2023-11-15T07:54:21-06:00 2022-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-01-01 810232121 Bozeman Deaconess Health Services BOZE 4064145000 915 Highland Boulevard Bozeman MT 59715 Brad Ludford CFO 4064145000 2023-11-14 1 Brad Ludford 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Bozeman Health Brad Ludford 915 Highland Boulevard Bozeman MT 59715 163884781 0 X www.bozemanhealth.org X 1911 MT To improve community health and quality of life for residents and visitors of the Bozeman, MT area. 10 9 931 225 1298362 0 690773 1661600 152604237 161780190 62326 229958 184564 213033 153541900 163884781 113500 677955 0 0 103026670 109372517 0 0 0 47851595 52824232 150991765 162874704 2550135 1010077 178954474 150278571 130061842 101326406 48892632 48952165 X To improve community health and quality of life. 0 0 61684165 59193546 Bozeman Health Medical Group employs physicians under the Bozeman Health system umbrella. This group of providers compassionately serves the patients of Bozeman Health Deaconess Hospital, Big Sky Medical Center, Bozeman Health Urgent Care, and Bozeman Health Convenience Care, LLC. 13257451 22239784 In efforts to reach our community and surrounding area in multiple facets of healthcare, the Bozeman Health system operates additional healthcare facilities which allows more access and levels of care.Big Sky Medical Center had 23 admissions and saw 6,014 patients in the Emergency Room and over 6,200 patients in the clinic in 2022. The net revenue yield on these operations was only 63.8%, or $2,176 per equivalent ER visit. With challenging core staffing and related costs, the operating expense (excluding interest, taxes and depreciation) was $1,391 per equivalent ER visit. This resulted in a $1M operating loss for the year. Bozeman Health is committed to providing access and patient care to the Big Sky community in spite of the financial operational challenges the facility continues to face.Bozeman Health also continues to operate our Main Street Urgent Care as an outpatient healthcare access point. With a 53.2% yield on $6M of patient charges and operating costs of $5.7M, the Urgent Care netted a gain of $319K in 2022. 8884504 677955 80346860 Bozeman Health serves as the parent company of the Bozeman Health system. As the corporate parent, management, general and administrative services are centralized here and provided to the operating units caring for our patients. These administrative and support services aim to optimize executive, organizational and financial responsibilities to allow the health system to continue to grow and serve the population. In this past year, Bozeman Health had 24,851 inpatient days, 224,330 outpatient hospital visits, 303,145 outpatient clinic visits, 42,650 emergency room visits and performed 6,684 surgeries. 83826120 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 200 0 1 931 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X Carrie Morasko 4064145039 915 Highland Blvd Bozeman MT 59715 Katie Daughenbaugh Chair (Jan-Jun) 1.00 1.00 X X 0 0 0 Signe Farris Vice Chair (Jan-Oct) 1.00 0.00 X X 0 0 0 Jim Berend Treasurer 1.00 0.00 X X 0 0 0 Don Beeman Secretary (Jan-Mar) 1.00 0.00 X X 0 0 0 Elizabeth Carver - Director (Jan-Jun)/Secretary starting July 1.00 0.00 X X 0 0 0 Kerri Brown - Treasurer (Jan-Jun)/Vice Chair starting July 1.00 1.00 X X 0 0 0 John How Director (Jan-Jun)/Chair (Jul-Dec) 1.00 1.00 X X 0 0 0 Jerry Cashman Director until June 1.00 1.00 X 0 0 0 Bruce Hamory Director 1.00 0.00 X 0 0 0 Kerry Petitt Director until June 1.00 1.00 X 0 0 0 Walt Sales Director 1.00 1.00 X 0 0 0 Alyce Schultz Director 1.00 0.00 X 0 0 0 Dane Sobek Director/Cardiologist 50.00 1.00 X 734469 0 49928 Amy Strader Director until June 1.00 0.00 X 0 0 0 Jon Knokey Director starting July 1.00 0.00 X 0 0 0 Bekcy Franks Director starting July 1.00 0.00 X 0 0 0 John Hill CEO until October 20.00 30.00 X 877924 0 103626 Kathryn Bertany - Pres of Hosps(Jan-Oct)/Interim CEO(Nov start) 20.00 30.00 X 611024 0 90626 Brad Ludford CFO 20.00 30.00 X 463552 0 77854 Darci Bentson CAO 20.00 30.00 X 428215 0 73708 Mark Williams Chief Physician Officer 20.00 30.00 X 583751 0 81438 Diane Patterson Chief Nursing Officer 20.00 30.00 X 343095 0 75903 Tamara Havenhill-Jacobs Chief Information Officer 20.00 30.00 X 381950 0 69899 Edie Willey Chief People Officer 20.00 30.00 X 317422 0 64016 