2025-07-21T11:17:21-05:00 2024-09-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2023-10-01 473263272 CHALLIS AREA HEALTH CENTER INC CHAL 2088794351 PO BOX 980 CHALLIS ID 832260980 STEPHEN D REMBELSKI CHIEF EXECUTIVE OFFICER 2088794351 2025-07-17 1 1 KURT BENNION CPA P01469618 4252506100 2025-07-17 2023 2025-03-06 01:10:19Z STEPHEN D REMBELSKI PO BOX 980 CHALLIS ID 832260980 3247372 0 X WWW.CAHCINC.COM X 2014 ID WE PROVIDE QUALITY HEALTHCARE TO OUR COMMUNITY. 11 9 32 12 0 0 1927855 1096809 2180717 2097071 9795 43134 9694 10358 4128061 3247372 0 0 0 0 2047443 2164906 0 0 0 756612 765931 2804055 2930837 1324006 316535 4618289 5002366 115403 182945 4502886 4819421 WE PROVIDE QUALITY HEALTHCARE TO OUR COMMUNITY. 0 0 2560191 0 2097071 CHALLIS AREA HEALTH CENTER OPERATES A FEDERALLY QUALIFIED HEALTH CENTER LOCATED IN CHALLIS, IDAHO. 2560191 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 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 1 0 0 0 1 4 0 32 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 1 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SHARLENE MILLER 2088794351 PO BOX 980 CHALLIS ID 832260980 STEPHEN D REMBELSKI CHIEF EXECUTIVE OFFICER 40.00 10.00 X 173521 0 24127 THOMAS FIFE PHYSICIAN ASSISTANT 40.00 0.00 X 161137 0 33544 MILES HAEBERLE PHYSICIAN ASSISTANT 40.00 0.00 X 155878 0 33744 S MAX SMITH PHYSICIAN ASSISTANT 40.00 0.00 X 142572 0 43129 M CHAD BANKS PHYSICIAN ASSISTANT 40.00 0.00 X 140127 0 39520 SHARLENE MILLER CHIEF FINANCIAL OFFICER 40.00 5.00 X 92518 0 41284 JD BENNETTS CHAIR 1.50 0.75 X X 0 0 0 RAYNAE CHAMBERLAIN VICE CHAIR 1.20 0.60 X X 0 0 0 TEILA LEUZINGER TREASURER 1.50 0.60 X X 0 0 0 CORINNE JONES SECRETARY 1.20 0.00 X X 0 0 0 ROBERT BOREN DIRECTOR 1.20 0.75 X 0 0 0 SHELBIE BRYANT DIRECTOR 1.20 0.60 X 0 0 0 JEN BUTTERFIELD DIRECTOR 1.20 0.00 X 0 0 0 MATT CAHOON DIRECTOR 1.20 0.00 X 0 0 0 BETSY DOUGHTY DIRECTOR 1.20 0.60 X 0 0 0 SHELLY HELM DIRECTOR 1.20 0.00 X 0 0 0 STEPHANIE STRAND DIRECTOR 1.20 0.60 X 0 0 0 RAYNA WESTERGARD DIRECTOR (THROUGH APRIL 2024) 1.20 0.00 X 0 0 0 865753 0 215348 5 0 1 0 RIVERS WEST CONSTRUCTION 4063 COMMERCE CIRCLE IDAHO FALLS ID 83401 CONSTRUCTION 417737 1 1012200 29168 55441 1096809 PATIENT SERVICE REVENU 621110 1723384 1723384 340B PROGRAM REVENUE 621110 332818 332818 HEALTH CONNECTIONS 621110 40869 40869 2097071 43134 43134 INCOME FROM COOPERATIV 900099 10358 10358 10358 3247372 2097071 0 53492 335933 335933 1517494 1517494 36031 36031 140370 140370 135078 123028 12050 10451 9519 932 217592 198181 19411 5071 5071 45019 45019 109543 109543 48095 48095 14509 13215 1294 306 306 131298 131298 11506 10480 1026 MEDICAL SUPPLIES 125725 125725 EDUCATION 23167 23167 RECRUITING & RETENTION 15378 15378 MEMBERSHIP DUES 8271 8271 2930837 2560191 370646 0 1085145 1412334 1522449 1565406 172550 292068 4740 4694 19344 16397 1794967 405349 1520916 1389618 212419 221398 80726 80726 0 19725 4618289 5002366 115403 163134 0 19811 115403 182945 X 2981970 3393953 1520916 1425468 4502886 4819421 4618289 5002366 316535 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1495493 192624 1302869 11196 3079 8117 288278 209646 78632 1389618 RIGHT-OF-USE LEASE LIABILITIES 19811 19811 X PART X, LINE 2: THE CAHC IS A CHARITABLE ORGANIZATION UNDER THE STATE OF IDAHO TAX REGULATIONS AND UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM STATE OR LOCAL INCOME TAXES. THE CAHC IS REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE INTERNAL REVENUE SERVICE (IRS) ANNUALLY. IN ADDITION, THE CAHC IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE CAHC 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. THE