2020-05-12T10:11:31-05:00 2019-06-30 GREEN HEALTH GROUP PC 110 5TH ST S SUITE 106 GLASGOW MT 592302338 990 2018-07-01 810231786 FRANCES MAHON DEACONESS HOSPITAL FRAN 4062283500 621 3RD STREET SOUTH GLASGOW MT 59230 CAMI KALINSKI DIRECTOR OF FINANCE 4062283660 2020-05-08 true DANIEL GREEN P01311679 4062632615 2020-05-12 52.38.98.93 2020-05-12 10:11:31 CD P 299715511C6F2C3736520DF5CC568F95C9BA9327 B74F1DB2C605EC9DD13E93A00C1C844138DDD1A4 2018 2020-09-22 18:59:49Z CAMI KALINSKI 621 3RD STREET SOUTH GLASGOW MT 59230 30816142 false X WWW.FMDH.ORG X 1914 MT TO ADVANCE THE COORDINATED DELIVERY OF HEALTH SERVICES, GUIDED WITH RESPECT FOR THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEREBY IMPROVING THE HEALTH OF OUR REGIONAL COMMUNITY. 9 7 302 389932 38027 34177 31976147 30148525 755418 483430 54986 150010 32824578 30816142 0 0 14882883 15684457 0 67928 12897481 13294560 27780364 28979017 5044214 1837125 70907553 74727228 4072697 5485156 66834856 69242072 TO ADVANCE THE COORDINATED DELIVERY OF HEALTH SERVICES, GUIDED WITH RESPECT FOR THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEREBY IMPROVING THE HEALTH OF OUR REGIONAL COMMUNITY. false false 23397511 30148525 PROVIDE QUALITY MEDICAL CARE TO PATIENTS. 23397511 true true false true false false false false false false true false true true true true false true false false false false false false false false true true false false true false false false false false false false true false false false false false true true true false false true 20 0 true 302 true true true false false false false false false false false false false false X 9 7 false false false false true true false true true false false true true true true true true true true false X CAMI KALINSKI 4062283660 621 3RD ST S GLASGOW MT 59230 LOUIS BAILEY PHYSICIAN ME 40.00 X 600916 0 24760 RANDY HOLOM CEO 40.00 X X 274844 0 23134 DON FAST PRESIDENT 2.00 X 0 0 0 STAN OZARK VICE PRESIDE 1.00 X 0 0 0 KRIS SIMENSEN SECRETARY/TR 1.00 X 0 0 0 PATRICK MENGE TRUSTEE 1.00 X 0 0 0 ERIKA BENGOCHEA TRUSTEE 1.00 X 0 0 0 LARRY BERGSTROM TRUSTEE 1.00 X 0 0 0 KARLA ZERBE TRUSTEE 1.00 X 0 0 0 ELLEN GUTTENBERG COO 40.00 X 164348 0 21190 CAMI KALINSKI DIRECTOR OF 40.00 X 134942 0 5002 KEVIN ROSS MD 12.00 28.00 X 396790 0 21679 DAVID KNIERIM MD 12.00 28.00 X 390359 0 17091 ANNE MILLARD BRADLEY MD 23.00 17.00 X 371838 0 21507 ROBERT CROCHELT MD 2.00 38.00 X 350002 0 9636 DONNA SMITH MD 6.00 34.00 X 345015 0 19081 3029054 163080 30 false true false MCKINSTRY ESSENTION LLC PO BOX 3895 SEATTLE WA 98124 CONSTRUCTION 5086453 MARQUETTE COMMERCIAL NW 6333 PO BOX 1450 MINNEAPOLIS MN 554856333 CONSULTING SVCS 1619294 MEDICAL INFORMATION TECHNOLOGY INC PO BOX 74569 CHICAGO IL 60696 DATA PROCESSING 799253 AUSTIN MAJOR GROUP 545 E JOHN CARPENTER FREEWAY STE 97 IRVING TX 75062 CONTRACT STAFF 343644 MEDPRO HEALTHCARE STAFFING 1580 SAWGRASS CORPORATE PKWY STE 20 SUNRISE FL 33323 CONTRACT STAFF 314544 5 15457 15643 3077 34177 PATIENT REVENUE 621500 29146093 29146093 PROFESSIONAL RADIOLOGY 621110 751425 