Kallie Kujawa Chief Clinical Transformation Officer 20.00 30.00 X 282222 0 69280 Denise Juneau Chief Government & Community Affairs Officer 20.00 30.00 X 302889 0 35670 Mark Hancock Internal Medicine 50.00 0.00 X 734318 0 25694 Nathaniel Madsen Cardiology 50.00 0.00 X 733605 0 51079 Courtney Wagner Internal Medicine 50.00 0.00 X 724971 0 56215 Andrew Gentry Gastroenterologist 50.00 0.00 X 679748 0 51911 Peter Walsh Gastroenterologist 50.00 0.00 X 651824 0 51910 8850979 0 1028757 286 0 1 0 Nuwest Group Holdings LLC 325 118th Ave SE Ste 300 Bellevue WA 98005 Contract Labor 13505493 Absaroka Emergency Physicians 1184 N 15th Street Suite 1 Bozeman MT 59715 ER Physicians Fee 7575489 Impact Advisors LLC PO Box 379 Naperville IL 605660379 Software Consulting/Build 3192599 System4 of Idaho 82 S Baltic Place Ste 116 Meridian ID 83642 Facility Cleaning 1254430 Kiwi Enterprises LLC 121 N 3rd Ave Bozeman MT 59715 Snow Removal 917325 49 1661600 1661600 Health System Corp Services 900099 77331294 77331294 Health System Provider Services 621110 59193545 59193545 Patient Service Revenue 621110 20362261 20362261 Pharmacy Revenue 456110 1527485 229123 1298362 3365605 3365605 161780190 229958 229958 213033 0 213033 213033 213033 163884781 160481828 1298362 442991 X 663955 663955 14000 14000 6128046 960792 5167254 85195504 60283694 24911810 3173375 2390395 782980 9505060 4117689 5387371 5370532 3401494 1969038 692793 28871 663922 168300 168300 61746 61746 16389678 1598389 14791289 1698518 1698518 750912 209817 541095 1719418 198002 1521416 548333 18023 530310 365556 12016 353540 993304 993304 5984127 5984127 2231488 53506 2177982 Equipment Rent & Mainte 14893286 162527 14730759 Medical Supplies 2872074 2697742 174332 Goodwill Impairment 869549 869549 Taxes and Licenses 632461 22016 610445 1952689 15761 1936928 162874704 83826120 79048584 0 64185839 16577919 5917525 6791547 345128 353782 11554638 7798710 137387077 47413112 64286156 89973965 7885430 7671764 14566918 12923525 6086845 5217296 4125995 2970063 178954474 150278571 31893805 28301727 205000 10511 20560584 20232082 3458029 42827 73944424 52739259 130061842 101326406 X 46727032 47737108 2165600 1215057 48892632 48952165 178954474 150278571 X 1010077 -950544 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 56400 0 1 5346 61746 0 Part II-B, Line 1: Hired consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. Bozeman Deaconess Health Services reimburses certain professional membership dues of employees, a portion of such membership dues are used by the professional associations for lobbying activities. The dues for MHA, AHA, and Leading Age were $5,346. 24534132 68899 -3372760 558203 20672068 20745993 973493 3399161 584515 24534132 18430208 41677 2623596 349488 20745993 16272305 227769 3135666 1205532 18430208 16828400 335927 -723008 169014 16272305 0.63540 0.19020 0.17440 0 1 1 16497145 16497145 31134818 6330469 24804349 82825009 41082643 41742366 6930105 6930105 89973965 Investment in Affiliated Organizations 12923525 F 12923525 Deposits 3538 Capitalized Lease Obligation 1517790 Due To Affliates 50893549 Estimated third-party payor settlements 324382 52739259 X Part V, Line 4: Each endowment fund is privy to a separate agreement. Donations made for each purpose shall be received, held, and invested by the Bozeman Deaconess Foundation according to established policies governing gift acceptance, investment, and distribution. The principal of the fund shall be retained in perpetuity. The interest income is utilized for the greatest needs of the designated department. Policy says the organization can use a portion of interest for operations. The endowment fund reported in Line 1 is currently being held by a related organization, Bozeman Deaconess Foundation, and benefits Bozeman Health and related system entities. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. Part X, Line 2: The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 1 0 0 627465 46328 581137 0.00360 3612633 2548229 1064404 0.00650 4240098 2594557 1645541 0.01010 577421 182213 395208 0.00240 14150 14150 0.00010 2305653 1677018 628635 0.00390 663955 63725 600230 0.00370 3561179 1922956 1638223 0.01010 7801277 4517513 3283764 0.02020 7880 34 7846 0.00000 7880 34 7846 0.00000 1 1531349 0 3702972 6646566 -2943594 X 1 1 1 Rocky Mountain Surgical Center LLC Outpatient Surgical Center 0.51010 0.00000 0.48990 2 Deaconess Intercity Imaging LLC Radiology 0.77500 0.00000 0.22500 3 Spanish Peaks Plaza LLC Real Estate 0.69940 0.00000 0.30060 4 West Bozeman Surgery Center LLC Outpatient Surgical Center 0.35070 0.00000 0.30000 1 1 Big Sky Medical Center 334 Town Center Ave Big Sky MT 59716 www.bigskymedicalcenter.com 13563 X X X X Big Sky Medical Center LLC 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X https://www.bozemanhealth.org/chna/ X 1 20 1 https://www.bozemanhealth.org/chna/ 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Big Sky Medical Center, LLC Part V, Section B, Line 5: To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey (OKIS) was implemented as part of the CHNA process. The list for this survey included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. 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. In total, 25 individuals responded to the OKIS in the spring of 2020 from the following organizations many of which work directly with low-income, minority, or other medically underserved populations:Big Sky Community Organization Big Sky Fire Department Big Sky ResortBig Sky School District 72Bozeman Health Family Medicine Clinic, Big Sky Community Health Partners, West Yellowstone Conoco Big Sky Gallatin County Sheriff's Department Harrison Public School DistrictHuman Resource Development, Big Sky Community Food BankMadison County Public Health Department Schmieding Dental GroupSheridan School DistrictTown of West Yellowstone West Yellowstone Schools Woman in Action, Big Sky Big Sky Medical Center, LLC Part V, Section B, Line 6a: Bozeman Health Deaconess Hospital Big Sky Medical Center, LLC Part V, Section B, Line 6b: Community Health Partners, Gallatin City-County Health Department Big Sky Medical Center, LLC Part V, Section B, Line 11: We conducted a CHNA in 2020, which guides our implementation strategy for 2021-2023. The needs identified and adopted by BSMC are:-Behavioral Health (includes mental health and substance abuse)-Access to Healthcare Services-Nutrition & Physical Activity -Injury & ViolenceWe are addressing all needs identified by the CHNA, but we did shift our strategies for Access to Healthcare. We were providing free preventative health services through the HealthCare Connections mobile screening program through July 13, 2022; however, staffing required us to shift to meet this need via Coordinating with the Gallatin County Health Department Cancer Screening Program and providing free vouchers via the Mammogram Project and discounted lab vouchers for personalized bloodwork. Additionally, we shifted our strategy from hosting and sharing a podcast called All Things Health (through October 20, 2022) with limited engagement to Engaging in Service Coordination with the Housing First Village and developing a Medical Respite program, as a means of improving Access to Healthcare for houseless populations. We also shifted our focus from the 5210+ Gallatin County to an emerging steering committee called Health in All Policies, as one strategy to address nutrition and physical activity in our design of parks and trails for physical activity.In the current year the facility has taken the following actions:Behavioral Health: 1) Implemented Youth Aware of Mental Health (YAM) programming in high schools and middle schools, which included Lone Peak public schools and 2) Championed and disseminated community-wide awareness and stigma reduction efforts via the Are You In? campaign and 988 posters promoting mental health crisis support. Big Sky partners like Wellness in Action and Yellowstone Club Community Foundation are actively involved in Gallatin Behavioral Health Coalition activities and take a leadership role in developing local resources and behavioral health workforce development.We also provided grants to local nonprofits focused on mindfulness programing in schools.Access to Healthcare: 1a) Provided free preventative health services through the HealthCare Connections mobile screening program through July 13, 2022. 1b) Coordinated with the Gallatin County Health Department Cancer Screening Program and provide free vouchers via the Mammogram Project and discounted lab vouchers for personalized bloodwork. 2a) Hosted and shared the Bozeman Health podcast, All Things Health through October 20, 2022. 