2023-05-12T19:00:07-04:00 2022-06-30 GREEN HEALTH GROUP PC 405 FOURTH AVENUE NORTH GLASGOW MT 59230 990 2021-07-01 810231786 FRANCES MAHON DEACONESS HOSPITAL FRAN 4062283500 621 3RD STREET SOUTH GLASGOW MT 59230 CAMI KALINSKI DIRECTOR OF FINANCE 4062283660 2023-05-12 true CAMI KALINSKI XXX-XX-XXXX DANIEL GREEN P01311679 4062632615 2023-05-12 2021 2023-04-26 12:10:37Z CAMI KALINSKI 621 3RD STREET SOUTH GLASGOW MT 59230 43730333 false X WWW.FMDH.ORG X 1914 MT TO ADVANCE THE COORDINATED DELIVERY OF HEALTH SERVICES, GUIDED WITH RESPECT FOR THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEREBY IMPROVING THE HEALTH OF OUR REGIONAL COMMUNITY. 9 7 321 25 397631 7516848 116476 34530063 40804537 658163 2936490 318428 -127170 43023502 43730333 88471 0 16455812 18266625 0 67463 14601242 17681805 31057054 36036901 11966448 7693432 90280300 76364198 4579141 8901408 85701159 67462790 TO ADVANCE THE COORDINATED DELIVERY OF HEALTH SERVICES, GUIDED WITH RESPECT FOR THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEREBY IMPROVING THE HEALTH OF OUR REGIONAL COMMUNITY. false false 29043050 88471 40804537 PROVIDE QUALITY MEDICAL CARE TO PATIENTS. 29043050 true true false true false false false false false false true false true true true true false true false false false false false false false false true true true false true false false false false false false false true false false false false false true true true false false true 25 0 321 true true true false false false false false false false false false false false X 9 7 false false false false true true false true true false false true true true true true true true true false X CAMI KALINSKI 4062283660 621 3RD ST S GLASGOW MT 59230 LOUIS BAILEY PHYSICIAN ME 40.00 X 563154 0 26868 NICOLE LORENZ MD 40.00 X 556040 0 18588 DAVID KNIERIM MD 10.00 30.00 X 445972 0 18588 ANNE MILLARD BRADLEY MD 17.00 23.00 X 390187 0 23273 ANDREW FAHLGREN MD 10.00 30.00 X 388713 0 20070 ANTHONY COLACINO MD 40.00 X 367691 0 22210 RANDY HOLOM CEO 40.00 X X 278622 0 23210 ELLEN GUTTENBERG COO 40.00 X 177305 0 23309 CAMI KALINSKI DIRECTOR OF 40.00 X 153743 0 5445 ERIKA BENGOCHEA VICE PRESIDE 1.00 X 0 0 0 ANNIE CAPDEVILLE TRUSTEE 1.00 X 0 0 0 DON FAST TRUSTEE 1.00 X 0 0 0 CAMI GRAHAM TRUSTEE 1.00 X 0 0 0 PATRICK MENGE SECRETARY/TR 1.00 X 0 0 0 STAN OZARK PRESIDENT 2.00 X 0 0 0 MARISA SATHER TRUSTEE 1.00 X 0 0 0 3321427 181561 40 false true false SYNERGY SURGICALISTS PC 280 W KAGY BLVD STE D 320 BOZEMAN MT 59715 CONTRACT STAFF 1607960 GE PRECISION HEALTHCARE LLC PO BOX 96483 CHICAGO IL 60693 SVC CONTRACTS 710772 MCKINSTRY ESSENTION LLC PO BOX 3895 SEATTLE WA 98124 CONSTRUCTION 392951 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 CONTRACT STAFF 353734 MEDICAL INFORMATION TECHNOLOGY INC 7 BLUE HILL RIVER ROAD CANTON MA 02021 DATA PROCESSING 319135 11 35790 69825 10861 116476 PATIENT REVENUE 621500 39773325 39773325 GLASGOW CLINIC RENT 531120 213301 213301 PROFESSIONAL RADIOLOGY 621110 737702 568372 169330 OTHER RENTAL INCOME 531120 65209 65209 HI-LINE MEDICAL SRVCS RENT 531120 15000 15000 40804537 2936490 2936490 COUNTY CONTRIBUTION 900099 32260 32260 PARTNERSHIP INCOME 900099 -159430 -159430 -127170 43730333 43216226 397631 88471 88471 1239762 579340 660422 13812694 11156935 2614137 41622 385047 290257 93047 1743 1697109 1287083 400997 9029 1132013 902631 225724 3658 145037 145037 61697 61697 1482143 1137477 344291 375 246245 246245 960835 305918 654525 392 358310 281414 76289 607 143026 113164 29812 50 61402 46067 15298 37 3572563 2979876 586257 6430 384933 316244 68116 573 MEDICAL