BIG SANDY MEDICAL CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- BIG SANDY MEDICAL CENTER INC (EIN 81-0291695)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-04-21
- IRS object ID
- 202301119349301130
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-04-21T13:01:57-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST FRONT STREET 301 | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810291695 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BIG SANDY MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BIGS | BusinessNameControlTxt |
| Phone | 4063782188 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 530 | AddressLine1Txt |
| City | BIG SANDY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59520 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON WIENS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4063782188 | PhoneNum |
| Signature | 2023-04-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RON | PersonFirstNm |
| Person Last | WIENS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAM BRUNSON CPA | PreparerPersonNm |
| PTIN | P01696998 | PTIN |
| Phone | 4067281800 | PhoneNum |
| Preparation | 2023-04-18 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RON WIENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 530 | AddressLine1Txt |
| City | BIG SANDY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59520 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,375,866 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | BSMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1963 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY PATIENT CARE IN AN INNOVATIVE AND PROFESSIONAL MANNER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 64 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,854,531 | PYContributionsGrantsAmt |
| CY Contributions Grants | $170,328 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,351,469 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,089,697 | CYProgramServiceRevenueAmt |
| PY Investment Income | $29,710 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,941 | CYInvestmentIncomeAmt |
| PY Other Revenue | $122,600 | PYOtherRevenueAmt |
| CY Other Revenue | $93,900 | CYOtherRevenueAmt |
| PY Total Revenue | $6,358,310 | PYTotalRevenueAmt |
| CY Total Revenue | $5,375,866 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,374,508 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,450,716 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,458,841 | PYOtherExpensesAmt |
| CY Other Expenses | $2,711,609 | CYOtherExpensesAmt |
| PY Total Expenses | $4,833,349 | PYTotalExpensesAmt |
| CY Total Expenses | $5,167,325 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,524,961 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $208,541 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,319,048 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,439,477 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $495,536 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $407,424 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,823,512 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,032,053 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE QUALITY PATIENT CARE IN AN INNOVATIVE AND PROFESSIONAL MANNER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,410,093 | ExpenseAmt |
| Grant | $5,000 | GrantAmt |
| Revenue | $5,179,797 | RevenueAmt |
| Desc | BIG SANDY MEDICAL CENTER PROVIDES BOTH ACUTE AND SWING BED PATIENT SERVICES UNDER ONE ROOF. THE SWING BED PROGRAM HAS TWO PARTS, SKILLED AND INTERMEDIATE CARE. SKILLED SWING BED PATIENTS ARE HERE FROM 2-6 WEEKS IN WHICH THEY RECEIVED SKILLED NURSING SERVICES AND/OR SKILLED REHAB SERVICES. THE MAJORITY OF SWING BED PATIENTS ARE IN THE INTERMEDIATE CATEGORY AND REQUIRE LONG-TERM NURSING CARE SERVICES. TYPICALLY, THE MEDICAL CENTER'S 25 BED CAPACITY FLUCTUATES AROUND 80% FULL.BIG SANDY MEDICAL CENTER HAS A CERTIFIED RURAL HEALTH CLINIC WITH 3 EXAM ROOMS AND A PROCEDURE ROOM. IDEALLY, THE CLINIC IS STAFFED WITH 3 PROVIDERS, HOWEVER, WITH A NATIONAL PROVIDER SHORTAGE, THE CLINIC OFTEN UTILIZES SHORT-TERM TRAVELING PROVIDERS. THE CLINIC AVERAGES 10-12 PATIENTS A DAY SEEING A VARIETY OF AILMENTS FROM COUGHS TO CHRONIC DISEASE CONDITIONS.BIG SANDY MEDICAL CENTER PROVIDES AMAZING PHYSICAL THERAPY SERVICES FOR ITS COMMUNITY RESIDENTS. WITH A LONG-TERM LOCAL PHYSICAL THERAPIST ON STAFF, THE PROGRAM IS WELL RECEIVED AND HIGHLY UTILIZED. | Desc |