2b) Engaged in and provided grants for Service Coordination with the Housing First Village and capital campaign investments and program development for a Medical Respite program, as a means of improving Access to Healthcare for houseless populations. We also provided grants to nonprofits working on service coordination for Spanish speaking students in schools and Spanish speaking adults via health fairs. We provided a grant to host events where our doctors visit with Headstart parents to discuss access to healthcare and how to proactively address respiratory issues in children during cold and flu season. We also invested in a capital campaign for a nearby rural fire department with a rescue squad that transports patients to our emergency department.Nutrition & Physical Activity: 1) Convened and supported the 5210+ Gallatin County Coalition or supported the Health in All Policies steering committee. 2) Supported GoNoodle access for schools in Park, Madison, and Gallatin Counties. We also provided grants to nonprofits focused on physical activities on land trust trails, a cross country ski event, a learning garden for preschool students, afterschool programs with healthy snacks, and a capital campaign for a teaching kitchen at a local public library.Injury & Violence Prevention: 1) Provided "Stepping On" fall prevention trainings. 2) Promoted the "Stop the Bleed" campaign, which included Big Sky Search and Rescue. Another grant focused on Stop the Bleed kits via a high school Future Health Professionals student club.3) Hosted community events to raise awareness, reduce stigma, provide resources, and promote domestic violence prevention, which was completed in 2022 via a capital campaign to build intake rooms in our new domestic violence shelter and raising awareness in community organizations via a training on Violence Against Women Act and U Visa policies for women experiencing intimate partner violence and immigrants who have been victims of crime. We also provided a grant to a nonprofit focused on prevention programing for teen mothers with infants, as well as a bicycle rodeo focused on child safety in West Yellowstone. Additionally, we invested in a housing coalition to conduct strategic planning for affordable housing in our region which can prevent exposure related deaths tied to houselessness. Big Sky Medical Center, LLC Part V, Section B, Line 13h: Any individual and their dependents who are at 200% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the patient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Big Sky Medical Center, LLC Part V, Section B, Line 16j: Medical Advocacy Services in Healthcare (MASH) will give out our financial application after determining a patient is ineligible for federal and state programs. A summary of the financial assistance policy is attached to billing invoices, posted in the patient admissions area, and provided to patients upon admission to the hospital facility. Big Sky Medical Center, LLC Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be billed gross charges on elective procedures. Schedule H, Part V, Section B, Line 16a-16c: https://www.bozemanhealth.org/patients-and-visitors/patient-financial-services/financial-assistance/ 6 1 - Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Imaging Center 2 - Rocky Mountain Surgery Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 Outpatient Surgical Center 3 - Hospice of Southwest Montana LLC 3810 Valley Commons Dr Ste 1 Bozeman MT 59715 Hospice Services 4 - Bozeman Health Urgent Care LLC 1006 W Main Bozeman MT 59715 Outpatient Health Care 5 - Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 Contracted Provider Services 6 - Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Health Care Part I, Line 3c: Any individual and their dependents who are at 200% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the patient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care, Medicaid, and Other Means-Tested Programs. All net benefit expenses were calculated using direct costs and revenue with reasonable indirect overhead allocation methods. Benefits are allocated at 23% of payroll dollars. For Subsidized Services, other indirect overhead costs are allocated based on historical reasonableness of 15% of total expenses. Our internal system does record patient revenues based on type (inpatient vs. outpatient vs. emergency) and payor (Medicaid, Medicare, Commercial, Self-Pay, etc.). Related costs are then determined based on the pro-rated share as a percentage of the total. For example, if Medicaid comprises 7% of a department's revenue, Medicaid expenses are calculated at 7% of the total as well.Lines 7e, 7f, 7i are based on actual expenses. Part I, Line 7g: Amount of cost attributable to a physician clinic is $2,305,653. The Urgent Care disregarded entity was reported as a subsidized services, pulling out the financial assistance and Medicaid to report separately as appropriate. Part II, Community Building Activities: The expenses reported are for the Healthy Living Campaign. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located in Footnote 1 on pages 16-17 of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents a cost absorbed by the Hospital as a result of providing care to Medicare patients. The contract driving this loss is a nondiscretionary contract, as is providing the services to this population of individuals. The cost of providing this benefit to the community should be reportable as such. Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.For the Joint Ventures, Net Medicare Revenue was used as the revenue received, and that percentage of total revenues was applied against operating expenses to determine related costs. The Joint Venture portion of the shortfall is $5,166,625. Part III, Line 9b: Providing the patient, either directly or through its contracted collection agency with at least one written notice informing the patient about the Extraordinary Collection Actions that we intend to take if the patient does not submit an Application for Financial Assistance or pay the amount due by at least thirty days following the date of the notice. The notice will include a copy of the plain language summary and will not be mailed or delivered to a patient earlier than 30 days prior to the end of the Notification Period.No Extraordinary Collection Actions will be undertaken during the 120 day Notification Period, during which time we will take reasonable efforts to determine whether the patient is eligible for Financial Assistance. Patients that may qualify for financial assistance, and that have accounts with the contracted collection agencies, will be vetted throughout the financial assistance process. Meanwhile, accounts will be placed on hold until the financial assistance eligibility is determined. If the patient is eligible, accounts will be appropriately adjusted and adjusted amounts will be reported to the collection agency.No Extraordinary Collection Actions are taken prior to the 240th day after the date of the first invoice. Part VI, Line 2: In addition to the CHNA, Bozeman Health Big Sky Medical Center (BSMC) assesses community health care needs in a number of ways. We look at other available health data and reports for our service area provided by the State of Montana and our local City-County Health Department. We also work closely with area non-profits and social service providers to hear about the needs of their clients / customers to help inform our outreach strategies and community health improvement efforts. Part VI, Line 3: Bozeman Health is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. As a hospital operating in the Bozeman Health system, Big Sky Medical Center (BSMC) posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BSMC will attempt to determine whether a patient has third party coverage for any part of the hospital services provided. If a patient does not have third party coverage, a patient advocate from the MASH program will screen all inpatient cases and any outpatient cases exceeding $1,000 in total charges to determine if the patient qualifies for third party funding. If not, the patient advocate will explain the Financial Assistance Policy and give the patient an application if desired. In circumstances where payment in full will cause financial hardship that will significantly harm the patient or patient's family, the applicant may be asked to visit with Consumer Credit Counseling Services to further review their financial situations. Upon request, patients may be asked to complete an application for Medicaid participation or for coverage by other governmental payment programs. Patient bills also contain billing information explaining financial options and provide contact information to the appropriate resources. Part VI, Line 