2026-05-12T13:11:51-05:00 2025-06-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2024-07-01 810384618 BIG HORN HOSPITAL ASSOCIATION BIGH 4066652310 17 NORTH MILES AVENUE HARDIN MT 59034 KRISTI GATRELL CEO 4066652310 2026-05-12 1 0 JUSTIN HARTERT P02236744 5074467100 2026-05-11 2024 2025-03-06 01:10:19Z KRISTI GATRELL 17 NORTH MILES AVENUE HARDIN MT 59034 19661463 0 X WWW.BIGHORNHOSPITAL.ORG X 1980 MT TO PROVIDE QUALITY MEDICAL AND HEALTH SERVICES IN BIG HORN COUNTY AND SURROUNDING AREAS. 8 8 150 10 0 0 1688077 1067292 18072632 18063530 118520 359918 173677 126656 20052906 19617396 35840 10942 0 0 9997078 10480207 0 0 0 8852710 8096129 18885628 18587278 1167278 1030118 23354678 24119579 10765988 10222240 12588690 13897339 BIG HORN HOSPITAL ASSOCIATION PROVIDES QUALITY SERVICES AND PROMOTES RESPONSIBLE CHOICES TO ENHANCE THE HEALTH OF OUR COMMUNITIES. 0 0 14890099 10942 18063530 BIG HORN HOSPITAL ASSOCIATION IS COMPRISED OF BIG HORN HOSPITAL. BIG HORN HOSPITAL IS A 18-BED ACUTE CARE HOSPITAL. DURING THE YEAR ENDED JUNE 30, 2025, BIG HORN HOSPITAL PROVIDED 322 DAYS OF INPATIENT SERVICES, 7,603 OUTPATIENT VISITS (INCLUDING 4,485 ER VISITS) AND 2,655 DAYS OF RESIDENT SERVICES.BIG HORN HOSPITAL ASSOCIATION PROVIDES CARE TO PERSON COVERED BY GOVERNMENT PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF CARE TO THESE PATIENTS WAS $145,095 FOR THE YEAR ENDED JUNE 30, 2025 14890099 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 9 0 1 150 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X ROXIE CAIN 4066652310 17 NORTH MILES AVENUE HARDIN MT 59034 THOR TORSKE CHAIRMAN 0.40 0.20 X X 0 0 0 COLLEEN SCHAAK VICE-CHAIRMAN 0.40 0.20 X X 0 0 0 JAMES SEYKORA SECRETARY 0.40 0.20 X X 0 0 0 MATT TORSKE TREASURER 0.40 0.20 X X 0 0 0 SANDY MORSE MEMBER 0.40 0.00 X 0 0 0 LARRY VANDERSLOOT MEMBER 0.40 0.00 X 0 0 0 TERRY BULLIS MEMBER 0.40 0.00 X 0 0 0 NICHOLE MEHLING MEMBER 0.40 0.00 X 0 0 0 KRISTI GATRELL CEO 39.00 1.00 X 0 0 0 ROXIE CAIN CONTROLLER 39.00 1.00 X 140045 0 46270 SHANNON WAGENMAN DIRECTOR OF PROVIDER SERVICES 40.00 0.20 X 258969 0 45197 JOSEPH PURCELL DIRECTOR OF NURSING 40.00 0.00 X 163164 0 18259 PAULA SMALL-PLENTY HR/EMERGENCY PREPAREDNESS 40.00 0.00 X 150729 0 42101 ANGELA REGALADO IMAGING DIRECTOR 40.00 0.00 X 169978 0 11064 CHARLOTTE JEFFERSON PHARMACY DIRECTOR 40.00 0.00 X 169494 0 9816 PAULINE KING PROVIDER 40.00 0.00 X 224308 0 9969 MARTHA ARAMBEL-JUDICE PROVIDER 40.00 0.00 X 217255 0 13609 TIFFANI SCHUBERT PROVIDER 40.00 0.00 X 178742 0 18683 1672684 0 214968 30 0 1 1 BILLINGS CLINIC 2800 10TH AVENUE N BILLINGS MT 59101 MANAGEMENT & IMAGING SERVICES 1275354 NXC IMAGING 1325 QUINCY STREET NE MINNEAPOLIS MN 55413 IMAGING MAINTENACE 255980 B SQUARED IMAGING LLC PO BOX 137 STANTON NJ 08885 IMAGING READING FEES 240000 TRUBRIDGE 54 ST EMANUEL STREET MOBILE AL 36602 BILLINGS SERVICE CONTRACT 