560815 190610 GLASGOW CLINIC RENT 531120 139322 139322 HI-LINE MEDICAL SRVCS RENT 531120 60000 60000 OTHER RENTAL INCOME 531120 51685 51685 30148525 483430 483430 PARTNERSHIP INCOME 900099 123815 123815 COUNTY CONTRIBUTION 900099 26195 26195 150010 30816142 30392033 389932 1208037 593040 614997 11568598 9739910 1786224 42464 347027 272469 73036 1522 1559746 1202418 346648 10680 1001049 824229 173709 3111 763273 763273 62190 62190 1388731 1117019 271559 153 140089 140089 764656 333903 430142 611 9219 7540 1652 27 289657 240415 48720 522 173752 129256 43794 702 108202 84777 23358 67 2527062 2097462 425052 4548 287017 235490 51118 409 MEDICAL SUPPLIES 5009439 5009439 REPAIRS & MAINTENANCE 1330917 1178910 149703 2304 FOOD & DIETARY SUPPLIES 254332 195912 57810 610 MISCELLANEOUS 96930 68122 28610 198 89094 67200 21894 28979017 23397511 5513578 67928 3078934 3385913 1997667 4590697 5990183 3973485 4163345 785378 845235 916704 682585 52342797 28577023 19251271 23765774 19206385 16649673 17107032 19244520 70907553 74727228 3447019 4153448 625678 1331708 4072697 5485156 X 66834856 69242072 66834856 69242072 70907553 74727228 1837125 570091 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 51101 3235 54336 28856753 28911089 1000000 250000 1000000 1000000 2000000 3000000 65908 54336 120244 250000 250000 500000 750000 62404 51101 113505 88748 88748 30369354 16155922 14213432 21884695 12421101 9463594 23765774 US GOVT AGENCY SECURITIES 7051462 F MUTUAL FUNDS - EQUITY GROWTH 2664345 F DIVIDEND INDEX FUND ETF 2429280 F BROKERED CERTIFICATES OF DEPOSIT 1987467 F MUTUAL FUNDS - BOND 1271205 F CORPORATE DEBT SECURITIES 743655 F BANK CERTIFICATES OF DEPOSIT 502259 C 16649673 INTERCOMPANY AND OTHER RECEIVABLES 13711826 NE MT STAT AIR AMBULANCE INVESTMENT 3300846 MEDICARE/MEDICAID RECEIVABLES 1274714 INTEREST IN FMDH FOUNDATION 957134 19244520 MEDICARE & MEDICAID PAYABLES 1052078 NET INVESTMENT IN PRAIRIE RIDGE VILL 279630 1331708 X 31386233 570091 570091 30816142 30816142 28979017 28979017 28979017 SCHEDULE D, PAGE 3, PART X IT IS THE JUDGMENT OF MANAGEMENT THAT THE COMPANY HAS NO SIGIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THIS FOOTNOTE IS ON PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS. true true true X 1.400000000000 true X 2.400000000000 true true false true true 131231 131231 0.00450 131231 131231 0.00450 17600 17600 0.00060 2837552 1580347 1257205 0.04340 30911 30911 0.00110 2886063 1580347 1305716 0.04510 3017294 1580347 1436947 0.04960 true 982364 11996735 12066371 -69636 X true true 1 1 FRANCES MAHON DEACONESS HOSPITAL 621 3RD ST S GLASGOW MT 59230 WWW.FMDH.ORG X X X X FRANCES MAHON DEACONESS HOSPITAL 1 false false true X X X X X X X X X X 18 true false true true X WWW.FMDH.ORG X true 18 true WWW.FMDH.ORG false false true X 140.000000000000 240.000000000000 X X X X true true X X X X true X WWW.FMDH.ORG X WWW.FMDH.ORG X WWW.FMDH.ORG X X X X X true X false X X X X true X false true FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 3E AREAS OF OPPORTUNITY REPRESENT THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY, BASED ON THE INFORMATION GATHERED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE GUIDELINES SET FORTH IN HEALTHY PEOPLE 2020. FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 5 TO SOLICIT INPUT FROM INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THE CHNA PROCESS AND SENT TO A LIST OF RECOMMENDED PARTICIPANTS INCLUDING PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS AND A VARIETY OF OTHER COMMUNITY LEADERS. ALSO, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY, AND OTHER MEDICALLY UNDERSERVED POPULATIONS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. THE PARTICIPANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 64 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. THE INPUT WAS GATHERED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. ON BEHALF OF FRANCES MAHON DEACONESS HOSPITAL IN THE SPRING OF 2019. FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 6B VALLEY COUNTY PUBLIC HEALTH DEPARTMENT FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 11 THE ONLINE KEY INFORMANT SURVEY PRESENTED THE PARTICIPANTS WITH 19 HEALTH TOPICS AND WERE ASKED TO RATE EACH AS A MAJOR PROBLEM, MODERATE PROBLEM, MINOR PROBLEM, OR NOT A PROBLEM AT ALL IN THEIR OWN COMMUNITY. THESE RESULTS WERE SUMMARIZED AND THROUGH A MEETING WITH INTERNAL AND EXTERNAL STAKEHOLDERS, PRIORITIZATION WAS ACCOMPLISHED USING A PRIORITIZATION EXERCISE THAT GAUGED THE SCOPE & SEVERITY OF THE ISSUES AS WELL AS THE ABILITY OF FRANCES MAHON DEACONESS HOSPITAL TO HAVE SIGNIFICANT IMPACT ON EACH ISSUE. THROUGH DISCUSSION, A CONSENSUS WAS REACHED TO ESTABLISH THE FOLLOWING AS PRIORITIES FOR FRANCES MAHON DEACONESS HOSPITAL TO ADDRESS IN ITS IMPLEMENTATION STRATEGY IN THE COMING YEARS: MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY & WEIGHT, AND ACCESS TO HEALTH CARE SERVICES. FMDH IS ADDRESSING THE PRIORITIZED HEALTH NEEDS BY THREE OVERALL GOALS: THE FIRST GOAL IS TO UTILIZE EVIDENCE BASED TACTICS TO ADDRESS BARRIERS TO ACCESSING MENTAL HEALTH SERVICES BY AUGMENTING THE RANGE AND ACCESSIBILITY OF MENTAL/BEHAVIORAL HEALTH SERVICES THROUGH THREE STRATEGIES WHICH ARE TEXT-MESSAGE BASED HEALTH INTERVENTIONS, AN EMPLOYEE ASSISTANCE PROGRAM, AND CRISIS LINES IN SCHOOLS. THE SECOND GOAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITY BY IMPLEMENTING AND SUPPORTING EVIDENCE BASED APPROACHES TO IMPACT BEHAVIORS RELATED TO NUTRITION, WEIGHT AND PHYSICAL ACTIVITY THEREBY HAVING A POSITIVE IMPACT ON A MULTITUDE OF HEALTH CONDITIONS THROUGH THREE STRATEGIES WHICH ARE OUTDOOR EXPERIENTAL EDUCATION AND WILDERNESS THERAPY, COMMUNITY BASED SOCIAL SUPPORT FOR PHYSICAL ACTIVITY, AND COMPETITIVE PRICING FOR HEALTH FOODS. THE THIRD GOAL IS TO IMPROVE ACCESS TO HEALTH CARE SERVICES THROUGH THREE STRATEGIES WHICH ARE RURAL TRANSPORTATION SERVICES, TRAINING IN MEDICAL EDUCATION, AND COMMUNITY INTEGRATED HEALTH. NINE ADDITIONAL SIGNFICANT HEALTH NEEDS THAT EMERGED FROM THIS COMMUNITY HEALTH NEEDS ASSESSMENT ARE OUTLINED BELOW. THESE NEEDS WILL NOT BE SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION STRATEGY, ALTHOUGH SOME MAY BE ADDRESSED IN SOME WAY THROUGH PROGRAMS TARGETING THE TOP HEALTH NEEDS WHICH WILL BE ADDRESSED. 