2025-10-06T09:54:15-05:00 2024-12-31 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2024-01-01 450358986 Wishek Hospital Clinic Association WISH 7014522326 PO Box 647 Wishek ND 584950647 Lukas Fischer CEO 7014522326 2025-10-02 1 1 Lisa Chaffee CPA P00193453 7012551091 2025-10-02 2024 2025-03-06 01:10:19Z South Central Health Lukas Fischer 1007 4th Ave S Wishek ND 58495 11565732 0 X https://schealthnd.com/ X 1949 ND Providing the highest possible standard of healthcare in a compassionate and professional manner. 9 8 99 9 0 0 390081 597711 9557290 10880344 3879 54183 77564 20247 10028814 11552485 0 0 0 0 5904552 5782833 0 0 200 4297400 5047084 10201952 10829917 -173138 722568 7022344 7773462 2197939 2035350 4824405 5738112 X Wishek Hospital Clinic Association is a progressive and innovative healthcare leader providing personalized services promoting the creation of healthier communities. 0 1 6500899 9168673 Wishek Hospital-Clinic Association d/b/a South Central Health is a 24-bed acute care hospital located in Wishek North Dakota providing acute healthcare, outpatient, emergency, and skilled swingbed services. The Association provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Association does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was $33,000 for the year ended December 31, 2024, calculated by multiplying the ratio of cost to gross charges for the Association by the gross uncompensated charges associated with providing charity care to its patients. 1871348 1711671 Healthcare services provided to four communities within our service area of rural ND. Four rural health clinics. 8372247 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 21 0 1 99 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Megan Rath 7014522326 PO Box 647 Wishek ND 584950647 Lila Raile President 1.00 X X 0 0 0 Nathan Wolf Vice President 1.00 X X 0 0 0 Rebecca Schnabel Secretary 1.00 X X 0 0 0 Sheila Brosy Board Member 1.00 X 0 0 0 Marla Berntson Board Member 1.00 X 0 0 0 Lisa Weigel Board Member (Until May 24) 1.00 X 0 0 0 Laurie Vetter Board Member (As of May 24) 1.00 X 0 0 0 Tanya Schnabel Board Member 1.00 X 0 0 0 Lee Aipperspach Board Member 1.00 X 0 0 0 Donald Hochhalter Board Member 1.00 X 0 0 0 Megan Rath CFO 40.00 X 137590 0 48075 Lukas Fischer CEO 20.00 X 25000 0 0 Shawna Bradley FNP 40.00 X 180572 0 20275 Jayme Martell FNP 40.00 X 177860 0 46933 Trina Schilling FNP 40.00 X 174630 0 48272 Dan Beach FNP 40.00 X 143437 0 52087 Carly Sanders Chief Nursing Officer 40.00 X 129795 0 49292 968884 0 264934 8 0 1 0 Linton Regional Medical Center 111 Elm Ave W Linton ND 58552 CEO & CMO Services 279556 Nuray Staffing 3003 32 St S Ste 240 Fargo ND 58103 Contracted Radiology Technician 234835 Wishek Drug PO Box 267 Wishek ND 58495 Contract Pharmacy Services 203960 NXC Imaging PO Box L-4360 Columbus OH 43260 Radiology Service Contracts 126332 Northern Plains Laboratory 3502 Franklin Ave Bismarck ND 58502 Reference Laborator 121551 5 4750 444691 148270 597711 Patient Service Revenue 624100 9813883 9813883 Pharmacy Revenue 456110 968053 968053 98408 98408 10880344 54183 54183 4444 0 4444 4444 4444 29050 4750 13247 15803 15803 11552485 10880344 0 74430 X 210666 210666 4223274 3583417 639857 119625 102376 17249 921206 771568 149638 308062 250813 57249 302476 302476 7159 7159 81907 81907 1890984 1818466 72518 23443 964 22479 293621 137419 156002 200 489726 489726 223713 213440 10273 35261 31552 3709 33859 23604 10255 32552 32552 447069 389064 58005 98070 98070 Medical Supplies 1016090 1016090 Repairs and Maintenance 67425 33334 34091 3729 140 3589 10829917 8372247 2457470 200 788232 891956 1854172 3018739 1673875 1138773 69789 99616 111948 121755 8645156 6570238 2198667 2074918 325661 427705 7022344 7773462 1204873 880055 53510 53510 680237 619557 259319 482228 2197939 2035350 X 4702404 5563184 122001 174928 4824405 5738112 7022344 7773462 X 722568 191139 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12708 12708 128459 5006964 3544107 1591316 3429743 2963302 466441 67282 62829 4453 2074918 Finance Lease Asset 427705 427705 Lease Liabilities 436846 Estimated Third-Party Payor Settlements 45382 482228 X 11587350 21618 21618 11565732 -13247 -13247 11552485 10864782 21618 13247 34865 10829917 0 10829917 Part X, Line 2: The Association 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 Association 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. Part XI, Line 4b - Other Adjustments: Special Event Expenses reclassed to Revenue on Form 990 -13,247. Part XII, Line 2d - Other Adjustments: Special Event Expenses reclassed to Revenue on Form 990 13,247. Fall Foundation Fundraiser 25189 4000 21189 5008 4000 2367 Bike-a-thon 5079 750 4329 592 245 30268 4750 25518 592 5253 4000 2367 12212 13306 1 1 X 1 X 1 X 1 1 1 0 0 33000 33000 0.00300 354531 187895 166636 0.01540 387531 187895 199636 0.01840 387531 187895 199636 0.01840 1 132446 16635 4547067 4714589 -167522 X 1 1 1 1 Wishek Community Hospital 1007 4th Ave S Wishek ND 58495 https://schealthnd.com/ 5053 DBA South Central Health X X X 4 provider based RHCs Wishek Community Hospital 1 0 0 1 X X X X X X X X X 23 1 0 1 1 X www.schealthnd.com X 1 23 1 www.schealthnd.com 0 1 X 100.000000000000 200.000000000000 X 1 1 X X X X 1 X