147146 CLIFTONLARSONALLEN LLP 220 S SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 ACCOUNTING SERVICES 140305 8 18000 995827 53465 1067292 PATIENT REVENUE 621110 18033297 18033297 OTHER PATIENT REVENUE 541900 30233 30233 18063530 296151 296151 160368 36688 123680 123680 123680 71146 7379 63767 63767 63767 CAFETERIA 900099 2976 2976 2976 19617396 18063530 0 486574 X 10942 10942 877122 877122 8078974 6910350 1168624 267327 228433 38894 656599 567329 89270 600185 504005 96180 17231 17231 160383 160383 21094 21094 1874858 1337812 537046 24135 2864 21271 166463 99277 67186 6662 6473 189 338852 337315 1537 18715 8765 9950 31983 15726 16257 305961 305961 1547945 1547945 238687 238687 MEDICAL SUPPLIES 1318293 1318293 BAD DEBT EXPENSE 1181544 1181544 REPAIRS AND MAINT 405383 405383 BED TAXES 114004 114004 323936 293639 30297 18587278 14890099 3697179 0 2415779 3091897 60310 52194 1560 0 3483961 2582375 93000 93000 502380 439984 156458 114349 26789742 17778361 10402002 9011381 1956501 7668551 4282727 1065848 23354678 24119579 2483974 2042598 425243 8000000 7595000 282014 159399 10765988 10222240 X 12581718 13891924 6972 5415 12588690 13897339 23354678 24119579 X 1030118 94603 152984 30944 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1673 1673 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE MONTANA HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AND LEADING AGE (FORMERLY AAHSA) ARE USED FOR LOBBYING PURPOSES. 242904 242904 18562456 11018259 7544197 7865601 6760102 1105499 118781 118781 9011381 LEASE LIABILITIES 159399 159399 1 1 X 1 X 1 X 1 1 1 0 0 104442 104442 0.00560 5296549 5825212 0 0.00000 5400991 5825212 104442 0.00560 4854520 3933962 920558 0.04950 4854520 3933962 920558 0.04950 10255511 9759174 1025000 0.05510 1 1181544 0 2835536 2877467 -41931 X 1 0 1 1 BIG HORN HOSPITAL ASSOCIATION 17 NORTH MILES AVENUE HARDIN MT 59034 WWW.BIGHORNHOSPITAL.ORG 12469 X X X BIG HORN HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 24 1 0 1 1 X SEE PART V, SECTION B, LINE 7D X X 1 24 1 SEE PART V, SECTION B, LINE 7D 0 1 X 150.000000000000 300.000000000000 X X X 1 1 X X X X 1 X SEE LINE 16J X SEE LINE 16J X SEE LINE 16J X X X X X X 1 X 0 X X X X 1 X 0 0 BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR BIG HORN HOSPITAL ASSOCIATION WAS CONDUCTED IN COLLABORATION WITH BIG HORN COUNTY PUBLIC HEALTH AND WITH SUPPORT FROM THE MONTANA OFFICE OF RURAL HEALTH AND THE MONTANA PUBLIC HEALTH SYSTEM IMPROVEMENT OFFICE. THE ASSESSMENT PROCESS INCORPORATED INPUT FROM A BROAD RANGE OF COMMUNITY STAKEHOLDERS AND OCCURRED OVER AN EXTENDED PERIOD IN 2024 AND 2025.A COMMUNITY STAKEHOLDER COMMITTEE WAS CONVENED TO PROVIDE GUIDANCE THROUGHOUT THE CHNA PROCESS. THIS COMMITTEE INCLUDED A DIVERSE GROUP OF COMMUNITY REPRESENTATIVES, INCLUDING HEALTHCARE PROVIDERS, PUBLIC HEALTH OFFICIALS, AND INDIVIDUALS