| Total Program Service Expenses | $4,410,093 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 64 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON WIENS | PersonNm |
| Phone | 4063782188 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 530 | AddressLine1Txt |
| City | BIG SANDY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59520 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| HARVEY KELLER | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT NELSON | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NICOLE ALLDERDICE | |||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ANNA BOLD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANN QUINN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEAH GRIFFITH | |||||||
| CEO | 40.00 | Yes (X) | $91,189 | $0 | $29,385 | ||
| COLETTE TERRY | |||||||
| CFO (THRU 11/21) | 40.00 | Yes (X) | $68,649 | $0 | $7,373 | ||
| SARAH SCHLEPP | |||||||
| DIRECTOR OF FINANCE (2/22) | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| KRYSTYL KULBECK | |||||||
| PA-C | 40.00 | $147,930 | $0 | $30,214 | Yes (X) | ||
| ZANE BENDIG | |||||||
| NP | 40.00 | $110,675 | $0 | $24,814 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $418,443 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $91,786 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CYPRESS HEALTHCARE | |||||
| 791 EASTSIDE ROAD | DEER LODGE | MT | 59722 | MANAGEMENT SERVICES | $147,261 |
| AUREUS RADIOLOGY | |||||
| 13609 CALIFORNIA STREET | OMAHA | NE | 68154 | INTERIM LAB TECH SERVICES | $140,628 |
| MONTANA HEALTH NETWORK | |||||
| 519 PLEASANT STREET | MILES CITY | MT | 59301 | INTERIM NURSING SERVICES | $134,334 |
| BADLANDS MEDICAL STAFFING | |||||
| PO BOX 103 | UNDERWOOD | ND | 58576 | INTERIM NURSING SERVICES | $131,526 |
| KC CORPORATION | |||||
| PO BOX 1246 | BIG SANDY | MT | 59520 | PT SERVICES | $100,920 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $138,750 | GovernmentGrantsAmt |
| All Other Contributions | $31,578 | AllOtherContributionsAmt |
| Total Contributions | $170,328 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621110 | $4,704,366 | $4,704,366 |
| OTHER OPERATING REVENU | 621110 | $200,741 | $200,741 |
| 340B REVENUE | 621110 | $164,536 | $164,536 |
| DIETARY REVENUE | 621110 | $20,054 | $20,054 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,089,697 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,941 | TotalRevenueColumnAmt |
| Exclusion | $21,941 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,800 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,800 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,800 | TotalRevenueColumnAmt |
| Exclusion | $3,800 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HOSPITAL TAX DISTRICT | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $90,100 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $90,100 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $90,100 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,375,866 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,179,797 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $25,741 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,000 | TotalAmt |
| Program Services | $5,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,596 | TotalAmt |
| Program Services | $168,381 | ProgramServicesAmt |
| Management And General | $28,215 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,788,745 | TotalAmt |
| Program Services | $1,532,017 | ProgramServicesAmt |
| Management And General | $256,728 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,535 | TotalAmt |
| Program Services | $11,593 | ProgramServicesAmt |
| Management And General | $1,942 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,845 | TotalAmt |
| Program Services | $260,243 | ProgramServicesAmt |
| Management And General | $43,602 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,995 | TotalAmt |
| Program Services | $126,758 | ProgramServicesAmt |
