2012-08-28T11:44:45-07:00 2011-12-31 990 2011-01-01 450349152 HOSPICE OF THE RED RIVER VALLEY HOSP 7013561500 1701 38th St S Suite 101 Fargo ND 581034499 Steve Slabik 7013561500 2012-08-28 2011 2016-02-24 21:20:13Z Susan J Fuglie 1701 38th St S Suite 101 Fargo ND 581034499 20550656 0 X www.hrrv.org X 1981 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. 12 12 234 392 0 0 1072026 1085175 20360325 18298323 215718 237016 92547 102207 21740616 19722721 0 0 0 0 9552105 9239298 0 0 488207 10575506 9673664 20127611 18912962 1613005 809759 12270647 12600628 4102743 3724034 8167904 8876594 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 15019246 0 18291437 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 abiliities, 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 2011, Hospice of the Red River Valley served 1,323 patients from offices in Fargo, Grand Forks, Lisbon, Mayville and Valley City, North Dakota and Detroit Lakes and Thief River Falls, Minnesota. 113652 0 6888 Public education on dying, death, grief and loss, plus public support through support groups and classes. 0 0 0 15132898 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 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 0 1 53 0 1 234 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 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 2 X X 0 0 0 Tim Richard 2 X X 0 0 0 Roberta Young 2 X X 0 0 0 Jerry Schutz 2 X 0 0 0 James Ferragut 2 X X 0 0 0 Jenny Amon 2 X 0 0 0 Wade Stubson 2 X 0 0 0 Peter Jacobson 2 X 0 0 0 Jane Kelly 2 X 0 0 0 Paulette Korsmo Frith 2 X 0 0 0 Russ Tweiten 2 X 0 0 0 Dave Selland 2 X 0 0 0 James Jensen 2 X 0 0 0 Jon Benson 2 X 0 0 0 Ruth Hanson 2 X 0 0 0 Tim Haugen 2 X 0 0 0 Mary Wichmann 2 X 0 0 0 Susan J Fuglie 40 X 122185 0 13003 Steve Slabik 40 X 98177 0 12123 Tricia Langlois 40 X 176147 0 877 396509 0 26003 3 0 1 0 Sanford Hospital 801 North Broadway Fargo ND 58102 Medical & Hospitalization 341204 Suncoast Solutions 19337 US Highway 19 n Suite 450 Clearwater FL 33764 Software support and maintenance 146754 Verizon Wireless PO Box 25505 Lehigh Valley PA 18002 Cell phone and data plan services 139894 Nurse Communication after Hours PO Box 54246 Irvine CA 92619 On-call Nursing Services 108606 4 157333 0 0 0 0 927842 0 1085175 Net Patient Service Revenue 621610 18291435 18291435 0 0 Public Grief Support 624100 6888 6888 0 0 0 0 0 0 18298323 173166 0 0 173166 0 0 0 0 0 0 0 0 58171 0 54662 0 3509 0 3509 0 0 3509 554658 53037 529438 14407 25220 38630 63850 0 0 63850 328126 0 229428 98698 0 98698 0 19722721 18298323 0 339223 396509 176147 220362 0 7140184 5284421 1552401 303362 215705 156285 50738 8682 900574 652494 211831 36249 586326 424812 137914 23600 0 0 0 0 25821 0 25821 0 30985 0 30985 0 0 0 0 0 0 0 0 0 0 0 183328 159215 19416 4697 80573 350 55614 24609 506536 182620 274982 48934 127135 0 127135 0 0 0 0 0 398844 0 398844 0 636216 560542 53787 21887 0 0 0 0 39355 5306 21215 12834 5 0 5 0 0 0 0 0 379729 379729 0 0 72261 0 72261 0 Contracted Services 6399699 6399699 0 0 Medical Supplies 704281 704281 0 0 Dues, licenses & subscriptions 46139 6205 37333 2601 Bad Debt 36401 36401 0 0 6356 4391 1213 752 18912962 15132898 3291857 488207 760 612 1650552 1227696 20000 0 2011345 2951214 61793 57395 160482 138630 6512265 2757196 3732253 3755069 3965403 3805219 200000 200000 468059 464793 12270647 12600628 1717743 1429034 2385000 2295000 0 0 4102743 3724034 X 6948931 7588472 77674 42185 1141299 1245937 8167904 8876594 12270647 12600628 X 809759 -101069 X 0 1 0 X 0 X 1030615 1485436 1090353 1072026 1085175 5763605 0 0 0 0 0 0 0 0 0 0 0 0 1030615 1485436 1090353 1072026 1085175 5763605 344396 5419209 177994 103649 62711 181113 176675 702142 270155 273154 79577 85140 98698 806724 7272471 0.74517 0.71214 X Fundraising