2026-02-08T10:48:37-06:00 2025-04-30 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2024-05-01 113686120 Coal Country Community Health Center COAL 7018737788 1312 Highway 49 N Beulah ND 585236038 Kurt Waldbilling CEO 7018737788 2026-02-06 1 1 Lisa Chaffee CPA P00193453 7012551091 2026-02-06 2024 2025-03-06 01:10:19Z Kurt Waldbilling 1312 Highway 49 N Beulah ND 585236038 17589341 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. 14 14 136 14 0 0 3326081 4000528 12633404 13520375 0 0 67318 68438 16026803 17589341 0 0 0 0 10934400 11258128 0 0 0 6462047 6419551 17396447 17677679 -1369644 -88338 15618101 16454187 4459122 5383546 11158979 11070641 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. 0 0 14996442 13520375 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, with 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.com 14996442 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 38 0 1 136 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X David Whipps 7018737493 1312 Hwy 49 N Beulah ND 585236038 Aaron Garman MD Physician 40.00 X 347429 0 54424 Michelle Placke Physician 40.00 X 326461 0 53864 Jacinta-Jon Klindworth MD Physician 40.00 X 307936 0 54547 Ann Ruffo Physician 40.00 X 295245 0 47091 Kelsey Wiseman Physician 40.00 X 296757 0 39776 Kurt Waldbillig CEO 40.00 X 272232 0 52292 Victoria Oberlander CFO (Until Dec 2024) 40.00 X 119213 0 33463 David Whipps Interim CFO (From Sep-Feb)/CFO(Began Mar 2025) 40.00 X 90207 0 42759 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 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 1.00 X 0 0 0 Myria Perry Director (Until Nov 2024) 1.00 X 0 0 0 Martha Gunderson Director (Began July 2024) 1.00 X 0 0 0 Brandon Zahn Director (Began July 2024) 1.00 X 0 0 0 Bill Zingg Director (Began July 2024) 1.00 X 0 0 0 Darrold Bertsch Director (Began July 2024) 1.00 X 0 0 0 Kari Cutting Director (Began Dec 2024) 1.00 X 0 0 0 2055480 0 378216 21 0 1 0 Beulah Drug 147 W Main Beulah ND 58523 Contract Pharmacy Dispensing Fees 1106923 Sakakawea Medical Center 510 8th Avenue NE Hazen ND 58545 Rent for Hazen Clinic, Shared Staff: HR, 321967 Altru Health System PO Box 6002 Grand Forks ND 582066002 Software Subscription & Support 231942 Stroudwater Associates 1685 Congress Street Portland ME 04102 Business Consulting Services 116244 High Point Networks 728 East Beaton Dr West Fargo ND 58078 Security System Upgrades 113502 6 4000528 4000528 Patient Service Revenue 621110 9516256 9516256 340B Program Revenue 621110 3558255 3558255 Other Program Revenue 621110 445864 445864 13520375 68438 0 68438 68438 68438 17589341 13520375 0 68438 X 587217 587217 8762595 8373097 389498 343867 268823 75044 946013 760432 185581 618436 440684 177752 7914 7914 85195 85195 2067328 1819096 248232 73768 73768 472031 388264 83767 568888 427591 141297 77201 46554 30647 29453 3124 26329 28669 28669 867241 808211 59030 82101 28007 54094 Medical Supplies 1533618 1533618 Licenses 36665 35558 1107 Dues & Subscriptions 35488 15552 19936 453991 19162 434829 17677679 14996442 2681237 0 6243818 6424072 1577364 1573814 9711 0 97529 124695 166269 335093 12686974 6079927 7329932 6607047 193478 1389466 15618101 16454187 1345802 1638615 229018 3113320 3515913 4459122 5383546 X 11158979 11070641 11158979 11070641 15618101 16454187 -88338 0 X 0 1 X 1 1 1 X 5431566 4190746 4741649 3326081 4000528 21690570 5431566 4190746 4741649 3326081 4000528 21690570 21690570 65968 66368 64168 67318 68438 332260 22022830 58337175 0.98490 0.98420 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10406970 4416807 5990163 33136 16996 16140 2012617 1421605 591012 234251 224519 9732 6607047 Estimated Third Party Payor Settlements 97335 Right of Use Assets - Operating 645698 ERC Receivable 646433 1389466 X 17589341 0 17589341 0 17589341 17677679 0 17677679 0 17677679 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 291424 0 54763 0 1242 0 13182 0 42661 0 403272 0 0 0 Michelle Placke Physician 260960 0 65015 0 486 0 13823 0 41459 0 381743 0 0 0 Jacinta-Jon Klindworth MD Physician 259967 0 46727 0 1242 0 13618 0 42348 0 363902 0 0 0 Ann Ruffo Physician 249822 0 45018 0 405 0 12066 0 36340 0 343651 0 0 0 Kelsey Wiseman Physician 248329 0 48068 0 360 0 12232 0 28859 0 337848 0 0 0 Kurt Waldbillig CEO 264042 0 0 0 8190 0 10553 0 43055 0 325840 0 0 0 Victoria Oberlander CFO (Until Dec 2024) 118978 0 0 0 235 0 5342 0 28781 0 153336 0 0 0 Schedule J, Part II: Kurt Waldbilling is an employee of Coal Country Community Health Center (CCCHC) and also provided services to Sakakawea Medical Center (SMC). The compensation reported in Part VII and Part II of Schedule J, reflects total compensation Kurt 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. 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 A, line 2 Wayne Hoffner and William Suter have a business relationship. 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 1,819,096. Management and general expenses 248,232. Fundraising expenses 0. Total expenses 2,067,328.