2021-05-17T18:32:42-05:00 2020-06-30 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2019-07-01 816016920 DANIELS MEMORIAL HOSPITAL DANI 4064872296 P O BOX 400 SCOBEY MT 59263 MARION A THOMPSON CEO 4064872296 2021-05-12 1 PHILIP L YASENAK CPA P01248379 4067281800 2021-05-12 2019 2022-09-23 18:48:47Z DANIELS MEMORIAL HEALTHCARE CENTER MARION A THOMPSON P O BOX 400 SCOBEY MT 59263 10172084 0 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X 1956 MT TO PROMOTE THE GENERAL HEALTH CARE OF THE COMMUNITY THROUGH PROVIDING HIGH QUALITY HEALTH CARE. 10 10 108 9 0 0 432562 942596 8214104 8757108 -39950 997 319273 471383 8925989 10172084 0 0 0 0 4790579 5027164 0 0 0 3817470 3576064 8608049 8603228 317940 1568856 3648084 7986334 1461744 4231138 2186340 3755196 X TO PROVIDE A HEALTH CARE SYSTEM WITH CLINIC, ACUTE INPATIENT, EMERGENCY, OUTPATIENT, AND 25-BED CRITICAL ACCESS HOSPITAL SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 0 0 3642640 7695411 PROFESSIONAL CARE - PRIMARY, ACUTE, AND CRITICAL ACCESS CARE. 1052976 1494130 CLINIC SERVICES FOR OUTPATIENT CLIENTS. 755015 HOUSEKEEPING, LAUNDRY, LINEN & PLANT SERVICES - PROVIDE FOR THE HOUSEKEEPING AND BUILDING MAINTENANCE OF THE FACILTIY. 415999 38950 DIETARY SERVICES FOR ACUTE CARE PATIENTS. 415999 38950 5866630 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 1 0 0 0 0 0 0 0 1 0 0 0 1 4 0 1 108 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X THE ORGANIZATION 4064872296 P O BOX 400 SCOBEY MT 59263 X GREG CROWER NP 40.00 X 185405 0 15668 SHERRY GAIRRETT NP 40.00 X 164427 0 16441 DEANNA FERESTAD FNP 40.00 X 121955 0 15526 SHIRLEY RELLER PT 40.00 X 124293 0 12417 WENDY DAHL MANAGER OF HIM 40.00 X 110137 0 13291 PAUL KANNING CHAIR 2.00 X X 0 0 0 CARRIE WILSON VICE CHAIR 2.00 X X 0 0 0 JEDDA BARRON SECRETARY 2.00 X X 0 0 0 JACK PITTENGER DIRECTOR 2.00 X 0 0 0 JAMIE ZUMBUHL DIRECTOR 2.00 X 0 0 0 GARY TOMLJENOVICH DIRECTOR 2.00 X 0 0 0 MIKE BJARKO DIRECTOR 2.00 X 0 0 0 TANNER TROWER DIRECTOR 2.00 X 0 0 0 TARA THOMAS DIRECTOR 2.00 X 0 0 0 LIANA HANDRAN DIRECTOR 2.00 X 0 0 0 ERIC CONNELL CEO 40.00 X 0 0 0 706217 0 73343 5 0 1 0 BILLINGS CLINIC PO BOX 30357 BILLINGS MT 59107 MANAGEMENT SERVICES 751674 MONTANA HEALTH NETWORK 519 PLEASANT ST MILES CITY MT 59301 STAFFING SERVICES AND TRAVELERES 135696 BADLANDS MEDICAL STAFFING BOX 133 UNDERWOOD ND 58576 CONTRACTED NURSE STAFFING 132805 SYSCO 1509 MONAD RD BILLINGS MT 59107 FOOD & FOODSERVICE SUPPLIES 122344 4 66961 875635 942596 PROFESSIONAL CARE REVENUE 623000 7328868 7328868 CLINIC REVENUE 623000 1428240 1428240 8757108 997 997 600 0 600 600 600 HOSPLITAL TAX DISTRICT REVENUE 623000 220168 220168 INCOME/LOSS FROM INSURANCE CAPTIV 623000 -6879 -6879 257494 257494 470783 10172084 9228491 0 997 X 3919859 2819698 1100161 67134 60442 6692 757996 621470 136526 282175 248586 33589 1561025 461361 1099664 35511 791 34720 36901 18287 18614 173075 163526 9549 38371 11487 26884 4208 4208 192468 190029 2439 124717 124717 CONTRACTUAL ALLOWANCES 531341 483810 