SIDNEY HEALTH CENTER: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SIDNEY HEALTH CENTER (EIN 81-0233499)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-08
IRS object ID
202311289349300826
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

FieldValueIRS element (for citing)
Return2023-05-08T09:34:41-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110700 NORTHUP WAY SUITE 200AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810233499EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SIDNEY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSIDNBusinessNameControlTxt
Phone4064882100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1216 14TH AVENUE SWAddressLine1Txt
CitySIDNEYCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59270ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTINA MONTGOMERYPersonNm
Person TitleCFOPersonTitleTxt
Phone4064882100PhoneNum
Signature2023-05-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTINAPersonFirstNm
Person LastMONTGOMERYPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNION CPAPreparerPersonNm
PTINP01469618PTIN
Phone4252506100PhoneNum
Preparation2023-05-04PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEN DOTYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1216 14TH AVENUE SWAddressLine1Txt
CitySIDNEYCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59270ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$104,336,517GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SIDNEYHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionTO HELP THOSE WE SERVE ACHIEVE THEIR HIGHEST LEVEL OF HEALTH BY PROVIDING QUALITY MEDICAL CARE.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee648TotalEmployeeCnt
Total Volunteers135TotalVolunteersCnt
Total Gross UBI$1,541,234TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$25,791NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$11,978,788PYContributionsGrantsAmt
CY Contributions Grants$5,578,804CYContributionsGrantsAmt
PY Program Service Revenue$83,785,111PYProgramServiceRevenueAmt
CY Program Service Revenue$92,316,930CYProgramServiceRevenueAmt
PY Investment Income$1,089,815PYInvestmentIncomeAmt
CY Investment Income$1,451,731CYInvestmentIncomeAmt
PY Other Revenue$963,124PYOtherRevenueAmt
CY Other Revenue$892,134CYOtherRevenueAmt
PY Total Revenue$97,816,838PYTotalRevenueAmt
CY Total Revenue$100,239,599CYTotalRevenueAmt
PY Grants And Similar Paid$27,600PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$161,801CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$39,044,753PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,441,124CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$287,857CYTotalFundraisingExpenseAmt
PY Other Expenses$47,133,592PYOtherExpensesAmt
CY Other Expenses$55,329,536CYOtherExpensesAmt
PY Total Expenses$86,205,945PYTotalExpensesAmt
CY Total Expenses$96,932,461CYTotalExpensesAmt
PY Revenues Less Expenses$11,610,893PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,307,138CYRevenuesLessExpensesAmt
Total Assets BOY$99,470,484TotalAssetsBOYAmt
Total Assets EOY$98,812,336TotalAssetsEOYAmt
Total Liabilities BOY$35,829,557TotalLiabilitiesBOYAmt
Total Liabilities EOY$33,906,830TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$63,640,927NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$64,905,506NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO HELP THOSE WE SERVE ACHIEVE THEIR HIGHEST LEVEL OF HEALTH AND WELL-BEING.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$86,638,813ExpenseAmt
Grant$161,801GrantAmt
Revenue$90,255,073RevenueAmt
DescSIDNEY HEALTH CENTER IS A NOT-FOR-PROFIT COMMUNITY-BASED MEDICAL CENTER THAT HAS BEEN SERVING PEOPLE IN THE MONDAK REGION FOR MORE THAN 100 YEARS. OUR PASSION FOR CARING IS SHARED BY THE DOCTORS, NURSES, AND SEVERAL HUNDRED EMPLOYEES AND VOLUNTEERS. THIS COMMITMENT TO CARING IS OUR ALLEGIANCE TO THE COMMUNITY AS WE STRIVE TO PROVIDE "EXCEPTIONAL CARE FOR LIFE."LOCATED IN THE HEART OF RICHLAND COUNTY, THE ATTRACTIVE EASTERN MONTANA CAMPUS INCLUDES AN ACUTE CARE HOSPITAL, CLINIC, CANCER CARE, RETAIL PHARMACY AND AN EXTENDED CARE FACILITY OFFERING A COMPLETE RANGE OF SERVICES FROM BIRTH THROUGH END-OF-LIFE, WHICH IS COMPLEMENTED BY AN ARRAY OF OUTREACH SERVICES. THIS CONTINUUM OR SUCCESSION OF SERVICES IS NOT TYPICAL OF RURAL HEALTHCARE ORGANIZATIONS, BUT SIDNEY HEALTH CENTER IS NOT TYPICAL. A STRONG COMPLEMENT OF PRIMARY CARE PHYSICIANS AND A UNIQUE SELECTION OF SURGICAL SPECIALISTS, COMBINED WITH A MODERN FACILITY AND UP-TO-DATE MEDICAL EQUIPMENT, MAKES SIDNEY HEALTH CENTER A SPECIAL PLACE TO WORK, RECEIVE CARE AND PRACTICE MEDICINE.SIDNEY HEALTH CENTER ALSO PROVIDES VARIOUS COMMUNITY BENEFIT PROGRAMS FOR THE INDIVIDUALS IN OUR SERVICE REGION.RICHLAND COUNTY TRANSPORTATION - THIS PROGRAM GIVES OPPORTUNITIES FOR THOSE WHO CANNOT DRIVE THE OPTION OF A RIDE. SIDNEY HEALTH CENTER PROVIDES A DRIVER AND HELPS PAY FOR BUSSES. SINCE ITS CONCEPTION, WE HAVE GONE FROM ONE BUS AND ONE DRIVER FOR THE FULL PROGRAM TO MULTIPLE BUSSES AND DRIVERS. WE WORK WITH THE HEALTH DEPARTMENT, RICHLAND COUNTY AND THE LODGE.MILES CITY NURSING PROGRAM - WE PROVIDE THE FACILITY AND PROGRAM COSTS TO HAVE MILES CITY COMMUNITY COLLEGE RUN A SATELLITE SCHOOL HERE IN SIDNEY. THIS PROMOTES NURSING AS A PROFESSION AND KEEPS THOSE WHO ARE INTERESTED IN OUR COMMUNITY AS POSSIBLE EMPLOYEES LATER.OUTREACH CLINIC - SOME OF THE OUTLYING COMMUNITIES DO NOT HAVE ACCESS TO SPECIALTY SERVICES. SIDNEY HEALTH CENTER SENDS PROVIDERS TO THESE NEIGHBORING COMMUNITIES SO PATIENTS DO NOT HAVE TO TRAVEL. SHC ALSO HOSTS SPECIALISTS FROM LARGER FACILITIES TO OFFER QUALITY AND CONVENIENT CARE WE ARE UNABLE TO PROVIDE TO PATIENTS IN AND AROUND RICHLAND COUNTY.HEALTH SCREENINGS, EDUCATION