2022-05-02T15:30:34-05:00 2021-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-07-01 264230898 Barrett Hospital Development Corporation BARR 4066833000 600 Highway 91 South Dillon MT 59725 Tina Giem CFO 4066833000 2022-05-02 1 Tina Giem 999009999 Kim Hunwardsen CPA P00484560 6122536500 2022-05-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Barrett Hospital & Healthcare Tina Giem 600 Highway 91 South Dillon MT 59725 44370245 0 X www.barretthospital.org X 2009 MT Barrett Hospital & HealthCare provides compassionate care, healing, and health-improving service to all community members throughout life's journey. 5 4 315 21 0 0 668323 5463219 35653358 38452998 190333 344681 65042 67310 36577056 44328208 0 0 0 0 19846233 19666209 0 0 0 16518267 17145239 36364500 36811448 212556 7516760 69015190 67300968 41610867 31171323 27404323 36129645 X Barrett Hospital & HealthCare provides compassionate care, healing, and health-improving service to all community members throughout life's journey. 0 0 33525428 38452998 Barrett Hospital & HealthCare is an 18 licensed bed acute care critical access hospital. Our patients are served by an inpatient hospital, 24-hour emergency department, and a provider based clinic. Our ancillary services include diagnostic imaging, laboratory, inpatient and outpatient surgery, physical and occupational therapy, non-surgical pain management, vein care, integrated behavioral health, transitional care, chronic care management, home health, hospice, cardiac rehab, pharmacy, cardiopulmonary, respiratory and diabetic education.The hospital provided 1,602 days of acute care services, 354 observation days and 589 swing bed days. In addition, the hospital provided 28,211 clinic visits, 33,065 outpatient visits, 4,224 emergency room visits, 4,134 home health visits and 1,476 hospice visits. 33525428 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 67 0 1 315 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 1 0 0 1 0 0 1 0 0 0 1 1 1 1 1 1 0 1 0 X Tina Giem 4066833006 600 Highway 91 South Dillon MT 59725 Patti Mitchell Chair 0.50 0.00 X X 6324 0 0 Nate Finch Vice Chair 0.50 0.00 X X 0 0 0 Joe Morstein Director (Jul-Jan) 0.50 0.00 X 0 0 0 Susan Briggs Director (Feb-Jun) 0.50 0.00 X 0 0 0 Shane Puyear Director 0.50 2.00 X 0 0 0 Lawrence Morrisroe Director 0.50 0.00 X 0 0 0 Ken Westman CEO 40.00 2.00 X 0 0 0 Richard Achter CFO (Jul-Sept) 40.00 0.50 X 145075 0 11100 Tina Giem CFO (Oct-Jun) 40.00 0.50 X 96981 0 19391 Carol Kennedy CCO 40.00 0.00 X 141715 0 20332 Gregory Moore ED Physician 31.20 0.00 X 403597 0 41816 Nicholas Fromm Physician 40.00 0.00 X 386486 0 22482 Michael Clarke ED Physician 31.20 0.00 X 306354 0 34904 Meghan Combs Clinic Physician 40.00 0.00 X 285917 0 23686 Kelly Smith Clinic Physician 40.00 2.00 X 269002 0 37365 2041451 0 211076 28 0 1 0 HealthTech Management Services Inc 5110 Maryland Way Ste 200 Brentwood TN 37027 Management Service Fees 494482 David Fortenberry 605 7th Ave East Kalispell MT 59901 Physician 300303 Daniel Richards 13929 Buck Hollow Cove Bluffdale UT 84065 Physician 207300 Kalispell Regional Medical Center 310 Sunnyview Lane Kalispell MT 10030 Nuclear Medicine Services 157823 Gallatin Gynecology PC 767 Triple Tree Road Bozeman MT 59715 Physician 156831 7 434177 4934403 94639 5463219 Net Patient Service Revenue 621110 37468519 37468519 Mortgage Subsidy 900099 409015 409015 Property Taxes 900099 70971 70971 504493 504493 38452998 325871 325871 105632 38322 67310 67310 67310 22525 0 3715 22525 -3715 18810 18810 44328208 38452998 0 411991 X 373772 6479 367293 15497906 14965446 532460 653236 616581 36655 2085563 1971138 114425 1055732 998301 57431 548415 548415 22557 22557 78926 78926 2111 2111 4063545 3180851 882694 87909 86394 1515 633024 522674 110350 79996 57241 22755 776175 776125 50 28056 22772 5284 115176 108996 6180 1285915 1282148 3767 1887439 1887439 809331 725630 83701 Medical Supplies 4438569 4438424 145 Repairs and Maintenance 738996 722260 16736 Provision for Bad Debts 461360 461360 MT Medicaid 424358 301018 123340 663381 394151 269230 36811448 33525428 3286020 0 925 925 17835920 14876818 4685509 5405734 779749 960715 362173 408988 52962339 22574803 31794451 30387536 13467160 15170694 22762 19924 66541 69634 69015190 67300968 3452986 3145599 9415671 2170226 25536749 24562143 2772700 432761 1293355 41610867 31171323 X 27404323 36129645 27404323 36129645 69015190 67300968 7516760 1208562 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2111 0 0 0 2111 0 Part II-B, Line 1: The Organization is a member of several organizations that take part in lobbying. A portion of the dues paid to the various organizations is for lobbying costs. These various organizations advocate on behalf of their members by supporting legislation that is in their collective interests. 