| Management And General | $21,237 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,565 | TotalAmt |
| Management And General | $5,565 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,600 | TotalAmt |
| Program Services | $11,700 | ProgramServicesAmt |
| Management And General | $24,900 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,148,998 | TotalAmt |
| Program Services | $933,659 | ProgramServicesAmt |
| Management And General | $215,339 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,996 | TotalAmt |
| Program Services | $23,890 | ProgramServicesAmt |
| Management And General | $1,106 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,981 | TotalAmt |
| Program Services | $10,760 | ProgramServicesAmt |
| Management And General | $32,221 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,243 | TotalAmt |
| Program Services | $49,878 | ProgramServicesAmt |
| Management And General | $16,365 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,365 | TotalAmt |
| Program Services | $16,040 | ProgramServicesAmt |
| Management And General | $1,325 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,116 | TotalAmt |
| Program Services | $1,116 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,549 | TotalAmt |
| Program Services | $121,766 | ProgramServicesAmt |
| Management And General | $42,783 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,630 | TotalAmt |
| Program Services | $64,846 | ProgramServicesAmt |
| Management And General | $22,784 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $785,407 | $764,681 | $20,726 |
| EQUIPMENT | $88,236 | $88,236 | |
| COVID EXPENSES | $87,220 | $87,220 | |
| DUES & SUBSCRIPTIONS | $41,875 | $36,805 | $5,070 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,828 | TotalAmt |
| Program Services | $95,504 | ProgramServicesAmt |
| Management And General | $17,324 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,167,325 | TotalAmt |
| Program Services | $4,410,093 | ProgramServicesAmt |
| Management And General | $757,232 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $313,213 | BOYAmt |
| EOY | $314,933 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,525,662 | BOYAmt |
| EOY | $1,528,034 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,536 | BOYAmt |
| EOY | $889,537 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,313 | BOYAmt |
| EOY | $151,852 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,388,762 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,506,716 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,900,273 | BOYAmt |
| EOY | $1,882,046 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,435,244 | BOYAmt |
| EOY | $1,442,446 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $218,807 | BOYAmt |
| EOY | $230,629 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,319,048 | BOYAmt |
| EOY | $6,439,477 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,544 | BOYAmt |
| EOY | $360,206 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $15,133 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,057 | BOYAmt |
| EOY | $32,085 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $220,935 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $495,536 | BOYAmt |
| EOY | $407,424 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,823,512 | BOYAmt |
| EOY | $6,032,053 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,823,512 | BOYAmt |
| EOY | $6,032,053 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,319,048 | BOYAmt |
| EOY | $6,439,477 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $208,541 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,159 | OtherCostOrOtherBasisAmt |
| Book Value | $57,159 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,103,073 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,594,036 | DepreciationAmt |
| Book Value | $509,037 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,228,530 | OtherCostOrOtherBasisAmt |
| Depreciation | $912,680 | DepreciationAmt |
| Book Value | $1,315,850 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,882,046 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,355,485 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,355,485 | RevenueSubtotalAmt |
