Rough Rider High Value Network

Nonprofit profile at a glance

EIN
922764055
IRS 990 coverage
2023–2024
Forms available
Form 990 2024
Location
Bottineau, ND, USA
Phone
2314097069
Rating
79
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Health - General and Rehabilitative N.E.C.

Official website

Reported finances

Revenue
$1,618,595
Expenses
$2,276,310
Assets
$553,139
Liabilities
$985,000

Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.

Leadership & pay

9 people listed

Executive titles in this filing

  • Alfred Sams (President)

Highest reported compensation

  • Alfred Sams (President): $269,832 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.

Overview

Mission

To create and advance a sustainable network of rural North Dakota hospitals and clinics that increases clinical quality, pools member resources, manages financial risk, and improves community health.

What it reported doing in 2024

Rough Rider High-Value Network was created for the advancement of a sustainable network of rural North Dakota hospitals and clinics that increases clinical quality, pools member resources, manages financial risk, and improves community health. Through the network, 22 rural hospitals joined forces on clinical and operational fronts, amplifying the accessibility, affordability, and quality of care in North Dakota's rural communities. The organization is a beacon for over 350,000 patients, ensuring they receive nothing but the best care. The organization conducts several activities to achieve its missions, including (1) creation of a shared services co-op, (2) development of a clinically integrated network (CIN), and (3) expansion of care management capabilities through innovative collaborations to enhance the continuum of care. The organization provides its members an opportunity to encompass vendor solutions ranging from project specific assistance to complete infrastructure management and operation in a variety of operational and service areas. The organization also assists facilities in implementing strategies that enhance quality and care coordination based on their patients' specific needs through ACO Management, Care Coordination, Transitional Care Management, and Chronic Care Management. The Rough Rider Clinical Integration Network (CIN) empowers its member hospitals to offer continuous care to patients across the network. The CIN's Clinical Integration Committee, comprising a practitioner from each member hospital, supervises all clinical and quality initiatives.

Operating model

Revenue model
Grant-funded. 89% of the money available for current operations came from government grants.
Distribution model
Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.

The verdict

SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. Some filing-based governance responses are negative or unanswered and expenses are high relative to revenue.

Rating breakdown

  • Financial Efficiency: 88
  • Transparency & Controls: 74
  • Accountability: 79
  • Sustainability: 9
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 100%; rating input score 100
  • Program expense ratio: 97.8%; rating input score 98
  • Fundraising efficiency: Limited

Transparency & Controls

  • Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
  • Pay-setting controls: 2 of 6 controls in place; rating input score 33
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Pass
    • Board or committee approval: Pass
  • Foreign activity oversight: Limited
  • Grant itemization coverage: Limited
  • Major donor itemization: Yes; rating input score 100
  • Related-party transparency: Limited

Accountability

  • Independent voting board: 100%; rating input score 100; 63rd percentile among comparable filings
  • Governance controls: 4 of 8 controls in place; rating input score 50
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Fail
    • Document-retention policy: Fail
    • CEO compensation review process: Pass
    • Other executive compensation review process: NotApplicable
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Missing
    • Independent financial-statement audit: Fail

Sustainability

  • Operating margin: -40.6%; rating input score 4; 4th percentile among comparable filings
  • Total-asset coverage ratio: 0.24; rating input score 11; 11th percentile among comparable filings
  • Liabilities to assets ratio: 1.78; rating input score 2; 2nd percentile among comparable filings
  • Officer compensation ratio: 11.9%; rating input score 31; 31st percentile among comparable filings

Growth

  • Program expense growth: 104.3% per year; rating input score 100; 99th percentile among comparable filings
  • Revenue growth: 40.8% per year; rating input score 100; 95th percentile among comparable filings
  • Asset growth: 79.7% per year; rating input score 100; 98th percentile among comparable filings

Details

  • Where the money goes: 100% of revenue deployed · 97.8% of spending went to programs
  • Governance: 7 of 7 board members independent · 4 of 8 filing controls reported
  • Programs: 1 filed program accomplishment · $2.2M in reported program spending
  • Leadership: top reported pay $270K · 9 people listed · 2 of 6 pay-setting controls reported
  • Highest-paid contractors: 1 contractor listed · $534K reported
  • Consistency: 24 of 24 current checks pass
  • Schedules: 4 filed schedules · includes major donors and executive pay
  • Filing history: 2 filing years from 2023 to 2024
  • Contacts: How to reach this organization
  • Money network: 1 filed money-flow record
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

  • Review — Accountability: Governance controls: 3 of 7 not reported.
  • High — Sustainability: Operating margin scored 4/100.
  • High — Sustainability: Total-asset coverage ratio scored 11/100.
  • High — Sustainability: Liabilities to assets ratio scored 2/100.
  • Moderate — Sustainability: Officer compensation ratio scored 31/100.