https://schealthnd.com/patient-resources/patient-portal-2/ X https://schealthnd.com/patient-resources/patient-portal-2/ X https://schealthnd.com/patient-resources/patient-portal-2/ X X X X X X 1 X 0 X X X X 1 X 0 0 Wishek Community Hospital Part V, Section B, Line 5: Through a joint effort, professionals from Wishek Hospital and Clinics, with the assistance of the Center for Rural Health at the University of ND School of Medicine and Health Sciences conducted a Community Health Needs Assessment in 2023. A community group along with a forementioned professionals serves as a focus group that identified the general health needs of the communities of the three counties they serve. A survey was distributed to residents in Lamoure, Logan, and McIntosh county and the results of this survey were shared with the focus group and priority health needs were determined. Wishek Community Hospital Part V, Section B, Line 6b: The other facilities included in Wishek's 2023 CHNA were Central Valley Health District and McIntosh District Health Unit. Wishek Community Hospital Part V, Section B, Line 11: In response to the Community Health Needs Assessment (CHNA), conducted in 2023, South Central Health (SCH), has identified the following needs.- Availability of mental health services- Attracting and retaining young families- Availability of home health- Cost of healthcare insuranceIn addressing the significant needs identified by our 2023 CHNA, Wishek Hospital Clinic Association will continue to partner with Rural Psychiatry Associates to provide telehealth psychiatry services. Also, WHCA will work with Avel to try to get telehealth services in the local schools.The Hospital staff continues to work with the local JDA committee to recruit and retain young families to our community. The board of directors is also looking into housing options for staff to rent to attract individuals to the area. Wishek Hospital Clinic Association provides visiting nurse services in patient's homes to patients that qualify as there is a lack of a formal home health program.The organization will not address the identified need "cost of healthcare insurance" due to budget constraints. Wishek Community Hospital Part V, Section B, Line 16j: The financial assistance documents are translated to Spanish and available upon request but are not on the Hospital's website. The Hospital does not meet the requirement to translate but has done so as a convenience for a few of its Spanish speaking patients. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the cost-to-charge ratio derived from worksheet 2. Part III, Line 2: The amount 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 estimated amount of the Organization's implicit price concessions attributable to patients eligible under the Organization's charity care policy is calculated based on the percentage of individuals living below the poverty level in 2024. The CNHA states the Organization's service area is Logan, McIntosh, and Lamoure counties in ND. Based on the average poverty level for these counties from the Census Bureau data, the average poverty level is 12.56%. With this data an estimate of the amount of implicit price concessions which is attributable to patients eligible under the organization's financial assistance policy would be $16,635. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 12 and 13 of the attached audited financial statements. Part III, Line 8: Wishek Hospital Clinic Association is a critical access hospital with a Medicare shortfall. This is considered a community benefit because providing services to Medicare patients is essential to the patients and the community and increases their access to healthcare services.The amounts were determined based upon the cost-to-charge ratio from the cost report that was filed for the year. Part III, Line 9b: All patients are notified on their monthly statement that the organization offers an uncompensated care program for anyone unable to meet their private pay policy and that they are to contact the accounts receivable department. For patients who qualify for charity and who are cooperating with the organization in good faith to resolve their bills, the organization will offer extended payment plans to eligible patients, reduce the bill by the appropriate amounts, will not impose wage garnishments or liens, will not send unpaid bills to outside collection agencies and will cease all collection efforts.Wishek Hospital Clinic Association will accept the Uncompensated Care Financial Assistance application on accounts up to 240 days following the first billing statement. After the initial 120 days, SCH may undertake collection actions, but must still accept and process the Uncompensated Care Financial Assistance application up to the 240 days. the Hospital will suspend all collection activities while it processes the application. Part VI, Line 2: The medical staff team meets monthly to discuss current or most recent cases that they have encountered. Unique cases, as well as the routine cases are discussed. Every other month, support staff, which include the directors of nursing, health information management, laboratory/radiology, pharmacy, discharge planning and administration, are invited