BIG SANDY MEDICAL CENTER INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: BIG SANDY MEDICAL CENTER INC (EIN 81-0291695)
Tax period: 2020-07-01 to 2021-06-30
Filed: 2022-05-10
IRS object ID: 202211309349301346
Schema version: 2020v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-05-10T11:20:32-05:00	ReturnTs
Tax Period End	2021-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390758449	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	101 EAST FRONT STREET 301	AddressLine1Txt
City	MISSOULA	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59802	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	810291695	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BIG SANDY MEDICAL CENTER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	BIGS	BusinessNameControlTxt
Phone	4063782188	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 530	AddressLine1Txt
City	BIG SANDY	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59520	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LEAH GRIFFITH	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	4063782188	PhoneNum
Signature	2022-05-07	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	LEAH	PersonFirstNm
Person Last	GRIFFITH	PersonLastNm

Field	Value	IRS element (for citing)
SSN	XXX-XX-XXXX	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	WAYNE R HIETT CPA	PreparerPersonNm
PTIN	P00159424	PTIN
Phone	4067281800	PhoneNum
Preparation	2022-05-07	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	LEAH GRIFFITH	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 530	AddressLine1Txt
City	BIG SANDY	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59520	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$6,358,310	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	BSMC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1963	FormationYr
Legal Domicile State	MT	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS AT THE MOST REASONABLE COST IN A COMPETENT, PROFESSIONAL MANNER.	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	62	TotalEmployeeCnt
Total Volunteers	5	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$542,820	PYContributionsGrantsAmt
CY Contributions Grants	$1,854,531	CYContributionsGrantsAmt
PY Program Service Revenue	$3,457,559	PYProgramServiceRevenueAmt
CY Program Service Revenue	$4,351,469	CYProgramServiceRevenueAmt
PY Investment Income	$41,472	PYInvestmentIncomeAmt
CY Investment Income	$29,710	CYInvestmentIncomeAmt
PY Other Revenue	$35,200	PYOtherRevenueAmt
CY Other Revenue	$122,600	CYOtherRevenueAmt
PY Total Revenue	$4,077,051	PYTotalRevenueAmt
CY Total Revenue	$6,358,310	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$2,078,133	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$2,374,508	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,654,654	PYOtherExpensesAmt
CY Other Expenses	$2,458,841	CYOtherExpensesAmt
PY Total Expenses	$3,732,787	PYTotalExpensesAmt
CY Total Expenses	$4,833,349	CYTotalExpensesAmt
PY Revenues Less Expenses	$344,264	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,524,961	CYRevenuesLessExpensesAmt
Total Assets BOY	$6,275,980	TotalAssetsBOYAmt
Total Assets EOY	$6,319,048	TotalAssetsEOYAmt
Total Liabilities BOY	$1,977,429	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$495,536	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$4,298,551	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$5,823,512	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS AT THE MOST REASONABLE COST IN A COMPETENT, PROFESSIONAL MANNER.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$4,277,005	ExpenseAmt
Revenue	$4,472,969	RevenueAmt
Desc	BIG SANDY MEDICAL CENTER PROVIDES HOSPITAL AND LONG-TERM MEDICAL CARE FOR THE TOWN OF BIG SANDY AND NORTHERN CHOUTEAU COUNTY, MONTANA.	Desc
Total Program Service Expenses	$4,277,005	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	2	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	62	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	LEAH GRIFFITH	PersonNm
Phone	4063782188	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 530	AddressLine1Txt
City	BIG SANDY	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59520	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
HARVEY KELLER
CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
ROBERT NELSON
VICE CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
NICOLE ALLDERDICE
SECRETARY/TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
ANNA BOLD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ANN QUINN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
LEAH GRIFFITH
CEO	40.00		Yes (X)	$81,513	$0	$28,127
COLETTE TERRY
CFO	40.00		Yes (X)	$59,689	$0	$7,662
KRYSTYL KULBECK
PA-C	40.00			$138,740	$0	$28,772	Yes (X)
ZANE BENDIG
NP	40.00			$100,309	$0	$14,250	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$380,251	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$78,811	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KC CORPORATION	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1246	AddressLine1Txt