AND MAINTENANCE SIDNEY HEALTH CENTER SUPPORTS A VARIETY OF EVENTS WHERE OUR COMMUNITY CAN BE EDUCATION ON HEALTH ISSUES. OUR CANCER CENTER SPONSORS THE "TOUGH ENOUGH TO WEAR PINK" DAY THE COUNTY FAIR; SUPPORTS "PINK NIGHTS" AT AREA SCHOOLS FOR VOLLEYBALL AND FOOTBALL DURING THE MONTH OF OCTOBER; AND HOLDS ANNUAL MENS HEALTH SCREENINGS. THE MENS SCREENING PROVIDES FREE PSA TESTS AND DRE EXAMS. IN OCTOBER, THE RADIOLOGY DEPARTMENT EXTENDS ITS HOURS TO OFFER MAMMOGRAMS A FEW EVENINGS DURING THE MONTH. SIDNEY HEALTH CENTER PROMOTES PREVENTATIVE CARE, DIABETES EDUCATION, LAB SCREENINGS AND MANY OTHER TOPICS. SIDNEY HEALTH CENTER OFTEN PARTNERS WITH THE RICHLAND COUNTY HEALTH DEPARTMENT, COALITION ON AGING, FIRE, POLICE AND MENTAL HEALTH PROFESSIONS, JUST TO NAME A FEW. SIDNEY HEALTH CENTER ALSO PARTICIPATES IN SUPPORTIVE HEALTH MAINTENANCE GROUPS, INCLUDING COMMUNITIES IN ACTION GROUPS.RICHLAND COUNTY FAIR & RODEO - SIDNEY HEALTH CENTER IS THE DAY SPONSOR AT THE COUNTY FAIR (DAILY ATTENDANCE OF AROUND 5,000), WHERE PEOPLE CAN HAVE THEIR BLOOD PRESSURE CHECKED AND RECEIVE A FREE COLD LEMONADE OR WATER DURING THE HOT AUGUST FAIR.GRIEF RECOVERY SUPPORT GROUPS - SIDNEY HEALTH CENTER ASSISTS INDIVIDUALS IN CONNECTING WITH LOCAL BEREAVEMENT SUPPORT GROUPS AND INDIVIDUAL COUNSELING AS REQUESTED OR WHEN A NEED IS IDENTIFIED. IN ADDITION, THE HOSPITAL'S BEREAVEMENT PROGRAM PROVIDES FAMILIES WITH MATERIALS AND RESOURCES FOLLOWING THE LOSS OF A LOVED ONE WHO RECEIVED CARE IN OUR FACILITY. BIRTHDAY HEALTH FAIR - PATIENTS WHO SIGN UP CAN GET AN ANNUAL HEALTH SCREEN AT A DISCOUNTED RATE DURING THEIR BIRTHDAY MONTH. THE LAB SCREENING INCLUDES A CHEMISTRY PANEL THAT EVALUATES KIDNEY AND LIVER FUNCTION, BLOOD SUGAR AND ELECTROLYES, A BLOOD COUNT WITH IDENTIFIES ANEMIA OR INFECTION AS WELL AS LIPIS (CHOLESTROL) PANEL.VISITING NURSE SERVICE - INITIAL NURSE VISIT AND POST DISCHARGE MEDICATION RECONCILIATION ALONG WITH ONGOING MEDICATION SETUPS TO THOSE IN NEED.MEDICATION ASSISTANCE THE MEDICATION ASSISTANCE PROGRAM OFFERS A 30-DAY SUPPLY OF SOME MEDICATIONS PRESCRIBED BY SIDNEY HEALTH CENTER PHYSICIANS AND ADVANCED PRACTICE PROVIDERS FREE OF CHARGE TO THOSE WHO QUALIFY. THIS PROGRAM WORKS WITH PATIENTS WHO ARE UNINSURED OR UNDERINSURED TO SECURE ONGOING COVERAGE FOR MEDICATIONS. THE PROGRAM WAS EXPANDED IN 2020 TO INCLUDE THE LIFELINE SERVICES FOR THOSE WHO FIT WITHIN THE 200% FPG. RX BOXES - PHARMACY SETS UP PILLS IN MEDICATION BOXES SO THAT GROUP HOME RESIDENTS GET THE CORRECT PILLS FOR EACH ADMINISTRATION TIME.CHAMBER OF COMMERCE - VARIOUS DONATIONS FOR COMMUNITY AND CHAMBER FUNCTIONS.CHILDBIRTH CLASSES - CLASSES OFFERED ON A QUARTERLY BASIS TO THE COMMUNITY.INTERACTIVE TOUR FOR ELEMENTARY STUDENTS - AS REQUESTED, LOCAL ELEMENTARY CLASSES PARTICIPATE IN INTERACTIVE STATIONS THAT ARE HOSTED BY VARIOUS SIDNEY HEALTH CENTER DEPARTMENTS.REACH TOUR - EVERY OTHER YEAR, SIDNEY HEALTH CENTER HOSTS R.E.A.C.H. (RESEARCH AND EXPLORE AWESOME CAREERS IN HEALTHCARE) TOUR THROUGH AHEC FOR HIGH SCHOOL STUDENTS INTERESTED IN HEALTHCARE CAREERS. STUDENTS SPEND THE DAY AT SIDNEY HEALTH CENTER PARTICIPATING IN INTERACTIVE DEMONSTRATIONS, VISITING WITH HEALTHCARE PROFESSIONALS AND MORE.FITNESS CENTER - SIDNEY HEALTH CENTER PARTNERED WITH HEALTHWORKS FITNESS CENTER TO SUBSIDIZE MEMBERSHIPS TO LOW INCOME INDIVIDUALS WITH DOCTOR ORDERED FITNESS REGIMENS.COVID-19 VACCINATION CLINICS SIDNEY HEALTH CENTER PARTNERS WITH THE RICHLAND COUNTY HEALTH DEPARTMENT TO VACCINATE INDIVIDUALS AGAINST COVID-19 ACCORDING THE STATE DISTRIBUTION PLAN. COVID-19 DRIVE-THRU TESTING SIDNEY HEALTH CENTER OFFERS FREE COVID-19 TESTS TO SYMPTOMATIC INDIVIDUALS MONDAY THROUGH FRIDAY BY APPOINTMENT. TEST RESULTS ARE SHARED VIA MY CHART WITHIN A FEW HOURS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$691,408ExpenseAmt
Grant$0GrantAmt
Revenue$583,123RevenueAmt
DescSIDNEY HEALTH CENTER CARE FLIGHT OFFERS HIGH QUALITY, AFFORDABLE, AIR MEDICAL TRANSPORTATION FOR PATIENTS REQUIRING EMERGENT OR URGENT MEDICAL CARE THAT IS NOT PROVIDED LOCALLY. APPROXIMATELY 24 PATIENTS ARE FLOWN OUT EACH MONTH FOR CRITICAL MEDICAL CONDITIONS INCLUDING HEART, STROKE, TRAUMA, AND PEDIATRIC NEEDS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$87,330,221TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document127IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee648EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTINA MONTGOMERY CFOPersonNm
Phone4064882117PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1216 14TH AVENUE SWAddressLine1Txt
CitySIDNEYCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59270ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
RAJOHN KARANJAI MD
TRUSTEE/CMO39.001.00Yes (X)$1,090,745$0$0
LESZEK JASZCZAK MD
TRUSTEE/CMO (THROUGH JUNE 2022)39.001.00Yes (X)$795,330$0$36,717
ERIC SIGMOND MD
PHYSICIAN35.000.00$612,797$0$43,178Yes (X)
JEROME KESSLER MD
PHYSICIAN40.000.00$567,858$0$34,925Yes (X)
MALUA TAMBI MD
PHYSICIAN40.000.00$512,543$0$41,957Yes (X)
JOHN CAREY MD
VICE-CHIEF OF MEDICAL STAFF39.001.00$509,285$0$41,957Yes (X)
CHAD PEDERSEN MD
PHYSICIAN40.000.00$524,039$0$14,361Yes (X)
RALF KIEHL MD
CHIEF OF MEDICAL STAFF39.001.00Yes (X)$449,031$0$23,066Yes (X)
JEN DOTY
CEO39.001.00Yes (X)$271,494$0$30,741
TINA MONTGOMERY
CFO39.001.00Yes (X)$172,691$0$23,629
LANCE AVERETT
PRESIDENT1.001.00Yes (X)$0$0$0Yes (X)
RANDY JOHNSON
VICE PRESIDENT1.001.00Yes (X)$0$0$0Yes (X)
REBECCA BRADLEY
SECRETARY/TREASURER1.001.00Yes (X)$0$0$0Yes (X)
ERIC BEENKEN
TRUSTEE1.001.00$0$0$0Yes (X)
ROBERT BURNISON
TRUSTEE1.001.00$0$0$0Yes (X)
STEPHANIE CARROLL
TRUSTEE1.001.00$0$0$0Yes (X)
KEVIN MAYER
TRUSTEE1.001.00$0$0$0Yes (X)
TERRY SILVERTSON
TRUSTEE (THROUGH NOVEMBER 2021)1.001.00$0$0$0Yes (X)
CHERYL VAN EVERY
