2025-05-15T15:49:25-05:00 2024-06-30 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-07-01 770637498 McKenzie County Healthcare Systems Inc MCKE 7018423000 709 4th Avenue NE Watford City ND 58854 Peter Edis CEO 7018423000 2025-05-15 1 0 Lisa Chaffee CPA P00193453 7012551091 2025-05-15 2023 2025-03-06 01:10:19Z Peter Edis 709 4th Avenue NE Watford City ND 58854 65913377 0 X www.mckenziehealth.com X 2004 ND Health care service provider. 9 9 0 10 467526 0 11743198 13164480 43954736 51824222 -267163 389988 -559823 -324897 54870948 65053793 0 0 0 0 21966744 25775871 0 0 0 28668869 32257295 50635613 58033166 4235335 7020627 105701816 112198103 70906408 69889231 34795408 42308872 X Mckenzie County Healthcare Systems is a faith-based organization dedicated to professional, compassionate and quality healthcare. 0 0 34858381 38632518 McKenzie County Healthcare Systems provides 24 hour x 7 days a week services. MCHS provided in-patient, observation, and swing bed services and obstetrics - hospital - total inpatient/observation days -1,213. Total swing bed days -1,046. MCHS offers various other services. They offer Ortho, Gen Surgery, Urol and ENT. Total Surgeries - 1015.The emergency room is open 24 hours a day, 7 days a week. Total Emergency Room visits - 5,673. The laboratory is located within the Hospital facility. Birthday lab screenings are available to the community at the hospital at a reduced rate. Total lab procedures - 64,202; Total births 99; Total clinic visits -19,775. 3344868 5393619 The McKenzie County Healthcare System (MCHS) Good Shepherd Home (GSH) is a 47 bed skilled nursing home with an attached 9-bed basic care unit. The GSH offers Day Care and/or Respite Care for those caring for a loved one in their home. A Dementia Support Group is offered to families. They maintain regular Resident Family Council Meetings. Along with qualified nursing care and staff, social services, physical therapy, occupational therapy, restoration nursing, laundry, housekeeping, beautician services, and activity programs are offered (beautician and activities held when COVID conditions allow). Visitors are welcome when COVID conditions allow; regular electronic "visits" are arranged otherwise. Pastoral care and chapel are offered 7 days a week. Activities include birthday parties, musical groups, baking, and bus trips. The Skilled Nursing total percent of occupancy has been 85%. 8778102 6867986 The MCHS Clinic (Rural Health Clinic) maintains the same mission as the Hospital. It provides care Monday through Friday. The RHC recently started conducting Telehealth visits as rendering providers due to COVID. A full-time contracted locum physician group provide Emergency Room Coverage at the hospital 24 hours a day x 7 days a week as well as 7 day a week Urgent Care coverage from 8am to 8pm utilizing mid-level providers. An RHC provider offered regular visits to the Good Shepherd Home. Both the Value Based Program involvement as well as our Visiting Nurse Program have been a great asset to the clinic, providing care to homebound patients within our community. After the onset of the COVID-19 pandemic the RHC developed point-of-care services and rapid testing for the community. 343635 455901 Horizon Assisted Living provides assisted and independent living services. It consists of 15 apartments that provide a 24 hour call system to health care personnel. The staff is dedicated to helping seniors live at their highest level of independence and ability. Its percent of occupancy is currently at 95.6%. 343635 455901 47324986 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 104 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Peter Edis 7018423000 709 4th Avenue NE Watford City ND 58854 Gary Brown Chair 1.00 2.00 X X 0 0 0 Justin Voll Vice-chair 1.00 0.00 X X 0 0 0 Randy Quale Treasurer 1.00 2.00 X X 0 0 0 Jan Dodge Secretary 1.00 2.00 X X 0 0 0 Virginia Ceynar Director 1.00 0.00 X 0 0 0 Kristen Heen Director (As of Jan) 1.00 0.00 X 0 0 0 Yolanda Rojas Director 1.00 0.00 X 0 0 0 Monty Bulzomi Director 1.00 0.00 X 0 0 0 Chase Wisness Director 1.00 0.00 X 0 0 0 Tammy James Director (Until Dec) 1.00 0.00 X 0 0 0 Peter Edis CEO 40.00 0.00 X 301617 0 40890 Theo Stoller COO 40.00 0.00 X 116318 0 39049 Cheryl Batchelor Interim CFO (Until Sept) 37.00 