to these meetings for similar discussions, in addition to unifying the approach in various matters such as standards of care, quality assurance study review, Medicare/Medicaid or 3rd party guidelines on standards of care and/or reimbursement.The organization has also established a "call-back" system. All patients discharged from the hospital are followed up with a call and/questionnaires asking about how they are doing, if there are any questions, additional areas of need or services that we may need to get in place for them. We have a system in our organization that also allows for our staff to review the patient's chart prior to a clinic visit to identify any needs such as mammograms, bone density, PSA, cholesterol, pap, colonoscope or any other identified follow-up screening or test. A sheet is placed on the front of the chart to assist the medical staff in cueing into these needs. Once the visit is complete the chart is then re-routed back into the call-back office for placing into the system the next date of screening services or to schedule follow-up or referral appointments for that patient needs. Messages are also sent to patients in relation to the routine follow-ups for medication refills or monitoring of chronic medical conditions such as diabetes, heart disease, kidney or liver disease process, osteoporosis or any other identified disease process/abnormality. The management team and the board of directors also meets monthly to bring to the table the current operations and discussion of current happenings and feedback. Due to the fact we represent different areas that come together as a team to ensure access to healthcare at a low-cost high-quality manner is in place - this opportunity allows variable discussion to community needs and how we can address them in an interdisciplinary team approach. Utilization is monitored in relation to the current programs in place. Such programs include the cardiac rehab program, women's way program, charity care or uncompensated care program, home health and extended care programs. To expand a bit on how far our community reaches and its representation - we have established four rural health clinics in surrounding communities which reach as far out as 45 miles for the clinic location, however community citizen expansion reaches beyond the 45-mile radius. Representation on the medical staff and board of directors reaches into these areas, as we have both designated professionals from those areas on our teams for ensuring access to healthcare and addressing those needs of the population in the area. Part VI, Line 3: The uncompensated care notice is on the back of every statement and posted around the facilities. The policy and application are posted on the website. Also when patients are called or sent letters about their past due accounts, the option of uncompensated care is suggested. Part VI, Line 4: Wishek Hospital Clinic Association (WHCA) is a 24-bed non-profit Critical Access Hospital (CAH) located in South Central North Dakota. Our organization provides such services as 24-hour emergency care, clinic, ambulance, outpatient hospital and ancillary services, inpatient and swingbed, and outpatient surgery. WHCA has four rural health clinics located in Wishek, Kulm, Napoleon, and Gackle and of the four; three are located more than 30 miles away. We closed the Gackle Clinic on March 31, 2024. We still serve the community of Gackle. We provide care to the residents of the Gackle Care Center monthly. WHCA serves the counties of McIntosh, Logan, and Western Lamoure, which includes a geographic area of over 2,000 square miles and approximately 8,400 residents according to the U.S. Census Bureau, Census 2020 report. Statistics in relation to this population include a majority of the population of age 65 or older with McIntosh at 29.7%, Logan 27%, and Lamoure 27.4%. The case mix for the hospital and clinics is 69% Medicare, 20% BCBs, 2% Medicaid and 9% other. The median age of residents of McIntosh County is 54 years of age. With this statistic, the main area which WHCA serves indicates McIntosh County is the second oldest county of the 53 counties in North Dakota. The state median age is 35.2 years and the national median age is 38.2. Figures are according to the 2020 census. The percent of North Dakota residents living in poverty was estimated in 2020 to be 10.5%. McIntosh County was estimated to be 10.2%, Logan County 7.1%, and Lamoure County 13.5%. The community of Wishek possesses a 60-bed nursing home (Wishek Living Center), which is independent of the hospital. The community of Napoleon, which is located in Logan County, has a 44-bed nursing home (Napoleon Care Center) and we provide the majority of health care in these two skilled facilities. We also provide health care services to the residents of the Gackle Care Center's basic care residents in Gackle, ND. WHCA is located in a designated medically underserved area and in a health professional shortage area in North Dakota. Part VI, Line 5: The WHCA governing board is composed primarily of members from the communities it serves and are not employees, contractors, nor family members. The surplus of funds is used to update the aging facility as well as updated