1844813 1844813 35800943 10182462 25618481 14203621 11645573 2558048 1112962 746768 366194 30387536 Estimated Third Party Payor Settlements 1293355 1293355 43386718 1208562 -1747275 -538713 43925431 402777 402777 44328208 35064173 0 35064173 1747275 1747275 36811448 Part XI, Line 2d - Other Adjustments: Interest expense reported in revenue on financial statements -1,285,915. Provision for bad debt reported in revenue on financial statements -461,360. Part XI, Line 4b - Other Adjustments: Contributions reported in fund balance on financial statements 402,777. Part XII, Line 4b - Other Adjustments: Interest expense reported in revenue on financial statements 1,285,915. Provision for bad debt reported in revenue on financial statements 461,360. 1 1 X 1 X 0 1 1 1 0 1 1 554000 554000 0.01520 554000 554000 0.01520 328191 20792 307399 0.00850 9671537 7354566 2316971 0.06370 9999728 7375358 2624370 0.07220 10553728 7375358 3178370 0.08740 41896 41896 0.00120 35218 35218 0.00100 46455 25500 20955 0.00060 123569 25500 98069 0.00280 1 461360 0 9453073 9186086 266987 X 1 1 1 1 Barrett Hospital Development Corp 600 MT Hwy 91 S Dillon MT 59725 www.barretthospital.org 13549 X X X X Barrett Hospital Development Corporation 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X www.barretthospital.org X 1 19 1 www.barretthospital.org 0 1 X 200.000000000000 X X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Barrett Hospital Development Corporation Part V, Section B, Line 5: Barrett Hospital & HealthCare and the Beaverhead County Health Department participated in the Community Health Services Development (CHSD) program, administered by the Montana Office of Rural Health, which was utilized to create the CHNA. A steering committee was convened to assist Barrett Hospital & HealthCare and Beaverhead County Health Department in conducting a CHSD. A diverse group of community members representing various organizations and populations within the community (ex. Public health, elderly, uninsured) came together in January 2020. The Steering Committee met twice during the CHSD process; first to discuss health concerns in the community and offer their perspective in designing the survey instrument, and again to review results of the survey and key informant interviews and to assist in prioritization of health needs. In February 2020, surveys were mailed out to residents in Beaverhead and Madison Counties, Barrett Hospital & HealthCare's service area. Survey respondents had the ability to complete the survey mailed to them, or via an online survey hosted at Montana State University's Human Ecology Learning and Problem Solving (HELPS) web portal. The survey was based on a design that has been used extensively in the states of Washington, Wyoming, Alaska, Montana and Idaho. The survey was designed to provide each facility with information from local residents regarding:-Demographics of respondents-Hospitals, primary care providers and specialists used, plus reasons for selection-Local healthcare provider usage-Services preferred locally-Perception and satisfaction of local healthcare-Overall health of the communityBarrett Hospital & HealthCare provided a list of outpatient and inpatient admissions. Those zip codes with the greatest number of admissions were selected to be included in the survey. A random list of 800 residents was then selected with the assistance of the MSU HELPS Lab.Additionally, 15 key informant interviews were conducted in March and April of 2020. Participants were identified as people living in Barrett Hospital & HealthCare's and the Beaverhead County Health Department's service area. Barrett Hospital Development Corporation Part V, Section B, Line 6b: Beaverhead County Public Health Barrett Hospital Development Corporation Part V, Section B, Line 11: The most recently completed CHNA identified the following prioritized health needs within the community which the organization will address:1. Additional mental health resources2. Paid staffing for EMS3. Economic growth4. Support services for low-income individuals and families5. Affordability6. General/basic retailThe following prioritized health needs identified within the community will not be addressed:1. Lower cost of health insurance and payment assistance programs2. Dermatology and ENT ServicesThe prioritized health needs as determined through the assessment process and which the facility will be addressing can be grouped into the following healthcare issues:1. Mental and Behavioral Health2. Access to Healthcare ServicesDuring the course of the year, Barrett Hospital & HealthCare has worked to implement many of the needs addressed in the most recent CHNA. The investigation of EMR-integrated monitoring as an addition to telehealth provider visits has been completed. Marketing of telehealth services and community education on the availability of options as well as how to access such options continues.A new pain management program has been implemented at Barrett Hospital & HealthCare, and marketing of the program continues, as well as efforts to educate the community on the availability