2024-12-11T08:28:07-06:00 2024-04-30 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-05-01 113686120 Coal Country Community Health Center COAL 7018737788 1312 Highway 49 N Beulah ND 585236038 Kurt Waldbilling CEO 7018737788 2024-12-11 1 1 Lisa Chaffee CPA P00193453 7012551091 2024-12-11 2023 2024-10-15 13:58:12Z Kurt Waldbilling 1312 Highway 49 N Beulah ND 585236038 16026803 0 X www.coalcountryhealth.com X 2003 ND CCCHC provides and promotes quality health care to the medically underserved population in the North Dakota counties of Mercer, Dunn, and Oliver. 12 11 153 12 0 0 4741649 3326081 11567539 12633404 0 0 64168 67318 16373356 16026803 0 0 0 0 10045033 10934400 0 0 0 6050015 6462047 16095048 17396447 278308 -1369644 17189852 15618101 4661229 4459122 12528623 11158979 X Working together as partners to enhance the lives of area residents by providing a neighborhood of patient centered healthcare services that promote wellness, prevention and care coordination. 1 1 14713873 12633404 Coal Country Community Health Center is part of a family of over 1,400 health centers nationally that provide care to more than 32 million people in the United States. Community health centers are local, non-profit health care providers serving low income and medically underserved communities. Also known as Federally-Qualified Health Centers (FQHCs), they are located in areas where care is needed, and improve access to care for millions of Americans. Their costs of care rank among the lowest, and their focus on prevention reduces the need for more expensive in-patient and specialty care, saving billions of dollars for taxpayers. (Continued on Schedule O)The focus of the care we provide can be summed up in one word - community. Coal Country is governed by a board of members from the communities we serve, and every decision they make has the best interest of the community in mind. Our medical staff and support staff are also your neighbors, helping us truly understand you and the health care issues that are important to you.The team of providers delivers primary care for the entire community. Funded by a federal grant, our sliding fee scale allows patients to pay according to their individual ability. This and other efforts ensure that no one in the community goes without proper health care services. That's what we're all about.Coal Country Community Health Center has clinics in Beulah, Center, Hazen, and Killdeer. Furthermore, Coal Country remains a member of health care networks in the region.At Coal Country Community Health Center, our top priority is to provide complete health care services for the entire community.With a background in every area of medicine, our primary care physicians provide continuing and comprehensive care, from preventative care to diagnosis and treatment of health conditions. A full list of services provided by Coal Country Community Health Center can be obtained at www.coalcountryhealth.comCCCHC opened a seasonal school medical clinic located in Killdeer and Hazen School Districts. Services began in the Spring 2023 and will continue annually September through May indefinitely. 14713873 1 1 0 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 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 34 0 1 153 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Victoria Oberlander 7018737788 1312 Hwy 49 N Beulah ND 585236038 Aaron Garman MD Physician 40.00 X 343920 0 51168 Michelle Placke Physician 40.00 X 301570 0 48826 Jacinta-Jon Klindworth MD Physician 40.00 X 288401 0 51361 Ann Ruffo Physician 40.00 X 250165 0 43628 Kelsey Wiseman Physician 40.00 X 249509 0 38649 Brian Williams CEO (Admin Leave May-Aug) 40.00 X 219575 0 35827 Darrold Bertsch Interim CEO 40.00 X 173805 0 0 Victoria Oberlander CFO 40.00 X 128958 0 32736 Kurt Waldbillig CEO (Oct-April) 40.00 X 57172 0 10905 Dr DJ Erickson Chair 1.00 X X 0 0 0 Kathy Kelsch Vice Chair 1.00 X X 0 0 0 Heidi Moore Secretary/Treasurer 1.00 X X 0 0 0 Fred Stern Director 1.00 X 0 0 0 Anna Mae Batke Director 1.00 X 0 0 0 Myria Perry Director 1.00 X 0 0 0 Wayne Hoffner Director 1.00 X 0 0 0 Sharon Rud Director 1.00 X 0 0 0 Sarah Duttenhefner Director 1.00 X 0 0 0 William Suter Director 1.00 X 0 0 0 Brian Nolan Director (Began June 2023) 1.00 X 0 0 0 Carl Blackhurst Director (Until May 2023) 1.00 X 0 0 0 2013075 0 313100 23 0 1 0 Beulah Drug 147 W Main Beulah ND 58523 Contract Pharmacy Dispensing Fees 1146763 Comstock Construction Inc PO Box 1145 Whapeton ND 58074 Construction General Contractor 877034 Sakakawea Medical Center 510 8th Avenue NE Hazen ND 58545 Rent for Hazen Clinic, Shared Staff: HR, 367861 Altru Health System PO Box 6002 Grand Forks ND 582066002 Software Subscription & Support 251352 Trisha Walker DBA A Fresh Start LLC 639 S Main Ave Dickinson ND 58601 Housekeeping Services 170344 7 3158181 167900 3326081 Patient Service Revenue 621110 8359513 8359513 340B Program Revenue 621110 3718303 3718303 Other Program Revenue 621110 555588 555588 12633404 67318 0 67318 67318 67318 16026803 12633404 0 67318 X 444835 444835 56533 56533 8417891 7825199 592692 310471 235519 74952 1092619 859038 233581 612051 434758 177293 14694 14694 71868 71868 2184089 1966613 217476 74071 74071 673693 563007 110686 709656 535575 174081 105056 63355 41701 37613 9156 28457 30664 30664 991999 925502 66497 68641 -6000 74641 Medical Supplies 1142199 1142199 Dues & Subscriptions 54121 10296 43825 Licenses 37449 36235 1214 266234 26224 240010 17396447 14713873 2682574 0 6726159 6243818 1663867 1577364 12963 9711 83307 97529 240426 166269 12636407 5306475 7993781 7329932 469349 193478 17189852 15618101 1232718 1345802 3428511 3113320 4661229 4459122 X 12528623 11158979 12528623 11158979 17189852 15618101 -1369644 0 X 0 1 X 1 1 1 X 2925137 5431566 4190746 4741649 3326081 20615179 2925137 5431566 4190746 4741649 3326081 20615179 20615179 66860 65968 66368 64168 67318 330682 20945861 54991580 0.98420 0.98540 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10406970 3719868 6687102 33136 22848 10288 1957050 1360068 596982 239251 203691 35560 7329932 X 16026803 0 16026803 0 16026803 17396447 0 17396447 0 17396447 Part X, Line 2: The Health Center 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. The Health Center 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. X X X 0 0 0 0 0 0 0 0 0 Aaron Garman MD Physician 282850 0 59828 0 1242 0 11146 0 41442 0 396508 0 0 0 Michelle Placke Physician 237318 0 63648 0 604 0 12305 0 37940 0 351815 0 0 0 Jacinta-Jon Klindworth MD Physician 233269 0 53890 0 1242 0 11257 0 41523 0 341181 0 0 0 Ann Ruffo Physician 209314 0 33164 0 7687 0 9103 0 35841 0 295109 0 0 0 Kelsey Wiseman Physician 202850 0 46299 0 360 0 8739 0 31225 0 289473 0 0 0 Brian Williams CEO (Admin Leave May-Aug) 212258 0 6000 0 1317 0 8939 0 27765 0 256279 0 0 0 Darrold Bertsch Interim CEO 173805 0 0 0 0 0 0 0 0 0 173805 0 0 0 Victoria Oberlander CFO 113738 0 15000 0 220 0 5706 0 27672 0 162336 0 0 0 Schedule J, Part II: Brian Williams was an employee of Coal Country Community Health Center (CCCHC) and also provided services to Sakakawea Medical Center (SMC). Brian was paid on administrative leave until August. The compensation reported in Part VII, and Part II of the Schedule J, reflects total compensation Brian received from CCCHC for services to both SMC and CCCHC. 49% of his compensation was reimbursed by SMC as part of a shared services agreement. Darrold Bertsch served as the interim CEO until Kurt Waldbillig took over in October. Darrold and Kurt both also provided services to SMC. The compensation reported in Part VII and Part II of the schedule J, reflects total compensation Darrold and Kurt received from CCCHC for services to both SMC and CCCHC. 49% of Darrold and Kurt's compensation was reimbursed by SMC as part of a similar share services agreement. Amber Blackhurst Spouse of Board Member, Carl Blackhurst 56533 Employee Wages and Benefits 0 Form 990, Part III, line 2 The organization began offering Fluoride treatment application and continuous blood glucose monitoring during the year. Form 990, Part III, line 3 Nutritional Counseling - Registered Dietician resigned. Form 990, Part VI, Section A, line 1a The Executive Committee shall consist of at least five (5) voting members, including the Chair, Vice Chair, Secretary, Treasurer, and one (1) at-large member. The Executive Director of the Corporation shall serve without voting powers. The Executive Committee shall have the power to transact all business of the Corporation during the interim between meetings of the Board of Directors, provided that any action so taken shall not conflict with the policies and express wishes of the Board of Directors, and that it shall refer all matters of major importance to the full Board of Directors, including any amendments to the Articles and Bylaws. Form 990, Part VI, Section B, line 11b The full copy of the Form 990 is provided to the board via email. The Form 990 is reviewed and approved by the board and signed by the CEO after approval. Form 990, Part VI, Section B, line 12c The conflict of interest and compensation disclosure statements are completed annually. All board members and officers of CCCHC are covered by the policy. The annual conflict of interest and compensation disclosure statements obtained from board members and officers of CCCHC are reviewed by the CEO and Administration staff of CCCHC. It is at this review that the determination is made as to whether a conflict exists. Actual conflicts of interest identified are brought before the Board Executive Committee or the entire Board, depending on the situation and circumstances. Board members and officers of CCCHC are required to recuse themselves from voting on issues where it has been determined that a conflict of interest does exist. If the conflict of interest is pervasive, the Board Executive Committee or the entire Board will determine if further actions are needed. In all situations, the Board will document the restrictions imposed or acted upon. Form 990, Part VI, Section B, line 15a To determine compensation, the organization uses the following salary surveys for both the CEO and CFO as well as other positions within the organization: National Community Health Center Association (NACHC), Community Healthcare Association of the Mountain Plain States (CHAMPS), Medical Group Management Association (MGMA), and state of ND. The board of directors determines the salary of the CEO. CEO Salary adjustments are documented on a payroll notification form, signed by the board chair and forwarded to the accounting department for entry into the accounting/payroll system. Compensation for the CFO is reviewed and approved by the CEO. The board of directors approves an annual budget to provide guidance for expenditures which includes personnel salaries. In addition, annual salary adjustments are presented to the board for approval through the budgetary process. Personnel salary adjustments are documented on a payroll notification form signed by the CEO or Human Resources and forwarded to the accounting department for entry into the accounting/payroll system. The process for determining compensation is undertaken annually before the new fiscal year in May begins. 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 IX, line 11g Other Medical Service Fees: Program service expenses 1,966,613. Management and general expenses 217,476. Fundraising expenses 0. Total expenses 2,184,089.