47531 MEDICAL SUPPLIES AND PH 316808 316808 OTHER SUPPLIES 204189 180237 23952 REPAIRS AND MAINTENANCE 141818 135551 6267 215632 154547 61085 8603228 5866630 2736598 0 319780 1540924 330999 3586297 1439138 985510 138923 207212 177444 247453 72049 76460 6404062 5340598 886449 1063464 283302 279014 3648084 7986334 1033011 564509 0 3256714 145996 230103 282737 179812 1461744 4231138 X 1997877 3566733 188463 188463 2186340 3755196 3648084 7986334 1568856 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13500 13500 3889784 3349214 540570 2293796 1964495 329301 206982 26889 180093 1063464 GUARANTEE OF PATIENT LOANS 124367 COST REPORT SETTLEMENT PAYABLE 49000 RESIDENT TRUST FUND 6445 179812 X 9557171 0 9557171 614913 614913 10172084 7988315 0 7988315 614913 614913 8603228 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT UNRELATED BUSINESS INCOME IN ACCORDANCE WITH THE CODE. CURRENT ACCOUNTING GUIDELINES REQUIRE AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. FEDERAL RETURNS FOR TAX YEARS 2017 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRACTUAL ALLOWANCES & DISCOUNTS 531,341. BAD DEBT EXPENSE 83,572. PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRACTUAL ALLOWANCES & DISCOUNTS 531,341. BAD DEBT EXPENSE 83,572. 1 1 1 X 1 X 1 1 1 0 0 75000 75000 0.00870 1403539 1403539 0.16310 1478539 1478539 0.17180 73421 25207 48214 0.00560 95331 18681 76650 0.00890 2799 2799 0.00030 171551 43888 127663 0.01480 1650090 43888 1606202 0.18660 1 78232 3523015 3544664 -21649 X 1 1 1 1 DANIELS MEMORIAL HOSPITAL PO BOX 400 SCOBEY MT 59263 WWW.DANIELSMEMORIALHEALTHCARE.ORG X X X X RURAL HEALTH CLINIC DANIELS MEMORIAL HEALTHCARE CENTER 1 0 0 1 X X X X X X X X 18 1 0 0 1 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X 1 18 1 WWW.DANIELSMEMORIALHEALTHCARE.ORG 0 1 X 100.000000000000 400.000000000000 X X X 0 1 X X 1 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X WWW.DANIELSMEMORIALHEALTHCARE.ORG X WWW.DANIELSMEMORIALHEALTHCARE.ORG X X X X X X 1 X 0 X X X X 1 0 1 DANIELS MEMORIAL HEALTHCARE CENTER PART V, SECTION B, LINE 5: FOUR KEY INFORMANT INTERVIEWS WERE CONDUCTED TO IDENTIFY IMPORTANT LOCAL HEALTHCARE ISSUES, HOW TO IMPROVE THE HEALTH OF THE COMMUNITY, AND GAPS IN HEALTH SERVICES. IN ADDITION, SURVEYS WERE PROVIDED TO 534 PEOPLE IN THE DMHC SERVICE AREA WITH 125 COMPLETED SURVEYS BEING RETURNED. DANIELS MEMORIAL HEALTHCARE CENTER PART V, SECTION B, LINE 11: THOUGH COVID HAS CAUSED US TO SLOW DOWN WITH SOME OF THE WORK AROUND THE IMPLENTATION PLAN, DMHC CONDINUED TO FOCUS ON ACCESS AND SERVICES AVAILABILITY DURING THIS PERIOD.THE HOSPITAL IS ADDRESSING THE FOLLOWING SIGNIFICANT NEEDS:1. IMPROVE ACCESS/SPECIALISTS/TELE-MEDICINE - DMHC IS WORKING ON EXPANDING PRIMARY CARE ACCESS AND ADDING EDUCATION FOR TELE-MEDICINE SERVICES. THE ORGANIZATION IS ALSO LOOKING TO EXPAND SERVICES PATIENTS CAN RECEIVE LOCALLY. 2. HEALTH AND WELLNESS - DMHC IS WORKING WITH OTHER ORGANIZATIONS TO SUPPORT COMMUNITY HEALTH AND WELLNESS ACTIVITIES AS WELL AS WORKING TO EXPAND SOCIAL MEDIA PRESENCE TO SUPPORT THOSE COMMUNITY ACTIVITIES. 