2024-10-25T15:22:50-05:00 2023-12-31 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-01-01 810232121 Bozeman Deaconess Health Services BOZE 4064145000 915 Highland Boulevard Bozeman MT 59715 Brad Ludford CFO 4064145000 2024-10-25 1 1 Lisa Chaffee CPA P00193453 7012551091 2024-10-25 2023 2024-10-15 13:58:12Z Bozeman Health Brad Ludford 915 Highland Boulevard Bozeman MT 59715 179160277 0 X www.bozemanhealth.org X 1911 MT To improve community health and quality of life for residents and visitors of the Southwest Montana area. 13 11 927 132 1112099 0 1661600 232868 161780190 177637504 229958 1090659 213033 199246 163884781 179160277 677955 619881 0 0 109372517 117614490 0 0 0 52824232 61128489 162874704 179362860 1010077 -202583 150278571 167581983 101326406 118866125 48952165 48715858 X To improve community health and quality of life. 0 0 68013946 63501631 Bozeman Health Medical Group employs physicians under the Bozeman Health system umbrella. This group of providers compassionately serves the patients of Bozeman Health Deaconess Hospital, Big Sky Medical Center, Bozeman Health Urgent Care, and Bozeman Health Convenience Care, LLC. 16270845 26317659 In efforts to reach our community and surrounding area in multiple facets of healthcare, the Bozeman Health system operates additional healthcare facilities which allows more access and levels of care.Big Sky Medical Center had 51 admissions and saw 4,434 patients in the Emergency Room and 6,318 patients in the clinic in 2023. The net revenue yield on these operations was only 68.6%, or $1,982 per adjusted patient day.. With challenging core staffing and related costs, the operating expense (excluding interest, taxes and depreciation) was $1,865 per adjusted patient day. This resulted in a $800k operating loss for the year. Bozeman Health is committed to providing access and patient care to the Big Sky community in spite of the financial operational challenges the facility continues to face.Bozeman Health also continues to operate our Main Street Urgent Care as an outpatient healthcare access point. With a 46.7% yield on $7.5M of patient charges and operating costs of $9.1M, the Urgent Care netted a loss of $1.6M in 2023. 12692852 619881 86582860 Bozeman Health serves as the parent company of the Bozeman Health system. As the corporate parent, management, general and administrative services are centralized here and provided to the operating units caring for our patients. These administrative and support services aim to optimize executive, organizational and financial responsibilities to allow the health system to continue to grow and serve the population. In this past year, Bozeman Health had 24,295 inpatient days, 234,351 outpatient hospital visits, 284,751 outpatient clinic visits, 37,211 emergency room visits and performed 6,406 surgeries. 96977643 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 228 0 1 927 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 1 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X Carrie Morasko 4064145039 915 Highland Blvd Bozeman MT 59715 John How Chair 1.00 1.00 X X 0 0 0 Kerri Brown Vice Chair (Jan-Jun) 1.00 1.00 X X 0 0 0 Jim Berend - Treasurer (Jan-Jun)/Vice Chair (as of July) 1.00 1.00 X X 0 0 0 Becky Franks - Director (Jan-Jun)/2nd Vice Chair (as of July) 1.00 0.00 X X 0 0 0 Jon Knokey - Director (Jan-Jun)/Treasurer (as of July) 1.00 0.00 X X 0 0 0 Elizabeth Carver Secretary 1.00 0.00 X X 0 0 0 Vicki Groenweg Director (as of July) 1.00 0.00 X 0 0 0 Bruce Hamory Director 1.00 0.00 X 0 0 0 Meghan Johnston Director (as of July)/Internist 50.00 0.00 X 246623 0 44020 Cory Pulfrey Director (as of July) 1.00 0.00 X 0 0 0 Melinda Roberts Director (as of July) 1.00 0.00 X 0 0 0 Walt Sales Director 1.00 0.00 X 0 0 0 Alyce Schultz Director 1.00 0.00 X 0 0 0 Dane Sobek Director/Cardiologist 50.00 0.00 X 691179 0 51297 Kathryn Bertany CEO 20.00 30.00 X 636011 0 134381 Brad Ludford CFO 20.00 30.00 X 399699 0 118580 Steve Klein Chief Legal Officer 20.00 30.00 X 314835 0 78598 Denise Juneau Chief Government & Community Affairs Officer 20.00 30.00 X 284214 0 58797 Kallie Kujawa Chief Operating Officer 20.00 30.00 X 282796 0 77020 Tamara Havenhill-Jacobs Chief Information Officer (thru May) 20.00 30.00 X 315429 0 13577 Kiera Pattison Chief Nursing Officer 20.00 30.00 X 336053 0 55333 Nathaniel Madsen Cardiology 50.00 0.00 X 682074 0 55605 Kleanthis Dendrinos Gastroenterologist 50.00 0.00 X 718785 