SUPPLIES 7738486 7738486 REPAIRS & MAINTENANCE 1749564 1462359 284848 2357 PROPERTY TAXES 349618 349618 FOOD & DIETARY SUPPLIES 285343 222368 62433 542 142603 134960 7595 48 36036901 29043050 6926388 67463 8528450 7525940 5776047 5968548 3825243 2985936 1019372 1248929 804471 854917 52967728 35893127 19462865 17074601 27928727 31458248 22935125 9247079 90280300 76364198 3761710 4865479 100000 1481389 717431 2554540 4579141 8901408 X 85701159 67462790 85701159 67462790 90280300 76364198 X 7693432 -9557704 -5 -16374092 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4213 4213 35965225 35969438 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 54336 3942 3715 4213 66206 250000 250000 250000 250000 1000000 1500000 51101 51101 SCHEDULE C, PART II-A FOR TAX YEAR 2021 THERE WERE NOT ANY GRASSROOTS LOBBYING EXPENDITURES. 88748 88748 33367508 19345655 14021853 19511472 16547472 2964000 17074601 EQUITIES 10369669 F BROKERED CERTIFICATES OF DEPOSIT 7862740 F CORPORATE DEBT SECURITIES 7582960 F MUTUAL FUNDS 5104008 F BANK CERTIFICATES OF DEPOSIT 500000 C GOVERNMENTAL BONDS 38871 F 31458248 MEDICARE/MEDICAID RECEIVABLES 3832955 INVESTMENTS IN JOINT VENTURES 3058023 INTERCOMPANY AND OTHER RECEIVABLES 1398967 INTEREST IN FMDH FOUNDATION 957134 9247079 MEDICARE & MEDICAID PAYABLES 2554540 2554540 X 34172629 -9557704 -9557704 43730333 43730333 36036901 36036901 36036901 SCHEDULE D, PAGE 3, PART X THE AUDITED FINANCIAL STATEMENTS ARE NOT YET AVAILABLE, SO THE ATTACHED FINANCIAL STATEMENTS ARE INTERNAL FINANCIAL STATEMENTS THAT DO NOT INCLUDE FOOTNOTE DISCLOSURES. THEREFORE, THERE IS NO FIN 48 (ASC 740) FOOTNOTE DISCLOSURE. true true true X 1.400000000000 true X 2.400000000000 true true true false true true 279276 279276 0.00770 279276 279276 0.00770 141651 141651 0.00390 4086071 2039480 2046591 0.05680 6942 6942 0.00020 4234664 2039480 2195184 0.06090 4513940 2039480 2474460 0.06870 true 15645785 15520737 125048 X true true 1 1 FRANCES MAHON DEACONESS HOSPITAL 621 3RD ST S GLASGOW MT 59230 WWW.FMDH.ORG X X X X FRANCES MAHON DEACONESS HOSPITAL 1 false false true X X X X X X X X X X 21 true false true true X WWW.FMDH.ORG X true 21 true WWW.FMDH.ORG false false true X 140.000000000000 240.000000000000 X X X X true true X X X X true X WWW.FMDH.ORG X WWW.FMDH.ORG X WWW.FMDH.ORG X X X X X true X false X X X X true X false true FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 3E "AREAS OF OPPORTUNITY" REPRESENT THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY, BASED ON THE INFORMATION GATHERED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT. FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 5 TO SOLICIT INPUT FROM INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THE CHNA PROCESS AND SENT TO A LIST OF RECOMMENDED PARTICIPANTS INCLUDING PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS AND A VARIETY OF OTHER COMMUNITY LEADERS. ALSO, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY, AND OTHER MEDICALLY UNDERSERVED POPULATIONS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. THE PARTICIPANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 43 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. THE INPUT WAS GATHERED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. ON BEHALF OF FRANCES MAHON DEACONESS HOSPITAL IN THE SPRING OF 2022. FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 6B VALLEY COUNTY PUBLIC HEALTH DEPARTMENT FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 11 THE ONLINE KEY INFORMANT SURVEY PRESENTED THE PARTICIPANTS WITH VARIOUS HEALTH TOPICS