2021-11-09T09:22:49-06:00 2021-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2020-07-01 205970239 BULLHOOK COMMUNITY HEALTH CENTER INC BULL 4063954305 521 4TH STREET HAVRE MT 59501 MICHAEL RAPPOLD BOARD CHAIR 4063954305 2021-11-08 1 MICHAEL RAPPOLD 999009999 KURT BENNION CPA P01469618 4252506100 2021-11-08 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KYNDRA HALL 521 4TH STREET HAVRE MT 59501 7720491 0 X WWW.BULLHOOK.COM X 2007 MT INSPIRING A HEALTHY COMMUNITY THROUGH PATIENT-CENTERED CARE. 11 11 81 14 0 0 2134183 8649928 4167399 3994521 67034 23399 82671 -4947357 6451287 7720491 0 121045 0 0 3965078 3944511 0 0 396 1673308 2288106 5638386 6353662 812901 1366829 10598651 10995444 1344846 374810 9253805 10620634 X INSPIRING A HEALTHY COMMUNITY THROUGH PATIENT-CENTERED CARE. 0 0 4974068 121045 3994521 BULLHOOK COMMUNITY HEALTH CENTER'S MISSION IS TO INSPIRE A HEALTHY COMMUNITY THROUGH PATIENT-CENTERED CARE.OUR VISION:- WE ARE A COMMUNITY LEADER IN HEALTHCARE.- PEOPLE TRUST US.- WE RESPECT ALL CULTURES.- WE ARE FINANCIALLY VIABLE.- WE ARE COMMITTED TO UTILIZING HEALTHCARE EFFICIENTLY.- OUR PROVIDERS ARE CHAMPIONS OF PATIENT-CENTERED CARE. - OUR STAFF IS COMPETENT, CARING AND HAPPY.(CONTINUED ON SCHEDULE O)BULLHOOK COMMUNITY HEALTH CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). HEALTH CENTERS ARE IMPORTANT SAFETY NET PROVIDERS IN RURAL AND URBAN AREAS. IN ORDER TO QUALIFY AS A FQHC, AN ORGANIZATION MUST: 1. PROVIDE SERVICES TO ALL PERSONS, REGARDLESS OF THE PERSON'S ABILITY TO PAY;2. ESTABLISH A SLIDING FEE DISCOUNT PROGRAM;3. BE A NONPROFIT OR PUBLIC ORGANIZATION;4. BE COMMUNITY-BASED, WITH THE MAJORITY OF THEIR GOVERNING BOARD OF DIRECTORS COMPOSED OF THEIR PATIENTS;5. SERVE A MEDICALLY UNDERSERVED AREA OR POPULATION;6. PROVIDE COMPREHENSIVE PRIMARY CARE SERVICES; AND7. HAVE AN ONGOING QUALITY ASSURANCE PROGRAM.BULLHOOK COMMUNITY HEALTH CENTER'S COMMITMENT TO QUALITY CARE MAKES A DIFFERENCE IN THE LIVES OF THE COMMUNITY. OUR COMMITMENT STEMS FROM OUR GOAL TO PROVIDE COMPLETE HEALTHCARE FOR OUR PATIENTS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY. AS A CERTIFIED PATIENT CENTERED MEDICAL HOME (PCMH) WE PUT YOU, THE PATIENT, AT THE CENTER OF THE HEALTHCARE SYSTEM. OUR TEAM OF FAMILY PHYSICIANS AND FAMILY NURSE PRACTITIONERS, DENTISTS, PHARMACISTS, ADDICTION COUNSELORS, LICENSED CLINICAL SOCIAL WORKERS, AND THEIR STAFF, ARE TRAINED IN PROVIDING HEALTHCARE SERVICES TO PEOPLE OF ALL AGES. WE PROVIDE A WIDE RANGE OF SERVICES INCLUDING ROUTINE PREVENTATIVE CARE, INCLUDING IMMUNIZATIONS, EDUCATION, WELL CHILD CHECKS, AND MEN'S AND WOMEN'S HEALTH PHYSICALS, AS WELL AS MANAGEMENT OF ACUTE AND CHRONIC DISEASES, DENTAL CARE, MENTAL HEALTH COUNSELING, ADDICTION COUNSELING, AND PHARMACY SERVICES INCLUDING DIABETIC EDUCATION AND MEDICATION MANAGEMENT. WE PROVIDE THESE SERVICES TO ENSURE THAT OUR PATIENTS AND THEIR FAMILIES HAVE THE INFORMATION AND TOOLS NECESSARY TO TAKE CONTROL OF THEIR HEALTH AND INCREASE THEIR QUALITY OF LIFE.BULLHOOK HAS HELPED THROUGH THE COVID PANDEMIC IN PROVIDING COVID TESTING DRIVE-THROUGH EVENTS AND ON-SITE COVID TESTING FOR PATIENTS AND THOSE WHO HAVE BEEN IDENTIFIED THROUGH CONTRACT TRACING. BULLHOOK HAS ALSO PLAYED IN INTEGRAL PART IN GETTING VACCINATIONS OUT IN OUR COMMUNITY. WE PARTICIPATED IN SEVERAL MASS VACCINATION CLINICS AND ALSO OFFERED VACCINATIONS IN-HOUSE TO PATIENTS AND NON-PATIENTS ALIKE, THANKS TO VACCINATIONS SUPPLIED THROUGH THE STATE. 