0 44773 Justin Thomas Hematologist 50.00 0.00 X 648547 0 59524 Mark Hancock Internal Medicine 50.00 0.00 X 727307 0 55683 Andrew Gentry Gastroenterologist 50.00 0.00 X 671712 0 57369 John Hill Former CEO 0.00 0.00 X 822059 0 0 Edie Willey Former Chief People Officer 0.00 0.00 X 300358 0 0 Mark Williams Former Chief Physician Officer 0.00 1.00 X 128219 0 0 Darci Bentson Former CAO 0.00 0.00 X 388832 0 0 8594732 0 904557 285 1 1 0 Absaroka Emergency Physicians 1184 N 15th Street Suite 1 Bozeman MT 59715 ER Physicians Fee 8357258 System4 of Idaho 82 S Baltic Place Ste 116 Meridian ID 83642 Facility Cleaning 1238760 Kiwi Enterprises LLC 121 N 3rd Ave Bozeman MT 59715 Snow Removal 934742 Impact Advisors LLC PO Box 379 Naperville IL 605660379 Software Consulting/Build 913735 Coding Network LLC PO Box 101794 Pasadena CA 91189 Coding Services 696461 47 232868 232868 Health System Corp Services 900099 83868814 83868814 Health System Provider Services 621110 63501631 63501631 Patient Service Revenue 621110 24277021 24277021 Pharmacy Revenue 456110 1945030 832931 1112099 4045008 4045008 177637504 1090659 1090659 199246 0 199246 199246 199246 179160277 176525405 1112099 1289905 X 607581 607581 12300 12300 4166417 1573697 2592720 1639554 1639554 92010627 66121222 25889405 3653282 2708152 945130 10325290 4371255 5954035 5819320 3646694 2172626 491087 491087 228144 228144 49641 49641 19526790 2192736 17334054 1832231 33189 1799042 554473 203403 351070 1675555 216702 1458853 383044 24672 358372 255363 16448 238915 873781 873781 11261042 11261042 2357046 32885 2324161 Equipment Rent & Mainte 14194215 26863 14167352 Medical Supplies 3304333 3002990 301343 Goodwill Impairment 1991422 1991422 Taxes and Licenses 555202 32101 523101 1595120 19930 1575190 179362860 96977643 82385217 0 16577919 41521511 6791547 8484626 353782 443257 7798710 9123623 133413714 53136878 89973965 80276836 7671764 8672100 12923525 11979450 5217296 4347747 2970063 2732833 150278571 167581983 28301727 33745739 10511 100259 20232082 19888580 42827 150047 52739259 64981500 101326406 118866125 X 47737108 47534525 1215057 1181333 48952165 48715858 150278571 167581983 X -202583 -33724 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 42623 0 1 7018 49641 0 Part II-B, Line 1: Hired consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. Bozeman Deaconess Health Services reimburses certain professional membership dues of employees, a portion of such membership dues are used by the professional associations for lobbying activities. The dues for MHA, AHA, and Leading Age were $7,018. 20672068 943397 3632532 369850 24878147 24534132 68899 -3372760 558203 20672068 20745993 973493 3399161 584515 24534132 18430208 41677 2623596 349488 20745993 16272305 227769 3135666 1205532 18430208 0.64350 0.15890 0.19760 0 1 1 7095841 9401304 16497145 37025110 7798715 29226395 78651144 45338163 33312981 1240315 1240315 80276836 Investment in Affiliated Organizations 11979450 F 11979450 Deposits 5038 Capitalized Lease Obligation 1310785 Due To Affliates 63341295 Estimated third-party payor settlements 324382 64981500 X Part V, Line 4: Each endowment fund is privy to a separate agreement. Donations made for each purpose shall be received, held, and invested by the Bozeman Deaconess Foundation according to established policies governing gift acceptance, investment, and distribution. The principal of the fund shall be retained in perpetuity. The interest income is utilized for the greatest needs of the designated department. Policy says the organization can use a portion of interest for operations. The endowment fund reported in Line 1 is currently being held by a related organization, Bozeman Deaconess Foundation, and benefits Bozeman Health and related system entities. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. Part X, Line 2: The Organization 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 consolidated financial statements. The Organization 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. 