 0 Tricia Langlois Medical Director 284790 0 0 0 0 0 11279 0 2437 0 298506 0 0 0 Steve Slabik Director of Finance 136570 0 0 0 0 0 5587 0 10327 0 152484 0 0 Schedule J, Part I, Line 4 Severance Kevin C Provost Wages - $29,040 A Cass County North Dakota 456002205 2015-11-09 1600000 Hospice of the Red River Valley Project-Mortgage Revenue Refunding Bonds (to refund 7/31/2007 issue) 0 0 0 A 25078 0 1600000 0 0 0 0 0 0 0 1600000 0 2015 1 0 1 1 A 0 0 0 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 X 3 62336 Market Value 0 0 1 0 Form 990, Part VI, Section A, Line 2 Jon Benson, Vice President, is the church council president where board member/secretary-treasurer Jeff Sandgren is a pastor. Form 990, Part VI, Section A, Line 8b There are no committees that act on behalf of the board of directors; all business of the board is conducted and approved by the full board of directors. Form 990, Part VI, Section B, Line 11b The organization contracted with an external advisor to review and provide recommended changes to the tax return prepared by the organization. Those comments as well as a full copy of the entire return was provided to all board members prior to the return being filed. Form 990, Part VI, Section B, Line 12c All board members sign a conflict of interest policy on an annual basis. In addition, at the beginning of each board meeting, members are required to disclose if they have a conflict of interest regarding any agenda items. Form 990, Part VI, Section B, Line 15 A full review of salaries is conducted annually and compared to wage and salary survey data (salary surveys are done annually; last done in December of 2015). The following resources are used when conducting the survey: ND and MN Job Service, MN Healthcare, Multi-View (a national hospice financial consulting company), National Association of Home Care & Hospice, AHP (Association for Healthcare Philanthropy, Health Care Strategy and Market Development Survey. The Non-Profit Times Salary Report , a local report that was conducted with 5 long term care facilities in the Fargo-Moorhead area, a survey from the YMCA as well as the North Dakota Salary Guide. An additional survey was also conducted in December of 2015 for Executives' Salaries, through HR Advisors, LLC; this survey was specific to CEO, COO, CFO, Chief Development Officer, Director of Management Systems, Director of Human Recourse and Director of IT Services positions. Based on the above and recommendations from the director of human resources and budgetary constraints, the executive director approves the salaries of all staff except her own. The board of directors used the same information as the executive director in setting the salary for that position. Form 990, Part VI, Section C, Line 19 The organization does not make its governing documents, conflict of interest policy and financial statements available to the public. Form 990, Part XI, Line 9 Rounding - $2