4974068 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 2 0 81 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X KYNDRA HALL 4063954305 521 4TH STREET HAVRE MT 59501 DEE ALTHOUSE PHYSICIAN 40.00 0.00 X 190037 0 12901 CRAIG KANESHIRO CDO/DENTIST 40.00 0.00 X 156486 0 11895 JAMES CONRAD KUSEL DENTIST 40.00 0.00 X 148587 0 11658 KYNDRA HALL CEO 54.90 0.10 X 149108 0 4473 CINDY BRANDON PHARMACIST 40.00 0.00 X 131335 0 10474 DARIN MILLER PHARMACIST 40.00 0.00 X 131477 0 3944 EMILY RIGGIN CFO (THROUGH SEPTEMBER 2020) 40.00 0.00 X 61820 0 3055 MARIE GILLETT CFO 40.00 0.00 X 0 0 0 DEBI RHINES CHAIR & DIRECTOR 2.00 0.00 X X 0 0 0 MICHAEL RAPPOLD DIRECTOR & CHAIR 2.00 0.00 X X 0 0 0 WILLIAM LANIER VICE-CHAIR 2.00 0.00 X X 0 0 0 CAROL REIFSCHNEIDER SECRETARY 2.00 0.00 X X 0 0 0 THOMAS LAFOND TREASURER DIRECTOR (THROUGH NOVEMBER 2020) 2.00 0.00 X X 0 0 0 JUSTIN DONEY DIRECTOR & TREASURER 2.00 0.00 X X 0 0 0 ZACHARY CICHOSZ DIRECTOR 1.00 0.00 X 0 0 0 SHANTEL CRONK DIRECTOR 1.00 0.00 X 0 0 0 MICHELLE ENTROT DIRECTOR 1.00 0.00 X 0 0 0 JOHN KELLEHER DIRECTOR 1.00 0.00 X 0 0 0 SARAH MCKINNEY DIRECTOR (THROUGH SEPTEMBER 2020) 1.00 0.00 X 0 0 0 WILL RAWN DIRECTOR 1.00 0.00 X 0 0 0 TERRY SYKES DIRECTOR (THROUGH JUNE 2021) 1.00 0.00 X 0 0 0 CORI WINSOR DIRECTOR 1.00 0.00 X 0 0 0 968850 0 58400 7 0 1 0 FIRST CALL COMPUTER SOLUTIONS PO BOX 7219 MISSOULA MT 59807 IT SUPPORT SERVICES 171380 ECLINICAL WORKS PO BOX 847950 BOSTON MA 02284 ELECTRONIC MEDICAL RECORD SERVICES 131062 2 4435911 3891173 322844 4380958 8649928 NET PATIENT SERVICES 621400 2617623 2617623 PHARMACY REVENUE 624100 1376898 1376898 3994521 23399 23399 MISCELLANEOUS INCOME 900099 165453 165453 LOSS ON NMTC DISSOLUTION 900099 -5112810 -5112810 -4947357 7720491 3994521 0 -4923958 121045 121045 202613 202613 3113566 2679103 434463 82424 71865 10559 332922 270547 62375 212986 172460 40526 92979 92979 29525 29525 415908 164703 251205 195396 175865 19531 113955 7498 106457 142435 142039 396 58344 39279 19065 3174 2852 322 20626 18530 2096 276383 237614 38769 51603 51603 MEDICAL SUPPLIES 741425 741425 MAINTENANCE 85552 68442 17110 DUES & SUBSCRIPTIONS 60405 60405 MISCELLANEOUS EXPENSES 396 396 6353662 4974068 1379198 396 670714 110770 3495735 5151857 24374 115673 119823 5112810 142179 153043 21233 27331 7492022 2133067 955216 5358955 60717 73665 10598651 10995444 429368 374810 187278 728200 1344846 374810 X 9241009 10607753 12796 12881 9253805 10620634 10598651 10995444 1366829 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 880939 880939 5360891 1491670 3869221 1090192 641397 448795 160000 160000 5358955 X 8414102 5129522 5129522 3284580 4435911 4435911 7720491 6249330 16713 16713 6232617 121045 121045 6353662 PART X, LINE 2: THE CLINIC IS TAX-EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND COMPARABLE STATE LAW. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS INCLUDED IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CLINIC'S TAX POSITIONS AND CONCLUDED THAT THE CLINIC HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE CLINIC'S FEDERAL EXEMPT ORGANIZATION INCOME TAX RETURNS (FORM 990) ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISSOLUTION OF NEW MARKETS TAX CREDIT 5,112,809. PATIENT ASSISTANCE 16,713. PART XI, LINE 4B - OTHER ADJUSTMENTS: TRANSFER FROM RELATED ORGANIZATION 4,435,911. PART XII, LINE 2D - OTHER ADJUSTMENTS: PATIENT ASSISTANCE 16,713. PART XII, LINE 4B - OTHER ADJUSTMENTS: TRANSFER TO RELATED ORGANIZATION 121,045. 