3.00 X 0 0 0 William Merkle CFO (As of Sept) 37.00 3.00 X 50654 0 39949 Cheryl Faulkner CNO 40.00 0.00 X 134300 0 31711 Dr Gary Ramage Medical Director, Physician 32.00 0.00 X 376136 0 39943 Dr Ravindra Joshi Orthopedic Surgeon 40.00 0.00 X 1184581 0 20200 Dr Yolanda Newton Medical Doctor 40.00 0.00 X 524535 0 24892 Dr Trevor Thorpe Interim Anesthesia Chief 40.00 0.00 X 353064 0 46408 Dr Kathryn Kovar CRNA 40.00 0.00 X 321817 0 28083 Dr Paul Dearing Medical Doctor 40.00 0.00 X 297000 0 13148 Daniel Kelly Former President 0.00 19.85 X 180151 0 23321 3840173 0 347594 10 1 1 0 Compassionate Hospitalist Care 102 Polo Ln Sanford FL 32771 Physician 548635 Mastrapa Medical Services LLC 1541 Palm Ave Winter Park FL 32789 Physician 528126 Construction Engineers Inc PO Box 13378 Grand Forks ND 58208 Construction 509955 WelkerPR Inc 6226 Red Canyon Dr Apt A Highlands Ranch CO 80130 Marketing 249710 Robert Bates MD 1515 N Astor St Apt 22A Chicago IL 60610 Physician 228376 8 2641173 10097899 425408 13164480 Hospital Patient Service Revenue 621110 34658891 34658891 Clinic Service Revenue 621110 6867986 6867986 Nursing Home Service Revenue 623000 5393619 5393619 340B Pharmacy Revenue 456110 3258395 3258395 Assisted Living Rental 623000 455901 455901 1189430 715232 474198 51824222 329961 329961 534687 859584 -324897 -324897 -6672 -318225 60027 0 60027 60027 60027 65053793 51350024 467526 71763 X 1303011 114701 1188310 300521 300521 19995348 17901876 2093472 691805 646647 45158 2096345 1546183 550162 1388841 1155018 233823 78766 78766 94849 94849 17281075 14009041 3272034 234736 38408 196328 668617 449482 219135 503199 503199 629581 554679 74902 531530 470355 61175 171497 125449 46048 1406440 1192098 214342 5700821 4793395 907426 414506 139918 274588 Medical Supplies 1972093 1972093 Pharmaceuticals 996466 996466 Food Service Supplies 531572 529584 1988 Repairs and Maintenance 510687 484592 26095 530860 205001 325859 58033166 47324986 10708180 0 4807834 3024500 5324223 3992323 7655818 9237755 1037389 1584540 618785 485653 115911058 46356127 71205401 69554931 14693173 23532439 359193 785962 105701816 112198103 3621798 6577103 800 74070 72478 67190540 62805316 20000 433534 70906408 69889231 X 34795408 42308872 34795408 42308872 105701816 112198103 7020627 492837 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3162 3162 0 Part II-B, Line 1: The Organization is a member of North Dakota Hospital Association and North Dakota Long Term Care Association. A portion of membership dues to the above listed associations is used for lobbying. These associations advocate on behalf of its members for improving efficiency and accessibility of the healthcare delivery systems and the health status of North Dakota's population. 0 1 X 1063726 1063726 57536284 19577349 37958935 49447403 24392994 25054409 7863645 2385784 5477861 69554931 Postretirement Benefit Obligation 10000 Lease Liability 423534 433534 X 66406214 492837 492837 65913377 -859584 -859584 65053793 58892750 859584 859584 58033166 0 58033166 Part IV, Line 2b: The Organizations holds security deposits, as well as resident trust funds. Part X, Line 2: The Health System believes it has appropriate support for any tax positions taken affecting the annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Health System would recognize future accrued interest and penalties related to unrecognized tax liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 4b - Other Adjustments: Rental Expenses Included in Expenses on Financials -859,584. Part XII, Line 2d - Other Adjustments: Rental Expenses Included in Revenue on Form 990 859,584. 1 1 X 1 X 1 X 1 1 0 0 75000 75000 0.00130 75000 75000 0.00130 18105138 5407013 12698125 0.21880 18105138 5407013 12698125 0.21880 18180138 5407013 12773125 0.22010 1 5270673 385330 9780612 9849642 -69030 X 1 1 1 1 McKenzie County Healthcare Systems Inc 709 4th Ave NE Watford City ND 58854 http://mckenziehealth.com/ 5051A X X X X Swing bed unit, Urgent care, PT/OT McKenzie County Healthcare Systems Inc 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X https://mckenziehealth.com/chna/ X 1 21 1 https://mckenziehealth.com/chna/ 0 1 X 100.000000000000 250.000000000000 X X X 1 1 X X X X 1 X https://mckenziehealth.com/patient-services/billing/ X https://mckenziehealth.com/patient-services/billing/ X https://mckenziehealth.com/patient-services/billing/ X X X X X X 1 X 0 X X X X 1 X 0 0 McKenzie County Healthcare Systems Inc. Part V, Section B, Line 5: Residents of the area were given the opportunity to participate in a survey. One hundred twenty-nine MCHS service area residents completed the survey. Additional information was collected through seven key informant interviews with community members. The input from the residents, who primarily reside in McKenzie County, represented the broad interests of the communities in the service area. Together with secondary data gathered from a wide range of sources, the survey presents a snapshot of the health needs and concerns in the community. A steering committee was responsible for planning and implementing the process. The committee consisted of the McKenzie County Courthouse Job Development Authority, a local bank Public Relations representative, the Chief of Ambulance at McKenzie County Ambulance, the Interim Director of Operations at MCHA, and the school Superintendent. McKenzie County Healthcare Systems Inc. Part V, Section B, Line 11: The most recent CHNA conducted in fiscal year 2022 identified the following significant needs:1. Not enough Affordable Housing2. Availability of resources to help the elderly remain at home. 3. Having enough child daycare services. 4. Availability of mental health ServicesActions taken in prior years to address the fiscal year 2022 CHNA needs that continued in the current tax year:Need 1: Not enough affordable housing - Since the last CHNA process, McKenzie Health has purchased several homes in the community to utilize as resources for providers and staff who are in Watford City providing services. Additionally, with many offers of employment, housing is an added benefit where either housing is provided or a stipend issued. Housing continues to be a challenge in Watford City and, as such, some legislative action has been suggested as well to address the need.Need 2: Availability of resources to help the elderly stay in their homes - McKenzie Health's Chronic Care Management Team deploys to see individuals in their homes to address needs. They provide blood pressure monitoring, bring flu and COVID vaccinations, assist patients with getting access to assistive devices like walkers, and help with follow-up care.Need 3: Having enough child daycare services - McKenzie Health worked to address daycare services and the expense associated with it by reserving several slots with the local daycare specifically for our staff members. A flexible work schedule is offered as well to help accommodate staff with children.Need 4: Availability of mental health resources - McKenzie Health now has a listing in FirstLink, a 501(c)3 nonprofit, which is responsible for answering the 2-1-1 Helpline statewide for North Dakota and the National Suicide Prevention Lifeline for the entire state of North Dakota and parts of Minnesota. Anyone can call this number 24 hours/day and be connected to a live person who can provide information about local resources and a listening ear. A "Preventing Suicide - What to Know and Expect with Suicidal Thoughts, Plans, or Threats in Pediatric Patients" trifold was developed for utilization in the Emergency Department for parents and guardians. Philomena Cunningham, Psychiatric Mental Health Nurse Practitioner (PMHNP), was hired to see patients for psychiatric assessments, diagnoses, and medication management. Her services are offered via telemedicine on Tuesdays, Wednesdays, and Fridays. She is bilingual (English/Spanish) and will see patients from age 6 to adult. McKenzie County Healthcare Systems Inc. Part V, Section B, Line 16j: In addition to providing the full policy upon request, a summary of the policy is posted in the emergency rooms, waiting rooms, and admissions office. Upon admission, the patients receive a brochure in a packet referencing the financial assistance policy. The patients also receive information in their first billing invoice regarding the financial assistance policy. 