and access to the program.The hospital continues active participation in ACO MSSP to promote wellness care and better manage chronic illnesses.Barrett Hospital & Healthcare has completed work with community partners to identify and catalogue social services in Beaverhead County, and continues work in collaboration with Beaverhead County Public Health and other social service organization to better address area socioeconomic needs. In an effort to reduce barriers when accessing care, work with partners to streamline the referral process to area social services is ongoing, as well as the dissemination of community and service provider education on new and updated resources and referral processes.Work to improve access to mental and behavioral health services has resulted in re-engagement with local school health counselors to discuss current screening and resources as well as research into additional areas of collaboration and support. We have partnered with Public Health to conduct an environmental scan and update of available mental health providers and services. Barrett Hospital & HealthCare continues to offer integrated behavioral health care into primary care functions, and we continue to improve crisis response in the ED.The prioritized health needs which are not being addressed and why are as follows:1. Lower cost of health insurance and payment assistance programs:Lowering the cost of health insurance is an issue that is beyond the control of both the hospital and the public health department. According to iVantage Health Analytics, Barrett Hospital and HealthCare is one of the lowest cost CAHs in the nation and our internal pricing methodology places us at the median or lower for our Montana competition. Barrett Hospital and HealthCare has implemented and advertised a payment assistance program to the best of our ability and this is outside of the purview of public health.2. Dermatology and ENT Services:Barrett Hospital and HealthCare previously engaged with an ENT, but ultimately the partnership was not successful. Dermatologists are in short supply and have not had interest in doing outreach. Part V, Line 16a-16c: Part V, Line 16a, FAP Website:https://www.barretthospital.org/patient-financial-informationPart V, Line 16b, FAP Application Website:https://www.barretthospital.org/patient-financial-informationPart V, Line 16c, FAP Plain Language Summary Website:https://www.barretthospital.org/patient-financial-information Part I, Line 3c: The Organization does not provide discounted care. If a patient qualifies for financial assistance, their full bill is written off. Part I, Line 6a: The organization mailed the community benefit report to their Beaverhead County residents as well as portions of Madison and Jefferson county. The community benefit report is also available on the facility website and in public waiting areas throughout the facility. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Health Professions Education on line 7f was determined using actual costs. Subsidized health services on line 7g was determined using the costing methods to prepare the cost reports. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator is $461,360. Part II, Community Building Activities: Barrett Hospital & Healthcare is an active community emergency preparedness advocate and partners with the county Public Health Director and community organizations (e.g. YMCA) on community wellness initiatives. Barrett Hospital & HealthCare maintains over a mile of walking trails on the campus grounds for community member use. Barrett Hospital & HealthCare partners with local volunteer EMS services and law enforcement to provide education and training. Part III, Line 2: Bad debt expense is reported at charges as recorded by the organization. All discounts and payments on a patient's account are accounted for prior to determining bad debt expense. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 17 and 18 of the attached audited financial statements. Part III, Line 8: The facility is designated as a Critical Access Hospital and is reimbursed by Medicare at 101% of Medicare's costs.Medicare allowable costs were obtained from the 2020 Medicare cost report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. Part III, Line 9b: Once a patient applies for financial assistance, their accounts are held at Barrett Hospital & HealthCare or at our extended business office until a determination has been made on their eligibility for financial assistance. Accounts are not sent to collections during the period the patient is eligible for assistance. If an application does not contain all necessary documentation, the patient is notified of all missing elements and an extended deadline is set for the patient to provide additional documentation. All applicants for financial assistance are notified in writing upon approval or denial of financial assistance. Part VI, Line 2: Barrett Hospital & HealthCare