1 1 X 1 X 1 X 1 1 1 0 0 570978 62849 508129 0.00280 4282739 3302394 980345 0.00550 4853717 3365243 1488474 0.00830 494827 42505 452322 0.00250 12300 12300 0.00010 6786449 5935823 850626 0.00470 630650 20000 610650 0.00340 7924226 5998328 1925898 0.01070 12777943 9363571 3414372 0.01900 1 1843682 0 3842422 7115290 -3272868 X 1 1 1 Rocky Mountain Surgical Center LLC Outpatient Surgical Center 0.51010 0.00000 0.48990 2 Deaconess Intercity Imaging LLC Radiology 0.77500 0.00000 0.22500 3 Spanish Peaks Plaza LLC Real Estate 0.69940 0.00000 0.30060 4 West Bozeman Surgery Center LLC Outpatient Surgical Center 0.35070 0.00000 0.30000 1 1 Big Sky Medical Center 334 Town Center Ave Big Sky MT 59716 www.bigskymedicalcenter.com 13563 X X X X Big Sky Medical Center LLC 1 0 0 1 X X X X X X X X X 23 1 1 0 1 X https://www.bozemanhealth.org/chna/ X 1 23 1 https://www.bozemanhealth.org/chna/ 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Big Sky Medical Center, LLC Part V, Section B, Line 5: The 2023 CHNA focused on mailed surveys and focus groups. The Montana Office of Rural Health conducted the surveying for the 2023 CHNA and helped inform the questions and validate the data. A steering committee comprised of the Gallatin County Health Department, the local Federally Qualified Health Center (FGHC), and the local social service provider, Human Resource Development Council (HRDC), were all collaborated with when creating the survey questions and identifying potential focus group participants. 2,402 surveys were mailed out in a randomized approach to residents in the Bozeman Health service area in May 2023. Bozeman Health conducted 9 focus groups that targeted medically underserved, low-income, and minority populations from May to November, 2023. Planning for the CHNA began in April, and their surveys were mailed out in May, with final results from the Office of Rural Health given in November of 2023. Big Sky Medical Center, LLC Part V, Section B, Line 6a: Bozeman Health Deaconess Hospital, dba Bozeman Deaconess Regional Medical Center Big Sky Medical Center, LLC Part V, Section B, Line 11: We conducted a CHNA in 2023, which guides our implementation strategy for 2024-2027. The needs identified and adopted by BSMC are:-Behavioral Health-Access to Care-Socioeconomic and Health Measures-Chronic Disease PreventionBozeman Health is addressing priority area needs identified by the CHNA either through direct services or via partnering with local organizations on programming to address the needs. There were needs that were identified but not selected as priority areas due to being indirectly impacted through other priority areas or due to focusing on needs that Bozeman Health is best able to leverage existing resources. Alzheimer's and Dementia was an identified need that is being indirectly addressed through our Geriatric Services and memory consults. Diabetes and heart disease is a need that falls indirectly under Chronic Disease Prevention. Maintaining a healthy weight was a final need that is not a priority area, however, also is indirectly affected through our chronic disease prevention strategies and through our Lifestyle Medicine services.Behavioral Health: 1) Continued supporting Youth Aware of Mental Health (YAM) programming in high schools and middle schools, which included Big Sky public schools2) Championed and disseminated community-wide awareness and stigma reduction efforts via the Are You In? campaign and 988 posters promoting mental health crisis support. Big Sky partners like Wellness in Action and Yellowstone Club Community Foundation are actively involved in Gallatin Behavioral Health Coalition activities and take a leadership role in developing local resources and behavioral health workforce development.3) We also provided a grant to Wellness in Action to provide a sliding fee scale for behavioral health services to Big Sky community members.4) We were leaders on the Gallatin County Behavioral Health Coalition and finalized plans for our behavioral health inpatient unit. Access to Healthcare: 1) Coordinated with the Gallatin County Health Department Cancer Screening Program and provide free vouchers via the Mammogram Project. 2) We launched the second year of the Medical Respite program that provides brief housing and case management to houseless individuals who cannot safely be discharged from the hospital back to their current living situation (car, shelter, street, etc). We engaged in and provided program development for the Medical Respite program, and funded service coordination for residents, as a means of improving Access to Healthcare for houseless populations. 3) We also provided grants to nonprofits working on increasing access to services to Spanish speaking individuals via health fairs. 