5 1 - Good Shepherd Home 709 4th Ave NE Watford City ND 58854 LT Care and Basic Care 2 - McKenzie County Clinics 709 4th Ave NE Watford City ND 58854 Rural Health Clinic 3 - McKenzie County Urgent Care Clinic 525 N Main St Watford City ND 58854 Urgent Care Clinic 4 - Connie Wold Wellness Center 200 8th St NE Watford City ND 58854 Wellness Center 5 - Horizon Assisted Living 705 4th Ave NE Watford City ND 58854 Assisted Living Facility Part I, Line 7: Charity care for Part I, line 7a was converted to cost by multiplying the ratio of cost to gross charges by the gross uncompensated charges associated with providing charity care to its patients.The costs for Subsidized Health Services in Part I, line 7g were determined based on costs allocated to the relevant cost centers on the Medicare Cost Report. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: The organization calculated Line 3 by multiplying the implicit price concessions by the percent of the population in the community that is below the Federal Poverty Guidelines. The percent of the population in the community that is below the Federal Poverty Guidelines is 7.5%. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 13 and 14 of the attached audited financial statements. Part III, Line 8: MCHS provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services.Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall, if any, is considered a community benefit. The Organization reported only those allowable costs and Medicare reimbursements reported in the Medicare cost report for the year.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare Services.Hospital services rendered on a fee schedule are not included in the Medicare calculations per the 990 instructions. Had this been reported the Hospital would have had a greater loss from Medicare services of $262,913. Medicare fee schedule revenue $339,953 Medicare estimated costs of care relating to payments $602,866 Net (shortage) $(262,913) Part III, Line 9b: The Organization does not collect on accounts that, at any point, have a financial assistance application in review or that has been approved. This is the practice even if the patient applies after the 240 days period after the date of the first invoice for the service. If the account is not completely written off (based on the sliding fee schedule), and they do not follow through on their payment plan for the balance, that would be the only time the account was outsourced to collections. Self pay patients are identified at the point of registration and receive a 35% write off.The Organization provides a copy of the plain language summary of the financial assistance policy with all billing statements and communications that occur within the first 120 days following the first billing statement. Part VI, Line 2: Separate evaluations are completed annually for the Critical Access Hospital and the Rural Health Clinic. At this time, services and statistics are reviewed. Each report is presented to the medical staff members and Board of Directors. Current services are discussed along with the needs not currently being met. Managers of each department annually review their services with the budgeting process and discuss possible projection of new services. Once a need is determined, it is discussed on a departmental level, and information is gathered and presented to the CEO/CFO for approval. MCHS holds their annual meeting for the public in the fall of each calendar year. This is an open meeting allowing the public to voice concerns and suggestions. Part VI, Line 3: The MCHS charity care policy is posted in the hospital and clinic admissions areas and emergency room. Copies of the policy and applications are available in each reception area of the hospital and clinic. Information is sent out to all patients with their first statement. If a bill is unpaid, after two statements have been sent, a billing employee will attempt to reach the responsible party by phone to discuss installment plans, charity care, and/or discuss various government benefits such as Medicaid. The MCHS business offices also have the applications at all times. The business office staff counsel anyone who presents themselves with overdue balances and present the above options. Part VI, Line 4: McKenzie County Healthcare Services serves McKenzie County. McKenzie County is the largest county in the state of North Dakota. It is very rural and includes part of the Fort Berthold Reservation. McKenzie County Hospital is the only healthcare system within a 45 mile radius. The McKenzie County Healthcare Systems, Inc. County's population was estimated in 2021 at 13,819. The median household income in 2021 was reported at $75,238. 