uses various tools throughout the year to assess additional community health needs including utilization of a Patient/Family Advisory Council, reviewing patient surveys regarding services provided at Barrett Hospital, and participating in community-wide health initiatives. Part VI, Line 3: Barrett Hospital & HealthCare is committed to implementing and applying their billing and collection policy in a consistent manner while making every effort to assist patients with limited means to receive the support necessary for their financial obligations whether the patient is insured or uninsured.Financial Assistance Policy (FAP) information can be found on our website. The FAP is distributed in multiple patient areas of our clinic (exam rooms/front desk) and hospital (public areas/registration desks). Our Financial Assistance Policy is advertised monthly in a local publication and copies have been mailed out to area businesses and churches in our service area to be posted in their buildings. There is written notification regarding our FAP on every bill that is sent to the patient/guarantor. When calling patients to educate them on their benefits, we advise patients that if they have concerns about the estimated patient costs that they can discuss them with our financial counselors. All patients calling in to discuss their bills or setup payment plans are routed through the financial counselors for process consistency and to provide the best resources available to the patient. A financial assistance notification also prints on after visit summaries and discharge instructions that are provided to patients after all visits. Part VI, Line 4: Barrett Hospital & HealthCare serves the majority of Beaverhead County and Western Madison County residents. The primary service area includes 9 zip codes through Beaverhead County and 5 zip codes in Madison County. The size and rural makeup of Barrett Hospital's service area play a significant role in the services Barrett Hospital & HealthCare provides. Beaverhead County is the largest county in the State of Montana and consists of a population of approximately 9,246 with a population density of 1.7 people per square mile. The nearest major hospital is 64.4 miles from Barrett Hospital.The population aged 65+ in Beaverhead County is 20.6% which is higher than the demographics for the State of Montana (17.2%) and national demographics (14.9%) for this population group. The upsurge in population aged 65+ continues to increase the need for senior services including healthcare.Socioeconomic factors also play a role in the health of the population that Barrett Hospital & HealthCare services. Beaverhead County has a higher percentage of the population that falls below the federal poverty levels and higher uninsured rates than National and State of Montana measures. 16.1% of the population of Beaverhead County is considered low income and falls below the federal poverty levels compared to 14.4% for the State of Montana. The median income for Beaverhead County is $43,880, which is lower than the Montana median income of $50,801. Beaverhead County also has an uninsured rate of 18%, as compared to the State of Montana rate of 17% and the national measure at 15.7%. Part VI, Line 5: Barrett Hospital & HealthCare is dedicated to providing high value healthcare and services for our community. All surplus revenues are reinvested into the facility, equipment, or programs at Barrett Hospital & HealthCare. The funds are utilized for quality initiatives to improve patient care, expand our facility, expand available services, and advance training programs. As a not-for-profit health system, Barrett Hospital & HealthCare reinvests profits into the community by helping manage chronic conditions including diabetes, promoting wellness, and providing programs to serve the poor and uninsured. In addition, Barrett Hospital is invested in the education and training of physician residents, medical students and other medical professional students at our site including 23 physician resident/students and PA/NP students and 13 occupational therapy, nursing, EMT, laboratory scientists and diagnostic imaging students. Barrett Hospital also had 10 students job shadow.Barrett Hospital & HealthCare offers low cost wellness programs (e.g. weight loss, lab screenings, student-athlete sports physicals) to the community, is an active community emergency preparedness partner, provides trauma prevention education, and partners with the county Public Health Director and community organizations (e.g. YMCA) on community wellness initiatives. Barrett Hospital & HealthCare sponsors the local Cancer Support Community gatherings and maintains over a mile of walking trails on the campus grounds for community member use. Barrett Hospital & HealthCare subsidizes the Home Health and Hospice programs for the community and partners with local volunteer EMS services and law enforcement to provide education and