AND WERE ASKED TO RATE EACH AS A MAJOR PROBLEM, MODERATE PROBLEM, MINOR PROBLEM, OR NOT A PROBLEM AT ALL IN THEIR OWN COMMUNITY. THESE RESULTS WERE SUMMARIZED AND THROUGH A MEETING WITH INTERNAL AND EXTERNAL STAKEHOLDERS, PRIORITIZATION WAS ACCOMPLISHED USING A PRIORITIZATION EXERCISE THAT GAUGED THE SCOPE & SEVERITY OF THE ISSUES AS WELL AS THE ABILITY OF FRANCES MAHON DEACONESS HOSPITAL TO HAVE SIGNIFICANT IMPACT ON EACH ISSUE. THROUGH DISCUSSION, A CONSENSUS WAS REACHED TO ESTABLISH THE FOLLOWING AS PRIORITIES FOR FRANCES MAHON DEACONESS HOSPITAL TO ADDRESS IN ITS IMPLEMENTATION STRATEGY IN THE COMING YEARS: ACCESS TO HEALTHCARE SERVICES, TOBACCO USE/SUBSTANCE ABUSE, MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY & WEIGHT, INFANT HEALTH & FAMILY PLANNING, AND SEXUAL HEALTH. THE FIRST HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO HEALTHCARE SERVICES. THE GOALS ARE TO INCREASE AWARENESS OF WHAT THE FMDH PATIENT PORTAL CAN HELP WITH AND TO PROMOTE TELEMEDICINE SERVICES THROUGH THREE STRATEGIES WHICH ARE PROVIDING EDUCATION ON HOW TO USE THE PATIENT PORTAL, PROVIDING TELEMEDICINE SERVICES EITHER AT HOME OR IN THE FACILITY FOR PEOPLE TO SEE PROVIDERS FOR SERVICES THAT ARE NOT AVAILABLE AT FMDH, AND MAKING SURE FMDH HAS THE APPRORIATE NUMBER OF PROVIDERS TO SERVE OUR AREA. THE SECOND HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO TOBACCO USE/SUBSTANCE ABUSE RESOURCES. THE GOALS ARE TO DECREASE USE OF TOBACCO AND OTHER SUBSTANCES AND TO EDUCATE PEOPLE ON THE HEALTH HAZARDS ASSOCIATED WITH TOBACCO AND DRUG USE THROUGH TWO STRATEGIES WHICH ARE PARTNERING WITH IDEAL OPTION TO BUILD MORE RESOURCES AND HAVING A AWARENESS CAMPAIGN ON TOBACCO USE. THE THIRD HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES. THE GOAL IS TO PROVIDE BETTER ACCESS TO MENTAL HEALTH SERVICES FOR A VARIETY OF NEEDS THROUGH TWO STRATEGIES WHICH ARE PROVIDING TELEMEDICINE SESSIONS TO THOSE PEOPLE STRUGGLING WITH AREAS THAT FMDH DOESN'T CURRENTLY HAVE PROVIDERS FOR AND CONTINUING TO PROVIDE ACCESS TO PSYCHOLOGISTS AND SOCIAL WORKERS. THE FOURTH HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO NUTRITION, PHYSICAL ACTIVITY & WEIGHT RESOURCES. THE GOALS ARE TO IMPROVE ACCESSIBILITY TO FRESH FRUIT AND VEGGIES, DECREASE CHRONIC ISSUES LIKE DIABETES, COPD, AND HEART DIDEASE, AND PROVIDE MORE RESOURCES TO MANAGE AND TRACK CHRONIC ISSUES THROUGH FIVE STRATEGIES WHICH ARE PARTNERING WITH HOSPITALS/ HEALTHCARE FACILITIES IN DANIELS, ROOSEVELT AND PHILLIPS COUNTIES TO SEE IF THE FRESH FRUIT AND VEGGIE PROGRAM CAN BE EXPANDED, PHYSICAL ACTIVITY CAMPAIGN, IMPROVE ON/BUILD RELATIONSHIP WITH FARMER'S MARKET, PROVIDING A NOOM SUBSCRIPTION FOR FREE, AND PURCHASING A GREENHOUSE TO HAVE A COMMUNITY GARDEN. THE FIFTH HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO INFANT AND NEW MOM RESOURCES. THE GOALS ARE TO PROVIDE PEOPLE WHO CARE FOR NEWBORNS RESOURCES SO THEY KNOW WHAT TO DO FOR DIFFERENT MILESTONES AND PROVIDE EXERCISES AND RESOURCES FOR NEW MOMS ON HOW TO TAKE CARE OF THEMSELVES, NOT JUST THEIR BABY THROUGH THREE STATEGIES WHICH ARE PROVIDING EDUCATION ON WHAT TO DO WITH YOUR NEWBORN FOR DIFFERENT MILESTONES, PROVIDING EDUCATION ON POSTPARTUM HEALTH, AND PROVIDING RESOURCES TO DAY CARE PROVIDERS AND YOUNG PARENTS SO THEY HAVE A PLAN TO FOLLOW. THE SIXTH HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO SEXUAL HEALTH RESOURCES. THE GOAL IS TO CREATE RESOURCES AND SPACES WHERE CHILDREN CAN FIND HELP AND ANSWERS TO THEIR QUESTIONS FROM RELIABLE SOURCES THROUGH THREE STRATEGIES WHICH ARE CREATING AND PROVIDING