4: BH Big Sky Medical Center (BSMC) primarily serves a three zip code region in Gallatin County Montana: 59716 Big Sky, 59730 Gallatin Gateway, and 59758 West Yellowstone (note in certain zip code boundary definitions, 59716 Big Sky is in both Gallatin and Madison County-although the most populous area is in Gallatin County). These 3 communities account for more than 74% of clinic visits at BSMC Big Sky Clinic in 2018. In addition, these same communities account for 24.2% of BSMC's inpatient admissions while 75.8% were of patients originating outside Montana-likely driven by the Big Sky area being a popular tourist destination.The population of the tri-zip code area was an estimated 6,523 (59716: 2,208, 59730: 2,065, and 59758: 2,250) in 2018 (IBM Watson Health). The average median household income (weighted by number of households) in the combined communities was an estimated $59,770 and 12.5% of the population was estimated to be in poverty in 2017 (ACS 5yr estimates, 2017). 2018 estimates suggest that 12.7% of the population in the tri-zip code area are covered by Medicaid, 6.6% are uninsured, and 15.5% are insured under Medicare (IBM Watson Health, 2018). Bozeman Health Big Sky Medical Center is the only hospital in the BSMC three zip code service area, and is one of two hospitals in Gallatin County (BH BSMC and BH Deaconess Hospital). The low income population within Gallatin County is designated as a Primary Care HPSA and the total geographic population of Gallatin County is designated as a Mental Health Professional Shortage (HPSA) Geographic Area HPSA based on 2019 HPSA data.(https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations) Part VI, Line 5: The governing body of Bozeman Health is comprised of individuals who represent our community and live in our service area; a majority of whom are independent of the organization. To ensure immediate access to care, we have an open medical staff and require each medical staff member to care for anyone presenting in the Emergency Department. As an organization, we devote a significant amount of funds into maintaining and advancing high-level, innovative, and responsive patient care. This includes recent investments in expanding integrated behavioral health, access to telepsychiatry, and embedding crisis response in our facility. We also use surplus funds, among other ways, to award multiyear scholarships to college students studying health professions, support medical and nursing students at our facility, and provide community health improvement grants to local organizations who are working in alignment with our community benefit priority area. Part VI, Line 6: Bozeman Deaconess Health Services owned a majority interest in Deaconess Intercity Imaging, LLC and Rocky Mountain Surgery Center in the current tax year. Although these joint ventures are not licensed hospitals, these organizations hold similar policies regarding providing care to all members of the community and offering financial assistance as determined by ability to pay. 1 Cancer Support Comununity MT 102 S 11th Ave Bozeman MT 59715 810542266 501(c)(3) 60000 0 Support cancer support services within our service area Greater Gallatin United Way 945 Technology Blvd 101F Bozeman MT 59718 810384820 501(c)(3) 25000 0 Support human service needs within our service area Montana Mindfulness Project PO Box 5106 Bozeman MT 59717 832891383 501(c)(3) 10000 0 Support mindfulness based education in schools Haven PO Box 752 Bozeman MT 59771 810389914 501(c)(3) 50000 0 Support domestic violence programs within our service area Bridgercare 1288 N 14th Ave 201 Bozeman MT 59715 810363189 501(c)(3) 10000 0 Support improving access to Health Services in our service area MT State University Anna P Sherrick Hall RM 210 Bozeman MT 59717 816010045 State of Montana 11640 0 Support improving access to Health Services in our service area Bozeman Public Library 626 E Main St Bozeman MT 59715 810405940 City of Bozeman 50000 0 Support healthy lifestyles in our service area Fort Ellis Fire Foundation 3725 Bozeman Trail RD Bozeman MT 59718 882903854 501(c)(3) 25000 0 Support the recreation and fitness scholarship program and the medical program Human Resource Development Council of District IX (HRDC) 32 S Tracy Ave Bozeman MT 59715 810350886 501(c)(3) 54500 0 Support improving access to Health Services in our service area