1. SUBSTANCE ABUSE - FMDH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS ALCOHOL, TOBACCO AND OTHER DRUG ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE MENTAL HEALTH WILL HAVE A POSITIVE IMPACT ON THE COMMUNITY'S SUBSTANCE ABUSE, AND THAT A SEPARATE SET OF SUBSTANCE ABUSE INITIATIVES WAS NOT NECESSARY GIVEN LIMITED RESOURCES. 2. TOBACCO USE - FMDH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS ALCOHOL, TOBACCO AND OTHER DRUG ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. WHILE THIS NEED WAS NOT SCHEDULED TO BE ADDRESSED, IN 2018, FMDH EXECUTED A TOBACCO CESSATION MASS MARKETING PLAN TO RAISE AWARENESS OF THE RISKS ASSOCIATED WITH TOBACCO AS WELL AS OPPORTUNITIES WITHIN OUR COMMUNITY TO QUIT. WE RAN WEEKLY AND MONTHLY ADS IN OUR LOCAL PUBLICATIONS, SPONSORED A 'SMOKE FREE' MOVIE NIGHT TARGETING HIGH SCHOOL YOUTH, SPONSORED ANTI-TOBACCO T-SHIRTS FOR HIGH SCHOOL YOUTH, AND RAN A RADIO MEDIA CAMPAIGN, SOCIAL MEDIA CAMPAIGN AND A BILLBOARD CAMPAIGN TARGETING ADULTS. FMDH ALSO SPONSORED RED THUMB DAY, A COMMUNITY EVENT RAISING AWARENESS OF UNHEALTHY BEHAVIORS AND PARTICIPATING IN THE VALLEY CARE COALITION. 3. CANCER - ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 4. RESPIRATORY DISEASES - ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 5. INJURY & VIOLENCE PREVENTION - FMDH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 6. INFANT HEALTH & FAMILY PLANNING - FMDH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 7. STD HIV/AIDS - FMDH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 8. DIABETES - FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE NUTRITION, WEIGHT AND PHYSICAL ACTIVITY WILL HAVE A POSITIVE IMPACT ON THE COMMUNITY'S DIABETIC POPULATION, AND THAT A SEPARATE SET OF DIABETIC- SPECIFIC INITIATIVES WAS NOT NECESSARY GIVEN LIMITED RESOURCES. 9. HEART DISEASE & STROKE - FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE NUTRITION, WEIGHT AND PHYSICAL ACTIVITY WILL HAVE A POSITIVE IMPACT ON THE COMMUNITY'S PROPENSITY TOWARD HEART DISEASE AND STROKE, AND THAT A SEPARATE SET OF SPECIFIC INITIATIVES WAS NOT NECESSARY GIVEN LIMITED RESOURCES. FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 24 SOME SERVICES PROVIDED BY THE HOSPITAL ARE CONSIDERED ELECTIVE. ELECTIVE SERVICES ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE THUS A PERSON QUALIFYING FOR A DISCOUNT FOR MEDICALLY NECESSARY SERVICES MAY NEED TO PAY FULL PRICE FOR ELECTIVE SERVICES. 1 GLASGOW CLINIC PC 621 THIRD STREET SOUTH GLASGOW MT 59230 RURAL HEALTH CLINIC PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THE COST OF BAD DEBT REMOVED FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C IS 197,824. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND COMMUNITY BENEFIT. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF BAD DEBT WHICH REDUCE BAD DEBT EXPENSE. NONE OF THE BAD DEBT IS CONSIDERED ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. BAD DEBTS ARE AN INEVITABLE RESULT OF OPERATING A NON PROFIT HOSPITAL. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 - MEDICARE EXPLANATION THERE IS A MEDICARE SHORTFALL SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE, BUT THIS IS THEN REDUCED BY THE 2 PERCENT SEQUESTRATION ADJUSTMENT AND INPATIENT SERVICES ARE REDUCED BY 1 PERCENT FOR NOT MEETING MEANINGFUL USE FOR EHR. THIS MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT SINCE THE HOSPITAL IS PROVIDING MEDICARE PATIENT CARE SERVICES AT LESS THAN THE COST. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT. THE ELECTRONIC HEALTH RECORD CAPITAL COSTS AND RELATED INCENTIVE PAYMENTS ARE EXCLUDED FROM THIS CALCULATION. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, COMBINED WITH AN ASSET TEST AND A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS FINANCIAL ASSISTANCE. FOR PATIENTS THAT HAVE HAD A PORTION OF THEIR ACCOUNT WRITTEN OFF AS FINANCIAL ASSISTANCE AND THAT LATER DEFAULT ON THE PORTION THAT WAS DETERMINED TO BE THEIR RESPONSIBILITY, AND THEREFORE IS NOT CONSIDERED FINANACIAL ASSISTANCE, THE ORGAINIZATION DOES ATTEMPT TO COLLECT THIS BALANCE. PART VI, LINE 2 - NEEDS ASSESSMENT PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, FRANCES MAHON DEACONESS HOSPITAL COMPLETED A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION PLAN DURING FISCAL YEARS 2013, 2016, & 2019 (TAX YEARS 2012, 2015, & 2018). THESE ASSESSMENTS ARE LOCATED ON THE ENTITY'S WEBSITE. HOWEVER, FRANCES MAHON DEACONESS HOSPITAL (FMDH) HAS TRADITIONALLY INCLUDED COMMUNITY NEEDS ASSESSMENTS IN ITS PLANNING FOR MANY YEARS AND UTILIZES MANY METHODS OF ASSESSING THE PATIENT SERVICES NEEDS FOR OUR SERVICE AREA. THESE INCLUDE BUT ARE NOT LIMITED TO: ANALYSIS OF OUTMIGRATION STATISTICS OBTAINED THROUGH ACCESS TO THE COMPDATA DATABASE PROVIDED THROUGH THE MONTANA HOSPITAL ASSOCIATION AND MODELING OF PATIENT TO POPULATION RATIOS TO IDENTIFY AND PLAN FOR THE APPROPRIATE PROVIDER MIX TO SERVE THE COMMUNITY. IN ADDITION, FMDH PARTICIPATED IN AN AREA HEALTH EDUCATION CENTER LEAD COMMUNITY HEALTH SERVICES DEVELOPMENT ASSESSMENT. IDEAS GENERATED OUT OF EACH OF THESE EFFORTS ARE THEN EVALUATED AS TO THE CAPABILITIES OF OUR ORGANIZATION TO DEVELOP IDENTIFIED SERVICES. MINIMUM CRITERIA FOR DEVELOPMENT OF NEW OR MODIFICATION OF EXISTING SERVICES ARE: THE NEW OR MODIFIED SERVICE CAN REASONABLY FINANCIALLY SUPPORT ITS OPERATION; WE HAVE OR CAN ACQUIRE THE NECESSARY PERSONNEL WITH THE CREDENTIALS TO DELIVER THE SERVICE AND RETAIN ENOUGH PERSONNEL WITH THE REQUIRED SKILL SETS TO AVOID INTERRUPTION OF SERVICE DELIVERY IF SAID PERSONNEL TURN OVER; THE SERVICES CAN BE DELIVERED IN A MANNER THAT ACHIEVES APPROPRIATELY HIGH LEVELS OF PATIENT SATISFACTION. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FRANCES MAHON DEACONESS HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO HAS THE SOLE RESPONSIBILITY TO WORK WITH PATIENTS TO NAVIGATE OUR FINANCIAL ASSISTANCE PROGRAM. ALL PATIENTS ARE SENT INFORMATION AT THE INITIAL BILLING FOR DELIVERED PATIENT SERVICES THAT DESCRIBES OUR FINANCIAL ASSISTANCE PROGRAM. OUR WEBSITE HAS INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM ALONG WITH ACCESS TO THE APPLICATION. FRANCES MAHON DEACONESS HOSPITAL ALSO EMPLOYS A STAFF MEMBER THAT IS A CERTIFIED APPLICATION COUNSELOR THAT HELPS COMMUNITY MEMBERS WITH APPLYING FOR INSURANCE AND MEDICAID ON THE MARKETPLACE. PART VI, LINE 4 - COMMUNITY INFORMATION FRANCES MAHON DEACONESS HOSPITAL IS LOCATED IN GLASGOW MONTANA WHICH IS OVER FOUR HOURS HIGHWAY TRAVEL TIME AWAY FROM ANY TERTIARY MEDICAL CENTER. WHILE OUR PRIMARY SERVICE AREA CONSISTS OF GLASGOW MONTANA AND VALLEY COUNTY, OUR FACILITY AND SPECIALTY SERVICES ALSO DRAW FROM PORTIONS OF THE SURROUNDING COUNTIES OF DANIELS, ROOSEVELT, AND PHILLIPS. THE AREA IS PRIMARILY AGRICULTURAL BASED WITH LOW POPULATION DENSITIES WHICH HOUSES A TOTAL POPULATION OF 24,706 RESIDENTS OVER 13,847.01 SQUARE MILES. THE DIFFERENT AGE GROUPS OF THE SERVICE AREA ARE AS FOLLOWS: 27.0% ARE INFANTS, CHILDREN OR ADOLESCENTS AGES 0-17; ANOTHER 56.5% ARE AGES 18 TO 64, WHILE 16.5% ARE AGES 65 AND OLDER. THE POPULATION IS MOSTLY WHITE, BUT PORTIONS OF OUR EXTENDED SERVICE AREA HAVE HIGH POPULATIONS OF NATIVE AMERICAN ANCESTRY (29.9% IN THE TOTAL SERVICE AREA) TO WHICH WE PROVIDE SERVICES. THE STATISTICS PROVIDED ABOVE ARE BASED ON THE US CENSUS BUREAU AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017). PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH FRANCES MAHON DEACONESS HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF. WE ARE GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY PERSONS REPRESENTING MOST OF THE INDIVIDUAL TOWNS OR GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. FOR NONELECTIVE SERVICES, WE TREAT PATIENTS WITHOUT REGARD TO ABILITY TO PAY, CONSISTENT WITH OUR ORIGINS AS A HILL BURTON FUNDED FACILITY. ALTHOUGH OUR HILL BURTON OBLIGATION WAS SATISFIED MANY YEARS AGO, WE STILL ADHERE TO THE PRINCIPLES INHERENT IN THAT OBLIGATION. SURPLUS FUNDS ARE RETAINED WITHIN THE ORGANIZATION TO ASSURE FULFILLMENT OF OUR CHARITABLE MISSION BOTH IN THE PRESENT AND IN THE FUTURE. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM FRANCES MAHON DEACONESS HOSPITAL PROVIDES HOSPITAL INPATIENT AND OUTPATIENT SERVICES. GLASGOW CLINIC PC PROVIDES PROFESSIONAL PRIMARY CARE PHYSICIAN, MIDLEVEL PROVIDER, AND SPECIALTY PHYSICIAN SERVICES. HI-LINE MEDICAL SERVICES INC PROVIDES RETAIL PHARMACY SERVICES. ADDITIONAL INFORMATION PART I, LINE 6A: THE FORM 990 SCHEDULE H IS CONSIDERED AN ANNUAL COMMUNITY BENEFIT REPORT AND IT IS AVAILABLE TO THE PUBLIC ON OUR WEBSITE. PART 1, LINE 7E: FMDH ENGAGED IN CHNA ACTIVITIES AND CREATED A BILLBOARD SUPPORTING NUTRITION, WEIGHT, AND PHYSICAL ACTIVITY. PART I, LINE 7I: FMDH CONTRIBUTED TO THE SCHOOLS IN VALLEY COUNTY FOR THE HEALTHY SCHOOL SNACK PROGRAM AND COMMUNITY POOL CAMPAIGN. PART V: GLASGOW CLINIC PC IS A SEPARATE ORGANIZATION THAT IS A RURAL