activities, primarily Heirlooms resale store, net of expenses RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1966170 67965 22023 0 98309 12388 1945461 1840233 10746 211970 0 83210 13569 1966170 1502327 84034 266716 0 0 12844 1840233 1715895 275967 -391141 0 85297 13097 1502327 0.3291 0.6492 0.0217 0 0 0 870000 870000 0 2314201 461880 1852321 0 113675 10749 102926 0 3175303 2278647 896656 0 39086 5920 33166 3755069 0 0 19722721 18912962 809759 -101072 0 0 0 -69150 -170222 639537 19861685 0 0 0 285110 285110 19576575 0 146146 146146 19722721 19198072 0 0 0 285110 285110 18912962 0 0 0 18912962 SchD_P05_S00_L04 Schedule D, Part V, Line 4 The stated purpose of the organization's endowment fund is to fulfill the board of director's ENDS polilcies ensuring the organization's finanicial stability through preservation and protection of it assets, and to allow for satisfactory total return on all funds. SchD_P10_S00_L02 Schedule D, Part X, Line 2 Hospice is 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 required to file an annual 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 requirments, 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. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 Permanently Restricted Donations - (104,638) Temporarily Restricted Donations - (78,500) Release of Restriced Assets - 178,808 Realized Gains on investments - (64,820) TOTAL - (69,150) SchD_P12_S00_L02d Schedule D, Part XII, Line 2d Fundraising Expenses included on Schedule G, Part II (netted against fundraising income) - 229,428 Expenses related to real estate rental - 54,663 Other revenue offset against expenses - 1,019 TOTAL - 285,110 SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Permanently Restricted Donations - 104,638 Temporarily Restricted Donations - 78,500 Release of Restricted Assets -(178,808) Contributions released for long-lived assets - 77,000 Realized Gains on Investments - 64,820 Rounding - (4) TOTAL - 146,146 SchD_P13_S00_L02d Schedule D, Part XIII, Line 2d Fundraising Expenses - 229,428 Expenses related to real estate rental - 54,663 Other revenue offset against expenses - 1,019 TOTAL - 285,110 Heirlooms Resale Store 327652 0 327652 0 0 79974 0 0 132769 0 0 327652 0 327652 0 0 79974 0 0 132769 212743 114909 X X 0 0 0 0 0 0 0 0 0 Tricia Langlois 176147 0 0 0 0 0 0 0 877 0 177024 0 Cass County North Dakota 456002205 14805RAL2 2007-07-31 2600000 Hospice of the Red River Valley Project 0 0 0 0 0 2600000 217487 0 0 52000 0 0 2330513 0 0 2007 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 F990_P06_S0A_L08b 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 F990_P06_S0B_L11b 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. F990_P06_S0B_L12c 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 regarding any agenda items. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 A full review of all salaries is conducted annually and compared to wage and salary survey data (salary surveys are done annually; last done in December, 2011). The following resources are used when conducting the survey: local health care agencies, ND and MN Job Service, Fargo-Moorhead Human Resource Association, MN healthcare, Mulit-View (a national hospice financial consulting company) and National Association of Home Care & Hospice. An additional survey is also conducted (the most recent was in 2010) for executive (director) positions. Based on the above and recommendations from the director of human resources and budgetary constraints, the executive drector 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. F990_P06_S0C_L19 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. F990_P11_S00_L05 Form 990, Part XI, Line 5 Change in unrealized gains and losses on investments - (101,072) Rounding - 3 TOTAL (101,069)