REPRESENTING VULNERABLE POPULATIONS SUCH AS THE ELDERLY AND UNINSURED. THE COMMITTEE MET FOUR TIMES DURING THE ASSESSMENT PROCESS. THESE MEETINGS WERE HELD TO: (1) IDENTIFY COMMUNITY HEALTH CONCERNS AND PROVIDE INPUT INTO THE DEVELOPMENT OF THE COMMUNITY SURVEY, (2) REVIEW AND DISCUSS SECONDARY AND PRIMARY DATA COLLECTED FROM THE COMMUNITY, (3) FINALIZE THE SURVEY INSTRUMENT, AND (4) REVIEW THE RESULTS OF THE CHNA AND ASSIST IN PRIORITIZING SIGNIFICANT HEALTH NEEDS.IN ADDITION TO STAKEHOLDER ENGAGEMENT, COMMUNITY INPUT WAS OBTAINED THROUGH A COMPREHENSIVE COMMUNITY SURVEY ADMINISTERED DURING THE SPRING OF 2025, BEGINNING IN APRIL 2025. THE SURVEY WAS MADE AVAILABLE ELECTRONICALLY TO RESIDENTS THROUGHOUT BIG HORN COUNTY VIA MULTIPLE METHODS, INCLUDING QR CODES DISTRIBUTED THROUGH PRINTED FLYERS, THE HARDIN BRIEF, AND HOSPITAL INTAKE FORMS. TO FURTHER BROADEN PARTICIPATION AND ENSURE INCLUSION OF DIVERSE COMMUNITY PERSPECTIVES, MEMBERS OF THE STAKEHOLDER COMMITTEE ALSO COLLECTED SURVEY RESPONSES IN PERSON USING HANDHELD ELECTRONIC DEVICES AT COMMUNITY EVENTS, INCLUDING LOCAL PUBLIC GATHERINGS AND RETAIL LOCATIONS.THE SURVEY WAS DESIGNED TO OBTAIN INPUT FROM COMMUNITY MEMBERS REGARDING A WIDE RANGE OF TOPICS, INCLUDING ACCESS TO HEALTHCARE, UTILIZATION OF LOCAL PROVIDERS, SATISFACTION WITH AVAILABLE SERVICES, AND GENERAL HEALTH NEEDS AND PERCEPTIONS. RESPONDENTS WERE ALSO GIVEN THE OPPORTUNITY TO PROVIDE OPEN-ENDED FEEDBACK TO FURTHER DESCRIBE COMMUNITY CONCERNS AND PRIORITIES.THROUGH THIS MULTI-FACETED PROCESSCONSISTING OF STAKEHOLDER MEETINGS CONDUCTED OVER THE COURSE OF THE ASSESSMENT PERIOD AND COMMUNITY-WIDE SURVEYS ADMINISTERED IN SPRING 2025BIG HORN HOSPITAL ASSOCIATION OBTAINED INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, AND INCORPORATED THAT INPUT INTO THE IDENTIFICATION AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: BIG HORN COUNTY PUBLIC HEALTH, MONTANA STATE UNIVERSITY AND MONTANA OFFICE OR RURAL HEALTH. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ON OUR WEBSITE AT: HTTPS://WWW.BIGHORNHOSPITAL.ORG/CHNA DIRECT LINK:HTTPS://WWW.BIGHORNHOSPITAL.ORG/WP-CONTENT/UPLOADS/BIG-HORN-CHNA-CHA-2025_DRAFT-6.PDFIMPLEMENTATION DIRECT LINK:HTTPS://WWW.BIGHORNHOSPITAL.ORG/WP-CONTENT/UPLOADS/BHHA-IP-REPORT-2025-FINAL.PDF BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: BASED ON THE FINDINGS OF ITS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), CONDUCTED IN COLLABORATION WITH BIG HORN COUNTY PUBLIC HEALTH, BIG HORN HOSPITAL ASSOCIATION (BHHA) IDENTIFIED SEVERAL PRIORITY AREAS AFFECTING COMMUNITY HEALTH, INCLUDING ACCESS TO CARE, TRANSPORTATION BARRIERS, WORKFORCE CAPACITY, AND THE NEED FOR SUSTAINABLE SYSTEMS TO SUPPORT HEALTHCARE DELIVERY IN A RURAL AND FRONTIER COMMUNITY. IN RESPONSE TO THESE FINDINGS, BHHA DEVELOPED AND ADOPTED A MULTIYEAR IMPLEMENTATION PLAN