CAHC 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 CAHC 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 1 0 0 0 0 0 STEPHEN D REMBELSKI CHIEF EXECUTIVE OFFICER 168339 0 5182 0 0 0 5091 0 19036 0 197648 0 0 0 THOMAS FIFE PHYSICIAN ASSISTANT 157141 0 3996 0 0 0 4738 0 28806 0 194681 0 0 0 MILES HAEBERLE PHYSICIAN ASSISTANT 151146 0 4732 0 0 0 4714 0 29030 0 189622 0 0 0 S MAX SMITH PHYSICIAN ASSISTANT 138337 0 4235 0 0 0 4359 0 38770 0 185701 0 0 0 M CHAD BANKS PHYSICIAN ASSISTANT 137138 0 2989 0 0 0 4624 0 34896 0 179647 0 0 0 PART I, LINE 5 ALL EMPLOYEES PARTICIPATE IN AN INCENTIVE COMPENSATION PROGRAM. REVENUE-RELATED GOALS COMPRISE 25 PERCENT OF THE INCENTIVE COMPENSATION DETERMINATION. PATIENT SATISFACTION, QUALITY MEASURES AND PATIENT VOLUME COMPRISE THE OTHER 75 PERCENT. THE INCENTIVE COMPENSATION AMOUNTS CAN BE UP TO 5 PERCENT OF EACH INDIVIDUAL'S TOTAL COMPENSATION. WENDY CHESLEY CHILD OF BETSY DOUGHTY, BOARD MEMBER 36669 EMPLOYEE COMPENSATION 0 TARA CHAMBERLAIN CHILD OF RAYNAE CHAMBERLAIN, BOARD MEMBER 17690 EMPLOYEE COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATION'S BYLAWS PERMIT AN EXECUTIVE COMMITTEE TO TRANSACT EMERGENCY BUSINESS TRANSACTIONS BETWEEN BOARD MEETINGS. THE EXECUTIVE COMMITTEE WOULD CONSIST OF THE OFFICERS OF THE BOARD AND UP TO TWO MORE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 THE CHIEF MEDICAL OFFICER IS AN INDEPENDENT CONTRACTOR COMPENSATED THROUGH A 1099. THE CHIEF MEDICAL OFFICER HAS DECISION-MAKING AUTHORITY OVER CLINICAL PROCESSES. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024, THE CMO WAS PAID $50,921 FOR THESE SERVICES. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN JUNE 2024 (A) TO ELIMINATE THE LIMITATION ON BOARD TERMS AND (B) TO ALLOW BOARD MEMBERS TO BE RELATED TO CHALLIS AREA HEALTH CENTER AND/OR NORTH CUSTER HOSPITAL DISTRICT EMPLOYEES, PROVIDED THAT THEY DISCLOSE SUCH RELATIONSHIP AND RECUSE THEMSELVES FROM DISCUSSIONS IMPACTING THOSE RELATIVES. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 WAS PROVIDED TO THE GOVERNING BOARD AT A BOARD MEETING FOR THEIR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL EMPLOYEES AND BOARD MEMBERS. ANY POTENTIAL CONFLICTS SHOULD BE DISCLOSED TO THE BOARD. IF THERE IS A POTENTIAL CONFLICT, THE BOARD MAY INVITE THE INDIVIDUAL WITH THE CONFLICT TO BRIEFLY STATE A POSITION ON THE MATTER AND ANSWER PERTINENT QUESTIONS OF THE BOARD; HOWEVER, THE INDIVIDUAL MUST ABSTAIN FROM VOTING ON THE ISSUE. THE BOARD WILL REVIEW AND DETERMINE IF A CONFLICT DOES EXIST. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS, WHICH OPERATES INDEPENDENTLY FROM THE HEALTH CENTER'S EMPLOYEES, ESTABLISHES PAY RANGES FOR ALL EMPLOYEES, INCLUDING MANAGEMENT STAFF. THE PAY RANGES ARE BASED ON COMPARABILITY DATA FROM A BIANNUAL REGIONAL HEALTHCARE COMPENSATION SURVEY. THE BOARD DISCUSSES AND APPROVES THE PROCESS FOR ESTABLISHING PAY RANGES ANNUALLY AT A REGULAR BOARD MEETING. THE BIANNUAL COMPENSATION SURVEY WAS LAST PUBLISHED IN 2024 AND COMPENSATION WAS LAST REVIEWED IN MAY 2024. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, NORTH CUSTER HOSPITAL DISTRICT PUBLISHES THE CONSOLIDATED FINANCIAL STATEMENTS IN THE LOCAL NEWSPAPER. FORM 990, PART XII, LINE 2C: THE AUTHORITY AND PROCESS FOR SELECTING THE INDEPENDENT ACCOUNTANT TO AUDIT THE FINANCIAL STATEMENTS AND FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE FISCAL YEAR. NORTH CUSTER HOSPITAL DISTRICT PO BOX 357 611 CLINIC ROAD CHALLIS ID 83226 820402107 EMERGENCY & PRIMARY HEALTHCARE ID 115 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 NORTH CUSTER HOSPITAL DISTRICT C 1012000 CASH