4) We provided 3 off-site no-cost flu and COVID vaccine clinics to underserved populations in West Yellowstone, the local food bank, and a low-income apartment complex in Bozeman. We served 59 individuals through these clinics. Due to the timing of the 2023 CHNA, the followings efforts were made to support the needs identified in the prior CHNA:Nutrition & Physical Activity: 1) Support the Health in All Policies steering committee. 2) Support GoNoodle access for schools in Park, Madison, and Gallatin Counties. 3) We also provided grants to nonprofits focused on physical activities on land trust trails, a cross country ski event, and supplies and programming for a teaching kitchen at a local public library.4) We launched a Prescription Produce Program that allowed pediatricians to "prescribe" produce and through a third part vendor, a weekly produce box would be delivered to their homes weekly for 16 weeks. Injury & Violence Prevention: 1) Provided "Stepping On" fall prevention trainings to more 75 older adult participants and 10 training opportunities in 2023. 2) Promoted the "Stop the Bleed" campaign, which included Big Sky Search and Rescue. Another grant focused on Stop the Bleed kits via schools and public buildings along with trainings on how to use the kits.3) Supported a local Indigenous Women violence prevention symposium and provided 50 copies of the book "Incarceration of Native American Women".4) We also helped support a bicycle rodeo focused on child safety in West Yellowstone. 5) Additionally, we invested in a housing coalition to conduct strategic planning for affordable housing in our region which can prevent exposure related deaths tied to houselessness. 6) We provided over 230 bike and ski helmets to local youth across the Bozeman and Big Sky service areas to reduce the number of traumatic brain injuries caused by not wearing a helmet while recreating. Big Sky Medical Center, LLC Part V, Section B, Line 13h: Any individual and their dependents who are at 200% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the patient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Big Sky Medical Center, LLC Part V, Section B, Line 16j: Medical Advocacy Services in Healthcare (MASH) will give out our financial application after determining a patient is ineligible for federal and state programs. A summary of the financial assistance policy is attached to billing invoices, posted in the patient admissions area, and provided to patients upon admission to the hospital facility. Big Sky Medical Center, LLC Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be billed gross charges on elective procedures. Schedule H, Part V, Section B, Line 16a-16c: https://www.bozemanhealth.org/patients-and-visitors/patient-financial-services/financial-assistance/ 6 1 - Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Imaging Center 2 - Rocky Mountain Surgery Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 Outpatient Surgical Center 3 - Hospice of Southwest Montana LLC 3810 Valley Commons Dr Ste 1 Bozeman MT 59715 Hospice Services 4 - Bozeman Health Urgent Care LLC 1006 W Main Bozeman MT 59715 Outpatient Health Care 5 - Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 Contracted Provider Services 6 - Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Health Care Part I, Line 3c: Any individual and their dependents who are at 200% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the patient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care, Medicaid, and Other Means-Tested Programs. All net benefit expenses were calculated using direct costs and revenue with reasonable indirect overhead allocation methods. Benefits are allocated at 23% of payroll dollars. For Subsidized Services, other indirect overhead costs are allocated based on historical reasonableness of 15% of total expenses. Our internal system does record patient revenues based on type (inpatient vs. outpatient vs. emergency) and payor (Medicaid, Medicare, Commercial, Self-Pay, etc.). Related costs are then determined based on the pro-rated share as a percentage of the total. For example, if Medicaid comprises 7% of a department's revenue, Medicaid expenses are calculated at 7% of the total as well.Lines 7e, 7f, 7i are based on actual expenses. Part I, Line 7g: Amount of cost attributable to a physician clinic is $6,786,449. The Urgent Care disregarded entity was reported as a subsidized services, pulling out the financial assistance and Medicaid to report separately as appropriate. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located in Footnote 1 on pages 15-16 of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents a cost absorbed by the Hospital as a result of providing care to Medicare patients. The contract driving this loss is a nondiscretionary contract, as is providing the services to this population of individuals. The cost of providing this benefit to the community should be reportable as such.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.For the Joint Ventures, Net Medicare Revenue was used as the revenue received, and that percentage of total revenues was applied against operating expenses to determine related costs. The Joint Venture portion of the shortfall is $3,230,545. Part III, Line 9b: Providing the patient, either directly or through its contracted collection agency with at least one written notice informing the patient about the Extraordinary Collection Actions that we intend to take if the patient does not submit an Application for Financial Assistance or pay the amount due by at least thirty days following the date of the notice. The notice will include a copy of the plain language summary and will not be mailed or delivered to a patient earlier than 30 days prior to the end of the Notification Period.No Extraordinary Collection Actions will be undertaken during the 120 day Notification Period, during which time we will take reasonable efforts to determine whether the patient is eligible for Financial Assistance. Patients that may qualify for financial assistance, and that have accounts with the contracted collection agencies, will be vetted throughout the financial assistance process. Meanwhile, accounts will be placed on hold until the financial assistance eligibility is determined. If the patient is eligible, accounts will be appropriately adjusted and adjusted amounts will be reported to the collection agency.No Extraordinary Collection Actions are taken prior to the 240th day after the date of the first invoice. Part VI, Line 2: In addition to the CHNA, Bozeman Health Big Sky Medical Center (BSMC) assesses community health care needs in a number of ways. We look at other available health data and reports for our service area provided by the State of Montana and our local City-County Health Department. We also work closely with area non-profits and social service providers to hear about the needs of their clients / customers to help inform our outreach strategies and community health improvement efforts. Part VI, Line 3: Bozeman Health is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. As a hospital operating in the Bozeman Health system, Big Sky Medical Center (BSMC) posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BSMC will attempt to determine whether a patient has third party coverage for any part of the hospital services provided. If a patient does not have third party coverage, a patient advocate from the MASH program will screen all inpatient cases and any outpatient cases exceeding $1,000 in total charges to determine if the patient qualifies for third party funding. If not, the patient advocate will explain the Financial Assistance Policy and give the patient an application if desired. In circumstances where payment in full will cause financial hardship that will significantly harm the patient or patient's family, the applicant may be asked to visit with Consumer Credit Counseling Services to further review their financial situations. Upon request, patients may be asked to complete an application for Medicaid participation or for coverage by other governmental payment programs. Patient bills also contain billing information explaining financial options and provide contact information to the appropriate resources. Part VI, Line 4: BH Big Sky Medical Center (BSMC) primarily serves a three zip code region in Gallatin County Montana: 59716 Big Sky, 59730 Gallatin Gateway, and 59758 West Yellowstone (note in certain zip code boundary definitions, 59716 Big Sky is in both Gallatin and Madison County-although the most populous area is in Gallatin County). These 3 communities account for more than 74% of clinic visits at BSMC Big Sky Clinic in 2018. In addition, these same communities account for 24.2% of BSMC's inpatient admissions while 75.8% were of patients originating outside Montana-likely driven by the Big Sky area being a popular tourist destination.The population of the tri-zip code area was an estimated 6,523 (59716: 2,208, 59730: 2,065, and 59758: 2,250) in 2018 (IBM Watson Health). The average median household income (weighted by number of households) in the combined communities was an estimated $59,770 and 12.5% of the population was estimated to be in poverty in 2017 (ACS 5yr estimates, 2017). 