City	BIG SANDY	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59520	ZIPCd

Field	Value	IRS element (for citing)
Services	PHYSICAL THERAPY	ServicesDesc
Compensation	$156,760	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Government Grants	$1,832,678	GovernmentGrantsAmt
All Other Contributions	$21,853	AllOtherContributionsAmt
Total Contributions	$1,854,531	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENU	621110	$3,945,227	$3,945,227
OTHER OPERATING REVENU	621110	$247,878	$247,878
340B REVENUE	621110	$142,263	$142,263
DIETARY REVENUE	621110	$16,101	$16,101

Field	Value	IRS element (for citing)
Total Program Service Revenue	$4,351,469	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$29,710	TotalRevenueColumnAmt
Exclusion	$29,710	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,100	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,100	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,100	TotalRevenueColumnAmt
Exclusion	$1,100	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	HOSPITAL TAX DISTRICT	Desc
Business	621110	BusinessCd
Total Revenue Column	$121,500	TotalRevenueColumnAmt
Related Or Exempt Func Income	$121,500	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$121,500	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,358,310	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,472,969	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$30,810	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$176,991	TotalAmt
Program Services	$148,710	ProgramServicesAmt
Management And General	$28,281	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,843,385	TotalAmt
Program Services	$1,548,846	ProgramServicesAmt
Management And General	$294,539	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$9,553	TotalAmt
Program Services	$8,026	ProgramServicesAmt
Management And General	$1,527	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$196,992	TotalAmt
Program Services	$165,513	ProgramServicesAmt
Management And General	$31,479	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$147,587	TotalAmt
Program Services	$124,003	ProgramServicesAmt
Management And General	$23,584	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$8,369	TotalAmt
Management And General	$8,369	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$27,190	TotalAmt
Program Services	$5,900	ProgramServicesAmt
Management And General	$21,290	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$817,293	TotalAmt
Program Services	$803,107	ProgramServicesAmt
Management And General	$14,186	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$11,376	TotalAmt
Program Services	$11,176	ProgramServicesAmt
Management And General	$200	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$36,828	TotalAmt
Program Services	$14,554	ProgramServicesAmt
Management And General	$22,274	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$58,267	TotalAmt
Program Services	$43,461	ProgramServicesAmt
Management And General	$14,806	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$26,132	TotalAmt
Program Services	$24,143	ProgramServicesAmt
Management And General	$1,989	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,316	TotalAmt
Program Services	$1,316	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$140,535	TotalAmt
Program Services	$103,996	ProgramServicesAmt
Management And General	$36,539	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$59,272	TotalAmt
Program Services	$43,861	ProgramServicesAmt
Management And General	$15,411	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUPPLIES	$809,425	$793,737	$15,688
MISCELLANEOUS	$317,039	$304,990	$12,049
REPAIRS	$37,881	$37,881
DUES & SUBSCRIPTIONS	$35,524	$35,049	$475

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$72,394	TotalAmt
Program Services	$58,736	ProgramServicesAmt
Management And General	$13,658	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,833,349	TotalAmt
Program Services	$4,277,005	ProgramServicesAmt
Management And General	$556,344	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$630,219	BOYAmt
EOY	$313,213	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,875,552	BOYAmt
EOY	$1,525,662	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,385,513	BOYAmt
EOY	$863,536	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$28,396	BOYAmt
EOY	$62,313	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$5,242,440	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$3,342,167	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$746,455	BOYAmt
EOY	$1,900,273	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,415,571	BOYAmt
EOY	$1,435,244	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$194,274	BOYAmt
EOY	$218,807	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,275,980	BOYAmt
EOY	$6,319,048	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$158,971	BOYAmt