3. MENTAL HEALTH SERVICES - DMHC IS WORKING TO EXPAND TELE-MEDICINE SERVICES IN THIS AREA AND IS COLLABORATING WITH CURRENT WORKGROUPS TO EXPLORE OPTIONS FOR FUTURE STEPS. NEEDS NOT BEING ADDRESSED CURRENTLY ARE AS FOLLOWS:1. CANCER - DMHC HAS IN PLACE EDUCATION AND PREVENTION EFFORTS FOR CANCER AND WILL INCLUDE THIS WITH TELE-MEDICINE/SPECIALTY OUTREACH.2. BARRIERS TO HEALTH INSURANCE COVERAGE - DMHC WILL CONTINUE TO OFFER PAYMENT PLANS/FAP AND PROGRAMS TO ASSIST PEOPLE WITH HEALTHCARE BILLS. THE ORGANIZATION WE WILL CONTINUE TO EDUCATE AND OFFER CHARITY CARE. DANIELS MEMORIAL HEALTHCARE CENTER PART V, SECTION B, LINE 24: PATIENT CARE WHICH IS NOT MEDICALLY NECESSARY INCLUDING ELECTIVE, COSMETIC, EXPERIMENTAL OR DEEMED TO BE GENERALLY NOT REIMBURSABLE BY TRADITIONAL INSURANCE CARRIERS AND GOVERNMENTAL PAYERS SHALL NOT BE CONSIDERED ELIGIBLE FOR CHARITY CARE. PART I, LINE 3C: THE ADMINISTRATOR CAN REVIEW ACCOUNTS ON A CASE-BY-CASE BASIS AND LOOK FOR INDICATION THAT THE FULL PAYMENT MAY CAUSE SOCIAL AND FINANCIAL HARDSHIP SO AS TO SIGNIFICANTLY HARM THE PATIENT OR THE FAMILY UNIT. PART I, LINE 7: LINE 7A: CHARITY CARE WAS CALCULATED BY MULTIPLYING THE RATIO OF COST TO GROSS CHARGES BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE TO PATIENTS.LINE 7B: THE MEDICAL CALCULATION IS BASED ON THE RATIO OF PATIENT CARE COSTS TO CHARGES.LINE 7E: ACTUAL COSTS WERE USED TO REPORT COMMUNITY HEALTH IMPROVEMENT SERVICES. PART III, LINE 2: BAD DEBT EXPENSE IS THE THE BAD DEBT EXPENSE LESS BAD DEBT RECOVERY FROM THE INCOME STATEMENT. PART III, LINE 4: SEE NOTE 1 PATIENT ACCOUNTS RECEIVABLES AND CREDIT POLICY STARTING ON PAGE 15 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE COST TO CHARGE RATIO IS USED TO DETERMINE COMMUNITY BENEFIT. THIS IS DONE BY APPLYING THE RATIO TO THE TOTAL MEDICARE REVENUE. A SHORTFALL OR OVERAGE IN ANY GIVEN YEAR IS A RESULT OF THE TIMING OF PAYMENTS FROM MEDICARE ON AN INTERIM BASIS AND WHEN FINAL SETTLEMENT IS MADE. MANAGEMENT USES ESTIMATES TO CALCULATE SUCH SETTLEMENTS BUT ACTUAL RESULTS VARY FROM THOSE ESTIMATES. ADDITIONALLY, SHORTFALLS CAN RESULT FROM VARIOUS EXPENSES THAT ARE INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE. SINCE PART OF THE COSTS ARE NOT REIMBURSED IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. ALSO MEDICARE RECIPIENTS ARE PART OF A CHARITABLE CLASS AND SO THE PROVISION OF MEDICAL CARE FURTHERS THIS CHARITABLE CLASS. PART III, LINE 9B: NOTIFICATION ABOUT THE DMHC CHARITY AVAILABILITY FORM, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY DMHC BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS. INFORMATION SHALL ALSO BE INCLUDED ON THE FACILITY WEBSITES AND IN THE CONDITIONS OF ADMISSION FORM. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY DMHC. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE DMHC STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL WORKERS, SOCIAL WORKERS, ETC. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE FOR THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 2: PUBLIC HEALTH NURSING SERVICE REQUESTS ALL PARTICIPANTS (BUSINESS, CIVIC, RELIGIOUS, HEALTHCARE, AND PUBLIC) AND WE IDENTIFY ISSUES THAT MAY ASSIST THE COMMUNITY, I.E. HEALTHCARE, HOUSING, ROADS, INFRASTRUCTURE. PART VI, LINE 3: WE INFORM THE PUBLIC ABOUT PROGRAMS, I.E. MEDICARE/MEDICAID THROUGH ADVERTISEMENT IN PRINT AND RADIO, PAMPHLETS IN THE WAITING ROOM, AND SOCIAL SERVICE VISITS WITH PATIENTS. PART VI, LINE 4: WE ARE DESIGNATED A FRONTIER CAH. THE COUNTY HAS 1,690 PEOPLE. WE ARE FIVE HOURS AWAY FROM A TERTIARY HOSPITAL AND THREE HOURS AWAY FROM A SECONDARY HOSPITAL. PART VI, LINE 5: WE ARE GOVERNED BY A COMMUNITY BOARD REPRESENTING THE FULL SERVICES AREA. WE ALSO PARTICIPATE IN EASTERN MONTANA TELEMEDICINE AND ARE ABLE TO OFFER VISITS WITH MULTIPLE SPECIALTY PROVIDERS. 0 0 0 0 0 0 0 0 0 GREG CROWER NP 175355 0 10050 0 0 0 0 0 15668 0 201073 0 0 0 SHERRY GAIRRETT NP 162377 0 2050 0 0 0 0 0 16441 0 180868 0 0 0 ERIC CONNELL MR. CONNELL IS THE CEO OF DANIELS MEMORIAL HOSPITAL MR. CONNELL IS AN EMPLOYEE OF BILLINGS CLINIC, THE INDEPENDENT CONTRACTOR HIRED TO MANAGE THE HOSPITAL, AND RECEIVED ALL COMPENSATION FOR HIS SERVICES AS CEO FROM BILLINGS CLINIC. 0 FORM 990, PART VI, SECTION A, LINE 3 DANIELS MEMORIAL HOSPITAL CONTRACTS WITH THE BILLINGS CLINIC FOR MANAGEMENT, IT, AND ACCOUNTING SERVICES. FORM 990, PART VI, SECTION A, LINE 4 THE MISSION, VISION, AND VALUES OF THE ORGANIZATION HAVE BEEN UPDATED TO BETTER DEPICT LONG TERM GOALS AND CURRENT OPERATIONS TO ENRICH THE HEALTH OF THOSE THE ORGANIZATION SERVERS AND TO STRENGTHEN THE COMMUNITY. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS AVAILABLE FOR REVIEW BY THE BOARD AFTER APPROVAL BY THE CEO. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND SIGNED BY ALL TRUSTEES AND THE CEO ANNUALLY. THE BOARD AND THE CEO MONITOR THE STATUS OF ALL TRUSTEES THROUGHOUT THE YEAR FOR CHANGES THAT COULD LEAD TO A NEW SITUATION REQUIRING DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF TRUSTEES REVIEWS AND MAKES DECISIONS ON THE COMPENSATION PACKAGE FOR THE CEO. THE CEO COMPENSATION IS PART OF THE MANAGEMENT CONTRACT PAID TO THE OUTSIDE MANAGEMENT COMPANY. ALL MANAGERS REPORT TO THE CEO AND THE CEO REVIEWS AND MAKES DECISIONS ON THE MANAGER'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST STATEMENTS AND THE FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 679. MANAGEMENT AND GENERAL EXPENSES 158,362. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 159,041. CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 460,682. MANAGEMENT AND GENERAL EXPENSES 941,302. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,401,984. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. DANIELS MEMORIAL HOSPITAL FOUNDATION 105 5TH AVE SCOBEY MT 59263 363461891 COMMUNITY HEALTHCARE SUPPORT MT 501(C)(3) LINE 12D, III-O N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0