Thrive PO Box 4325 Bozeman MT 59772 363501185 501(c)(3) 25000 0 Support human service needs within our service area Bozeman Area Community FoundationOne Valley Community Foundation 1627 W Main St Box 404 Bozeman MT 59715 810519514 501(c)(3) 27000 0 Support healthy lifestyles for youth in our service area Bridger Ski Foundation 851 Bridger Drive STE 1243 Bozeman MT 59771 810384359 501(c)(3) 10000 0 Support healthy lifestyles for youth in our service area MT State University Foundation PO Box 172750 Bozeman MT 59717 816001649 501(c)(3) 285715 0 Support improving access to Health Services in our service area 13 0 Scholarships 14 14000 Part I, Line 2: Recipients of grants and assistance prepare informational reports substantiating the use of the funds that were earmarked to support community health programs. Involvement of Bozeman Deaconess Health Services staff and/or administration as volunteers in the activities being supported also ensures proper usage of funds. Scholarships provided are paid directly to the institute on behalf of the recipient. X X X 0 1 0 0 0 0 0 0 0 John Hill CEO until October 685269 0 174858 0 17797 0 75959 0 28831 0 982714 0 0 0 Nathaniel Madsen Cardiology 679565 0 53500 0 540 0 18300 0 33538 0 785443 0 0 0 Dane Sobek Director/Cardiologist 680641 0 53000 0 828 0 18300 0 32387 0 785156 0 0 0 Courtney Wagner Internal Medicine 539110 0 185501 0 360 0 18300 0 38674 0 781945 0 0 0 Mark Hancock Internal Medicine 553335 0 179247 0 1736 0 0 0 26250 0 760568 0 0 0 Andrew Gentry Gastroenterologist 535540 0 143380 0 828 0 18300 0 34370 0 732418 0 0 0 Peter Walsh Gastroenterologist 520431 0 129017 0 2376 0 18300 0 34369 0 704493 0 0 0 Kathryn Bertany - Pres of Hosps(Jan-Oct)/Interim CEO(Nov start 524119 0 82663 0 4242 0 64820 0 26700 0 702544 0 0 0 Mark Williams Chief Physician Officer 487081 0 87892 0 8778 0 67530 0 14802 0 666083 0 0 0 Brad Ludford CFO 394386 0 64924 0 4242 0 44976 0 33772 0 542300 0 0 0 Darci Bentson CAO 362701 0 62352 0 3162 0 40380 0 34222 0 502817 0 0 0 Tamara Havenhill-Jacobs Chief Information Officer 315000 0 63788 0 3162 0 43489 0 27305 0 452744 0 0 0 Diane Patterson Chief Nursing Officer 300560 0 38293 0 4242 0 46126 0 30671 0 419892 0 0 0 Edie Willey Chief People Officer 276506 0 38187 0 2729 0 42282 0 22627 0 382331 0 0 0 Kallie Kujawa Chief Clinical Transformation Office 247773 0 10882 0 23567 0 37096 0 32862 0 352180 0 0 0 Denise Juneau Chief Government & Community Affairs 269173 0 30000 0 3716 0 23868 0 12528 0 339285 0 0 0 Part I, Line 4b Line 4b: Schedule J, Part II, column (c) reflects contributions paid by the organization into their individual 457(f) plan. The following contributions were made in 2022. John Hill: $63,845 Brad Ludford: $26,676 Darci Bentson: $22,080 Kathryn Bertany: $46,520 Mark Williams: $49,230 Diane Patterson: $27,826 Tamara Havenhill-Jacobs: $25,189 Edie Willey: $23,982 Kallie Kujawa: $18,796 Denise Juneau: $23,868 A Montana Facility Finance Authority 364615155 61240MBM8 2014-11-05 23005852 Refinance 2004 bond issued 3/4/2004; fund add'n of Big Sky Medical Facility 0 0 0 A 2482657 23008884 3032 377976 17500000 5127876 2015 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 06/21/2019 Schedule K, Part I, Line A(e): Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Form 990, Part VI, Section A, line 7a The Yellowstone Conference of the Methodist Church confirms the Board Members and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Changing the Articles of Incorporation in relationship to the process of selecting board membership must be approved by the Yellowstone Conference of the United Methodist Church. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Planning and Finance Committee will review the Form 990 with the Finance Team and will make a recommendation to the full Board for acceptance. A copy of the 990 is provided to the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c An annual Disclosure Statement is obtained from the Board, Operating Committee, and Executive Team Members. Disclosures are reviewed with the Conflict of Interest (COI) Panel (Compliance Officer, Board Compliance Committee Chair, Chief Executive Officer, & Chief Legal Officer). The COI Panel assesses the disclosure, develops an acknowledgement and management plan. The management plan is reviewed with the affected member, if the COI Panel and the member