| Other Revenues Not Included | $20,381 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $20,381 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,375,866 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,146,944 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,146,944 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $20,381 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $20,381 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $5,167,325 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE HOSPITAL HOLDS FUNDS FOR LONG-TERM CARE PATIENTS. |
| PART X, LINE 2: | THE MEDICAL CENTER, AS A NOT-FOR-PROFIT ORGANIZATION OPERATING UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THESE FINANCIAL STATEMENTS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | 340B EXPENSES 20,381. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | 340B EXPENSES 20,381. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,314 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,314 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $921,520 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $946,127 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $922,834 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $946,127 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,314 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $922,834 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $946,127 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,314 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,437,855 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,428,248 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $9,607 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BIG SANDY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 530 | AddressLine1Txt |
| City | BIG SANDY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59520 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | BSMC.ORG | WebsiteAddressTxt |
| State License | 12767 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BIG SANDY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.BSMC.ORG/COMMUNITYHEALTHNEEDS.HTML | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.BSMC.ORG/COMMUNITYHEALTHNEEDS.HTML | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.BSMC.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.BSMC.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.BSMC.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BIG SANDY MEDICAL CENTER | PART V, SECTION B, LINE 5: COMMUNITY LEADERS AND STAKEHOLDERS WERE INVITED TO A FOCUS GROUP SESSION HELD APRIL 27, 2021. THIS DIVERSE GROUP OF INDIVIDUALS ARE FROM VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY IN BSMC'S SERVICE AREA. THE OBJECTIVES OF THE FOCUS GROUP WERE TO IDENTIFY ONE TO THREE HEALTH NEEDS TO ADDRESS IN THE IMPLEMENTATION PLAN AND TO DECIDE WHAT INFORMATION IS NEEDED FROM THE 2021 CHNA SURVEY AS PART OF THE IMPLEMENTATION PLAN. |
| BIG SANDY MEDICAL CENTER | PART V, SECTION B, LINE 11: OBJECTIVE 1: MARKET ANALYSIS CONDUCTED BY STROUDWATER.- THE RESULTS OF THE MARKET ANALYSIS WILL BE DISTRIBUTED TO ALL FOCUS GROUP ATTENDEES ALONG WITH THE COMPILED DATA FROM THE CHNA SURVEY.OBJECTIVE 2: DISPENSE THE UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY TOOL TO RESIDENTS IN THE BSMC PRIMARY AND SECONDARY SERVICE AREAS:- THE SURVEY TOOL WILL BE MAILED TO POST OFFICE BOXES AND PHYSICAL ADDRESSES OF ALL HOUSEHOLDS IN THE SERVICE AREA.- AN ONLINE PLATFORM WILL BE DEVELOPED AND ADVERTISED FOR RESPONDENTS TO USE.- THE SURVEY TOOL WILL BE POSTED ON BSMC'S WEBSITE, PROVIDING A THIRD OPTION.THE FOCUS GROUP WILL MEET AGAIN TO REVIEW AND DISCUSS THE INFORMATION OBTAINED. THIS SESSION WILL ALLOW ALL STAKEHOLDERS TO PROVIDE INPUT INTO FURTHER PHASES OF THE IMPLEMENTATION PLAN TO INCLUDE SPECIFIC STRATEGIES AND ACTIVITIES TO ADDRESS THE TWO DEFINED OBJECTIVES. THESE WILL BE ONGOING IN THE NEXT THREE YEARS WITH COMMUNICATION, COORDINATION, AND COLLABORATION BETWEEN STAKEHOLDERS. FREQUENT EVALUATIONS OF EFFECTIVENESS AND SUSTAINABILITY WILL ALSO BE PART OF THESE STRATEGIES TO ENSURE THE BIG SANDY COMMUNITY'S HEALTH NEEDS ARE BEING ADDRESSED SUFFICIENTLY AND APPROPRIATELY. |
| PART V, SECTION B, LINE 20C | WE DO NOT PROCESS INCOMPLETE APPLICATIONS. APPLICANT IS NOTIFIED IN WRITING OF WHAT DOCUMENTATION IS REQUIRED IF THE APPLICATION IS CONSIDERED INCOMPLETE. |