MAGNETS TO PUBLIC PLACES, CREATING AN ANONYMOUS CALL LINE TO FMDH NURSE'S STATION WHERE PEOPLE CAN ASK QUESTIONS AND GET A CALL BACK WITH AN ANSWER, AND USING FMDH'S PATIENT PORTAL TO SCHEDULE APPOINTMENTS SO THAT ONE WOULDN'T HAVE TO DISCUSS THE ISSUE WITH A SCHEDULER. THE FOLLOWING SIX SIGNIFICANT HEALTH NEEDS THAT EMERGED FROM THE CHNA PROCESS WILL NOT BE ADDRESSED THROUGH THE IMPLEMENTATION STRATEGY, BUT FMDH IS ALREADY PROVIDING CERTAIN SERVICES AND RESOURCES RELATED TO THESE NEEDS WHICH ARE LISTED AFTER EACH HEALTH NEED BELOW. 1. CANCER (RANKED 4TH) - ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. FMDH CONTINUES TO PROVIDE MAMMOGRAPHY SERVICES, A CHEMOTHERAPY DEPARTMENT (SUBSIDIZED SERVICES), AND WE STAFF GENERAL SURGEONS. WE ALSO BRING IN AN ONCOLOGIST AND OFFER DERMATOLOGY AND UROLOGY SERVICES IN THE OUTREACH CLINIC ON A MONTHLY BASIS. THESE SERVICES HELP WITH EARLY DETECTION AND TREATMENT. 2. HEART ATTACK & STROKE (RANKED 7TH) - FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE NUTRITION, PHYSICAL ACTIVITY & WEIGHT WILL HAVE A POSITIVE IMPACT ON HEART ATTACKS AND STROKES AND THAT A SEPARATE SET OF SPECIFIC HEART ATTACK AND STROKE INITIATIVES WAS NOT NECESSARY. FMDH CONTINUES TO BE A COOPERATIVE MEMBER IN THE STAT AIR AMBULANCE SERVICE AND HAS A WHOLLY OWNED GROUND AMBULANCE SERVICE (SUBSIDIZED SERVICES) FOR OUR COUNTY. THESE EFFORTS HELP WITH A QUICKER RESPONSE, AND IF NEEDED, TRANSPORTATION TO A TERTIARY HEALTHCARE CENTER. WE ALSO OFFER CARDIAC REHAB WHICH IS INCLUDED IN THE SUBSIDIZED HEALTH SERVICES, AND WE HAVE HAD TELESTROKE SPECIALISTS AVAILBLE SINCE 2018. 3. ORAL HEALTH (RANKED 9TH) - ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. THERE ARE 3 DENTAL CLINICS IN TOWN AND THEY PROVIDE THIS SERVICE AND HAVE BETTER RESOURCES TO ADDRESS THIS HEALTH ISSUE. ALSO, AS PART OF THE PEDIATRIC WELLNESS EXAMS THERE ARE CONVERSATIONS ABOUT FLUORIDE SUPPLEMENTS AND DENTAL CARE, AND WE WILL REFER TO THE VALLEY COUNTY HEALTH DEPARTMENT FOR FLUORIDE VARNISH WHEN APPROPRIATE. 4. INJURY & VIOLENCE (RANKED 12TH) - FMDH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF LAW ENFORCEMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND A LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. FMDH CONTINUES TO COORDINATE RESPONSE EFFORTS WITH THE LOCAL LAW ENFORCEMENT ENTITIES THROUGH AN ANNUAL DRILL. THE PEDIATRIC WELLNESS EXAMS INCLUDE QUESTIONS ABOUT FIREARMS IN THE HOME. WELLNESS EXAMS INCLUDE VIOLENCE RELATED QUESTIONS REGARDING IF THE PATIENT FEELS SAFE IN THEIR HOME AND WE WILL MAKE THE NECESSARY REFERRALS BASED ON THE RESPONSE. THE WELLNESS EXAMS ALSO INCLUDE SCREENINGS OF SEATBELT/RESTRAINT USE FROM NEWBORNS TO THE ELDERLY. 5. RESPIRATORY DISEASE (RANKED 13TH) - ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. FMDH CONTINUES TO COLLABORATE WITH VALLEY COUNTY HEALTH DEPARTMENT ON COVID-19 SWABBING AND VACCINATION CLINIC EVENTS, AS WELL AS FOR DISTRIBUTION OF HOME TESTING KITS. WE ALSO CONTINUE TO KEEP OUR RESPIRATORY CLINIC ENTRANCE SEPARATE FROM THE MAIN CLINIC ENTRANCE. ADDITIONALLY, WE OFFER A RESPIRATORY REHAB PROGRAM THAT INCLUDES SMOKING CESSATION WHICH IS INCLUDED IN SUBSIDIZED HEALTH SERVICES. 6. DIABETES (RANKED 6TH) - FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE NUTRITION, PHYSICAL ACTIVITY & WEIGHT WILL HAVE A POSITIVE IMPACT ON DIABETES AND THAT A SEPARATE SET OF SPECIFIC DIABETES INITIATIVES WAS NOT NECESSARY. WE BEGAN PROVIDING NEW SERVICES LINES LIKE CHRONIC CARE MANAGEMENT AND TRANSITIONAL CARE MANAGEMENT SERVICES THAT MAY BENEFIT THOSE WITH DIABETES. FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 24 SOME SERVICES PROVIDED BY THE HOSPITAL ARE CONSIDERED ELECTIVE. ELECTIVE SERVICES ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE THUS A PERSON QUALIFYING FOR A DISCOUNT FOR MEDICALLY NECESSARY SERVICES MAY NEED TO PAY FULL PRICE FOR ELECTIVE SERVICES. 