2018 estimates suggest that 12.7% of the population in the tri-zip code area are covered by Medicaid, 6.6% are uninsured, and 15.5% are insured under Medicare (IBM Watson Health, 2018). Bozeman Health Big Sky Medical Center is the only hospital in the BSMC three zip code service area, and is one of two hospitals in Gallatin County (BH BSMC and BH Deaconess Hospital). The low income population within Gallatin County is designated as a Primary Care HPSA and the total geographic population of Gallatin County is designated as a Mental Health Professional Shortage (HPSA) Geographic Area HPSA based on 2019 HPSA data.(https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations) Part VI, Line 5: The governing body of Bozeman Health is comprised of individuals who represent our community and live in our service area; a majority of whom are independent of the organization. To ensure immediate access to care, we have an open medical staff and require each medical staff member to care for anyone presenting in the Emergency Department. As an organization, we devote a significant amount of funds into maintaining and advancing high-level, innovative, and responsive patient care. This includes recent investments in expanding integrated behavioral health, access to telepsychiatry, and embedding crisis response in our facility. We also use surplus funds, among other ways, to award multiyear scholarships to college students studying health professions, support medical and nursing students at our facility, and provide community health improvement grants to local organizations who are working in alignment with our community benefit priority area. Part VI, Line 6: Bozeman Deaconess Health Services owned a majority interest in Deaconess Intercity Imaging, LLC and Rocky Mountain Surgery Center in the current tax year. Although these joint ventures are not licensed hospitals, these organizations hold similar policies regarding providing care to all members of the community and offering financial assistance as determined by ability to pay. 1 MT State University Foundation PO Box 172750 Bozeman MT 59717 816001649 State of Montana 285715 0 Support improving access to Health Services in our service area Cancer Support Comununity MT 102 S 11th Ave Bozeman MT 59715 810542266 501(c)3 60000 0 Support cancer support services within our service area Help Center 421 E Peach St Bozeman MT 59715 810309373 501(c)3 50000 0 Support crisis counseling, advocacy, information and outreach Community Health Partners 214 E Mendenhall Bozeman MT 59715 841420492 501(c)3 25000 0 Support improving access to Health Services in our service area Wellness in Action 47855 Gallatin Rd Big Sky MT 59716 204166175 501(c)3 20000 0 Support behavioral health services within our service area Bridgercare 1288 N 14th Ave 201 Bozeman MT 59715 810363189 501(c)3 12000 0 Support improving access to Health Services in our service area Greater Gallatin United Way 945 Technology Blvd 101F Bozeman MT 59718 810384820 501(c)3 10035 0 Support human service needs within our service area Human Resource Development Council of District IX (HRDC) 32 S Tracy Ave Bozeman MT 59715 810350886 501(c)3 10000 0 Support resources for low income population in our service area Mountain Time Arts 544 E Main St Unit B Bozeman MT 59715 822924553 501(c)3 10000 0 Support social and environmental changes integrated with health and resiliency Montana Mindfulness Project PO Box 5106 Bozeman MT 59717 832891383 501(c)3 10000 0 Support mindfulness based education in schools Thrive PO Box 4325 Bozeman MT 59772 363501185 501(c)3 10000 0 Support human service needs within our service area Suffer Out Loud PO Box 6401 Bozeman MT 59715 815336718 501(c)3 10000 0 Supoprt crisis and suicide prevention within our service area Bozeman Symphony Society 402 E Main St Ste 202 Bozeman MT 59715 816019534 501(c)3 10000 0 Support cognitive health within our service area Heart of the Valley Animal Shelter 1549 E Cameron Bridge Rd Bozeman MT 59718 237375919 501(c)3 10000 0 Support mental health and connection in our service area Bridger Ski Foundation 851 Bridger Drive STE 1243 Bozeman MT 59771 810384359 501(c)3 9950 0 Support healthy