| PART V, SECTION B, LINE 20D | NO PRESUMPTIVE ELIGIBILITY DETERMINATIONS WERE MADE. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE ORGANIZATION USES THE COST-TO-CHARGE RATIO TO CALCULATE AMOUNTS ON PART I, LINE 7. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | RECRUITMENT OF FAMILY PRACTICE PROVIDERS TO BIG SANDY IS AN ONGOING ACTIVITY TO ENSURE THE COMMUNITY RESIDENTS AND HOSPITAL PATIENTS HAVE THE HIGHEST LEVEL OF QUALITY CARE PROVIDED TO THEM. |
| PART III, LINE 2: | BAD DEBTS ARE DETERMINED WHEN AN ACCOUNT IS SENT TO COLLECTIONS BASED ON THE POLICIES OF THE ORGANIZATION. |
| PART III, LINE 4: | THE FOOTNOTE THAT DESCRIBES THE BAD DEBT EXPENSE IS ON PAGES 7-8 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | BSMC USES THE AMOUNTS FROM MEDICARE PROVIDER STATISTICAL REIMBURSEMENT (PS&R) TO DETERMINE THE MEDICARE ALLOWABLE COSTS. |
| PART III, LINE 9B: | WHEN A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE DISCOUNT AMOUNT IS APPLIED TO THE GROSS CHARGES BILLABLE TO THE PATIENT. THE PATIENT IS THEN NOTIFIED IN WRITING THE REMAINING BALANCE. IN THE EVENT THAT A PATIENT THAT QUALIFIES FOR FINANCIAL ASSISTANCE BUT FAILS TO TIMELY PAY THE REMAINING BALANCE DUE, THE FACILITY MAY TAKEN ANY ACTIONS DEFINED IN THE BILLING AND COLLECTIONS POLICY. |
| PART VI, LINE 2: | BSMC SENDS OUT SATISFACTION SURVEYS AND ASKS FOR INPUT ON ANY CHANGES PATIENTS WOULD LIKE TO SEE. ALSO, ONCE A YEAR, AN ANNUAL PUBLIC MEETING IS HELD AND INPUT IS SOLICITED AS WELL AS A REPORT ON HOSPITAL ACTIVITIES GIVEN. THIS PUBLIC MEETING IS WELL ADVERTISED IN THE LOCAL PRESS. |
| PART VI, LINE 3: | A NOTICE OF PATIENT ELIGIBILITY IS POSTED IN ALL WAITING AREA AND ON THE WEBSITE - BSMC.ORG. NOTICE OF FINANCIAL ASSISTANCE IS ALSO SENT OUT WITH ALL PRE-COLLECTION CORRESPONDENCE. |
| PART VI, LINE 4: | THE COMMUNITY IS MOSTLY AGRICULTURAL WITH LARGE WHEAT FARMS AND LARGE CATTLE RANCHES. THOSE WHO DO NOT WORK AT THESE AGRICULTURAL BUSINESS SITES USUALLY WORK IN A BUSINESS THAT SUPPORTS THE WHEAT AND CATTLE OPERATIONS. UNEMPLOYMENT IS THE COUNTY AND AREA IS VERY LOW, USUALLY IN THE 2-3% RANGE. MOST PATIENTS HAVE AVERAGE TO NORMAL PAYING JOBS WITH AVERAGE BENEFITS. |
| PART VI, LINE 5: | EACH WEEK AN ARTICLE IS PLACED IN THE LOCAL PAPER PROVIDING EDUCATION ON A TOPIC OF MEDICAL IMPORTANCE AND/OR SAFETY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KRYSTYL KULBECK | PersonNm |
| Title | PA-C | TitleTxt |
| Base Compensation Filing Org | $147,930 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $2,959 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $27,255 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $178,144 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | IN FEBRUARY 2021, THE CENTER ENTERED INTO A MANAGEMENT AGREEMENT WITH CYPRESS HEALTHCARE, LLC, THROUGH FEBRUARY 2024. FEES PAID TO CYPRESS HEALTHCARE, LLC FOR THE FISCAL YEAR ENDED JUNE 30, 2022, WERE $147,261 WHICH INCLUDED ADMINISTRATION COMPENSATION, MANAGEMENT FEES, AND MISCELLANEOUS EXPENSES SUCH AS TRAVEL. |
| FORM 990, PART VI, SECTION A, LINE 6 | ANY RESIDENT AND/OR TAXPAYER OF CHOUTEAU COUNTY HOSPITAL DISTRICT II IS ELIGIBLE TO BECOME A MEMBER. MEMBERS ELECT THE GOVERNING BODY AT AN ANNUAL MEETING. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS ELECT THE GOVERNING BODY AT AN ANNUAL MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS EMAILED TO AND REVIEWED BY MANAGEMENT AND THE BOARD OF DIRECTORS BEFORE BEING FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | MEMBERS OF THE BOARD ARE MADE AWARE OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION AND DISCUSS SUCH ONCE A YEAR AT A REGULAR BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS WILL REFER TO THE MONTANA HOSPITAL ASSOCIATION ANNUAL SALARY SURVEY. |
| FORM 990, PART VI, SECTION C, LINE 18 | COPIES ARE AVAILABLE BY REQUEST AND VIA IRS.GOV |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,130. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,130. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 932,529. MANAGEMENT AND GENERAL EXPENSES 215,339. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,147,868. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Comments