LIBERTY COUNTY HOSPITAL AND NURSING HOME INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- LIBERTY COUNTY HOSPITAL AND NURSING HOME INC (EIN 81-0515463)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-06-28
- IRS object ID
- 202221799349300917
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-06-28T14:27:01-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 810446334 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS WILSON & COMPANY PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 FIRST AVENUE SOUTH | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59401 | 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 | 810515463 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIBERTY COUNTY HOSPITAL & NURSING HOME | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LIBE | BusinessNameControlTxt |
| Phone | 4067595181 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOX 705 315 WEST MADISON AVENUE | AddressLine1Txt |
| City | CHESTER | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59522 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHARI DOLAN | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 4067595181 | PhoneNum |
| Signature | 2022-06-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SHARI | PersonFirstNm |
| Person Last | DOLAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KAYCEE LEWIS | PreparerPersonNm |
| PTIN | P01361310 | PTIN |
| Phone | 4067614645 | PhoneNum |
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) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIBERTY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHARI DOLAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOX 705 315 WEST MADISON AVENUE | AddressLine1Txt |
| City | CHESTER | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,540,914 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.LIBERTYMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | HEALTHCARE | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 160 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $438,500 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,519,090 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,224,088 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,358,173 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,461 | PYInvestmentIncomeAmt |
| CY Investment Income | $88,797 | CYInvestmentIncomeAmt |
| PY Other Revenue | $139,724 | PYOtherRevenueAmt |
| CY Other Revenue | $90,477 | CYOtherRevenueAmt |
| PY Total Revenue | $8,821,773 | PYTotalRevenueAmt |
| CY Total Revenue | $13,056,537 | 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 | $5,481,680 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,810,765 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $10,460 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,702,494 | PYOtherExpensesAmt |
| CY Other Expenses | $4,041,263 | CYOtherExpensesAmt |
| PY Total Expenses | $9,184,174 | PYTotalExpensesAmt |
| CY Total Expenses | $9,852,028 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$362,401 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,204,509 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,100,374 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,173,365 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,421,009 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,950,726 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,679,365 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,222,639 | NetAssetsOrFundBalancesEOYAmt |
| Mission | LIBERTY MEDICAL CENTER IS IN BUSINESS TO IMPROVE THE HEALTH AND QUALITY OF LIFE IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,127,309 | ExpenseAmt |
| Revenue | $9,425,133 | RevenueAmt |
| Desc | LCHNH PROVIDED HEALTHCARE IN THE FORM OF HOSPITAL IN-PATIENT DAYS, EMERGENCY ROOM VISITS, HOSPITAL OUTPATIENT VISITS, SURGERIES, ASSISTED LIVING DAYS, LONG-TERM SWING BED DAYS, OBSERVATION VISITS, CLINIC VISITS, ETC. | Desc |