TRUSTEE1.001.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,505,813TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$290,531TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K55IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BRETT BENNION MD
214 14TH AVENUE SW SUITE 110SIDNEYMT59270PHYSICIAN SERVICES$1,680,899
MEDIKAR PC
214 14TH AVENUE SWSIDNEYMT59270PHYSICIAN SERVICES$1,090,745
BADLAND MEDICAL STAFFING
214 14TH AVENUE SW SUITE 108SIDNEYMT59270CONTRACT LABOR$438,298
JUSTIN SHAFER MD
214 14TH AVENUE SW SUITE 105SIDNEYMT59270PHYSICIAN SERVICES$415,024
O PETE COUNCIL MD
214 14TH AVENUE SW SUITE 104SIDNEYMT59270PHYSICIAN SERVICES$368,926
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K26CntrctRcvdGreaterThan100KCnt
Related Organizations$295,915RelatedOrganizationsAmt
Government Grants$4,761,453GovernmentGrantsAmt
All Other Contributions$521,436AllOtherContributionsAmt
Noncash Contributions$104,000NoncashContributionsAmt
Total Contributions$5,578,804TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUES621500$82,833,830$82,833,830
CLINIC PHARMACY446110$7,891,664$6,379,259$1,512,405
OTHER PATIENT CARE621500$1,641,688$1,641,688
JOINT VENTURE LOSS901101-$50,252-$16,581-$33,671
FieldValueIRS element (for citing)
Total Program Service Revenue$92,316,930TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$662,728TotalRevenueColumnAmt
Exclusion$662,728ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$3,600RealAmt
Personal$62,500PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$3,600RealAmt
Personal$62,500PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$66,100TotalRevenueColumnAmt
Unrelated Business Revenue$62,500UnrelatedBusinessRevenueAmt
Exclusion$3,600ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,599,772SecuritiesAmt
Other$35,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$3,828,918SecuritiesAmt
Other$16,851OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$770,854SecuritiesAmt
Other$18,149OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$789,003TotalRevenueColumnAmt
Exclusion$789,003ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$412,633GrossSalesOfInventoryAmt
Cost Of Goods Sold$251,149CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$161,484TotalRevenueColumnAmt
Exclusion$161,484ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEAL INCOME900099$382,271$382,271
MISCELLANEOUS REVENUE900099$282,279$282,279
FieldValueIRS element (for citing)
Other Revenue Total$664,550OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$100,239,599TotalRevenueColumnAmt
Related Or Exempt Func Income$90,838,196RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,541,234UnrelatedBusinessRevenueAmt
Exclusion$2,281,365ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$161,801TotalAmt
Program Services$161,801ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,376,784TotalAmt
Program Services$2,784,837ProgramServicesAmt
Management And General$551,543ManagementAndGeneralAmt
Fundraising$40,404FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$29,523,785TotalAmt
Program Services$26,998,078ProgramServicesAmt
Management And General$2,394,097ManagementAndGeneralAmt
Fundraising$131,610FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$639,276TotalAmt
Program Services$567,513ProgramServicesAmt
Management And General$67,807ManagementAndGeneralAmt
Fundraising$3,956FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,748,744TotalAmt
Program Services$4,881,952ProgramServicesAmt
Management And General$828,561ManagementAndGeneralAmt
Fundraising$38,231FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,152,535TotalAmt
Program Services$1,963,287ProgramServicesAmt
Management And General$177,424ManagementAndGeneralAmt
Fundraising$11,824FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$20,066TotalAmt
Management And General$20,066ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$107,259TotalAmt
Management And General$106,284ManagementAndGeneralAmt
Fundraising$975FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$132,290TotalAmt
Management And General$132,290ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$18,974,307TotalAmt
Program Services$17,735,012ProgramServicesAmt
Management And General$1,214,321ManagementAndGeneralAmt
Fundraising$24,974FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$321,959TotalAmt
Program Services$19,268ProgramServicesAmt
Management And General$300,984ManagementAndGeneralAmt
Fundraising$1,707FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,640,985TotalAmt
Program Services$2,197,931ProgramServicesAmt
Management And General$1,419,447ManagementAndGeneralAmt
Fundraising$23,607FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$883,187TotalAmt
Program Services$883,187ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,293,584TotalAmt
Program Services$1,623,405ProgramServicesAmt
Management And General$663,140ManagementAndGeneralAmt
Fundraising$7,039FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$769,272TotalAmt
Program Services$740,753ProgramServicesAmt
Management And General$26,474ManagementAndGeneralAmt
Fundraising$2,045FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$700,394TotalAmt
Management And General$700,394ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,255,476TotalAmt
Program Services$4,243,431ProgramServicesAmt
Management And General$12,045ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,146,543TotalAmt
Program Services$1,123,541ProgramServicesAmt
Management And General$23,002ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PHARMACY/LAB EXPENSE$17,770,536$17,770,279$257
BAD DEBT$1,749,133$1,749,133
GOOD CENTS STORE$351,937$55,329$296,608
UBI TAXES$9,034$9,034

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,203,574TotalAmt