1 GLASGOW CLINIC INC 621 THIRD STREET SOUTH GLASGOW MT 59230 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7G THERE IS NO COST OF BAD DEBT TO REMOVE FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C. SCHEDULE H, PART I, LINE 7 USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND COMMUNITY BENEFIT. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 2 THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT EXPENSE, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES, NOT INCLUDING IMPLICIT PRICE CONCESSIONS, TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS AND IMPLICIT PRICE CONCESSIONS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF IMPLICIT PRICE CONCESSIONS OR BAD DEBT, WHICH REDUCE IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. PATIENT OBLIGATIONS WHICH QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT RECORDED AS IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 4 THERE WERE NO BAD DEBT EXPENSES RECORDED AND THEREFORE NO RELATED FOOTNOTE AFTER ADOPTING THE NEW REVENUE RECOGNITION GUIDANCE IN FASB ASU 2014- 09. MOST TRANSACTIONS WHICH PREVIOUSLY WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE ARE CLASSIFIED AS IMPLICIT PRICE CONCESSIONS WHICH ARE RECORDED AS REDUCTIONS IN REVENUE VERSUS BAD DEBT EXPENSE. THE AUDITED FINANCIAL STATEMENTS ARE NOT YET AVAILABLE SO INTERNAL FINANCIAL STATEMENTS WERE ATTACHED. THE INTERNAL FINANCIAL STATEMENTS DO NOT INCLUDE FOOTNOTES. SCHEDULE H, PART III, LINE 8 THERE IS A MEDICARE SURPLUS SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE AND THE 2 PERCENT SEQUESTRATION ADJUSTMENT WAS REINSTATED IN APRIL 2022. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 9B THE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, COMBINED WITH AN ASSET TEST AND A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS FINANCIAL ASSISTANCE. FOR PATIENTS THAT HAVE HAD A PORTION OF THEIR ACCOUNT WRITTEN OFF AS FINANCIAL ASSISTANCE AND THAT LATER DEFAULT ON THE PORTION THAT WAS DETERMINED TO BE THEIR RESPONSIBILITY, AND THEREFORE IS NOT CONSIDERED FINANACIAL ASSISTANCE, THE ORGAINIZATION DOES ATTEMPT TO COLLECT THIS BALANCE. SCHEDULE H, PART VI, LINE 2 PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, FRANCES MAHON DEACONESS HOSPITAL COMPLETED A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION PLAN DURING FISCAL YEARS 2016, 2019, & 2022 (TAX YEARS 2015, 2018, & 2021). THESE ASSESSMENTS ARE LOCATED ON THE ENTITY'S WEBSITE. HOWEVER, FRANCES MAHON DEACONESS HOSPITAL (FMDH) HAS TRADITIONALLY INCLUDED COMMUNITY NEEDS ASSESSMENTS IN ITS PLANNING FOR MANY YEARS AND UTILIZES MANY METHODS OF ASSESSING THE PATIENT SERVICES NEEDS FOR OUR SERVICE AREA. THESE INCLUDE BUT ARE NOT LIMITED TO: ANALYSIS OF OUTMIGRATION STATISTICS OBTAINED THROUGH ACCESS TO THE COMPDATA DATABASE PROVIDED THROUGH THE MONTANA HOSPITAL ASSOCIATION AND MODELING OF PATIENT TO POPULATION RATIOS TO IDENTIFY AND PLAN FOR THE APPROPRIATE PROVIDER MIX TO SERVE THE COMMUNITY. IN ADDITION, FMDH PARTICIPATED IN AN AREA HEALTH EDUCATION CENTER LEAD COMMUNITY HEALTH SERVICES DEVELOPMENT ASSESSMENT. IDEAS GENERATED OUT OF EACH OF THESE EFFORTS ARE THEN EVALUATED AS TO THE CAPABILITIES OF OUR ORGANIZATION TO DEVELOP IDENTIFIED SERVICES. MINIMUM