are unable to resolve the disclosure, the disclosure is reported to the Board Compliance Committee for further review. Conflicts are addressed annually in writing and verbally during meetings. If a COI exists, the member shall not participate in any deliberations or vote regarding the transaction or arrangement at issue, and shall not be present in the meeting room for any part of the deliberations or vote relating to the transaction or arrangement. Form 990, Part VI, Section B, line 15 The Board Executive Committee, which is comprised of independent board members, serves as the organization's compensation committee. The Executive Committee receives a formal presentation by an independent compensation consultant (as selected by the Committee) qualified to perform compensation reviews including usage of comparability data. This person presents recommendations to the Executive Committee. The Executive Committee then makes decisions annually regarding compensation for Officers and Senior Administration. The Executive Committee's compensation review process is outlined in an Executive Compensation Philosophy Policy that was adopted by the full Board. Form 990, Part VI, Section C, line 19 Tax documents required to be available for public inspection are available upon request. The audited financial statements are required to be attached to the Form 990 and provided to the Municipal Securities Rulemaking Board, which is our tax-exempt bonds trustee, via an on-line, central filing location called Electronic Municipal Market Access (EMMA). The financial statements can be obtained by the general public at the EMMA website. Form 990, Part IX, line 11g Other Fees: Program service expenses 1,598,389. Management and general expenses 14,791,289. Fundraising expenses 0. Total expenses 16,389,678. Form 990, Part XI, line 9: Change in Temp Restricted Investment of Foundation -950,544. Big Sky Medical Center LLC 334 Town Center Ave Big Sky MT 59716 474718253 Healthcare - Inpatient and Outpatient Servcies MT 16506380 29044698 Bozeman Deaconess Health Services Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 822848277 Healthcare-Ambulatory Clinic Outpatient Care MT 1081173 1214987 Bozeman Deaconess Health Services Bozeman Health Urgent Cares LLC 1006 W Main Bozeman MT 59715 465318746 Healthcare - Physician Outpatient Care MT 6045434 15564160 Bozeman Deaconess Health Services Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 475126599 Physician Employment & Contract to Bozeman Health System MT 64176967 3821243 Bozeman Deaconess Health Services Bozeman Deaconess Foundation dba Bozeman Health Foundation 931 Highland Blvd Suite 3200 Bozeman MT 59715 841407943 Raise funds to support Bozeman Deaconess Health Services MT 501(c)(3) Line 7 Bozeman Deaconess Health Services 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 474717998 Healthcare - Inpatient and Outpatient Services MT 501(c)(3) Line 3 Bozeman Deaconess Health Services 1 Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT Bozeman Deaconess Health Services Related -466509 4809817 0 1 0.77500 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT Bozeman Deaconess Health Services Related 3758969 3805894 0 0 0.51010 Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT Bozeman Deaconess Health Services Related -10744 261723 0 1 0.69940 Bozeman HealthUSP Surgery Centers LLC 14201 Dallas Parkway Dallas TX 75254 823991148 Ambulatory Surgery Center TX Bozeman Deaconess Health Services Related 202415 1150029 0 0 0.50100 Bozeman Deaconess Real Estate Development Corp PO Box 10490 Bozeman MT 59719 205496567 Sale of real estate property and residences to seniors MT Bozeman Deaconess Health Services C 25391 4423651 1.00000 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 Bozeman Health Deaconess Hospital L 136507225 General ledger and corp. records Deaconess Intercity Imaging LLC S 348750 General ledger and corp. records Bozeman Deaconess Foundation C 1661600 General ledger and corp. records Bozeman Deaconess Foundation L 86618 General ledger and corp. records Bozeman Deaconess Foundation Q 82982 General ledger and corp. records Rocky Mountain Surgical Center LLC S 3647514 General ledger and corp. records Bozeman HealthUSP Surgery Centers LLC S 73519 General ledger and corp. records Bozeman Deaconess Real Estate Development Corp S 3000000 General ledger and corp. records