Program Services$1,831,484ProgramServicesAmt
Management And General$370,605ManagementAndGeneralAmt
Fundraising$1,485FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$96,932,461TotalAmt
Program Services$87,330,221ProgramServicesAmt
Management And General$9,314,383ManagementAndGeneralAmt
Fundraising$287,857FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$29,974,427BOYAmt
EOY$23,858,936EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$34,025BOYAmt
EOY$24,386EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,436,851BOYAmt
EOY$14,159,158EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,235,329BOYAmt
EOY$2,188,895EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$869,064BOYAmt
EOY$1,118,209EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$85,302,607LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$55,664,699LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$25,423,746BOYAmt
EOY$29,637,908EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$24,406,400BOYAmt
EOY$22,987,807EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,176,814BOYAmt
EOY$1,262,285EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$594,724BOYAmt
EOY$1,449,631EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,319,104BOYAmt
EOY$2,125,121EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$99,470,484BOYAmt
EOY$98,812,336EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,576,269BOYAmt
EOY$8,288,918EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,688,546BOYAmt
EOY$1,100,000EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,974,823BOYAmt
EOY$18,437,171EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$34,025BOYAmt
EOY$24,386EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,367,099BOYAmt
EOY$1,777,073EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$482,623BOYAmt
EOY$331,767EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,706,172BOYAmt
EOY$3,947,515EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$35,829,557BOYAmt
EOY$33,906,830EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$61,146,203BOYAmt
EOY$63,951,934EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,494,724BOYAmt
EOY$953,572EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,640,927BOYAmt
EOY$64,905,506EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$99,470,484BOYAmt
EOY$98,812,336EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,307,138ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$3,578,501NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,535,942OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$5,623OtherActivitiesAmt
Total Lobbying Expenditures$5,623TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF THE MEMBERSHIP DUES PAID TO THE MONTANA HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION AND LEADINGAGE ARE USED FOR LOBBYING. THESE ARE ALLOCATED ON A PERCENTAGE BASIS TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$198,261OtherCostOrOtherBasisAmt
Book Value$198,261BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,486,110OtherCostOrOtherBasisAmt
Depreciation$34,765,347DepreciationAmt
Book Value$15,720,763BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,901,737OtherCostOrOtherBasisAmt
Depreciation$1,003,688DepreciationAmt
Book Value$898,049BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,049,205OtherCostOrOtherBasisAmt
Depreciation$19,895,664DepreciationAmt
Book Value$9,153,541BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,667,294OtherCostOrOtherBasisAmt
Book Value$3,667,294BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$29,637,908TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescESTIMATED THIRD-PARTY PAYOR PAYABLESDesc
Amt$3,947,515Amt
FieldValueIRS element (for citing)
Total Liability$3,947,515TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$97,448,404TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$3,578,501NetUnrealizedGainsInvstAmt
Other Revenue$2,969,911OtherRevenueAmt
Revenue Not Reported-$608,590RevenueNotReportedAmt
Revenue Subtotal$98,056,994RevenueSubtotalAmt
Investment Expenses Not Incld$132,290InvestmentExpensesNotIncldAmt
Other Revenues Not Included$2,050,315OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,182,605RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$100,239,599TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$96,581,318TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1,727,462OtherExpensesIncludedAmt
Expenses Not Reported$1,727,462ExpensesNotReportedAmt
Expenses Subtotal$94,853,856ExpensesSubtotalAmt
Investment Expenses Not Incld2$132,290InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$1,946,315OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,078,605ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$96,932,461TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:RESIDENT TRUST ACCOUNT: THIS IS THE EXTENDED CARE RESIDENT TRUST ACCOUNT, WHICH IS MADE UP OF THE RESIDENTS' MONEY THAT SIDNEY HEALTH CENTER HOLDS ON THEIR BEHALF. THESE MONIES ARE KEPT IN A SEPARATE BANK ACCOUNT FROM THE ORGANIZATION'S FUNDS AND ARE DUE BACK TO THE RESIDENTS UPON LEAVING THE FACILITY.
PART X, LINE 2:THE IRS HAS DETERMINED THAT THE HEALTH CENTER IS A TAX-EXEMPT, NONPROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE IRC. THE HEALTH CENTER FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE HEALTH CENTER'S FINANCIAL STATEMENTS. THE HEALTH CENTER'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD 251,149. CHANGE IN VALUE OF FAIR VALUE SWAP 1,278,783. LONE TREE REVENUE PER CONSOLIDATED AFS 1,439,979.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 1,749,133. REAL ESTATE RESTRICTED CONTRIBUTION INCLUDED IN REVENUE 104,000. LONE TREE ELIMINATIONS PER CONSOLIDATED AFS 197,182.
