2014-07-08T15:42:10-07:00 2013-12-31 990 2013-01-01 450349152 HOSPICE OF THE RED RIVER VALLEY HOSP 7013561500 1701 38th St S Suite 101 Fargo ND 581034499 Steve Slabik Director of Finance 7013561500 2014-07-08 2013 2015-11-30 17:44:51Z Kevin Provost 1701 38th St S Suite101 Fargo ND 581034499 26154983 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. 14 14 245 384 0 0 1189311 1347449 19399323 20409405 288864 560765 80586 66505 20958084 22384124 0 0 0 0 10293788 11189276 0 0 449062 9893354 10937494 20187142 22126770 770942 257354 13701054 14161239 3827329 3987099 9873725 10174140 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 17508365 20374244 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 2013, Hospice of the Red River Valley served 1,551 patients from offices in Fargo, Grand Forks, Lisbon, Mayville and Valley City, North Dakota and Detroit Lakes and Thief River Falls, Minnesota. 752181 35161 Public education on dying, death, grief and loss, plus public support through support groups and classes and other community education events. 0 0 0 18260546 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 0 0 0 0 0 0 0 0 0 1 26 0 1 245 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 1 1 0 MN ND X Steve Slabik Director of Finance 7013561500 1701 38th St S Suite 101 Fargo ND 581034499 Dan Thorson President, HRRV Board 2 X X 0 0 0 Tim Richard Past President, HRRV Board 2 X X 0 0 0 Roberta Young Vice President - HRRV Board 2 X X 0 0 0 James Ferragut Secretary/Treasurer, HRRV Board 2 X X 0 0 0 Jenny Amon HRRV Board Member 2 X 0 0 0 Jane Kelly HRRV Board Member 2 X 0 0 0 Paulette Korsmo Frith HRRV Board Member 2 X 0 0 0 Dave Selland HRRV Board Member 2 X 0 0 0 Jon Benson HRRV Board Member 2 X 0 0 0 Ruth Hanson HRRV Board Member 2 X 0 0 0 Tim Haugen HRRV Board Member 2 X 0 0 0 Todd Fisher HRRV Board Member 2 X 0 0 0 Jeff Sandgren HRRV Board Member 2 X 0 0 0 Rebecca Nichol HRRV Board Member 2 X 0 0 0 Kevin Provost Executive Director - Started 9/9/13 40 X 43825 0 1130 Steve Slabik Director of Finance 40 X 107942 0 12928 Tricia Langlois Medical Director 40 X 268910 0 10807 Susan J Fuglie Executive Director - resigned 03/18/13 40 X X 107070 0 7503 527747 0 32368 3 1 1 0 Sanford Medical Center Fargo 801 North Broadway Fargo ND 58102 Medical & Hospitalization 201422 Verizon Wireless PO Box 25505 Lehigh Valley PA 18002 Cell phone and data plan services 142821 2 158665 0 0 0 0 1188784 0 1347449 Net Patient Service Revenue 621610 20374244 20374244 0 0 Public Grief Support and other Community Services 624100 35161 35161 0 0 0 0 0 0 20409405 280159 0 0 280159 0 0 0 0 0 0 0 0 57972 0 60250 0 -2278 0 -2278 0 0 -2278 3683480 1000 3402745 1129 280735 -129 280606 280606 0 0 0 0 0 0 0 0 375518 306735 68783 0 0 68783 0 22384124 20690011 0 346664 280398 0 280398 0 8700110 6901529 1498688 299893 223623 177018 38913 7692 1307341 1018970 244093 44278 677804 522147 132968 22689 0 0 0 0 16668 0 16668 0 29250 0 29250 0 0 0 0 0 0 0 0 0 0 0 118211 16393 100959 859 104279 2419 85786 16074 508979 226927 254354 27698 169835 0 169835 0 0 0 0 0 397724 0 397724 0 637020 556641 73338 7041 0 0 0 0 64634 45636 8729 10269 14 0 14 0 0 0 0 0 373325 373325 0 40495 0 40495 0 Contracted Services 7444316 7444316 0 0 Medical Supplies 821196 821196 0 0 Bad Debt 136197 136197 0 0 Dues, Licenses & Subscriptions & Miscellaneous 75351 17832 44950 12569 22126770 18260546 3417162 449062 612 612 2053821 1519515 2494044 2427961 62666 48907 162762 154000 6927861 3559617 3448564 3368244 4815197 5960929 202010 440762 461378 240309 13701054 14161239 1627329 1887099 2200000 2100000 0 0 3827329 3987099 X 8363301 8471655 188587 313748 1321837 1388737 9873725 10174140 13701054 14161239 257354 43061 0 0 0 0 X 0 1 X 0 0 X 1090353 1072026 1085175 1189311 1347449 5784314 0 0 0 0 0 0 0 0 1090353 1072026 1085175 1189311 1347449 5784314 376022 5408292 62711 181113 176675 256687 280159 957345 79577 85140 98698 80290 68783 412488 7154147 97990855 0.75597 0.75202 X Schedule A, Part II, Line 10 Income shown here is primarily net income from Heirlooms, the high-end retail store operated by Hospice of the Red River Valley in support of it's mission. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2175085 424582 226853 0 103602 0 2722918 1975762 111511 185085 0 97273 0 2175085 1966320 110143 -2393 0 98308 0 1975762 1840233 10379 198918 0 83210 0 1966320 1812448 84502 -56717 0 0 0 1840233 0.3758 0.5092 0.115 0 0 0 870000 870000 0 2399440 610205 1789235 0 123703 56901 66802 0 3483789 2879767 604022 0 50929 12744 38185 3368244 0 X 22630021 0 0 0 366985 366985 22263036 0 121088 121088 22384124 22493998 0 0 0 367228 367228 22126770 0 0 0 22126770 Schedule D, Part V, Line 4 The stated purpose of the organization's endowment fund is to fulfill the board of director's ENDS policies ensuring the organization's financial 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 as exempt from federal income taxes under Internal Revenue Code Section 501 (c) (3). Hospice is annuallly 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 subect to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) witht the IRS. Hospice believes that it has appropriate support for any 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 Fundraising expenses included in Part VIII line 10b (netted against fundraising income) -306,735. Expenses related to real estate rental - 60,250 Total - 366,985 Schedule D, Part XI, Line 4b Permanently Restricted Donations - 66,900 Temporarily Restricted Donations - 22,226 Release of Restricted Assets (123,918) Contributions released for long-lived assets 5,000 Investment income on restricted net assets - 151,123 Fundraising income included on Part VIII line 10a - (243) TOTAL - 121,088 Schedule D, Part XII, Line 2d Fundraising Expenses - 306,735 Expenses related to real estate rental - 60,250 Fundraising expenses included in Part VIII line 10b - 245 Rounding (2)TOTAL 367,228 X X 1 0 0 0 0 0 0 0 0 Tricia Langlois Medical Director 268910 0 0 0 0 0 0 0 10807 0 279717 0 Schedule J, Part I, Line 4 4a Severance Susan J Fuglie Wages 65,419 Health Insurance $3,447, Dental Insurance $249 Total severance of $69,115 A Cass County North Dakota 456002205 14805RAL2 2007-07-31 2600000 Hospice of the Red River Valley Project 0 0 0 A 500000 0 2600000 217487 0 0 52000 0 0 2330513 0 0 2007 0 0 1 1 A 0 0 0 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 1 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 member 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 November, 2013). 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 13 healthcare facilities in the Fargo-Moorhead area, as well as a survey from the YMCA. An additional survey was also conducted (the most recent was in 2013) for executive (director) 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 his 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.