HEALTH CLINIC WHICH INCLUDES SPECIALTY PHYSICIAN PRACTICES. FMDH WHOLLY OWNS AND MANAGES THIS ENTITY AND SUBSIDIZES THE PHYSICIAN PRACTICES AS NEEDED TO ASSURE ACCESS TO AS FULL OF A SCOPE OF SERVICES AS IS APPROPRIATE GIVEN THE NEEDS OF THE COMMUNITY WE SERVE. GLASGOW CLINIC'S REVENUES AND EXPENSES ARE NOT INCLUDED ON FMDH'S FORM 990. HI-LINE MEDICAL SERVICES, INC IS A SEPARATE ORGANIZATION WHICH CONSISTS OF A RETAIL PHARMACY AND IS WHOLLY OWNED AND OPERATED BY FMDH. THEIR REVENUES AND EXPENSES ARE NOT INCLUDED ON FMDH'S FORM 990. X X X false false false false false false false false false LOUIS BAILEY PHYSICIAN MEMBER 600916 9625 15135 625676 RANDY HOLOM CEO 274844 9625 13509 297978 ELLEN GUTTENBERG COO 164348 6055 15135 185538 KEVIN ROSS MD 396790 9625 12054 418469 DAVID KNIERIM MD 390359 9625 7466 407450 ANNE MILLARD BRADLEY MD 371838 9625 11882 393345 ROBERT CROCHELT MD 350002 9625 11 359638 DONNA SMITH MD 345015 9625 9456 364096 SCHEDULE J, PART III A PERCENTAGE OF THE COMPENSATION PAID TO KEVIN ROSS, M.D. (70%), DAVID KNIERIM, M.D. (70%), DONNA SMITH, M.D. (85%), ANNE MILLARD BRADLEY, M.D. (42%), AND ROBERT CROCHELT, M.D. (95%) IS AN EXPENSE OF GLASGOW CLINIC PC, A RELATED COMPANY. THE COMPENSATION WAS PAID TROUGH FRANCES MAHON DEACONESS HOSPITAL AS A CENTRAL PAYMASTER. FIRST COMMUNITY BANK BOARD MEMBERS 752419 BANKING & INVESTING false SCHEDULE L, PART V THE HOSPITAL CEO AND ONE BOARD MEMBER ARE BOTH BOARD MEMBERS OF FIRST COMMUNITY BANK, PLUS THE BOARD MEMBER IS ALSO AN OFFICER OF THE BANK. THE HOSPITAL HAS BANK ACCOUNTS AND INVESTMENTS WITH FIRST COMMUNITY BANK. THE BUSINESS RELATIONSHIP WITH THE BANK IS MANAGED BY THE DIRECTOR OF FINANCIAL SERVICES OF THE HOSPITAL AND SHE HAS A DIRECT REPORTING RELATIONSHIP TO THE BOARD FINANCE COMMITTEE IN THIS REGARD. FURTHER, ANY DECISION MADE BY THE DIRECTOR OF FINANCIAL SERVICES IS GOVERNED BY POLICIES AND PROCEDURES APPROVED BY THE ENTIRE BOARD OF TRUSTEES ON THE RECOMMENDATION OF THE FINANCE COMMITTEE. ADDITIONALLY, FOR ANY PARTICULAR BUSINESS TRANSACTION OR DECISION THAT DIRECTLY INVOLVES FIRST COMMUNITY BANK, THE CEO AND THE BOARD MEMBER WITH A CONFLICT OF INTEREST LEAVE THE BOARD MEETING WHILE THE REMAINING BOARD MEMBERS DELIBERATE OR ACT ON THE MATTER. THE TRANSACTION DOLLAR AMOUNT SHOWN ABOVE IS THE NET INCREASE IN THE HOSPITAL'S BANK ACCOUNT AND INVESTMENT BALANCES WITH FIRST COMMUNITY BANK AND AFFILIATED COMPANIES FOR THE FISCAL YEAR. FORM 990, PAGE 6, PART VI, LINE 6 MEMBERSHIP IN THE FRANCES MAHON DEACONESS HOSPITAL CORPORATION (FMDH) IS ACHIEVED BY VIRTUE OF DONATING AT LEAST 100 TO FMDH, TO THE FRANCES MAHON DEACONESS HOSPITAL FOUNDATION (ALTHOUGH THE FOUNDATION IS A SEPARATE CHARITABLE ENTITY AND NOT CONTROLLED BY THE FMDH CORPORATION, ITS STATED PURPOSE IS TO SUPPORT FMDH AND THE DELIVERY OF HEALTHCARE SERVICES IN VALLEY COUNTY, MONTANA, THROUGH CHARITABLE DONATIONS SUPPORTING SERVICES DEVELOPMENT AND EQUIPMENT PURCHASES), AND LUKE'S 100 (ANOTHER LOCAL CHARITABLE ORGANIZATION SEPARATE FROM FMDH BUT WHICH SUPPORTS FMDH THROUGH