PART XII, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD 251,149. LONE TREE EXPENSES PER CONSOLIDATED AFS 1,476,313.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 1,749,133. LONE TREE ELIMINATIONS PER CONSOLIDATED AFS 197,182.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$629,627TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$629,627NetCommunityBenefitExpnsAmt
Total Expense0.00660TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,156,524TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,453,104DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,703,420NetCommunityBenefitExpnsAmt
Total Expense0.03890TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,786,151TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,453,104DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,333,047NetCommunityBenefitExpnsAmt
Total Expense0.04550TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$177,104TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$177,104NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,500NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,285,538TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,398,057DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,887,481NetCommunityBenefitExpnsAmt
Total Expense0.13540TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,486,142TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,398,057DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,088,085NetCommunityBenefitExpnsAmt
Total Expense0.13750TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,272,293TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,851,161DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,421,132NetCommunityBenefitExpnsAmt
Total Expense0.18300TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,749,133BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$20,953,318ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$20,784,518CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$168,800MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SIDNEY HEALTH CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1216 14TH AVENUE SWAddressLine1Txt
CitySIDNEYCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59270ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.SIDNEYHEALTH.ORGWebsiteAddressTxt
State License12709StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SIDNEY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE LINE 7DOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.SIDNEYHEALTH.ORG/BILLINGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.SIDNEYHEALTH.ORG/BILLINGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.SIDNEYHEALTH.ORG/BILLINGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SIDNEY HEALTH CENTERPART V, SECTION B, LINE 5: IN APRIL 2022, SURVEYS WERE MAILED OUT TO A RANDOM SAMPLE OF 800 RESIDENTS OF RICHLAND COUNTY, MONTANA, THE HOSPITAL'S COMMUNITY. 65 COMPLETED SURVEYS WERE RETURNED. IN ADDITION, 3 FOCUS GROUP INTERVIEWS WERE CONDUCTED.
SIDNEY HEALTH CENTERPART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH THE MONTANA OFFICE OF RURAL HEALTH.
SIDNEY HEALTH CENTERPART V, SECTION B, LINE 7D: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT HTTPS://WWW.SIDNEYHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-ASSESSMENT-IMPLEMENTATION-PLAN.
SIDNEY HEALTH CENTERPART V, SECTION B, LINE 11: SIDNEY HEALTH CENTER ("SHC") IS RESPONDING TO ALL THE IDENTIFIED COMMUNITY HEALTH NEEDS, WITH THE EXCEPTION OF ONE THAT IS NOT WITHIN OUR SCOPE. SIDNEY HEALTH CENTER ADDRESSES THE NEEDS IDENTIFIED BY THE CHNA THAT ARE IN ALIGNMENT WITH OUR STRATEGIC GOALS. ONCE THESE NEEDS ARE IDENTIFIED, SHC CREATES A COMMUNITY HEALTH NEEDS IMPLEMENTATION PLAN.SHC IS ADDRESSING CHRONIC ILLNESS BY PROMOTING HEALTHY LIFESTYLES THROUGH COMMUNITY ENGAGEMENT ACTIVITIES, PROVIDING EDUCATIONAL RESOURCES AND SERVICES TO THE COMMUNITY, AND PROVIDING EDUCATIONAL SUPPORT TO THE COMMUNITY. OVERALL AWARENESS OF THE CANCER SERVICES PROVIDED BY SHC ARE BEING ADDRESSED BY IMPROVING ACCESS TO CANCER CARE SERVICES, IMPROVING QUALITY OF CARE FOR INDIVIDUALS WITH CANCER, AND PARTICIPATING IN COMMUNITY EVENTS SPECIFIC TO CANCER. SHC IS TRYING TO BETTER SERVE THE MENTAL AND BEHAVIORAL HEALTH NEEDS BY PARTICIPATING IN COMMUNITY GROUPS CONCERNED WITH MENTAL HEALTH, PROVIDING RESOURCES AND SUPPORT TO THE COMMUNITY TO ADDRESS MENTAL HEALTH, AND INCREASING ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES AND RESOURCES.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - SIDNEY HEALTH CENTER EXTENDED CARE
216 14TH AVE SWSIDNEYMT59270NURSING HOME
2 - THE LODGE AT LONE TREE
1015 7TH AVE SWSIDNEYMT59270ASSISTED LIVING COMPLEX

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:FINANCIAL ASSISTANCE IS BASED ON INCOME AND FAMILY SIZE ONLY. PRIOR TO QUALIFYING FOR FINANCIAL ASSISTANCE, AN INDIVIDUAL MUST (A) RECEIVE QUALIFYING MEDICAL SERVICES FROM SIDNEY HEALTH CENTER; (B) EXHAUST ALL ALTERNATIE PAYMENT RESOURCES INCLUDING THIRD-PARTY AND FEDERAL AND STATE PROGRAMS; AND (C) SUBMIT A COMPLETED APPLICATION WITH THE REQUIRED SUPPORTING DOCUMENTATION.
PART I, LINE 7:IN ORDER TO CALCULATE THE OVERALL HOSPITAL'S COST TO CHARGE RATIO USED FOR PART I, LINE 7, THE HOSPITAL FIRST DETERMINED A COST-TO-CHARGE RATIO BASED ON THE JUNE 30, 2022 FILED MEDICARE COST REPORT SEPARATELY FOR INPATIENT SERVICES, OUTPATIENT SERVICES, AND TOTAL SERVICES. TO CALCULATE THE COSTS INCLUDED ON LINES 7A AND 7B, THE HOSPITAL TOOK EACH OF THE SEPARATE COST-TO-CHARGE RATIOS DESCRIBED IN THE PRECEEDING PARAGRAPH AND APPLIED THEM ONLY TO THE RELATED CHARGES BY SERVICE TYPE. THE AMOUNTS IN LINES 7E-7I ARE BASED ON ACTUAL COST.
PART I, LINE 7G:THE FOLLOWING SUBSIDIZED HEALTH SERVICES WERE INCLUDED IN PART I, LINE 7G:OBSERVATION, NURSERY, AUDIOLOGY, CARDIAC REHAB, MEDICAL ONCOLOGY, CLINIC FACILITY, EMERGENCY ROOM, AMBULANCE SERVICES, ENT/RADIOLOGY/ONCOLOGY CLINIC, AND PROVIDER-BASED CLINIC.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,749,133.