| Total Program Service Expenses | $8,127,309 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 160 | 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 |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHARI DOLAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4067595181 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOX 705 315 WEST MADISON AVENUE | AddressLine1Txt |
| City | CHESTER | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 595220705 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 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 |
|---|---|---|---|---|---|---|---|
| LARRY HENDRICKSON | |||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MAUREEN WICKS | |||||||
| VICE-PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRITNEY TEMPEL | |||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIM BRONK | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KIRK SKARI | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KARLA KULPAS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RUDY CICON | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LAURA MERCHANT | |||||||
| CEO BY MGMT AGREEMENT | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| RON GLEASON | |||||||
| CEO BY MGMT AGREEMENT | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| SHARI DOLAN | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $67,429 | $0 | $0 | ||
| WYNAND NEL | |||||||
| PHYSICIAN | 40.00 | $246,847 | $0 | $0 | Yes (X) | ||
| GLADYS E YOUNG | |||||||
| PHYSICIAN | 20.00 | $106,291 | $0 | $0 | Yes (X) | ||
| DARREN YOUNG | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $150,172 | $0 | $0 | Yes (X) | ||
| PATRICK ARMSTRONG | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $162,601 | $0 | $0 | Yes (X) | ||
| TIMOTHY BLAIR | |||||||
| NURSE PRACTITIONER | 40.00 | $164,084 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $897,424 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AUREUS HEALTHCARE ONE LLC | |||||
| 13609 CALIFORNIA ST | OMAHA | NE | 68154 | TRAVELING STAFF | $282,616 |
| SANFORD USD MEDICAL CENTER | |||||
| P O BOX 5074 | SIOUX FALLS | SD | 571175074 | MANAGEMENT SERVICES | $169,602 |
| MEDICAL SOLUTIONS | |||||
| 1010 N 102ND ST STE 300 | OMAHA | NE | 68114 | TRAVELING STAFF | $159,489 |
| ENTRE TECHNOLOGY SERVICES | |||||
| 1501 14TH ST W STE 20 | BILLINGS | MT | 59102 | IT CONTRACTOR | $156,598 |
| KALISPELL REGIONAL MEDICAL CENTER | |||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | MAMMOGRAPHY & MRI SERVICES | $138,760 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,927,230 | GovernmentGrantsAmt |
| All Other Contributions | $591,860 | AllOtherContributionsAmt |
| Total Contributions | $3,519,090 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GROSS PATIENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $9,358,173 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,358,173 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,358,173 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,427 | TotalRevenueColumnAmt |
| Exclusion | $57,427 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,864 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,793 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,071 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,071 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,071 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $511,954 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $457,067 | SecuritiesAmt |
| Other | $23,517 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $54,887 | SecuritiesAmt |
| Other | -$23,517 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,370 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$23,517 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $54,887 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMPLOYEE/OTHER MEALS | 623000 | $49,236 | $49,236 |
| OTHER | 623000 | $26,170 | $26,170 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $75,406 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,056,537 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,425,133 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $112,314 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,429 | TotalAmt |
| Management And General | $67,429 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,650,814 | TotalAmt |