1 BULLHOOK QALICB INC 521 4TH STREET HAVRE MT 59501 900943022 501(C)(3) 121045 TRANSFER OF LIABILITIES UPON DISSOLUTION 1 0 PART I, LINE 2: THE ONLY TRANSFER WAS TO BULLHOOK QALICB, A SUBSIDIARY ORGANIZATION, UPON THE DISSOLUTION OF QALICB. ALL TRANSFERRED ASSETS WERE MONITORED BY COMMON MANAGEMENT BETWEEN THE ORGANIZATIONS. X X X X 0 0 0 0 0 0 0 0 0 DEE ALTHOUSE PHYSICIAN 190037 0 0 0 0 0 5701 0 7200 0 202938 0 0 0 CRAIG KANESHIRO CDO/DENTIST 156486 0 0 0 0 0 4695 0 7200 0 168381 0 0 0 JAMES CONRAD KUSEL DENTIST 148587 0 0 0 0 0 4458 0 7200 0 160245 0 0 0 KYNDRA HALL CEO 149108 0 0 0 0 0 4473 0 0 0 153581 0 0 0 SCHINE ELECTRICS THE SPOUSE OF DEBI RHINES, BOARD MEMBER, OWNS SCHINE ELECTRICS 161760 ELECTRICAL WORK 0 X 1 4363623 NET BOOK VALUE X 12 17335 INVOICE PRICE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS AND THE PAST-CHAIR IF THEY REMAIN A CURRENT BOARD MEMBER. THE EXECUTIVE COMMITTEE CONVENES AS NECESSARY AND, UNDER THE DIRECTION OF THE BOARD, ACTS FOR THE ORGANIZATION IN ALL MATTERS DURING THE INTERIM PERIOD BETWEEN BOARD MEETINGS. THE EXECUTIVE COMMITTEE CONDUCTS THE PRELIMINARY EVALUATION OF THE CEO AND MAKES RECOMMENDATIONS TO THE FULL BOARD ACCORDINGLY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE ORGANIZATION'S CEO, BY THE FINANCE COMMITTEE, AND BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS, MEMBERS OF A COMMITTEE WITH BOARD-DELEGATED POWERS, AND OFFICERS. IF A PERSON HAS AN ACTUAL OR POTENTIAL CONFLICT, THEY DISCLOSE ITS EXISTENCE AND ALL MATERIAL FACTS. THAT INDIVIDAUL THEN LEAVES THE MEETING WHILE THE REMAINING INDIVIDUALS VOTE ON WHETHER A CONFLIC EXISTS. IF A CONFLICT EXISTS, THE BOARD OR A COMMITTEE TAKES APPROPRIATE STEPS TO DETERMINE WHETHER THE TRANSACTION WOULD BE IN THE ORGANIZATION'S BEST INTEREST. IF NO BETTER TRANSACTION CAN BE IDENTIFIED, THE DISINTERESTED BOARD OF COMMITTEE MEMBERS VOTE ON WHETHER TO ENTER THE TRANSACTION. IF AN INDIVIDUAL VIOLATES THE CONFLICT OF INTEREST POLICY, THE BOARD OF DIRECTORS WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTIONS. EACH INDIVIDUAL IS REQUIRED TO SIGN A STATEMENT WHEN THEY ARE ELECTED OR APPOINTED TO THE POSITION. PERIODIC REVIEWS ARE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 15A TO EVALUATE THE CEO'S COMPENSATION, THE BOARD OF DIRECTORS REVIEWS THE CHAMPS SALARY SURVERY. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED. THE REVIEW PROCESS LAST OCCURED IN 2021. TO EVALUATE THE OTHER OFFICERS' COMPENSATION, THE CEO REVIEWS THE CHAMPS SALARY SURVEY. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED. THE REVIEW PROCESS LAST OCCURRED IN 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S MAIN OFFICE. BULLHOOK QALICB INC 521 4TH STREET HAVRE MT 59501 900943022 SUPPORT BULLHOOK COMMUNITY HEALTH CENTER, INC MT 501(C)(3) LINE 12A, I BULLHOOK COMMUNITY HEALTH CENTER INC 1 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 BULLHOOK QALICB INC B 121045 NET BOOK VALUE BULLHOOK QALICB INC C 4435911 NET BOOK VALUE