PART III, LINE 2:IN EVALUATING THE COLLECTABILITY OF PATIENT AND RESIDENT ACCOUNTS RECEIVABLE, THE HEALTH CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH CENTER RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE.
PART III, LINE 3:THE HEALTH CENTER IS UNABLE TO ESTIMATE THE AMOUNT OF ITS BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE IF THEY WERE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION.
PART III, LINE 4:SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE, NET" PARAGRAPH IN NOTE 1 (PAGE 12) OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 IS DERIVED FROM USING THE JUNE 30, 2022 FILED MEDICARE COST REPORT. THE SHORTFALL OCCURS DUE TO VARIOUS EXPENSES INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE. SINCE PART OF THE COSTS ARE NOT REIMBURSED, IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY.
PART III, LINE 9B:IF THE PATIENT INDICATES THEIR INABILITY TO PAY ACCORDING TO THE HOSPITAL CREDIT TERMS THEY WILL BE ASKED TO FILL OUT A FINANCIAL STATEMENT. THE HOSPITAL MAY PULL A CREDIT REPORT TO CONFIRM OR SUPPLEMENT INFORMATION PROVIDED TO THE HOSPITAL ON THE FINANCIAL STATEMENT. THE PATIENT CAN THEN BE EVALUATED TO DETERMINE WHETHER THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE OR AN EXTENDED PAYMENT PROGRAM.IF THE FINANCIAL STATEMENT SHOWS THAT THE PATIENT HAS ASSETS OR POTENTIAL SOURCES OF INCOME THAT WOULD ENABLE THEM TO PAY THE HOSPITAL BILL WITHIN A YEAR, THEY WILL BE DENIED THE EXTENDED PAYMENT WAIVER. IF A PATIENT REFUSES TO FURNISH A COMPLETED FINANCIAL STATEMENT, THEIR ACCOUNT WILL BE DEEMED DELINQUENT AND FURTHER COLLECTION ACTION WILL BE TAKEN. PRIOR TO ADMISSION, AT THE TIME OF ADMISSION, OR AS SOON AS POSSIBLE THEREAFTER, THE HOSPITAL WILL MAKE AN INITIAL ASSESSMENT OF POTENTIAL ELIGIBILITY BASED ON THE VERBAL APPLICATION FOR FINANCIAL ASSISTANCE. IF POTENTIAL ASSISTANCE IS INDICATED WITH INITIAL ASSESSMENT, THE HOSPITAL WILL NOT INITIATE COLLECTION EFFORTS OR REQUESTS FOR DEPOSITS PENDING THE RECEIPT OF THE COMPLETED APPLICATION AND FINAL ELIGIBILITY DETERMINATION. THE RESPONSIBLE PARTY MUST BE COOPERATIVE WITH THE HOSPITAL'S EFFORTS TO REACH A DETERMINATION OF ELIGIBILITY WITH OTHER ASSISTANCE PROGRAMS AND TO VALIDATE THE INFORMATION NEEDED.SIDNEY HEALTH CENTER WILL MAKE A CONCERTED EFFORT TO COMMUNICATE THE AVAILABILITY OF CHARITY CARE. EDUCATIONAL MATERIALS ABOUT THE PROGRAM WILL BE AVAILABLE TO PATIENTS THROUGH THE ADMISSIONS PROCESS. AS SOON AS A PATIENT EVIDENCES INABILITY TO PAY HE OR SHE WILL BE REFERRED TO THE PATIENT FINANCIAL SERVICES COUNSELOR FOR AN APPLICATION. APPLICATIONS ARE ALSO AVAILABLE AT THE ADMISSIONS AREA, AND THROUGH SOCIAL SERVICES.
PART VI, LINE 2:THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN THE YEAR ENDED JUNE 30, 2022. THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT HTTPS://WWW.SIDNEYHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-ASSESSMENTIMPLEMENTATION-PLAN.
PART VI, LINE 3:SIDNEY HEALTH CENTER HAS NOTICES LOCATED AT THE ADMISSIONS OFFICE INFORMING PATIENTS ABOUT THEIR FINANCIAL ASSISTANCE POLICY. THE PROGRAM IS ALSO STATED ON THE ORGANIZATION'S WEBSITE AND INCLUDED IN THE PATIENT'S PACKET UPON DISCHARGE FROM THE FACILITY.
PART VI, LINE 4:LOCATED IN THE HEART OF RICHLAND COUNTY, SIDNEY HEALTH CENTER SERVES PEOPLE IN ALL OF THE MONDAK REGION.
PART VI, LINE 5:THE HEALTH CENTER DEFINES AND MEASURES THEIR INVESTMENT IN AND PARTNERSHIP WITH THE COMMUNITY PRIMARILY THROUGH VARIOUS COMMUNITY-BASED SERVICES PROGRAMS, PROVIDING HEALTH EQUIPMENT IN AREA SCHOOLS, AND COMMUNITY PROGRAMS AND EDUCATION. A NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS, AND PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ST JOHNS LUTHERAN MINISTRIES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13940 RIMROCK RDAddressLine1Txt
CityBILLINGSCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59102ZIPCd
FieldValueIRS element (for citing)
Recipient EIN810288768RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$90,000CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantAT-HOME SENIOR SERVICE PROGRAM NEXT 3 YEARSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationSIDNEY HEALTH CENTER CONFIRMS THAT EACH RECIPIENT ORGANIZATION IS A QUALIFIED GOVERNMENT OR CHARITY ORGANIZATION. CONTRIBUTED FUNDS ARE INTENDED FOR GENERAL OPERATING SUPPORT, SO SIDNEY HEALTH CENTER DOES NOT CONDUCT ANY FOLLOW-UP MONITORING ACTIVITIES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (1)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RAJOHN KARANJAI MD
TRUSTEE/CMO$1,090,745$0$0$0$0$0$0$0$0$0$1,090,745$0$0$0
LESZEK JASZCZAK MD
TRUSTEE/CMO (THROUGH JUNE 2022)$794,330$0$1,000$0$0$0$6,683$0$30,034$0$832,047$0$0$0
ERIC SIGMOND MD
PHYSICIAN$611,797$0$1,000$0$0$0$8,700$0$34,478$0$655,975$0$0$0
JEROME KESSLER MD
PHYSICIAN$566,858$0$1,000$0$0$0$8,700$0$26,225$0$602,783$0$0$0
MALUA TAMBI MD
PHYSICIAN$511,543$0$1,000$0$0$0$8,700$0$33,257$0$554,500$0$0$0
JOHN CAREY MD
VICE-CHIEF OF MEDICAL STAFF$508,285$0$1,000$0$0$0$8,700$0$33,257$0$551,242$0$0$0
CHAD PEDERSEN MD
PHYSICIAN$523,039$0$1,000$0$0$0$0$0$14,361$0$538,400$0$0$0
RALF KIEHL MD
CHIEF OF MEDICAL STAFF$448,031$0$1,000$0$0$0$8,528$0$14,538$0$472,097$0$0$0
JEN DOTY
CEO$269,494$0$2,000$0$0$0$8,300$0$22,441$0$302,235$0$0$0
TINA MONTGOMERY
CFO$170,691$0$2,000$0$0$0$5,282$0$18,347$0$196,320$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ARALF KIEHL RECEIVED A HOUSING ALLOWANCE OF $16,350. THIS AMOUNT WAS INCLUDED IN HIS TAXABLE COMPENSATION.