EOY	$233,544	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,768,629	BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$49,829	BOYAmt
EOY	$41,057	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$220,935	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,977,429	BOYAmt
EOY	$495,536	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,298,551	BOYAmt
EOY	$5,823,512	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,298,551	BOYAmt
EOY	$5,823,512	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$6,275,980	BOYAmt
EOY	$6,319,048	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$1,524,961	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$57,159	OtherCostOrOtherBasisAmt
Book Value	$57,159	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,993,701	OtherCostOrOtherBasisAmt
Depreciation	$2,528,168	DepreciationAmt
Book Value	$465,533	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,191,580	OtherCostOrOtherBasisAmt
Depreciation	$813,999	DepreciationAmt
Book Value	$1,377,581	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,900,273	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS	Desc
Amt	$220,935	Amt

Field	Value	IRS element (for citing)
Total Liability	$220,935	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$6,335,395	TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$6,335,395	RevenueSubtotalAmt
Other Revenues Not Included	$22,915	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$22,915	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$6,358,310	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$4,810,434	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$4,810,434	ExpensesSubtotalAmt
Other Expenses Not Included	$22,915	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$22,915	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$4,833,349	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART X, LINE 2:	THE MEDICAL CENTER, AS A NOT-FOR-PROFIT ORGANIZATION OPERATING UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THESE FINANCIAL STATEMENTS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 3,891. 340B EXPENSES 19,024.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 3,891. 340B EXPENSES 19,024.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	0	FinancialAssistanceBudgetInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,459	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,459	NetCommunityBenefitExpnsAmt
Total Expense	0.00440	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$215,540	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$128,592	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$86,948	NetCommunityBenefitExpnsAmt
Total Expense	0.01800	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,813	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,202	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,611	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$245,812	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$133,794	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$112,018	NetCommunityBenefitExpnsAmt
Total Expense	0.02310	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$245,812	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$133,794	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$112,018	NetCommunityBenefitExpnsAmt
Total Expense	0.02310	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,891	BadDebtExpenseAmt
Reimbursed By Medicare	$2,478,523	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$2,464,136	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$14,387	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BIG SANDY MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 530	AddressLine1Txt
City	BIG SANDY	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59520	ZIPCd

Field	Value	IRS element (for citing)
Website Address	BSMC.ORG	WebsiteAddressTxt
State License	12767	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	RURAL HEALTH CLINIC	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	BIG SANDY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	20	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.BSMC.ORG/COMMUNITYHEALTHNEEDS.HTML	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	20	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	HTTP://WWW.BSMC.ORG/COMMUNITYHEALTHNEEDS.HTML	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.BSMC.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.BSMC.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.BSMC.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
BIG SANDY MEDICAL CENTER	PART V, SECTION B, LINE 5: COMMUNITY LEADERS AND STAKEHOLDERS WERE INVITED TO A FOCUS GROUP SESSION HELD APRIL 27, 2021. THIS DIVERSE GROUP OF INDIVIDUALS ARE FROM VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY IN BSMC'S SERVICE AREA. THE OBJECTIVES OF THE FOCUS GROUP WERE TO IDENTIFY ONE TO THREE HEALTH NEEDS TO ADDRESS IN THE IMPLEMENTATION PLAN AND TO DECIDE WHAT INFORMATION IS NEEDED FROM THE 2021 CHNA SURVEY AS PART OF THE IMPLEMENTATION PLAN.