7.5% of the population was reported below the poverty level in 2021. The rugged terrain, winter conditions, increased oil activity, and recreational activities have all added to the increased number of emergency room visits. With the recent oil activity in the state in the last decade, McKenzie County is experiencing an increase in population, new businesses, housing projects, and improved wage scales. With this rapid growth, MCHS is experiencing an influx in emergency room services, shortage of physicians and nurses, as well as growing bad debt expenses related to medical services provided to uninsured workers and patients that do not have a permanent residence to send bills to. Part VI, Line 5: The McKenzie County Board of Directors is made up of volunteer members from the local community of Watford City and the surrounding areas. MCHS does extend privileges to all physicians in the area. Specialists will also visit the local hospital and clinic to expand the present services. Surplus funds are applied for the purposes education, increasing patient services, wellness, and preventative care to its clients. MCHS is also a part of a worksite wellness North Dakota program. It allows their cardiac wellness manager (RN) to work closely in the state-wide program that can greatly improve the health of employees, resulting in lower health care costs, and increased productivity and morale. McKenzie County Healthcare Systems and the McKenzie County Healthcare Systems Benefit Fund together engaged in the building and funding of a wellness center. The wellness center opened in March 2013. The wellness center houses a physical therapy department to better utilize a therapy pool and has increased the present square footage of the hospital. Prevention is a key word today. The wellness center provides education and exercise to its members. It helps improve or prevent diseases like diabetes, high blood pressure, obesity, depression, and many not listed. In an effort to enhance services in the rural areas, McKenzie County Healthcare participates in several programs. The Rural Accountable Care Organization is intended to better serve our population by improving healthcare, patient satisfaction, and reducing costs while improving financial performance and sustainability. The Frontier Community Healthcare Integration Project (FCHIP) is a demonstration program that assists our Organization with providing telemedicine services to our population in order to provide access to more specialty services to the residents of our communities. These programs are aimed at increasing the integration and coordination of care amongst providers and improve the overall quality of care for our healthcare community.Our hospital provides charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit which is not quantified. Our hospital, like most rural hospitals, was created and is maintained in order to provide local access to many health services: birthing center, diagnostics, emergency services and urgent care, home care, hospice, infusion services, inpatient care, laboratory services, occupational health, rehabilitation services, specialty medicine, speech and audiology, surgical services, and women's health. Part VI, Line 6: MCHS is an affiliate of Sanford Healthcare which assists the healthcare system with software and integrated equipment, ultimately streamlining healthcare across multiple states who use the same E.H.R. and other Sanford resources. X 0 1 X X 0 0 0 0 0 0 0 0 0 Dr Ravindra Joshi Orthopedic Surgeon 995140 0 189441 0 0 0 10285 0 9915 0 1204781 0 0 0 Dr Yolanda Newton Medical Doctor 524535 0 0 0 0 0 5968 0 18924 0 549427 0 0 0 Dr Gary Ramage Medical Director, Physician 376136 0 0 0 0 0 19800 0 20143 0 416079 0 0 0 Dr Trevor Thorpe Interim Anesthesia Chief 353064 0 0 0 0 0 18207 0 28202 0 399473 0 0 0 Dr Kathryn Kovar CRNA 321817 0 0 0 0 0 18135 0 9948 0 349900 0 0 0 Peter Edis CEO 250492 0 51125 0 0 0 34025 0 6865 0 342507 0 0 0 Dr Paul Dearing Medical Doctor 297000 0 0 0 0 0 13148 0 0 0 310148 0 0 0 Daniel Kelly Former President 158651 0 0 0 21500 0 