lifestyles for youth in our service area Gallatin Valley Farm to School PO Box 563 Bozeman MT 59771 453528080 501(c)3 8000 0 Support healthy lifestyles for youth in our service area 16 0 Scholarships 13 12300 Part I, Line 2: Recipients of grants and assistance prepare informational reports substantiating the use of the funds that were earmarked to support community health programs. Involvement of Bozeman Deaconess Health Services staff and/or administration as volunteers in the activities being supported also ensures proper usage of funds. Scholarships provided are paid directly to the institute on behalf of the recipient. X X X 1 1 0 0 0 0 0 0 0 John Hill Former CEO 26647 0 0 0 795412 0 0 0 30 0 822089 0 0 0 Mark Hancock Internal Medicine 697923 0 27008 0 2376 0 19800 0 38252 0 785359 0 0 0 Kathryn Bertany CEO 626155 0 0 0 9856 0 106545 0 30519 0 773075 0 0 0 Kleanthis Dendrinos Gastroenterologist 566170 0 152075 0 540 0 19800 0 26934 0 765519 0 0 0 Dane Sobek Director/Cardiologist 682962 0 7389 0 828 0 19800 0 33890 0 744869 0 0 0 Nathaniel Madsen Cardiology 673324 0 8210 0 540 0 19800 0 38198 0 740072 0 0 0 Andrew Gentry Gastroenterologist 515227 0 154937 0 1548 0 19800 0 39379 0 730891 0 0 0 Justin Thomas Hematologist 627565 0 20622 0 360 0 19800 0 41843 0 710190 0 0 0 Brad Ludford CFO 395457 0 0 0 4242 0 82296 0 37957 0 519952 0 0 0 Steve Klein Chief Legal Officer 293245 0 0 0 21590 0 43538 0 36429 0 394802 0 0 0 Kiera Pattison Chief Nursing Officer 272478 0 0 0 63575 0 31800 0 24671 0 392524 0 0 0 Darci Bentson Former CAO 15186 0 0 0 373646 0 0 0 19 0 388851 0 0 0 Kallie Kujawa Chief Operating Officer 280400 0 0 0 2396 0 44977 0 33457 0 361230 0 0 0 Denise Juneau Chief Government & Community Affairs 278352 0 0 0 5862 0 42753 0 17438 0 344405 0 0 0 Tamara Havenhill-Jacobs Chief Information Officer (thru May) 132133 0 0 0 183296 0 0 0 14021 0 329450 0 0 0 Edie Willey Former Chief People Officer 11785 0 0 0 288573 0 0 0 19 0 300377 0 0 0 Meghan Johnston Director (as of July)/Internist 239069 0 7312 0 242 0 16319 0 28738 0 291680 0 0 0 Mark Williams Former Chief Physician Officer 4955 0 0 0 123264 0 0 0 19 0 128238 0 0 0 Part I, Lines 4a-b Line 4a: In 2023, the following former officers received severance payments: John Hill: $795,025 Darci Bentson: $373,477 Mark Williams: $123,000 Edie Willey: $288,462 In 2023, the following officers received severance payments: Tamara Havenhill-Jacobs: $181,971 Line 4b: Schedule J, Part II, column (c) reflects contributions paid by the organization into their individual 457(f) plan. The following employer contributions were made in 2023. Kathryn Bertany: $77,622 Brad Ludford: $40,933 Kiera Pattison: $12,000 Kallie Kujawa: $24,840 Steve Klein: $24,000 Denise Juneau: $24,000 Mark Williams was a participant in the 457f plan for 2023. He did not have any contributions in that year, but is still an active participant with a balance to be paid in the future. A Montana Facility Finance Authority 364615155 61240MBM8 2014-11-05 23005852 Refinance 2004 bond issued 3/4/2004; fund add'n of Big Sky Medical Facility 0 0 0 A 2839429 23008884 3032 377976 17500000 5127876 2015 1 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: 06/21/2019 Schedule K, Part I, Line A(e): Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Form 990, Part VI, Section A, line 4 The bylaws were revised in 2023 to simplify the board governance structure. This involved: (a) consolidating a number of overlapping board committees for the purpose of streamlining our governance structure; and (b) cleanup changes to ensure the bylaws are consistent with current practices. Form 990, Part VI, Section A, line 7a The Yellowstone Conference of the Methodist Church confirms the Board Members and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Changing the Articles of Incorporation in relationship to the process of selecting board membership must be approved by the Yellowstone Conference of the United Methodist Church. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Planning and Finance Committee will review the Form 990 with the Finance Team and will make a recommendation to the full Board for acceptance. A copy of the 990 is provided to the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c An annual Disclosure Statement is obtained from the Board, Operating Committee, and Executive Team Members. Disclosures are reviewed with the Conflict of Interest (COI) Panel (Compliance Officer, Board Compliance Committee Chair, Chief Executive Officer, & Chief Legal Officer). The COI Panel assesses the disclosure, develops an acknowledgement and management plan. The management plan is reviewed with the affected member, if the COI Panel and the member are unable to resolve the disclosure, the disclosure is reported to the Board Compliance Committee for further review. Conflicts are addressed annually in writing and verbally during meetings. If a COI exists, the member shall not participate in any deliberations or vote regarding the transaction or arrangement at issue, and shall not be present in the meeting room for any part of the deliberations or vote relating to the transaction or arrangement. Form 990, Part VI, Section B, line 15 The Board Executive Committee, which is comprised of independent board members, serves as the organization's compensation committee. The Executive Committee receives a formal presentation by an independent compensation consultant (as selected by the Committee) qualified to perform compensation reviews including usage of comparability data. This person presents recommendations to the Executive Committee. The Executive Committee then makes decisions annually regarding compensation for Officers and Senior Administration. The Executive Committee's compensation review process is outlined in an Executive Compensation Philosophy Policy that was adopted by the full Board. Form 990, Part VI, Section C, line 19 Tax documents required to be available for public inspection are available upon request. The audited financial statements are required to be attached to the Form 990 and provided to the Municipal Securities Rulemaking Board, which is our tax-exempt bonds trustee, via an on-line, central filing location called Electronic Municipal Market Access (EMMA). The financial statements can be obtained by the general public at the EMMA website. Form 990, Part IX, line 11g Other Fees: Program service expenses 2,192,736. Management and general expenses 17,334,054. Fundraising expenses 0. Total expenses 19,526,790. Form 990, Part XI, line 9: Change in Temp Restricted Investment of Foundation -33,724. Big Sky Medical Center LLC 334 Town Center Ave Big Sky MT 59716 474718253 Healthcare - Inpatient and Outpatient Servcies MT 17799529 29384349 Bozeman Deaconess Health Services Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 822848277 Healthcare-Ambulatory Clinic Outpatient Care MT 1171674 642449 Bozeman Deaconess Health Services Bozeman Health Urgent Cares LLC 1006 W Main Bozeman MT 59715 465318746 Healthcare - Physician Outpatient Care MT 7456757 16205692 Bozeman Deaconess Health Services Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 475126599 Physician Employment & Contract to Bozeman Health System MT 69708099 5863518 Bozeman Deaconess Health Services Bozeman Deaconess Foundation dba Bozeman Health Foundation 931 Highland Blvd Suite 3200 Bozeman MT 59715 841407943 Raise funds to support Bozeman Deaconess Health Services MT 501(c)(3) Line 7 Bozeman Deaconess Health Services 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 474717998 Healthcare - Inpatient and Outpatient Services MT 501(c)(3) Line 3 Bozeman Deaconess Health Services 1 Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT Bozeman Deaconess Health Services Related -1182232 2494917 0 1 0.77500 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT Bozeman Deaconess Health Services Related 2727017 3342341 0 0 0.51010 Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT Bozeman Deaconess Health Services Related 59850 244639 0 1 0.69940 Bozeman HealthUSP Surgery Centers LLC 14201 Dallas Parkway Dallas TX 75254 823991148 Ambulatory Surgery Center TX Bozeman Deaconess Health Services Related 1297303 1830389 0 0 0.50100 Bozeman Deaconess Real Estate Development Corp PO Box 10490 Bozeman MT 59719 205496567 Sale of real estate property and residences to seniors MT Bozeman Deaconess Health Services C 52955 4391745 1.00000 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 Bozeman Health Deaconess Hospital L 147357284 General ledger and corp. records Bozeman Deaconess Foundation C 232868 General ledger and corp. records Bozeman Deaconess Foundation Q 112041 General ledger and corp. records Rocky Mountain Surgical Center LLC S 3162881 General ledger and corp. records Bozeman HealthUSP Surgery Centers LLC S 551185 General ledger and corp. records Spanish Peaks Plaza LLC S 76934 Schedule K-1