PART I, LINE 5PHYSICIANS RECEIVE BONUSES BASED ON PRODUCTIVITY, AMONG OTHER FACTORS. PRODUCTIVITY IS CLOSELY CONNECTED WITH REVENUES.
PART I, LINE 6FOR THE EXECUTIVES, ANNUAL RAISES ARE BASED ON MEETING ORGANIZATIONAL GOALS RELATED TO VARIOUS FACTORS INCLUDING EMPLOYEE RETENTION, PATIENT SATISFACTION, QUALITY METRICS, AND OPERATING MARGIN.
FORM 990, PART VII, LINE 5DR. RAJON KARANJAI IS COMPESATED BY MEDIKAR PC, AN UNRELATED ORGANIZATION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
RICHLAND COUNTY MT
A8160014192011-09-15$24,370,000REDEEMING AND RETIRING PREVIOUSLY ISSUED DEBT (2006, 2007A AND 2007B)000
RICHLAND COUNTY MT
B8160014192018-01-09$5,700,000HOSPITAL CAPITAL IMPROVEMENTS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndCapital ExpendituresCapitalExpendituresAmt
A$10,075,000$24,370,000$233,683$137,747$23,998,5702012Yes (1)0Yes (1)Yes (1)
B$1,510,000$5,700,000201800Yes (1)Yes (1)$5,700,000

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AYes (1)000000
BYes (1)000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedInd
(no name)
A000000000
US BANK
B0Yes (1)00Yes (1)Yes (1)0003.80000000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
ROBERT MONTGOMERY
SPOUSE OF TINA MONTGOMERY, CFO$57,265EMPLOYEE COMPENSATION0
SEAN MONTGOMERY
CHILD OF TINA MONTGOMERY, CFO$40,749EMPLOYEE COMPENSATION0
SCOTT DOTY
SPOUSE OF JEN DOTY, CEO$89,423EMPLOYEE COMPENSATION0
NANCY STEFFAN
MOTHER OF JEN DOTY, CEO$41,018EMPLOYEE COMPENSATION0
TARYN MCMILLEN
DAUGHTER OF TERRY SILVERTSON, BOARD MEMBER$73,830EMPLOYEE COMPENSATION0

Schedule M IRS990ScheduleM

Real Estate Residential RealEstateResidentialGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$104,000NoncashContributionsRptF990Amt
Method Of Determining RevenuesAPPRAISALMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationTHE NUMBER OF CONTRIBUTIONS WAS USED IN PART I.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2DURING THE FISCAL YEAR, SIDNEY HEALTH CENTER BEGAN PROVIDING AIR AMBULANCE SERVICES.
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS AND ONE OTHER MEMEBER OF THE BOARD APPOINTED BY THE PRESIDENT. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE ARTICLES OF INCORPORATION, BYLAWS AND STATE POLICIES. ANY OFFICIAL ACTION TAKEN BY THE EXECUTIVE COMMITTEE IS SUBMITTED TO THE BOARD FOR RATIFICATION AT THE NEXT BOARD MEETING.
FORM 990, PART VI, SECTION A, LINE 6NATURAL PERSONS, CORPORATIONS, OR UNINCORPORATED ASSOCIATIONS MAY BECOME MEMBERS OF SIDNEY HEALTH CENTER BY: A. PAYMENT TO SIDNEY HEALTH CENTER A SUM OF NOT LESS THAN $100 CASH OR BY AN EQUIVALENT CONTRIBUTION OR METHOD AS APPROVED BY THE BOARD; B. RESIDING IN OR HAVING ITS PRINCIPAL PLACES OF BUSINESS IN THE SERVICE AREA OF SIDNEY HEALTH CENTER; AND C. AGREEING TO BE BOUND BY THE BYLAWS OF SIDNEY HEALTH CENTER.
FORM 990, PART VI, SECTION A, LINE 7AELECTION OF DIRECTORS IS HELD AT THE ANNUAL MEETING OF THE MEMBERS BY WRITTEN BALLOT LISTING THE CANDIDATES NOMINATED BY THE NOMINATING COMMITTEE OF THE MEMBERS. EACH MEMBER OF SIDNEY HEALTH CENTER, PRESENT IN PERSON OR BY PROXY, IS ENTITLED TO VOTE FOR ONE CANDIDATE FOR EACH DIRECTOR VACANCY TO BE FILLED. THE CANDIDATES RECEIVING THE HIGHEST NUMBER OF VOTES AT THE MEETING ARE CONSIDERED ELECTED AS DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BANY PROPOSED AMENDMENTS APPROVED BY THE BOARD OR BY VERIFIED PETITION TO THE ARTICLES OF INCORPORATION OR BYLAWS SHALL BE SUBMITTED FOR VOTE BY THE MEMBERS AT THE NEXT SPECIAL OR ANNUAL MEMBERSHIP MEETING.