CRITERIA FOR DEVELOPMENT OF NEW OR MODIFICATION OF EXISTING SERVICES ARE: THE NEW OR MODIFIED SERVICE CAN REASONABLY FINANCIALLY SUPPORT ITS OPERATION; WE HAVE OR CAN ACQUIRE THE NECESSARY PERSONNEL WITH THE CREDENTIALS TO DELIVER THE SERVICE AND RETAIN ENOUGH PERSONNEL WITH THE REQUIRED SKILL SETS TO AVOID INTERRUPTION OF SERVICE DELIVERY IF SAID PERSONNEL TURN OVER; THE SERVICES CAN BE DELIVERED IN A MANNER THAT ACHIEVES APPROPRIATELY HIGH LEVELS OF PATIENT SATISFACTION. SCHEDULE H, PART VI, LINE 3 FRANCES MAHON DEACONESS HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO HAS THE SOLE RESPONSIBILITY TO WORK WITH PATIENTS TO NAVIGATE OUR FINANCIAL ASSISTANCE PROGRAM. ALL PATIENTS ARE SENT INFORMATION AT THE INITIAL BILLING FOR DELIVERED PATIENT SERVICES THAT DESCRIBES OUR FINANCIAL ASSISTANCE PROGRAM. OUR WEBSITE HAS INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM ALONG WITH ACCESS TO THE APPLICATION. FRANCES MAHON DEACONESS HOSPITAL ALSO EMPLOYS A STAFF MEMBER THAT IS A CERTIFIED APPLICATION COUNSELOR THAT HELPS COMMUNITY MEMBERS WITH APPLYING FOR INSURANCE AND MEDICAID ON THE MARKETPLACE. SCHEDULE H, PART VI, LINE 4 FRANCES MAHON DEACONESS HOSPITAL IS LOCATED IN GLASGOW MONTANA WHICH IS OVER FOUR HOURS HIGHWAY TRAVEL TIME AWAY FROM ANY TERTIARY MEDICAL CENTER. WHILE OUR PRIMARY SERVICE AREA CONSISTS OF GLASGOW MONTANA AND VALLEY COUNTY, OUR FACILITY AND SPECIALTY SERVICES ALSO DRAW FROM PORTIONS OF THE SURROUNDING COUNTIES OF DANIELS, ROOSEVELT, AND PHILLIPS. THE AREA IS PRIMARILY AGRICULTURAL BASED WITH LOW POPULATION DENSITIES WHICH HOUSES A TOTAL POPULATION OF 24,453 RESIDENTS OVER 13,846.91 SQUARE MILES. THE DIFFERENT AGE GROUPS OF THE SERVICE AREA ARE AS FOLLOWS: 27.6% ARE INFANTS, CHILDREN OR ADOLESCENTS AGES 0-17; ANOTHER 55.1% ARE AGES 18 TO 64, WHILE 17.3% ARE AGES 65 AND OLDER. THE POPULATION IS MOSTLY WHITE, BUT PORTIONS OF OUR EXTENDED SERVICE AREA HAVE HIGH POPULATIONS OF NATIVE AMERICAN ANCESTRY (30.9% IN THE TOTAL SERVICE AREA) TO WHICH WE PROVIDE SERVICES. THE STATISTICS PROVIDED ABOVE ARE BASED ON THE US CENSUS BUREAU AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2015-2019). SCHEDULE H, PART VI, LINE 5 FRANCES MAHON DEACONESS HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF. WE ARE GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY PERSONS REPRESENTING MOST OF THE INDIVIDUAL TOWNS OR GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. FOR NONELECTIVE SERVICES, WE TREAT PATIENTS WITHOUT REGARD TO ABILITY TO PAY, CONSISTENT WITH OUR ORIGINS AS A HILL BURTON FUNDED FACILITY. ALTHOUGH OUR HILL BURTON OBLIGATION WAS SATISFIED MANY YEARS AGO, WE STILL ADHERE TO THE PRINCIPLES INHERENT IN THAT OBLIGATION. SURPLUS FUNDS ARE RETAINED WITHIN THE ORGANIZATION TO ASSURE FULFILLMENT OF OUR CHARITABLE MISSION BOTH IN THE PRESENT AND IN THE FUTURE. SCHEDULE H, PART VI, LINE 6 FRANCES MAHON DEACONESS HOSPITAL PROVIDES HOSPITAL INPATIENT AND OUTPATIENT SERVICES. GLASGOW CLINIC INC PROVIDES PROFESSIONAL PRIMARY CARE PHYSICIAN, MIDLEVEL PROVIDER, AND SPECIALTY PHYSICIAN SERVICES. HI-LINE MEDICAL SERVICES INC PROVIDES RETAIL PHARMACY SERVICES. SCHEDULE H, PART VI PART I, LINE 6A: THE FORM 990 SCHEDULE H IS CONSIDERED AN ANNUAL COMMUNITY BENEFIT REPORT AND IT IS AVAILABLE TO THE PUBLIC ON OUR WEBSITE. PART 1, LINE 7E: FMDH CONTRIBUTED TO THE VALLEY COUNTY SCHOOL SNACK PROGRAM, PAID FOR A WEBSITE SUBSCRIPTION AND OTHER SUPPORT FOR THE VALLEY CARE COALITION, AND PROVIDED MENTAL HEALTH FIRST AID TRAINING & RELATED BOOKS. FMDH ALSO SPONSORED A YOUTH EVENT AND WALK, PROVIDED