2021-05-13T14:25:54-05:00 2020-06-30 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2019-07-01 810291695 BIG SANDY MEDICAL CENTER INC BIGS 4063782188 PO BOX 530 BIG SANDY MT 59520 LEAH GRIFFITH CEO 4063782188 2021-05-11 1 WAYNE R HIETT CPA P00159424 4067281800 2021-05-11 2019 2022-09-23 18:48:47Z LEAH GRIFFITH PO BOX 530 BIG SANDY MT 59520 4077051 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 67 6 0 0 311884 542820 3218838 3457559 35358 41472 1221 35200 3567301 4077051 0 0 0 0 2377623 2078133 0 0 0 1146223 1654654 3523846 3732787 43455 344264 4275919 6275980 321632 1977429 3954287 4298551 X TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS AT THE MOST REASONABLE COST IN A COMPETENT, PROFESSIONAL MANNER. 1 1 2965479 3491559 BIG SANDY MEDICAL CENTER PROVIDES HOSPITAL AND LONG-TERM MEDICAL CARE FOR THE TOWN OF BIG SANDY AND NORTHERN CHOUTEAU COUNTY, MONTANA. 2965479 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 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 3 0 1 67 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 0 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 79101 0 25791 COLETTE TERRY CFO 40.00 X 58452 0 7289 KRYSTYL KULBECK PA-C 40.00 X 149660 0 26570 287213 0 59650 1 0 1 0 KC CORPORATION PO BOX 1246 BIG SANDY MT 59520 PHYSICAL THERAPY 108888 1 396400 146420 542820 PATIENT SERVICE REVENU 621110 2888186 2888186 OTHER OPERATING REVENU 621110 419959 419959 340B REVENUE 621110 130577 130577 DIETARY REVENUE 621110 18837 18837 3457559 39972 39972 1200 0 1200 1200 1200 1500 0 1500 1500 1500 HOSPITAL TAX DISTRICT 621110 34000 34000 34000 4077051 3491559 0 42672 X 187670 187670 1631938 1530193 101745 8580 8580 120899 120899 129046 129046 1625 1625 5600 5600 483685 447045 36640 6209 6209 19219 18606 613 60193 55139 5054 11464 11464 2717 2717 102000 102000 54390 54390 SUPPLIES 671798 654617 17181 BAD DEBT EXPENSE 45440 45440 REPAIRS 42643 36331 6312 DUES & SUBSCRIPTIONS 42260 42260 105411 21718 83693 3732787 2965479 767308 0 309807 630219 1994779 3291123 923838 1385513 8683 0 27482 28396 3948087 3201632 832215 746455 179115 194274 4275919 6275980 275240 158971 0 1768629 46392 49829 321632 1977429 X 3954287 4298551 3954287 4298551 4275919 6275980 344264 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22544 22544 2448076 2397581 50495 1008382 804051 204331 469085 469085 746455 X 4009893 0 4009893 67158 67158 4077051 3665629 0 3665629 67158 67158 3732787 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 45,440. 340B EXPENSES 21,718. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 45,440. 340B EXPENSES 21,718. 1 1 1 X 1 X 1 0 0 26291 26291 0.00700 216560 128592 87968 0.02360 8855 5202 3653 0.00100 251706 133794 117912 0.03160 251706 133794 117912 0.03160 1 45440 1294257 1310586 -16329 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 17 1 0 0 1 X WWW.BSMC.ORG/COMMUNITYHEALTHNEEDS.HTML X 1 17 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: A WRITTEN, COMMUNITY SURVEY WAS THE CHOSEN METHOD OF DATA COLLECTION FOR THE MOST RECENT CHNA. THE PRIMARY REASON FOR CHOOSING THIS METHOD AS OPPOSED TO OTHER METHODS, SUCH AS FOCUS GROUPS, ONLINE SURVEYS, AND INTERVIEWS, IS IT ACCOMMODATED THE BIG SANDY POPULATION AND WAS A FAIRLY COST-EFFECTIVE PROCESS. THE WRITTEN SURVEY WAS DISTRIBUTED BY MAIL TO 520 HOUSEHOLDS IN THE BSMC SERVICE AREA. BIG SANDY MEDICAL CENTER PART V, SECTION B, LINE 11: OBJECTIVE 1: IMPROVE PATIENT CARE AND SATISFACTION STRATEGIES: - INCREASED, ADDITIONAL SERVICES (I.E. SPECIALIST VISITS, PROCEDURES)- DEVELOP A PATIENT ADVISORY COMMITTEE- CONDUCT CONSISTENT, REAL-TIME SATISFACTION SURVEYS TAILORED TO THIS POPULATIONOBJECTIVE 2: COLLABORATE WITH OTHER COMMUNITY STAKEHOLDERS ON PROJECTS STRATEGIES:- COLLABORATE ON FUTURE CHNAS AND OTHER ASSESSMENTS (I.E. CRA, CHI, RALA)- COORDINATE GRANT WORK, INCLUDING SEARCHING, APPLYING, AND WRITING OF GRANTS- EDUCATE THE COMMUNITY ON HEALTH-RELATED ISSUES AND TOPICS- ACTIVELY SUPPORT HEALTHY LIFESTYLE ACTIVITIES WITHIN THE COMMUNITYSOME OF THE NEEDS ARE NOT FINANCIALLY OR GEOGRAPHICALLY FEASIBLE FOR A FACILITY THIS SIZE (I.E. MORE SPECIALISTS). WITH LARGER FACILITIES WITHIN 35 MILES, IT IS SOMETIMES MORE PRACTICAL TO REFER PATIENTS TO THE LARGER FACILITY. 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 7 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. 0 0 0 0 0 0 0 0 0 KRYSTYL KULBECK PA-C 149660 0 0 0 0 0 2882 0 23688 0 176230 0 0 0 FORM 990, PART III, LINE 2 THE 22-BED NURSING HOME WAS DELICENSED ON 10/01/2019 AND WAS CONVERTED TO A 25-BED CAH. FORM 990, PART III, LINE 3 THE 22-BED NURSING HOME WAS DELICENSED ON 10/01/2019 AND WAS CONVERTED TO A 25-BED CAH. 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 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 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 447,045. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 447,045. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 36,640. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,640. FORM 990, PART IX, LINE 24E MISCELLANEOUS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 31,411. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,411. TRAINING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 29,149. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,149. 340B EXPENSE: PROGRAM SERVICE EXPENSES 21,718. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,718. BED TAX: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 19,982. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,982. LICENSES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,151. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,151. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.