9812 0 13509 0 203472 0 0 0 Cheryl Faulkner CNO 134300 0 0 0 0 0 8501 0 23210 0 166011 0 0 0 Theo Stoller COO 116318 0 0 0 0 0 12047 0 27002 0 155367 0 0 0 Part I, Line 1a Dr. Yolanda Newton, Dr. Trevor Thorpe, and Dr. Kathryn Kovar received residence for personal use at no cost or below fair market value. These amounts have not been included in their W2 taxable income. Leslie Kelly Spouse of Former Officer 50586 Employee salary 0 Form 990, Part VI, Section A, line 3 The Interim CFO, Cheryl Batchellor, is paid by an unrelated management company, American Consultants, for her services to both the Benefit Fund of McKenzie County Healthcare Systems and McKenzie County Healthcare Systems (MCHS). In calendar year 2023, MCHS paid $322,000 for her services. Form 990, Part VI, Section B, line 11b The MCHS CEO and CFO review and approve the Form 990. The Board of Directors recieve a copy of the final Form 990 before it is filed with the IRS. Form 990, Part VI, Section B, line 12c An interested person is defined as any director, principal officer, and anyone who has a direct or indirect financial interest with respect to all entities in the healthcare system. An interested person must disclose the existence of the financial interest and will be given the opportunity to disclose all material facts to the Directors. The conflict will be reviewed by the remaining Board and will determine if a conflict exists. If a conflict exists, the interested person must abstain from voting on the issue and the remaining Board members will determine if the transaction is in the hospital's best interest, for its own benefit, and if it is fair and reasonable. This is accomplished through annual review and a signed statement stating that the interested person has obtained a copy of the policy and has read and understands the policy, and has agreed to comply with the policy. Form 990, Part VI, Section B, line 15a Members of the Board of Trustees review state-wide salary survey information and other Form 990s when determining any wage changes. The CEO has an annual evaluation completed. The CEO has the opportunity to give a proposal to the Board at their evaluation. Any change or revision is recorded in the Board minutes. An addendum to the terms of employment is signed by the Board President and CEO for the personnel file. The CEO approves other officer compensation based upon survey data on an annual basis. The results are documented in the officer's annual evaluation paperwork. Form 990, Part VI, Section C, line 19 The governing documents, conflict policy, and financial statements are available upon request. Form 990, Part IX, line 11g Service Contracts: Program service expenses 918,402. Management and general expenses 179,494. Fundraising expenses 0. Total expenses 1,097,896. Staffing Purchased Services: Program service expenses 6,380,768. Management and general expenses 503,406. Fundraising expenses 0. Total expenses 6,884,174. Contracted Physician and Medical: Program service expenses 5,397,215. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,397,215. Other Purchased Services: Program service expenses 1,236,184. Management and general expenses 1,972,793. Fundraising expenses 0. Total expenses 3,208,977. Collection Agency: Program service expenses 0. Management and general expenses 344,862. Fundraising expenses 0. Total expenses 344,862. Credit Card Fees: Program service expenses 7,307. Management and general expenses 196,347. Fundraising expenses 0. Total expenses 203,654. Software Maintenance Fees: Program service expenses 47,115. Management and general expenses 70,696. Fundraising expenses 0. Total expenses 117,811. Consulting Services: Program service expenses 22,050. Management and general expenses 4,436. Fundraising expenses 0. Total expenses 26,486. Benefit Fund of McKenzie County Healthcare Systems 709 4th Ave NE Watford City ND 58854 363431210 To support the McKenzie County Healthcare Systems ND 501(c)(3) Line 7 McKenzie County Healthcare Systems Inc 1 McKenzie County Healthcare Systems Properties 709 4th Ave NE Watford City ND 58854 462905447 Property Management ND McKenzie County Healthcare Systems Inc C 39700 386566 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 Benefit Fund of McKenzie County Healthcare Systems C 2641173 Accrual