FUNDS TOWARDS ACCESS TO CARE ACTIVITIES AND PAID FOR A NEW CHNA FOR 2022. PART I, LINE 7I: FMDH CONTRIBUTED TO THE VALLEY COUNTY POOL CAMPAIGN. PART V: GLASGOW CLINIC INC IS A SEPARATE ORGANIZATION THAT IS A RURAL HEALTH CLINIC WHICH INCLUDES SPECIALTY PHYSICIAN PRACTICES. FMDH WHOLLY OWNS AND MANAGES THIS ENTITY AND SUBSIDIZES THE PHYSICIAN PRACTICES AS NEEDED TO ASSURE ACCESS TO AS FULL OF A SCOPE OF SERVICES AS IS APPROPRIATE GIVEN THE NEEDS OF THE COMMUNITY WE SERVE. GLASGOW CLINIC'S REVENUES AND EXPENSES ARE NOT INCLUDED ON FMDH'S FORM 990. HI-LINE MEDICAL SERVICES, INC IS A SEPARATE ORGANIZATION WHICH CONSISTS OF A RETAIL PHARMACY AND IS WHOLLY OWNED AND OPERATED BY FMDH. THEIR REVENUES AND EXPENSES ARE NOT INCLUDED ON FMDH'S FORM 990. true VALLEY VIEW HOME 1225 PERRY LANE GLASGOW MT 59230 810295816 501C3 88471 SUPPORT OF OPERATION 1 SCHEDULE I, PAGE 1, PART I, LINE 2 PROVIDED FINANCIAL ASSISTANCE TO VALLEY VIEW HOME FOR PURPOSES OF PURCHASING A HANDICAPPED VAN AND MARKETING EXPENSES. X X X false false false false false false false false false LOUIS BAILEY PHYSICIAN MEMBER 563154 10150 16718 590022 NICOLE LORENZ MD 556040 10150 8438 574628 DAVID KNIERIM MD 445972 10150 8438 464560 ANNE MILLARD BRADLEY MD 390187 10150 13123 413460 ANDREW FAHLGREN MD 388713 9365 10705 408783 ANTHONY COLACINO MD 367691 9087 13123 389901 RANDY HOLOM CEO 278622 10087 13123 301832 ELLEN GUTTENBERG COO 177305 6591 16718 200614 CAMI KALINSKI DIRECTOR OF FINANCE 153743 5434 11 159188 SCHEDULE J, PART III A PERCENTAGE OF THE COMPENSATION PAID TO ANTHONY COLACINO, M.D. (100%), DAVID KNIERIM, M.D. (75%), ANDREW FAHLGREN, M.D. (75%), ANNE MILLARD BRADLEY, M.D. (57%), AND NICOLE LORENZ, M.D. (100%) IS AN EXPENSE OF GLASGOW CLINIC INC, A RELATED COMPANY. THE COMPENSATION WAS PAID THROUGH FRANCES MAHON DEACONESS HOSPITAL AS A COMMON PAYMASTER. OPPORTUNITY BANK OF MONTANA BOARD MEMBERS 3458877 BANKING & INVESTING false SCHEDULE L, PART V THE HOSPITAL CEO IS A BOARD MEMBER OF OPPORTUNITY BANK OF MONTANA AND ONE BOARD MEMBER IS AN EMPLOYEE OF THE BANK. THE HOSPITAL HAS BANK ACCOUNTS AND INVESTMENTS WITH OPPORTUNITY BANK OF MONTANA. THE BUSINESS RELATIONSHIP WITH THE BANK IS MANAGED BY THE DIRECTOR OF FINANCIAL SERVICES OF THE HOSPITAL AND SHE HAS A DIRECT REPORTING RELATIONSHIP TO THE BOARD FINANCE COMMITTEE IN THIS REGARD. FURTHER, ANY DECISION MADE BY THE DIRECTOR OF FINANCIAL SERVICES IS GOVERNED BY POLICIES AND PROCEDURES APPROVED BY THE ENTIRE BOARD OF TRUSTEES ON THE RECOMMENDATION OF THE FINANCE COMMITTEE. ADDITIONALLY, FOR ANY PARTICULAR BUSINESS TRANSACTION OR DECISION THAT DIRECTLY INVOLVES OPPORTUNITY BANK OF MONTANA, THE CEO AND THE BOARD MEMBER WITH A CONFLICT OF INTEREST LEAVE THE BOARD MEETING WHILE THE REMAINING BOARD MEMBERS DELIBERATE OR ACT ON THE MATTER. THE TRANSACTION DOLLAR AMOUNT SHOWN ABOVE IS THE NET INCREASE IN THE HOSPITAL'S BANK ACCOUNT AND INVESTMENT BALANCES WITH OPPORTUNITY BANK OF MONTANA FOR THE FISCAL YEAR. FORM 990, PAGE 1, PART I, LINE 6 VOLUNTEERS ARE EMTS. FORM 990, PAGE 6, PART VI, LINE 6 MEMBERSHIP IN THE FRANCES MAHON DEACONESS HOSPITAL CORPORATION (FMDH) IS ACHIEVED BY VIRTUE OF DONATING AT LEAST 100 TO FMDH, TO THE FRANCES MAHON DEACONESS HOSPITAL FOUNDATION (ALTHOUGH THE FOUNDATION IS A SEPARATE CHARITABLE ENTITY AND NOT CONTROLLED BY THE FMDH CORPORATION, ITS STATED PURPOSE IS TO SUPPORT FMDH AND THE DELIVERY OF HEALTHCARE SERVICES IN VALLEY COUNTY, MONTANA, THROUGH CHARITABLE DONATIONS SUPPORTING SERVICES DEVELOPMENT AND EQUIPMENT PURCHASES), AND LUKE'S 100 (ANOTHER LOCAL CHARITABLE