OUTLINING STRATEGIES AND ACTIONS TO ADDRESS IDENTIFIED NEEDS WITHIN THE LIMITS OF AVAILABLE RESOURCES.TO PRESERVE ACCESS TO ESSENTIAL HEALTHCARE SERVICES IN BIG HORN COUNTY, BHHA HAS FOCUSED ON MAINTAINING CORE HOSPITALBASED SERVICES AND STRENGTHENING ACCESS TO CARE. THE ORGANIZATION CONTINUES TO OPERATE AS A CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT CARE, EMERGENCY SERVICES, SWING BED SERVICES, REHABILITATION, DIAGNOSTIC IMAGING, LABORATORY SERVICES, AND OUTPATIENT THERAPIES. AS IDENTIFIED IN THE CHNA, TRANSPORTATION REMAINS A SIGNIFICANT BARRIER TO CARE; THEREFORE, BHHA APPLIED FOR AND RECEIVED GRANTS AND COMMUNITY SUPPORT TO REPLACE AGING TRANSPORTATION VEHICLES. THESE EFFORTS ARE INTENDED TO SUPPORT THE RELAUNCH OF COMMUNITY TRANSPORTATION SERVICES TO ASSIST RESIDENTS WITH ACCESS TO MEDICAL AND RELATED HEALTHCARE APPOINTMENTS WITHIN THE COMMUNITY.BHHA IS ALSO WORKING TO EXPAND AND STABILIZE ACCESS TO HEALTHCARE SERVICES IDENTIFIED AS PRIORITIES THROUGH THE CHNA PROCESS. THE ORGANIZATION HAS OBTAINED RESOURCES TO ADD SPEECH THERAPY SERVICES BEGINNING IN FISCAL YEAR 2025 AND CONTINUES TO EVALUATE OPPORTUNITIES TO EXPAND SERVICE LINES, INCLUDING SURGICAL SERVICES, INFUSION THERAPY, AND SPECIALTY PROCEDURES, AS WORKFORCE AVAILABILITY AND FINANCIAL FEASIBILITY PERMIT. THESE EFFORTS ALIGN WITH COMMUNITYIDENTIFIED NEEDS RELATED TO ACCESS TO SERVICES AND CONTINUITY OF CARE.WORKFORCE DEVELOPMENT AND SUSTAINABILITY WERE IDENTIFIED AS CRITICAL FACTORS AFFECTING HEALTHCARE ACCESS AND QUALITY. CONSISTENT WITH THESE FINDINGS, BHHA IS REVITALIZING EMPLOYEE EDUCATION AND TRAINING INITIATIVES THAT WERE DISRUPTED DURING THE COVID19 PANDEMIC, WITH THE GOAL OF STRENGTHENING STAFF CAPACITY, SUPPORTING RETENTION, AND ENSURING CONTINUED DELIVERY OF HIGHQUALITY CARE TO THE COMMUNITY.ADDITIONALLY, FOLLOWING THE NOTIFICATION IN 2023 THAT AN EXISTING CLINIC TENANT WOULD DISCONTINUE OPERATIONS AT THE HARDIN CLINIC FACILITY OWNED BY BHHA, THE ORGANIZATION TOOK PROMPT ACTION TO PRESERVE ACCESS TO PRIMARY CARE SERVICES IN THE COMMUNITY. BHHA WORKED WITH POTENTIAL HEALTHCARE PARTNERS AND ULTIMATELY ENTERED INTO AN AGREEMENT WITH ONE HEALTH TO CONTINUE CLINIC OPERATIONS AT THAT LOCATION, HELPING ENSURE UNINTERRUPTED ACCESS TO OUTPATIENT SERVICES IN AN UNDERSERVED AREA.THROUGH THESE ACTIONS, BHHA SEEKS TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS BY MAINTAINING ACCESS TO ESSENTIAL HEALTHCARE SERVICES, REDUCING BARRIERS TO CARE, SUPPORTING WORKFORCE STABILITY, AND STRENGTHENING LONGTERM SUSTAINABILITY IN ALIGNMENT WITH PRIORITIES IDENTIFIED IN THE 2025 CHNA AND THE ORGANIZATION'S IMPLEMENTATION PLAN. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16J: WHEN OUR PATIENT ACCOUNTS REPRESENTATIVE BECOMES AWARE OF A PATIENT'S POTENTIAL FINANCIAL HARDSHIP AND/OR SELF-PAY STATUS, A COMMUNITY CARE APPLICATION IS SENT TO THAT INDIVIDUAL.THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE, AND APPLICATION ARE AVAILABLE ON OUR WEBSITE AT: HTTPS://WWW.BIGHORNHOSPITAL.ORGFINANCIAL ASSISTANCE POLICY DIRECT LINK: HTTPS://WWW.RIDGEVIEWMEDICAL.ORG/APP/FILES/PUBLIC/264F2D22-0CC6-482F-BD6A-7CD75D9EABDD/P1225%20FINANCIAL%20ASSISTANCE%20POLICY.PDFPLAIN LANGUAGE SUMMARY DIRECT LINK: HTTPS://WWW.RIDGEVIEWMEDICAL.ORG/APP/FILES/PUBLIC/B8462B26-C867-4494-A02C-F60AD6674888/PATIENT_FINANCIAL_POLICY_PLAIN_LANGUAGE.PDFFINANCIAL APPLICATION DIRECT LINK: HTTPS://WWW.BIGHORNHOSPITAL.ORG/PATIENT-CONNECT/COMMUNITY-CARE-APPLICATION/ 1 1 - BIG HORN SENIOR LIVING NURSING HOME 200 N MITCHELL AVENUE HARDIN MT 59034 NURSING HOME WITH ASSISTED LIVING AND INDEPENDENT LIVING UNITS PART I, LINE 3C: CHARITY CARE MAY BE GRANTED TO A PATIENT ON A CASE BY CASE BASIS AS DETERMINED BY THE CEO AND CONTROLLER UPON SPECIAL REQUEST BY THE PATIENT DUE TO UNFORSEEN CIRCUMSTANCES. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON (A) HOUSEHOLD INCOME RELATIVE TO FEDERAL POVERTY GUIDELINES, THE RECEIPT OF MEDICALLY NECESSARY CARE, AND COMPLETION OF A FINANCIAL ASSISTANCE APPLICATION. PART I, LINE 7: A COST-TO-CHARGE RATIO DERIVED USING WORKSHEET 2 FROM THE IRS WAS USED TO CALCULATE THE AMOUNTS IN PART I, LINE 7A AND 7B BUT ACTUAL COST WAS USED FOR PART I, LINE 7G. PART I, LINE 7G: INCLUDED IN THE SUBSIDIZED HEALTH SERVICES ARE THE FOLLOWING DEPARTMENTS: OPERATING ROOM, BLOOD STORE AND PROCESS, OCCUPATIONAL THERAPY, EMERGENCY SERVICES, AND OBSERVATIONAL BEDS PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $1,181,544. PART III, LINE 2: BHHA USES HISTORICAL DATA TO ESTIMATE BAD DEBT EXPENSE BASED ON THE PAYOR TYPE AND AGE OF THE ACCOUNT. PART III, LINE 3: BIG HORN HOSPITAL ASSOCIATION CANNOT REASONABLY ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DID NOT COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE" PARAGRAPH IN NOTE 1 ON PAGE 15 OF THE FINANCIAL STATEMENTS FOR A DESCRIPTION OF BIG HORN HOSPITAL ASSOCIATION'S BAD DEBT EXPENSE. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WERE DERIVED FROM THE JUNE 2025 FILED MEDICARE COST REPORT. PART III, LINE 9B: CATASTROPHIC COMMUNITY CARE: BHHA MAY ALSO WRITE OFF AS COMMUNITY CARE AMOUNTS FOR PATIENTS WITH FAMILY INCOME IN EXCESS OF THE FEDERAL POVERTY STANDARDS WHEN CIRCUMSTANCES INDICATE SEVERE FINANCIAL HARDSHIP OR PERSONAL LOSS AS DETERMINED BY BHHA. EXAMPLES OF THIS WOULD INCLUDE, BUT ARE NOT LIMITED TO, LOSS OF A JOB AFTER TAXES WERE FILED, EXTENSIVE HEALTH ISSUES CAUSING LARGE BILLS, ETC. PART VI, LINE 2: BHHA CONTINUALLY ASSESSES THE NEEDS OF OUR COMMUNITY THRU SEVERAL AVENUES. IN ADDITION TO PERFORMING A COMMUNITY HEALTH NEEDS ASSESSMENT, BHHA WORKS CLOSELY WITH THE VARIOUS CLINICS IN TOWN TO DISCUSS TRENDS AND SOLUTIONS FOR A VARIETY OF ISSUES INCLUDING HEALTH TRENDS, STAFFING