| Program Services | $3,924,904 | ProgramServicesAmt |
| Management And General | $717,827 | ManagementAndGeneralAmt |
| Fundraising | $8,083 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,092,522 | TotalAmt |
| Program Services | $932,636 | ProgramServicesAmt |
| Management And General | $157,755 | ManagementAndGeneralAmt |
| Fundraising | $2,131 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,102 | TotalAmt |
| Management And General | $17,102 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,204 | TotalAmt |
| Program Services | $198,545 | ProgramServicesAmt |
| Management And General | $27,659 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,312 | TotalAmt |
| Program Services | $5,734 | ProgramServicesAmt |
| Management And General | $3,578 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $399,008 | TotalAmt |
| Program Services | $309,220 | ProgramServicesAmt |
| Management And General | $89,788 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,564 | TotalAmt |
| Program Services | $8,803 | ProgramServicesAmt |
| Management And General | $102,761 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PURCHASED SERVICES/PROF | $1,725,831 | $1,395,257 | $330,574 | |
| SUPPLIES | $902,724 | $865,994 | $36,730 | |
| REPAIRS AND MAINTENANCE | $370,994 | $346,870 | $24,124 | |
| OTHER | $277,737 | $139,124 | $138,367 | $246 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $787 | TotalAmt |
| Program Services | $222 | ProgramServicesAmt |
| Management And General | $565 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,852,028 | TotalAmt |
| Program Services | $8,127,309 | ProgramServicesAmt |
| Management And General | $1,714,259 | ManagementAndGeneralAmt |
| Fundraising | $10,460 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000 | BOYAmt |
| EOY | $1,000 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,124,842 | BOYAmt |
| EOY | $3,700,516 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,186,530 | BOYAmt |
| EOY | $1,009,602 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,028 | BOYAmt |
| EOY | $152,606 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,051 | BOYAmt |
| EOY | $9,754 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,626,772 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,625,886 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,109,806 | BOYAmt |
| EOY | $3,000,886 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,788,730 | BOYAmt |
| EOY | $3,270,622 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $725,387 | BOYAmt |
| EOY | $1,028,379 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,100,374 | BOYAmt |
| EOY | $12,173,365 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $914,624 | BOYAmt |
| EOY | $1,312,504 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $246,181 | BOYAmt |
| EOY | $205,248 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,260,204 | BOYAmt |
| EOY | $432,974 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,421,009 | BOYAmt |
| EOY | $1,950,726 | 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 | $6,645,415 | BOYAmt |
| EOY | $10,149,639 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,950 | BOYAmt |
| EOY | $73,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,679,365 | BOYAmt |
| EOY | $10,222,639 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,100,374 | BOYAmt |
| EOY | $12,173,365 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,204,509 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $299,715 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $39,050 | 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 | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 C IRS990ScheduleC
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I-A, LINE 1: | THROUGH DUES-MONTANA HOSPITAL ASSOCIATION-0.01%, AMERICAN HOSPITAL ASSOCIATION-25.56%, LEADING AG-2.8% |
| PART II-B, LINE 1: | NONE |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $61,138 | InvestmentCostOrOtherBasisAmt |
| Book Value | $61,138 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $3,289,941 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,700,696 | DepreciationAmt |