BIG SANDY MEDICAL CENTER	PART V, SECTION B, LINE 11: OBJECTIVE 1: MARKET ANALYSIS CONDUCTED BY STROUDWATER.- THE RESULTS OF THE MARKET ANALYSIS WILL BE DISTRIBUTED TO ALL FOCUS GROUP ATTENDEES ALONG WITH THE COMPILED DATA FROM THE CHNA SURVEY.OBJECTIVE 2: DISPENSE THE UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY TOOL TO RESIDENTS IN THE BSMC PRIMARY AND SECONDARY SERVICE AREAS:- THE SURVEY TOOL WILL BE MAILED TO POST OFFICE BOXES AND PHYSICAL ADDRESSES OF ALL HOUSEHOLDS IN THE SERVICE AREA.- AN ONLINE PLATFORM WILL BE DEVELOPED AND ADVERTISED FOR RESPONDENTS TO USE.- THE SURVEY TOOL WILL BE POSTED ON BSMC'S WEBSITE, PROVIDING A THIRD OPTION.THE FOCUS GROUP WILL MEET AGAIN TO REVIEW AND DISCUSS THE INFORMATION OBTAINED. THIS SESSION WILL ALLOW ALL STAKEHOLDERS TO PROVIDE INPUT INTO FURTHER PHASES OF THE IMPLEMENTATION PLAN TO INCLUDE SPECIFIC STRATEGIES AND ACTIVITIES TO ADDRESS THE TWO DEFINED OBJECTIVES. THESE WILL BE ONGOING IN THE NEXT THREE YEARS WITH COMMUNICATION, COORDINATION, AND COLLABORATION BETWEEN STAKEHOLDERS. FREQUENT EVALUATIONS OF EFFECTIVENESS AND SUSTAINABILITY WILL ALSO BE PART OF THESE STRATEGIES TO ENSURE THE BIG SANDY COMMUNITY'S HEALTH NEEDS ARE BEING ADDRESSED SUFFICIENTLY AND APPROPRIATELY.
PART V, SECTION B, LINE 20B	IN GENERAL, NO ORAL ATTEMPTS TO NOTIFY INDIVIDUALS WERE MADE BEFORE SENDING ACCOUNTS TO A THIRD-PARTY DURING THE FISCAL YEAR DUE TO STAFFING LIMITATIONS. HOWEVER, IF PATIENTS CALLED TO INQUIRE ABOUT THEIR ACCOUNT, THE OPTIONS WERE DISCUSSED VERBALLY. OTHERWISE ONLY WRITTEN ATTEMPTS TO NOTIFY INDIVIDUALS WERE MADE. THE ORGANIZATION HAS SINCE HIRED ADDITIONAL PERSONNEL SO THAT MORE ORAL ATTEMPTS TO NOTIFY INDIVIDUALS CAN BE MADE GOING FORWARD.
PART V, SECTION B, LINE 20C	WE DO NOT PROCESS INCOMPLETE APPLICATIONS. APPLICANT IS NOTIFIED IN WRITING OF WHAT DOCUMENTATION IS REQUIRED IF THE APPLICATION IS CONSIDERED INCOMPLETE.
PART V, SECTION B, LINE 20D	NO PRESUMPTIVE ELIGIBILITY DETERMINATIONS WERE MADE.

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7:	THE ORGANIZATION USES THE COST-TO-CHARGE RATIO TO CALCULATE AMOUNTS ON PART I, LINE 7.
PART III, LINE 2:	BAD DEBTS ARE DETERMINED WHEN AN ACCOUNT IS SENT TO COLLECTIONS BASED ON THE POLICIES OF THE ORGANIZATION.
PART III, LINE 4:	THE FOOTNOTE THAT DESCRIBES THE BAD DEBT EXPENSE BEGINS ON PAGE 8 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:	NONE OF THE SHORTFALL REPORTED IS TREATED AS COMMUNITY BENEFIT. BSMC USES THE AMOUNTS FROM MEDICARE PROVIDER STATISTICAL REIMBURSEMENT (PS&R) TO DETERMINE THE MEDICARE ALLOWABLE COSTS.