ANNUAL DONATIONS). THERE ARE NO DISTINCT CLASSES OF MEMBERS; ALL MEMBERS ARE PART OF A SINGLE MEMBERSHIP CLASS. FMDH CORPORATION MEMBERS EXERCISE NO GOVERNANCE CONTROL OVER FMDH WITH THE EXCEPTION OF THE ABILITY TO BRING CHARGES AGAINST A BOARD MEMBER FOR MALFEASANCE OR NONFEASANCE OF THE DUTIES AND RESPONSIBILITIES OF THE ENTITY WHICH, THROUGH A DUE PROCESS, CORPORATE MEMBERS CAN VOTE A BOARD MEMBER OUT WITH A VOTE OF 2/3 OF CORPORATE MEMBERS PRESENT AND CORPORATE MEMBERS TOTAL AT LEAST 50 MEMBERS OR 5% OF THE TOTAL CORPORATE MEMBERS, WHICHEVER IS FEWER. FORM 990, PAGE 6, PART VI, LINE 7A THERE ARE NO DISTINCT CLASSES OF MEMBERS; ALL MEMBERS ARE PART OF A SINGLE MEMBERSHIP CLASS. THE MEMBERS ELECT ALL MEMBERS OF THE FMDH BOARD OF TRUSTEES. ELECTION OF THE GOVERNING BOARD IS GRANTED TO THE FMDH BOARD OF TRUSTEES. HOWEVER, THE FMDH CORPORATION MEMBERS MAY VOTE OUT A TRUSTEE UPON DUE PROCESS. THEY EXERCISE NO OTHER GOVERNANCE OR CONTROL OVER FMDH. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND DIRECTOR OF FINANCIAL SERVICES AND IS MADE AVAILABLE FOR THE BOARD'S REVIEW PRIOR TO BEING FILED. FORM 990, PAGE 6, PART VI, LINE 12C CONFLICTS OF INTEREST ARE REQUIRED TO BE REPORTED AT THE FIRST MEETING OF EACH CALENDAR YEAR. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST THEY ARE REQUIRED TO LEAVE THE BOARD MEETING WHILE THE BUSINESS IS BEING DISCUSSED OR ACTED UPON. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF TRUSTEES APPROVES THE CEO'S COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B THE BOARD OF TRUSTEES APPROVES THE COMPENSATION FOR ALL PHYSICIANS EMPLOYED BY FMDH. THE CEO APPROVES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PAGE 6, PART VI, LINE 19 ALL WRITTEN POLICIES ARE KEPT IN THE OFFICE OF THE DIRECTOR OF FINANCIAL SERVICES AND ARE AVAILABLE UPON REQUEST. FMDH FOUNDATION 621 3RD STREET SOUTH GLASGOW MT 59230 810406872 SUPPORT MT 501C3 7 NA false PRAIRIE RIDGE VILLAGE LLP 521 4TH AVE S GLASGOW MT 59230 810515202 ASSTLIVING MT 501C3 10 NA false NE MT STAT AIR AMBULANCE COOPERATIV 519 PLEASANT STREET MILES CITY MT 59301 204748673 AIR AMBULA MT 501C3 12B NA false HI-LINE MEDICAL SERVICES INC 621 THIRD STREET SOUTH GLASGOW MT 59230 208393201 PHARMACY MT N/A false GLASGOW CLINIC PC 621 THIRD STREET SOUTH GLASGOW MT 59230 810341714 CLINIC MT N/A false true false true true false false false false false true false false false false true true false true false FMDH FOUNDATION O 52382 STAFF & OTHER ITEMS GLASGOW CLINIC PC J 139322 RENTAL INCOME GLASGOW CLINIC PC R 1835747 CHANGE IN RECEIVABLE HI-LINE MEDICAL SERVICES INC J 60000 RENTAL INCOME HI-LINE MEDICAL SERVICES INC R -950220 CHANGE IN RECEIVABLE PRAIRIE RIDGE VILLAGE LLP D 3415131 LOAN BALANCE PRAIRIE RIDGE VILLAGE LLP A 180439 INTEREST RECEIVED ON LOAN FMDH FOUNDATION C 15457 SUPPORT TAX YEAR 2017 WAS THE FIRST YEAR THE ORGANIZATION HAS HAD A SECTION 501(H) ELECTION IN EFFECT AND IT HAS NOT BEEN REVOKED. LOBBYING EXPENSES FOR YEARS BEFORE 2017 WERE DISCLOSED AND DEFINED IN PART II-B OF SCHEDULE C.