| Book Value | $1,589,245 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $84,988 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $74,235 | DepreciationAmt |
| Book Value | $10,753 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $4,183,691 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $2,850,955 | DepreciationAmt |
| Book Value | $1,332,736 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $7,014 | InvestmentCostOrOtherBasisAmt |
| Book Value | $7,014 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,000,886 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $309,353 |
| TAXES RECEIVABLE | $31,142 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $687,884 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,028,379 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REFUNDABLE ADVANCE - PROVIDER RELIEF FUNDS | Desc |
| Amt | $432,974 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $432,974 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $13,342,943 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $299,715 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $3,793 | OtherRevenueAmt |
| Revenue Not Reported | $303,508 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,039,435 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $17,102 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $17,102 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,056,537 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,838,719 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $3,793 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $3,793 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,834,926 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $17,102 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $17,102 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,852,028 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES AGAINST RENTAL INCOME 3793. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES AGAINST RENTAL INCOME 3793. |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,387 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $246,950 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $246,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02510 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $277,337 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $277,337 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02820 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $277,337 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $277,337 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02820 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $205,991 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $37,642 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,165,158 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,956,095 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$790,937 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | LIBERTY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 WEST MADISON | AddressLine1Txt |
| City | CHESTER | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | LEVEL 4 TRAUMA CENTER | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIBERTY 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 | 18 | 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.LIBERTYMEDICALCENTER.ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.LIBERTYMEDICALCENTER.ORG | 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 | 101.