ORGANIZATION SEPARATE FROM FMDH BUT WHICH SUPPORTS FMDH THROUGH ANNUAL DONATIONS). THERE ARE NO DISTINCT CLASSES OF MEMBERS; ALL MEMBERS ARE PART OF A SINGLE MEMBERSHIP CLASS. FMDH CORPORATION MEMBERS EXERCISE NO GOVERNANCE CONTROL OVER FMDH WITH THE EXCEPTION OF THE ABILITY TO BRING CHARGES AGAINST A BOARD MEMBER FOR MALFEASANCE OR NONFEASANCE OF THE DUTIES AND RESPONSIBILITIES OF THE ENTITY WHICH, THROUGH A DUE PROCESS, CORPORATE MEMBERS CAN VOTE A BOARD MEMBER OUT WITH A VOTE OF 2/3 OF CORPORATE MEMBERS PRESENT AND CORPORATE MEMBERS TOTAL AT LEAST 50 MEMBERS OR 5% OF THE TOTAL CORPORATE MEMBERS, WHICHEVER IS FEWER. FORM 990, PAGE 6, PART VI, LINE 7A THERE ARE NO DISTINCT CLASSES OF MEMBERS; ALL MEMBERS ARE PART OF A SINGLE MEMBERSHIP CLASS. THE MEMBERS ELECT ALL MEMBERS OF THE FMDH BOARD OF TRUSTEES. ELECTION OF THE GOVERNING BOARD IS GRANTED TO THE FMDH BOARD OF TRUSTEES. HOWEVER, THE FMDH CORPORATION MEMBERS MAY VOTE OUT A TRUSTEE UPON DUE PROCESS. THEY EXERCISE NO OTHER GOVERNANCE OR CONTROL OVER FMDH. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND DIRECTOR OF FINANCIAL SERVICES AND IS MADE AVAILABLE FOR THE BOARD'S REVIEW PRIOR TO BEING FILED. FORM 990, PAGE 6, PART VI, LINE 12C CONFLICTS OF INTEREST ARE REQUIRED TO BE REPORTED AT THE FIRST MEETING OF EACH CALENDAR YEAR. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST THEY ARE REQUIRED TO LEAVE THE BOARD MEETING WHILE THE BUSINESS IS BEING DISCUSSED OR ACTED UPON. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF TRUSTEES APPROVES THE CEO'S COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B THE BOARD OF TRUSTEES APPROVES THE COMPENSATION FOR ALL PHYSICIANS EMPLOYED BY FMDH. THE CEO APPROVES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PAGE 6, PART VI, LINE 19 ALL WRITTEN POLICIES ARE KEPT IN THE OFFICE OF THE DIRECTOR OF FINANCIAL SERVICES AND ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 CONTRIBUTED CAPITAL TO GLASGOW CLINIC INC -16,374,092 FMDH FOUNDATION 621 3RD STREET SOUTH GLASGOW MT 59230 810406872 SUPPORT MT 501C3 7 NA false PRAIRIE RIDGE VILLAGE LLP 521 4TH AVE S GLASGOW MT 59230 810515202 ASSTLIVING MT 501C3 10 NA false NE MT STAT AIR AMBULANCE COOPERATIV 81 AIRPORT ROAD GLASGOW MT 59230 204748673 AIR AMBULA MT 501C3 12B NA false HI-LINE MEDICAL SERVICES INC 621 THIRD STREET SOUTH GLASGOW MT 59230 208393201 PHARMACY MT N/A false GLASGOW CLINIC INC 621 THIRD STREET SOUTH GLASGOW MT 59230 810341714 CLINIC MT N/A false true true true true false false false false false false false false false false true false false false true FMDH FOUNDATION O 50961 STAFF & OTHER ITEMS GLASGOW CLINIC INC A 213301 RENTAL INCOME GLASGOW CLINIC INC S -12350636 CHANGE IN RECEIVABLE HI-LINE MEDICAL SERVICES INC A 15000 RENTAL INCOME HI-LINE MEDICAL SERVICES INC S -2659808 CHANGE IN RECEIVABLE PRAIRIE RIDGE VILLAGE LLP D 2978940 LOAN BALANCE PRAIRIE RIDGE VILLAGE LLP A 158764 INTEREST RECEIVED ON LOAN FMDH FOUNDATION C 35790 SUPPORT GLASGOW CLINIC INC B 16374092 CONTRIBUTED CAPITAL SCHEDULE R EFFECTIVE OCTOBER 1, 2021 HI-LINE MEDICAL SERVICES INC, EIN 20-8393201, WAS MERGED WITH AND INTO GLASGOW CLINIC INC, EIN 81-0341714, WITH GLASGOW CLINIC INC SURVIVING THE MERGER. FOR FEDERAL AND STATE INCOME TAX PURPOSES, THE MERGER IS INTENDED TO QUALIFY AS A REORGANIZATION UNDER 368(A)(1)(A) OF THE INTERNAL REVENUE CODE OF 1986 AS AMENDED. FRANCES MAHON DEACONESS HOSPITAL, EIN 81-0231786, OWNS 100% OF THE STOCK OF BOTH HI-LINE MEDICAL SERVICES INC AND GLASGOW CLINIC INC. FOR TAX YEAR 2021 THERE WERE NOT ANY GRASSROOTS LOBBYING EXPENDITURES.