2022-05-10T11:20:32-05:00 2021-06-30 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2020-07-01 810291695 BIG SANDY MEDICAL CENTER INC BIGS 4063782188 PO BOX 530 BIG SANDY MT 59520 LEAH GRIFFITH CEO 4063782188 2022-05-07 1 LEAH GRIFFITH XXX-XX-XXXX WAYNE R HIETT CPA P00159424 4067281800 2022-05-07 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LEAH GRIFFITH PO BOX 530 BIG SANDY MT 59520 6358310 0 X BSMC.ORG X 1963 MT TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS AT THE MOST REASONABLE COST IN A COMPETENT, PROFESSIONAL MANNER. 5 5 62 5 0 0 542820 1854531 3457559 4351469 41472 29710 35200 122600 4077051 6358310 0 0 0 0 2078133 2374508 0 0 0 1654654 2458841 3732787 4833349 344264 1524961 6275980 6319048 1977429 495536 4298551 5823512 TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS AT THE MOST REASONABLE COST IN A COMPETENT, PROFESSIONAL MANNER. 0 0 4277005 4472969 BIG SANDY MEDICAL CENTER PROVIDES HOSPITAL AND LONG-TERM MEDICAL CARE FOR THE TOWN OF BIG SANDY AND NORTHERN CHOUTEAU COUNTY, MONTANA. 4277005 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 0 0 0 0 1 2 0 62 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X LEAH GRIFFITH 4063782188 PO BOX 530 BIG SANDY MT 59520 HARVEY KELLER CHAIR 1.00 X X 0 0 0 ROBERT NELSON VICE CHAIR 1.00 X X 0 0 0 NICOLE ALLDERDICE SECRETARY/TREASURER 1.00 X X 0 0 0 ANNA BOLD DIRECTOR 1.00 X 0 0 0 ANN QUINN DIRECTOR 1.00 X 0 0 0 LEAH GRIFFITH CEO 40.00 X 81513 0 28127 COLETTE TERRY CFO 40.00 X 59689 0 7662 KRYSTYL KULBECK PA-C 40.00 X 138740 0 28772 ZANE BENDIG NP 40.00 X 100309 0 14250 380251 0 78811 2 0 1 0 KC CORPORATION PO BOX 1246 BIG SANDY MT 59520 PHYSICAL THERAPY 156760 1 1832678 21853 1854531 PATIENT SERVICE REVENU 621110 3945227 3945227 OTHER OPERATING REVENU 621110 247878 247878 340B REVENUE 621110 142263 142263 DIETARY REVENUE 621110 16101 16101 4351469 29710 29710 1100 0 1100 1100 1100 HOSPITAL TAX DISTRICT 621110 121500 121500 121500 6358310 4472969 0 30810 X 176991 148710 28281 1843385 1548846 294539 9553 8026 1527 196992 165513 31479 147587 124003 23584 8369 8369 27190 5900 21290 817293 803107 14186 11376 11176 200 36828 14554 22274 58267 43461 14806 26132 24143 1989 1316 1316 140535 103996 36539 59272 43861 15411 SUPPLIES 809425 793737 15688 MISCELLANEOUS 317039 304990 12049 REPAIRS 37881 37881 DUES & SUBSCRIPTIONS 35524 35049 475 72394 58736 13658 4833349 4277005 556344 0 630219 313213 1875552 1525662 1385513 863536 28396 62313 5242440 3342167 746455 1900273 1415571 1435244 194274 218807 6275980 6319048 158971 233544 1768629 49829 41057 0 220935 1977429 495536 X 4298551 5823512 4298551 5823512 6275980 6319048 1524961 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 57159 57159 2993701 2528168 465533 2191580 813999 1377581 1900273 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 220935 220935 X 6335395 0 6335395 22915 22915 6358310 4810434 0 4810434 22915 22915 4833349 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. 1 1 1 X 1 X 1 0 0 21459 21459 0.00440 215540 128592 86948 0.01800 8813 5202 3611 0.00070 245812 133794 112018 0.02310 245812 133794 112018 0.02310 1 3891 2478523 2464136 14387 X 1 1 1 1 BIG SANDY MEDICAL CENTER PO BOX 530 BIG SANDY MT 59520 BSMC.ORG 12767 X X X RURAL HEALTH CLINIC BIG SANDY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X WWW.BSMC.ORG/COMMUNITYHEALTHNEEDS.HTML X 1 20 1 HTTP://WWW.BSMC.ORG/COMMUNITYHEALTHNEEDS.HTML 0 1 X 100.000000000000 200.000000000000 1 1 X X X X 1 X WWW.BSMC.ORG X WWW.BSMC.ORG X WWW.BSMC.ORG X X X X X X 1 X 0 X 1 X 0 0 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. 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. X X 0 0 0 0 0 0 0 0 0 KRYSTYL KULBECK PA-C 138740 0 0 0 0 0 3012 0 25760 0 167512 0 0 0 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.