FORM 990, PART VI, SECTION B, LINE 11BBEFORE IT WAS FILED, THE FORM 990 WAS REVIEWED BY THE FINANCE DIRECTOR, CFO AND CEO. THE CEO AND CFO WILL REVIEW THE COMPLETED FORM 990 WITH THE BOARD OF DIRECTORS AT THEIR NEXT SCHEDULED MEETING AFTER THE FORM 990 IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE POLICY OF THE CORPORATION IS TO REQUIRE THAT EACH INDIVIDUAL SUBJECT TO THIS POLICY STATEMENT PROMPTLY AND FULLY DISCLOSE ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST, AND THAT THE CORPORATION WILL NOT ENGAGE IN ANY CONTRACT, TRANSACTION, OR ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS (ACTING AT A DULY CONSTITUTED MEETING THEREOF) DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF THE CORPORATION HAVE BEEN IMPLEMENTED. A CONFLICT OF INTEREST QUESTIONNAIRE IS DISTRIBUTED ANNUALLY TO ALL INTERESTED PERSONS (BOARD MEMBERS, OFFICERS, AND COMMITTEE MEMBERS). AN INTERESTED PERSON HAS A CONTINUING OBLIGATION TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST HE/SHE MAY HAVE. "DISCLOSURE" MEANS PROMPTLY PROVIDING A WRITTEN DESCRIPTION OF THE MATERIAL FACTS OF THE ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST TO THE EXECUTIVE COMMITTEE ON THE CONFLICTS-OF-INTEREST QUESTIONNAIRE. SUCH DISCLOSURE SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. AT ANY TIME THAT AN ACTUAL, APPARENT, OR A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED TO THE BOARD OF DIRECTORS, WHETHER THROUGH THE VOLUNTARY SUBMISSION OF A DISCLOSURE STATEMENT BY AN INTERESTED PERSON, OR BY A DISCLOSURE BY A PERSON OTHER THAN THE SUBJECT INTERESTED PERSON, THE EXECUTIVE COMMITTEE SHALL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE SUBJECT INTERESTED PERSON SHALL NOT BE PRESENT DURING ANY MEETING IN WHICH THE EXECUTIVE COMMITTEE CONDUCTS ITS EVALUATION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. THE EXECUTIVE COMMITTEE MAY REQUEST ADDITIONAL INFORMATION FROM ALL REASONABLE SOURCES AND MAY INVOLVE THE GENERAL COUNSEL IN ITS DELIBERATIONS. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, EXECUTIVE COMMITTEE SHALL MAKE A FINDING AS TO WHETHER A CONFLICT OF INTEREST INDEED EXISTS, AND SHALL FORWARD THAT FINDING TO THE BOARD OF DIRECTORS FOR DISCUSSION AND VOTE. ONLY DISINTERESTED DIRECTORS MAY VOTE TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE SUBJECT INTERESTED PERSON MAY NOT BE PRESENT WHEN THIS VOTE IS TAKEN. ONCE THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS HAVE DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WITH RESPECT TO A PARTICULAR TRANSACTION OR ARRANGEMENT: (I) THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS SHALL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER THE CORPORATION COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES AND, IF APPROPRIATE, SHALL APPOINT A NON-INTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, OR ARRANGEMENT. (II) IN CONSIDERING WHETHER TO ENTER INTO THE PROPOSED CONTRACT, TRANSACTION, OR ARRANGEMENT, THE BOARD OF DIRECTORS MAY APPROVE SUCH A CONTRACT, TRANSACTION, OR ARRANGEMENT ONLY IF THE DISINTERESTED DIRECTORS DETERMINE BY A MAJORITY VOTE THAT: (A) THE PROPOSED CONTRACT, TRANSACTION, OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTERESTS AND FOR THE CORPORATION'S OWN BENEFIT; AND (B) THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION, TAKING INTO ACCOUNT, AMONG OTHER RELEVANT FACTORS, WHETHER THE CORPORATION COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. (III) THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS MAY, IN THEIR DISCRETION, REQUIRE THE INTERESTED PERSON TO LEAVE THE ROOM WHILE THE PROPOSED CONTRACT, TRANSACTION, OR ARRANGEMENT IS DISCUSSED. THE INTERESTED PERSON SHALL LEAVE THE ROOM WHILE THE MATTER IS VOTED ON AND ONLY DISINTERESTED DIRECTORS MAY VOTE TO DETERMINE WHETHER TO APPROVE THE TRANSACTION OR ARRANGEMENT.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS DETERMINES SALARIES USING THE MHA SALARY SURVEY FOR MARKET INFORMATION AND ALSO PERFORMS A WRITTEN EVALUATION ANNUALLY. ADDITIONALLY, THE CEO USES MHA MANAGEMENT SURVEY, AS WELL AS OTHER COMPENSATION SURVEYS, TO DETERMINE ANNUAL PAY INCREASES FOR ADMINISTRATION. A WRITTEN EVALUATION IS PERFORMED. ALL ESTIMATED ANNUAL INCREASES ARE INCLUDED IN THE BUDGET, WHICH IS APPROVED BY THE BOARD OF DIRECTORS. THIS PROCEDURE WAS LAST PERFORMED IN JUNE OF 2022.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 17,735,012. MANAGEMENT AND GENERAL EXPENSES 1,214,321. FUNDRAISING EXPENSES 24,974. TOTAL EXPENSES 18,974,307.
FORM 990, PART XI, LINE 9:CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 257,159. CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 1,278,783.
FORM 990, PART XII, LINE 2C:THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
LONE TREE SENIOR LIVING
216 14TH AVENUE SWSIDNEYMT59270810518821ASSISTED LIVINGMT501(C)(3)LINE 10SIDNEY HEALTH CENTERYes (1)
FOUNDATION FOR COMMUNITY CARE OF RICHLAND COUNTY
221 2ND STREET NWSIDNEYMT59270810417465FUNDRAISINGMT501(C)(3)LINE 12A, ISIDNEY HEALTH CENTERYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SHC 2021 LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11429 KINGS VIEW DRIVEAddressLine1Txt
CityGRAND FORKSCityNm
State AbbreviationNDStateAbbreviationCd
ZIP58201ZIPCd
FieldValueIRS element (for citing)
EIN863920806EIN
Primary ActivitiesAIR AMBULANCEPrimaryActivitiesTxt
Legal Domicile StateNDLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$93,767ShareOfTotalIncomeAmt
Share Of EOY Assets$667,000ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
UBI Code V-$33,671UBICodeVAmt
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.49000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
LONE TREE SENIOR LIVING
A$54,841CONTRACTED INTEREST RATE
FOUNDATION FOR COMMUNITY CARE OF RICHLAND COUNTY
C$295,915CASH
LONE TREE SENIOR LIVING
L$142,341FAIR MARKET VALUE

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