training.Barrett Hospital & HealthCare participates in government sponsored health programs including Medicare, Medicaid, CHIP, Veteran's Affairs, and Tricare. Barrett Hospital & HealthCare relies on community involvement to help keep in touch with the current needs of the community. Barrett Hospital & HealthCare has a 5 member board of trustees. The members of the board are publicly elected residents of Beaverhead County. In addition, Barrett Hospital has a large volunteer program. Approximately 21 volunteers contribute their time and efforts to the hospital. The hospital also relies on community members for various advisory councils including the Patient Advisory Council. Barrett Hospital & HealthCare is the only hospital in Beaverhead County. Medical staff privileges in the hospital are open to all qualified physicians and providers. Barrett Hospital operates an emergency room that is accessible to anyone needing care regardless of their ability to pay. The emergency room has approximately 4,000 visits annually.Additionally, Barrett Hospital and HealthCare operates a walk-in clinic 5 days per week. 0 0 0 0 0 0 0 0 0 Gregory Moore ED Physician 372541 0 5056 0 26000 0 19950 0 21926 0 445473 0 0 0 Nicholas Fromm Physician 384284 0 0 0 2202 0 9838 0 12703 0 409027 0 0 0 Michael Clarke ED Physician 294780 0 2110 0 9464 0 14250 0 20714 0 341318 0 0 0 Meghan Combs Clinic Physician 246417 0 20000 0 19500 0 11400 0 12346 0 309663 0 0 0 Kelly Smith Clinic Physician 249502 0 0 0 19500 0 13961 0 23463 0 306426 0 0 0 Carol Kennedy CCO 134420 0 0 0 7295 0 7295 0 13097 0 162107 0 0 0 Richard Achter CFO (Jul-Sept) 136659 0 0 0 8416 0 10217 0 928 0 156220 0 0 0 Part I, Line 3 Ken Westman, the CEO, receives compensation from an unrelated management company, HealthTech Management Services. The organization relies on HealthTech Management Services to have a process in place for determining compensation for our CEO. Form 990, Part VI, Section A, line 3 HealthTech Management Services provides general management services including the employment of our CEO, Ken Westman. Ken Westman received $285,000 in compensation and benefits from HealthTech Management Services during the 2020 calendar year. Form 990, Part VI, Section A, line 6 The sole member of the organization is the Public Hospital District, Beaverhead County (d/b/a Barrett Hospital and Healthcare) a Montana statutory public hospital district. Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b An electronic copy of the 990 is presented to the Board during their regular board meeting for review and approval. Form 990, Part VI, Section B, line 12c Annually all employees, the CEO, and board members are required to complete a conflict of interest statement. All possible conflicts of interest are reviewed by the Compliance Committee. The Committee determines what, if any, action is necessary for the individual with the potential conflict to take to avoid said conflict. For board members, this would include recusing themselves during discussions/voting on related matters. Form 990, Part VI, Section B, line 15b Ken Westman receives compensation from an unrelated management company, HealthTech Management Services. The organization relies on HealthTech Management Services to have a process in place for determining compensation for our CEO. The Board of Directors approves the management agreement. Barrett Hospital & HealthCare participates in an annual salary survey with the Montana Hospital Association, which reviews all employee salary ranges, including the CFO, with like healthcare organizations throughout the State of Montana. The salary of the CCO is compared to national salary surveys, and all compensation grades are adjusted, as necessary, and reviewed with Leadership Council for approval. Physician/provider compensation is reviewed for fair market value with legal counsel upon execution or renewal of an employment agreement or contract. The Board of Directors reviews and approves all physician/provider agreements/contracts. The Board of Directors approves all other wages/salaries, including that of the CFO and CCO during the annual budget process. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available upon request. Form 990, Part IX, line 11g Purchased Services: Program service expenses 1,489,245. Management and general expenses 882,694. Fundraising expenses 0. Total expenses 2,371,939. Professional Fees: Program service expenses 737,087. Management and general expenses 0. Fundraising expenses 0. Total expenses 737,087. Physician Fees: Program service expenses 954,519. Management and general expenses 0. Fundraising expenses 0. Total expenses 954,519. Public Hospital District for Beaverhead County 600 Highway 91 South Dillon MT 59725 810357909 Healthcare MT N/A 0 Barrett Hospital Foundation Inc 600 Highway 91 South Dillon MT 59725 363597000 Fundraising for Hospital MT 501(c)(3) Line 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1