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.LIBERTYMEDICALCENTER.ORG/ | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Other Actions | Yes (X) | OtherActionsInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LIBERTY MEDICAL CENTER | PART V, SECTION B, LINE 5: THE HOSPITAL PARTICIPATES IN A COMMUNITY NEEDS ASSESSMENT, IN COOPERATION WITH MONTANA OFFICE OF RURAL HEALTH. A RANDOM LIST OF PATIENTS WERE MAILED SURVEYS. IT WAS DETERMINED THAT AREAS WHERE PATIENTS RESIDE WOULD BE REPRESENTED IN PROPORTION. THE SURVEY WAS BASED ON: DEMOGRAPHICS; HOSPITALS, PRIMARY CARE PROVIDERS AND SPECIALISTS USED AND THE REASON FOR A PATIENT'S SELECTION OF THAT PROVIDER; LOCAL HEALTH CARE PROVIDER USAGE; SERVICES PREFERRED LOCALLY; AND PERCEPTION AND SATISFACTION OF LOCAL HEALTH CARE. TWO FOCUS GROUP MEETINGS WERE HELD TO IDENTIFY THE MOTIVES OF LOCAL RESIDENTS WHEN SELECTING LOCAL HEALTH CARE AND DISCOVER REASONS WHY PEOPLE MAY LEAVE THE AREA TO SEEK HEALTH CARE SERVICES. THIS REPORT HAS BEEN REVIEWED BY LIBERTY MEDICAL CENTER'S ADMINISTRATIVE TEAM, MANAGERS, SHARED WITH EMPLOYEES AT THE MONTHLY EMPLOYEE ASSEMBLIES, AND THE BOARD OF DIRECTORS. THIS REPORT HAS BEEN USED BY THE BOARD TO ASSIST WITH THEIR STRATEGIC PLANNING. |
| LIBERTY MEDICAL CENTER | PART V, SECTION B, LINE 11: -REVIEWED THE FACILITY'S PRESENCE IN THE COMMUNITY-CONSIDERED ORGANIZATIONS OUTSIDE THE FACILITY WHICH MAY SERVE AS COLLABORATORS IN EXECUTING THE FACILITY'S IMPLEMENTATION PLAN-ASSESSED THE HEALTH INDICATORS OF THE COMMUNITY THROUGH SECONDARY DATE-EVALUATED THE FEEDBACK RECEIVED FROM CONSULTATIONS WITH THOSE REPRESENTING THE COMMUNITY'S INTERESTS INCLUDING PUBLIC HEALTH |
| LIBERTY MEDICAL CENTER | PART V, SECTION B, LINE 16J: DURING REVIEW OF AGED ACCOUNTS, A PATIENT CAN BE CONTACTED BY PHONE AND THEN INFORMATION IS SENT TO THE PATIENT TO APPLY. THEY CAN ALSO GET THE FORMS ONLINE OR AT ANY RECEPTION DESK. |
| LIBERTY MEDICAL CENTER | PART V, SECTION B, LINE 18E: JUDGEMENTS |
| LIBERTY MEDICAL CENTER | PART V, SECTION B, LINE 19E: JUDGEMENTS |
| LIBERTY MEDICAL CENTER | PART V, SECTION B, LINE 20E: SETUP PAYMENT AGREEMENTS ON PATIENT BALANCES DUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - WHEAT COUNTRY ESTATES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 6 W | AddressLine1Txt |
| City | CHESTER | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | ASSISTED LIVING | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | USE FPL, AS ADJUSTED FOR FAMILY UNIT AND GROSS FAMILY INCOME BETWEEN 100% AND 199% FPL0-100%=100% DISCOUNT101%-125%=80% DISCOUNT126%-150%=60% DISCOUNT151%-175%=40% DISCOUNT176%-199%=20% DISCOUNT |
| PART I, LINE 6A: | LINE 42-FINANCIAL ASSISTANCE APPLICATION REQUESTS ALL MEDICAL EXPENSES INCURRED BY THE INDIVIDUAL FAMILY AT ANY FACILITY. FOR THOSE WITH EXCESSIVE MEDICAL BILLS WE MAY INCREASE THE DISCOUNT WE PROVIDE. |
| PART I, LINE 7: | COST BASED |
| PART I, LINE 7G: | N/A |
| PART I, LN 7 COL(F): | N/A |
| PART II, COMMUNITY BUILDING ACTIVITIES: | HOSPITAL WORKED TO PROVIDE MENTAL AND EMOTIONAL HEALTH SUPPORT TO THE COMMUNITY DUE TO THE COVID-19 PANDEMIC. HOSPITAL WORKED WITH OPEN DOOR WELLNESS CENTER TO PROVIDE ONSITE PRIVATE SESSIONS AND TELEHEALTH PRIVATE SESSIONS. OPEN DOOR WELLNESS CENTER FOCUSES ON FAMILY, TRAUMA AND RELATIONSHIPS.HOSPITAL ENTERED INTO AGREEMENT WITH FRONTIER PSYCHIATRY IN SEPTEMBER 2021. FRONTIER PSYCHIATRY PROVIDES PROFESSIONAL PSYCHIATRIC SERVICES THROUGH THE EMERGENCY DEPARTMENT AND IN-PATIENTS VIA TELEHEALTH. THE SERVICES CAN ALSO EXTEND PAST THE ER AND IN-PATIENT STATUS UPON DISCHARGE OF THE PATIENT. FRONTIER PSYCHIATRY ALSO COLLABORATES FOR PATIENT ADMISSIONS TO PSYCHIATRIC UNITS WHEN DETERMINED THIS IS THE BEST CARE FOR THE PATIENT. HOSPITAL COORDINATED WITH THE MONTANA TOBACCO PREVENTION PROGRAM AND THE LIBERTY COUNTY CHAMBER OF COMMERCE FOR A COMMUNITY WALK WITH EASE SELF DIRECTED PROGRAM. THE PROGRAM WAS OFFERED TO HOSPITAL EMPLOYEES AS WELL AS THE COMMUNITY FOR A SIX-WEEK PROGRAM. THE GOAL OF THE COLLABORATION WAS TO INCREASE PHYSICAL ACTIVITY WHILE PROVIDING EDUCATION ON TOBACCO/VAPING CESSATION, MOST IMPORTANTLY DURING THE COVID-19 PANDEMIC. PARTICIPANTS RECEIVED A POSITIVE AND ENCOURAGING WEEKLY EMAIL. TOBACCO QUIT KITS WERE ALSO AVAILABLE TO PARTICIPANTS. |
| PART III, LINE 4: | THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS, AND THIRD PARTY PAYORS. MANAGEMENT REVIEWS PATIENT AND RESIDENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND RESIDENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF RECOVERY INFORMATION IN DETERMINING BAD DEBT PROVISION. COMMUNITY BENEFIT IS NOT A FACTOR IN BAD DEBT EXPENSE AS THE HOSPITAL HAS GUIDELINES IN PLACE TO DETERMINE ELIGIBILITY. |
