2012-06-04T11:59:47-05:00 2011-11-30 FIEBIGER SWANSON WEST & COPLLP 2537 S UNIVERSITY DR STE 200 FARGO ND 58103 990 2010-12-01 460341255 HORIZON HEALTH CARE INC HORI 6057724128 PO BOX 99 HOWARD SD 57349 JOHN MENGENHAUSEN 6057724128 2012-05-24 1 JEREMY ULMER CPA 7012802100 2010 2016-02-24 21:20:13Z JOHN MENGENHAUSEN PO BOX 99 HOWARD SD 57349 11805867 0 X WWW.HORIZONHEALTHCARE.ORG X 1978 SD HORIZON HEALTH CARE, INC. PROVIDES PERSONALIZED, AFFORDABLE, HIGH QUALITY PRIMARY HEALTH CARE THROUGH A RURAL COMMUNITY-BASED NETWORK IN SOUTH DAKOTA. 11 11 174 0 0 0 4034205 3355192 6778955 8343419 60166 97656 6100 9600 10879426 11805867 0 0 0 0 7485365 8152926 0 0 0 3100066 3526151 10585431 11679077 293995 126790 9350600 9463601 2132977 2121116 7217623 7342485 SEE PAGE 1, PART 1 0 0 10064278 8301455 HORIZON HEALTH CARE, INC. IS A RURAL COMMUNITY HEALTH CENTER PROVIDING MEDICAL SERVICES TO SMALL COMMUNITIES. HORIZON HEALTH CARE CONSISTS OF 15 CLINICS LOCATED THROUGHOUT SOUTH DAKOTA. THEY SERVE APPROXIMATELY 17,700 PATIENTS. 45864 51564 OFFICE OF RURAL HEALTH POLICY (ORHP) - FUNDS FOCUSED ON THE FURTHER DEVELOPMENT OF THE DAKOTA NETWORK OF COMMUNITY HEALTH CENTERS ALLOWING THE 22 CLINIC LOCATIONS TO SUPPORT SHARED ADMINISTRATIVE AND CLINICAL SERVICES; INCREASING THEIR EFFICIENCY AND IMPROVING THE QUALITY OF HEALTH CARE THEY PROVIDE. 10110142 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 174 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JOHN MENGENHAUSEN CEO 6057724525 PO BOX 99 HOWARD SD 57349 DAVE CALLIES 1.00 X 0 0 0 SAMANTHA PLANK 1.00 X 0 0 0 DAVE SCHMIDT 1.00 X 0 0 0 SALLY ROSIN 1.00 X 0 0 0 TRISTEN GRUENHAGEN 1.00 X X 0 0 0 MARGIE LARSON 1.00 X 0 0 0 ECHO PETERSON 1.00 X X 0 0 0 LYNDA LUYMES 1.00 X X 0 0 0 GARY HEINERT 1.00 X 0 0 0 RICHARD BAIR 1.00 X X 0 0 0 PAULA DAVIS 1.00 X 0 0 0 JOHN MENGENHAUSEN 40.00 X 226244 0 0 WADE ERICKSON 40.00 X 133742 0 0 THOMAS DEAN MD 30.00 X 175117 0 0 LANCE LIM MD 40.00 X 216978 0 0 MICHAEL MEDECK 40.00 X 185680 0 0 TRACY GROSSMAN 40.00 X 232377 0 0 ROBIN HATTERVIG 40.00 X 185511 0 0 1355649 0 0 7 0 1 0 WELLMARK PO BOX 5023 SIOUX FALLS SD 571175023 HEALTH INSURANCE 431428 AVERA HEALTH PLAN 3816 S ELMWOOD AVE SUITE 100 SIOUX FALLS SD 57105 HEALTH INSURANCE 427932 2 3335172 20020 19500 3355192 MEDICAL SERVICE FEES 621110 8343419 8343419 8343419 97656 97656 OTHER INCOME 621110 9600 9600 9600 11805867 8353019 0 97656 359986 359986 6160943 5516712 644231 1189852 999476 190376 442145 371402 70743 29313 3839 25474 16735 16735 18264 18264 400129 368547 31582 119627 30388 89239 4565 4565 37666 37389 277 425660 411289 14371 38336 24189 14147 CONTRACTED PROFESSIONAL 730322 726797 3525 MEDICAL SUPPLIES 482560 482560 0 340B DRUG COSTS 238185 238185 0 REPAIRS & MAINTENANCE 234848 220686 14162 BAD DEBTS 173410 173410 0 576531 505273 71258 11679077 10110142 1568935 0 1350651 835515 2313264 2819962 280342 105485 735396 859837 83744 452398 99372 105274 5837222 2744430 3184506 3092792 128344 111589 1174981 1080749 9350600 9463601 985337 1071738 261666 183908 885974 865470 2132977 2121116 X 7217623 7342485 7217623 7342485 9350600 9463601 X 126790 -1928 X X 0 1 1 X 1 1 X 2634509 2816214 4032475 4034205 3355192 16872595 2634509 2816214 4032475 4034205 3355192 16872595 16872595 113736 136354 19619 60166 97656 427531 17300126 33569457 0.97530 0.97680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 65290 65290 2186878 451055 1735823 296130 102678 193452 3288924 2190697 1098227 3092792 CASH VALUE OF ANNUITY 326633 NOTES RECEIVABLE 244109 RENTAL DEPOSITS 10007 INVESTMENT IN PARTNERSHIP 500000 1080749 11805867 11679077 126790 -1928 -1928 124862 11805867 0 11805867 0 11805867 11679077 0 11679077 0 11679077 X X X 0 1 0 1 0 0 0 0 0 JOHN MENGENHAUSEN 162248 0 63996 0 0 0 0 0 0 0 226244 0 265571 0 THOMAS DEAN MD 161826 0 13291 0 0 0 0 0 0 0 175117 0 230732 0 LANCE LIM MD 171383 0 45595 0 0 0 0 0 0 0 216978 0 206239 0 MICHAEL MEDECK 185680 0 0 0 0 0 0 0 0 0 185680 0 0 0 TRACY GROSSMAN 115011 0 117366 0 0 0 0 0 0 0 232377 0 233998 0 ROBIN HATTERVIG 159415 0 26096 0 0 0 0 0 0 0 185511 0 179185 0 PART I, LINE 5 HORIZON HAS AN INCENTIVE PLAN THAT PROVIDERS AND ADMINISTRATION PARTICIPATE IN. THE CALCULATION IS BASED ON PROVIDER REVENUE LESS APPLICABLE PROVIDER COSTS. JOHN MENGENHAUSEN EMPLOYEE RETENTION X 100000 62900 0 1 1 WADE ERICKSON EMPLOYEE RETENTION X 40000 0 0 1 1 ROBIN HATTERVIG EMPLOYEE RETENTION X 100000 62900 0 1 1 125800 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED AND ACCEPTED BY THE BOARD AT THE MONTHLY BOARD MEETING BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS CONSISTENTLY MONITORED & COMPLIANCE IS ENFORCED. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION IS THROUGH USE OF AN OUTSIDE CONSULTANT AND COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THESE DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,928. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.