technologically medical equipment and computer systems to meet the electronic medical records requirements to service our patient population. Having updated medical equipment not only keeps the services in to our rural area, but also allows us to provide for our patients.Our ambulance provides CPR training to those interested and is on standby call at local football games as a courtesy to the community. X X X 0 0 0 0 0 0 0 1 0 Jayme Martell FNP 162860 0 15000 0 0 0 7377 0 39556 0 224793 0 0 0 Trina Schilling FNP 171630 0 3000 0 0 0 5517 0 42754 0 222901 0 0 0 Shawna Bradley FNP 177572 0 3000 0 0 0 3689 0 16585 0 200846 0 0 0 Dan Beach FNP 143437 0 0 0 0 0 6495 0 45592 0 195524 0 0 0 Megan Rath CFO 112590 0 25000 0 0 0 6119 0 41956 0 185665 0 0 0 Carly Sanders Chief Nursing Officer 129795 0 0 0 0 0 5866 0 43425 0 179086 0 0 0 Part I, Line 3 Wishek Hospital Clinic Association does not pay compensation to the CEO directly. The CEO is compensated by Linton Regional Medical Center, an unrelated organization, through a management services agreement with Wishek and Linton. The Linton Regional Medical Center's Board of Directors uses some of the processes described in Part I, Question 3 to determine appropriate compensation for the CEO. The Wishek Hospital Clinic Association Board of Directors approves the Organization's management agreement. Part I, Line 7 Megan Rath, CFO, received a bonus that was at the board's discretion. Carla Aipperspach Wife of Board Member - Lee Aipperspach 203960 Payment to drug store for pharmacy services, Wishek Drug 0 Form 990, Part III, line 3 The Gackle Rural Health Clinic was closed on March 31, 2024. Form 990, Part VI, Section A, line 1a The Executive Committee consists of the President, Vice President, Secretary/Treasurer, and the Association's CEO. The Executive Committee transacts business, performs duties, and exercises powers as may be directed or delegated by the Board of Directors from time to time. Items of major importance will be referred to the Board of Directors. Minutes of the Executive Committee are submitted to the Board and its action is subject to the approval or disapproval at the next regular Board meeting. Form 990, Part VI, Section A, line 3 Lukas Fischer, CEO, is employed by and received W-2 compensation from Linton Regional Medical Center (LRMC), an unrelated organization, for providing CEO services to both LRMC and Wishek Hospital Clinic Association. Wishek Hospital Clinic Association had a management services agreement with LRMC. Wishek Hospital Clinic Association reimbursed LRMC $194,268 in 2024 for his services of supervising the management, administration, and operation of Wishek. In addition, Lukas received Form 1099 compensation in the amount of $25,000 directly from Wishek. The compensation is reported on Part VII. Form 990, Part VI, Section A, line 6 Membership is open to any individual in the service area who contributes $10.00 to the association and requests membership. Form 990, Part VI, Section A, line 7a All eligible members may vote at the annual meeting for the election of the board of directors. Form 990, Part VI, Section A, line 7b At the annual meeting, the members may discuss the business of the association and make and approve motions concerning that business or the actions of the board of directors. Form 990, Part VI, Section B, line 11b A copy of the Form 990 is provided to each board member of the governing body prior to filing. The CFO reviews the Form 990. Form 990, Part VI, Section B, line 12c Annually the board members and officers must disclose any potential conflicts of interest to the board and management and must not participate in any vote that involves a conflict. Form 990, Part VI, Section B, line 15 In 2023, Wishek Hospital Clinic Association and Linton Regional Medical Center signed an agreement to share the services of the CEO employed by Linton Regional Medical Center. In determining CEO compensation, current compensation and added responsibilities and duties are taken into account along with the percentage of his compensation each facility would have to pay. The results of the North Dakota Hospital Association annual survey is used to determine compensation for the CEO. Documentation is provided in the management agreements and personnel file. Compensation review and adjustments are done annually. The CFO's compensation is reviewed and adjusted on an annual basis. The North Dakota Hospital Association's annual survey is used for comparability data. The CEO submits the compensation adjustment into the budget which goes to the board to approve. Documentaton is provided in the peronnel file. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Contracted Services: Program service expenses 1,567,592. Management and general expenses 72,518. Fundraising expenses 0. Total expenses 1,640,110. Physician Fees: Program service expenses 250,874. Management and general expenses 0. Fundraising expenses 0. Total expenses 250,874. Form 990, Part XI, Line 8: During 2024, it was discovered that balances pertaining to contribution revenue and receivable balances as of and for the year end December 31, 2023 were recorded incorrectly. Accordingly, these errors were corrected and adjustments were made.