PART III, LINE 9B:	WHEN A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE DISCOUNT AMOUNT IS APPLIED TO THE GROSS CHARGES BILLABLE TO THE PATIENT. THE PATIENT IS THEN NOTIFIED IN WRITING THE REMAINING BALANCE. IN THE EVENT THAT A PATIENT THAT QUALIFIES FOR FINANCIAL ASSISTANCE BUT FAILS TO TIMELY PAY THE REMAINING BALANCE DUE, THE FACILITY MAY TAKEN ANY ACTIONS DEFINED IN THE BILLING AND COLLECTIONS POLICY.
PART VI, LINE 2:	BSMC SENDS OUT SATISFACTION SURVEYS AND ASKS FOR INPUT ON ANY CHANGES PATIENTS WOULD LIKE TO SEE. ALSO, ONCE A YEAR, AN ANNUAL PUBLIC MEETING IS HELD AND INPUT IS SOLICITED AS WELL AS A REPORT ON HOSPITAL ACTIVITIES GIVEN. THIS PUBLIC MEETING IS WELL ADVERTISED IN THE LOCAL PRESS.
PART VI, LINE 3:	A NOTICE OF PATIENT ELIGIBILITY IS POSTED IN ALL WAITING AREA AND ON THE WEBSITE - BSMC.ORG. NOTICE OF FINANCIAL ASSISTANCE IS ALSO SENT OUT WITH ALL PRE-COLLECTION CORRESPONDENCE.
PART VI, LINE 4:	THE COMMUNITY IS MOSTLY AGRICULTURAL WITH LARGE WHEAT FARMS AND LARGE CATTLE RANCHES. THOSE WHO DO NOT WORK AT THESE AGRICULTURAL BUSINESS SITES USUALLY WORK IN A BUSINESS THAT SUPPORTS THE WHEAT AND CATTLE OPERATIONS. UNEMPLOYMENT IS THE COUNTY AND AREA IS VERY LOW, USUALLY IN THE 2-3% RANGE. MOST PATIENTS HAVE AVERAGE TO NORMAL PAYING JOBS WITH AVERAGE BENEFITS.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	KRYSTYL KULBECK	PersonNm
Title	PA-C	TitleTxt
Base Compensation Filing Org	$138,740	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$3,012	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$25,760	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$167,512	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3	IN FEBRUARY 2021, THE CENTER ENTERED INTO A MANAGEMENT AGREEMENT WITH CYPRESS HEALTHCARE, LLC, THROUGH FEBRUARY 2024. FEES PAID TO CYPRESS HEALTHCARE, LLC FOR THE FISCAL YEAR ENDED JUNE 30, 2021 WERE $49,004, WHICH INCLUDED ADMINISTRATOR COMPENSATION, MANAGEMENT FEES, AND MISCELLANEOUS EXPENSES SUCH AS TRAVEL.
FORM 990, PART VI, SECTION A, LINE 6	ANY RESIDENT AND/OR TAXPAYER OF CHOUTEAU COUNTY HOSPITAL DISTRICT II IS ELIGIBLE TO BECOME A MEMBER. MEMBERS ELECT THE GOVERNING BODY AT AN ANNUAL MEETING.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBERS ELECT THE GOVERNING BODY AT AN ANNUAL MEETING.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS EMAILED TO AND REVIEWED BY MANAGEMENT AND THE BOARD OF DIRECTORS BEFORE BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12C	MEMBERS OF THE BOARD ARE MADE AWARE OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION AND DISCUSS SUCH ONCE A YEAR AT A REGULAR BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD OF DIRECTORS WILL REFER TO THE MONTANA HOSPITAL ASSOCIATION ANNUAL SALARY SURVEY.
FORM 990, PART VI, SECTION C, LINE 18	COPIES ARE AVAILABLE BY REQUEST AND VIA IRS.GOV
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST
FORM 990, PART IX, LINE 11G	CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 802,273. MANAGEMENT AND GENERAL EXPENSES 14,186. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 816,459. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 834. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 834.
FORM 990, PART XII, LINE 2C:	THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.