NEEDS AND MAKING PATIENT CARE AS SEAMLESS AS POSSIBLE. BHHA ALSO REVIEWS OUR INTERNAL UTILIZATION TO HELP ASSESS THE NEEDS OF OUR COMMUNITY. THIS ALLOWS BHHA STAFF AND OUR BOARD OF DIRECTORS TO MAKE DECISIONS ABOUT IMPROVEMENT AREAS SUCH AS WHAT EQUIPMENT TO UPGRADE AND WHICH SERVICES TO EXPAND IF POSSIBLE. BHHA IS VERY COMMITTED TO KEEPING AS MANY OF THE COMMUNITY HEALTH CARE NEEDS LOCAL AS POSSIBLE. PART VI, LINE 3: THE FACILITY KEEPS FORMS ON HAND THAT ARE AVAILABLE (IN PLAIN SIGHT) FOR DIFFERENT GOVERNMENT PROGRAMS SUCH AS HEALTHY MT KIDS. THE ADMINISTRATIVE STAFF WILL INFORM ANY PRIVATE PAY PATIENT OF OUR COMMUNITY CARE AND WILL ALSO RELAY THIS INFORMATION TO CUSTOMERS WHEN DISCUSSING PAYMENT OPTIONS FOR OUTSTANDING BILLS. WHEN OUR PATIENT ACCOUNTS REPRESENTATIVE BECOMES AWARE OF A PATIENT'S POTENTIAL FINANCIAL HARDSHIP AND/OR SELF-PAY STATUS, A COMMUNITY CARE APPLICATION IS SENT TO THAT INDIVIDUAL. PART VI, LINE 4: BHHA SERVES A HIGH POVERTY LEVEL. WE ARE ON THE EDGE OF THE CROW INDIAN RESERVATION AND HAVE A LOT OF CUSTOMERS WHO UTILIZE INDIAN HEALTH SERVICES AS A PAYOR SOURCE FOR HEALTH CARE. OUR POPULATION HAS A LARGE POPULATION OF MEDICARE AND MEDICAID CUSTOMERS. AS WE SERVE A SMALL TOWN IN MONTANA, THE POPULATION CONSISTS OF A LOT OF CHILDREN AS WELL AS ELDERLY, BOTH OF WHICH UTILIZE OUR HEALTHCARE SYSTEM. PART VI, LINE 5: BHHA DOES HAVE A COMMUNITY BOARD TO HELP NOT ONLY "RUN" THE FACILITY WITH POLICIES AND PROCEDURES, BUT TO GIVE INPUT TO THE MANAGEMENT TEAM ABOUT THE NEEDS THEY SEE FOR THE COMMUNITY IN WHICH THEY LIVE. BHHA IS DEVELOPING MORE EDUCATIONAL PROGRAMS FOR ITEMS SUCH AS WOMEN'S HEALTH, DIABETES MANAGMENT AND SMOKING CESSATION.BHHA USES THE LOCAL PAPERS AND SOCIAL MEDIA (FACEBOOK) AS AN OUTLET FOR GIVING THE PUBLIC INFORMATION ON DIFFERENT TYPES OF HEALTH CONCERNS, SUCH AS DIABETES, WEIGHT LOSS, ETC. BHHA ALSO USED THE COMMUNITY HEALTH NEEDS ASSESSMENT TO TRACK ITEMS THE COMMUNITY WANTS AND/OR NEEDS. 1 BIG HORN COUNTY MEMORIAL HOSPITAL AND HEALTHCARE FOUNDATION 17 N MILES AVENUE HARDIN MT 59034 810504410 501(C)(3) 5431 0 N/A N/A GENERAL SUPPORT 1 0 PART I, LINE 2: THE GRANTS MADE WERE AN EQUITY TRANSFER AND PASSING ALONG DONATIONS TO RELATED ORGANIZATIONS. THESE FUNDS ARE TRACKED THROUGH THE ORGANIZATION'S INTERNAL FINANCIAL REPORTING PROCESS. X X 0 0 0 0 0 0 0 0 0 SHANNON WAGENMAN DIRECTOR OF PROVIDER SERVICES 258969 0 0 0 0 0 9000 0 36197 0 304166 0 0 0 PAULINE KING PROVIDER 224308 0 0 0 0 0 9000 0 969 0 234277 0 0 0 MARTHA ARAMBEL-JUDICE PROVIDER 217255 0 0 0 0 0 9000 0 4609 0 230864 0 0 0 TIFFANI SCHUBERT PROVIDER 178742 0 0 0 0 0 9000 0 9683 0 197425 0 0 0 PAULA SMALL-PLENTY HR/EMERGENCY PREPAREDNESS 150729 0 0 0 0 0 9000 0 33101 0 192830 0 0 0 ROXIE CAIN CONTROLLER 140045 0 0 0 0 0 9000 0 37270 0 186315 0 0 0 JOSEPH PURCELL DIRECTOR OF NURSING 163164 0 0 0 0 0 9000 0 9259 