| PART III, LINE 8: | 5 DEPARTMENTS ARE ABOVE 1:1 COST RATIO:MEDICAL SUPPLIES 2.983480; BLOOD STORING 1.101089; OUTPATIENT SERVICES 1.724743; ER 1.408243; OBSERVATION 2.968409PUBLIC HEALTH CONTRACT WITH COUNTY TO PROVIDE SERVICES:IN KIND-OFFICE/TELEPHONE/UTILITY/ADMIN SUPPORT(+OR-)$15,000 PER YEAR |
| PART III, LINE 9B: | THERE IS A SEPARATE FINANCIAL ASSISTANCE POLICY |
| PART VI, LINE 2: | HOSPITAL PARTICIPATES IN COMMUNITY NEEDS ASSESSMENT IN COOPERATION WITH MT OFFICE OF RURAL HEALTH. THE OFFICE WILL BE DOING THESE EVERY 3 YEARS. THE LAST ONE WE PARTICIPATED IN WAS IN 2018. THE ORGANIZATION BEGAN A NEW ASSESSMENT IN 2021. |
| PART VI, LINE 3: | HOSPITAL'S FINANCIAL COUNCELOR MAILS INFORMATION TO THE PATIENTS. SHE IS ALSO AVAILABLE BY APPOINTMENT TO HELP WITH ANY PAPERWORK TO DETERMINE IF THE PATIENT IS ELIGIBLE BY FEDERAL POVERTY GUIDELINES TO QUALIFY FOR FINANCIAL ASSISTANCE. THE CLINIC'S RECEPTIONIST MEETS FACE TO FACE WITH PATIENTS AND ASSISTS THEM WITH THE PROPER PAPERWORK TO OBTAIN DRUGS AT NO COST FROM PHARMACEUTICAL COMPANIES. ONE EMPLOYEE ASSISTS WITH APPLICATIONS OF PATIENTS TO THE HEALTHY MT KIDS PROGRAM |
| PART VI, LINE 4: | HOSPITAL IS A 25 BED CAH BASED IN CHESTER, LIBERTY COUNTY, MT. SERVICE AREA IS 1,430 SQUARE MILES. COUNTY IS A FRONTIER COMMUNITY LOCATED IN NORTHCENTRAL MT WITH A POPULATION DENSITY OF 1.21/SQUARE MILE. POPULATION IS 1,099 BUT HOSPITAL SERVES APPROXIMATELY 2,500 PEOPLE. LIBERTY COUNTY IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA AS WELL AS A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA. 39.3% OF RESIDENTS ARE AT OR BELOW 200% FPL AND 26.1% ARE AT OR BELOW 100% FPL. |
| PART VI, LINE 5: | HOSPITAL PROVIDES ALL HEALTHCARE TO THE COMMUNITYALL PHYSICIAN SERVICES, LONG TERM CARE, ASSISTED LIVING IS PROVIDED TO THE HOSPITAL.HOSPITAL PROVIDES CARE TO ANYONE WHO REQUESTS IT. |
| PART VI, LINE 6: | NOT APPLICABLE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WYNAND NEL | ||||||||||||||
| PHYSICIAN | $246,847 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $246,847 | $0 | $0 | $0 |
| DARREN YOUNG | ||||||||||||||
| PHYSICIAN ASSISTANT | $150,172 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $150,172 | $0 | $0 | $0 |
| PATRICK ARMSTRONG | ||||||||||||||
| PHYSICIAN ASSISTANT | $162,601 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $162,601 | $0 | $0 | $0 |
| TIMOTHY BLAIR | ||||||||||||||
| NURSE PRACTITIONER | $164,084 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $164,084 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION RENEWED A MANAGEMENT AGREEMENT WITH SANFORD HEALTH SYSTEM. CEO IS PROVIDED THROUGH AGREEMENT. LMC BOARD OF DIRECTORS RETAINS FULL CONTROL. THE AGREEMENT EXPIRES IN MARCH 2022. |
| FORM 990, PART VI, SECTION B, LINE 11B | NOTIFICATION HAS BEEN SENT BY EMAIL TO BOARD MEMBERS THAT RETURN MAY BE REVIEWED |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS OR TRUSTEES REVIEW CONFLICT OF INTEREST POLICY ANNUALLY AND SIGN NOTICE |
| FORM 990, PART VI, SECTION B, LINE 15 | PARTICIPATE IN MT HOSPITAL ASSOC ANNUAL WAGE SURVEY. REPORT PROVIDED TO FACILITY SHOWING COMPARISONS OF OTHER PEER CAHS. INFORMATION IS THEN USED IN SALARY NEGOTIATIONS. |
| FORM 990, PART VI, SECTION C, LINE 18 | GUIDESTAR |
| FORM 990, PART VI, SECTION C, LINE 19 | COMMUNITY IS ENCOURAGED TO VIEW ALL DOCUMENTS AT THE HOSPITAL ADMINISTRATIVE OFFICES. ANY COMMUNITY MEMBER WHO REQUESTS TO SEE INFORMATION IS PROVIDED WHAT THEY REQUEST TO SEE ASIDE FROM INDIVIDUAL EMPLOYEE WAGES. MONTHLY BOARD MEETINGS ARE OPEN TO THE PUBLIC AS ALL OF OUR ASSETS ARE OWNED BY THE COUNTY AND THEREFORE REQUIRED TO HOLD OPEN MEETINGS. THE MONTHLY BOARD AGENDA ALLOWS TIME FOR PUBLIC COMMENT. |
| FORM 990, PART XI, LINE 9: | NET ASSETS RELEASED FROM RESTRICTIONS -25950. CONTRIBUTIONS WITH DONOR RESTRICTIONS 65000. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR |
| FORM 990, ITEM B | AMENDING THE 2020 FORM 990 FOR FINAL AUDITED FINANCIAL STATEMENTS ISSUED AFTER THE INITIAL FILING DATE. UPDATED AMOUNTS FOR CONTRIBUTIONS, PROGRAM SERVICE REVENUES AND OTHER LIABILITIES. |
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