0 181423 0 0 0 ANGELA REGALADO IMAGING DIRECTOR 169978 0 0 0 0 0 0 0 11064 0 181042 0 0 0 CHARLOTTE JEFFERSON PHARMACY DIRECTOR 169494 0 0 0 0 0 9000 0 816 0 179310 0 0 0 FORM 990 SCHEDULE J KRISTI GATRELL, THE CEO OF BIG HORN HOSPITAL ASSOCIATION, IS PAID BY BILLINGS CLINIC, AN UNRELATED ORGANIZATION. KRISTI RECEIVED THE FOLLOWING FROM BILLINGS CLINIC FOR SERVICES TO BIG HORN HOSPITAL: COMPENSATION- $180,328 NONTAXABLE BENEFITS- $16,529 A MONTANA FACILITY FINANCE AUTHORITY 364615155 2018-11-01 8000000 HOSPITAL REMODEL 0 0 0 A 405000 8000000 708645 160000 7131355 2019 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MONTANA FACILITY FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/03/2023 FORM 990, PART VI, SECTION A, LINE 3 BIG HORN HOSPITAL ASSOCIATION'S CEO IS PROVIDED THROUGH A SERVICES AGREEMENT WITH BILLINGS CLINIC. FORM 990, PART VI, SECTION A, LINE 7A TWO BOARD MEMBERS ARE APPOINTED BY BILLINGS CLINIC AND MAY BE REMOVED FROM THE BOARD AT ANY TIME BY BILLINGS CLINIC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL BY THE CONTROLLER AND CEO. THE FORM 990 WAS PRESENTED TO THE BOARD MEMBERS AT A BOARD MEETING AFTER BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C REGULAR COMPLIANCE MEETINGS DISCUSS ANY ACTUAL CONFLICTS OR POTENTIAL CONFLICTS. THERE IS ALSO A HOTLINE NUMBER TO CALL FOR COMPLIANCE OR HIPAA ISSUES THAT IS OPERATED BY MONTANA HOSPITAL ASSOCIATION, NOT BIG HORN HOSPITAL ASSOCIATION. BOARD MEMBERS SIGN YEARLY CONFLICT OF INTEREST STATEMENTS AND IF A CONFLICT OCCURS ON A SPECIFIC ITEM, THEY ABSTAIN FROM THE VOTE ON THAT ITEM. . FORM 990, PART VI, SECTION B, LINE 15 BIG HORN HOSPITAL ASSOCIATION UTILIZES THE MONTANA HOSPITAL ASSOCIATION SALARY SURVEY TO MAKE SURE EMPLOYEE WAGES ARE COMPARABLE TO SIMILAR JOBS IN SIMILAR AREAS. EXPERIENCE IS ALSO A FACTOR IN THE WAGE. THIS IS REVIEWED EACH FEBRUARY WHEN THE MHA SALARY SURVEY IS AVAILABLE FOR REVIEW. WAGES ARE ADJUSTED WITH THE SCALE IF NEEDED. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2025. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,337,812. MANAGEMENT AND GENERAL EXPENSES 537,046. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,874,858. FORM 990, PART XI, LINE 9: TRANSFER TO RELATED ENTITIES 30,944. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. BIG HORN COUNTY MEMORIAL HOSPITAL AND HEALTHCARE FOUNDATION 17 N MILES AVENUE HARDIN MT 59034 810504410 HOSPITAL FUNDRAISING MT 501(C)(3) LINE 12A, I BIG HORN HOSPITAL ASSOCIATION 1 BIG HORN COUNTY MEMORIAL HOSPITAL AUXILIARY HC 36 BOX 2065 HARDIN MT 59034 810428249 FUNDS TO BENEFIT BIG HORN COUNTY MEMORIAL HOSPITAL MT 501(C)(3) LINE 12B, II N/A 0 HERITAGE ACRES AUXILIARY LIMITED PO BOX 474 HARDIN MT 59034 810444017 FUNDS TO BENEFIT HERITAGE ACRES NURSING HOME MT 501(C)(3) LINE 12B, II N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 R S C