2020-07-14T20:31:43-05:00 2019-06-30 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2018-07-01 816016920 DANIELS MEMORIAL HOSPITAL DBA DANIELS MEMORIAL HEALTHCARE CENTER DANI 4064872296 P O BOX 400 SCOBEY MT 59263 ERIC CONNELL CEO 4064872296 2020-07-14 1 PHILIP L YASENAK CPA P01248379 4067281800 2020-07-14 4.4.25.242 2020-07-14 13:53:16 MD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BE7A92E7B0152C1C6812F3C99C620D56F411D8FD 2018 2021-01-29 14:40:06Z ERIC CONNELL P O BOX 400 SCOBEY MT 59263 8966570 0 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X 1956 MT TO PROMOTE THE GENERAL HEALTH CARE OF THE COMMUNITY THROUGH PROVIDING HIGH QUALITY HEALTH CARE. 10 10 113 2 0 0 373782 432562 7553856 8214104 405 -39950 533973 319273 8462016 8925989 0 0 0 0 4723642 4790579 0 0 0 3295153 3817470 8018795 8608049 443221 317940 3077613 3648084 1209213 1461744 1868400 2186340 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 4342148 7238967 PROFESSIONAL CARE - PRIMARY, ACUTE, AND CRITICAL ACCESS CARE. 859375 1253339 CLINIC SERVICES FOR OUTPATIENT CLIENTS. 788564 HOUSEKEEPING, LAUNDRY, LINEN & PLANT SERVICES - PROVIDE FOR THE HOUSEKEEPING AND BUILDING MAINTENANCE OF THE FACILTIY. 444592 41071 DIETARY SERVICES FOR ACUTE CARE PATIENTS. 444592 41071 6434679 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 5 0 113 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 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 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 TANNER TROWER DIRECTOR 2.00 X 0 0 0 LIANA HANDRAN DIRECTOR 2.00 X 0 0 0 MIKE BJARKO DIRECTOR 2.00 X 0 0 0 JACK PITTENGER DIRECTOR 2.00 X 0 0 0 TARA THOMAS 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 ERIC CONNELL CEO 40.00 X 0 0 0 SHIRLEY RELLER PT 40.00 X 126597 0 11153 DEANNA FERESTAD FNP 40.00 X 119874 0 11153 246471 0 22306 2 0 0 0 BILLINGS CLINIC PO BOX 30357 BILLINGS MT 59107 MANAGEMENT SERVICES 649986 WILDERNESS MEDICAL STAFFING 1124 W RIVERSIDE AVE STE 215 SPOKANE WA 99201 LOCUM PROVIDER 266330 NXC IMAGING 2118 S 4TH AVE MINNEAPOLIS MN 55404 RADIOLOGY 130213 CARDINAL HEALTH 5303 COLLECTION CENTER DR CHICAGO IL 60693 HEALTHCARE SUPPLIES 125853 SYSCO 1509 MONAD RD BILLINGS MT 59107 FOOD & FOODSERVICE SUPPLIES 121543 6 131882 13243 287437 432562 PROFESSIONAL CARE REVE 623000 6999253 6999253 CLINIC REVENUE 623000 1214851 1214851 8214104 631 631 780 0 780 780 780 40581 -40581 -40581 -40581 HOSPLITAL TAX DISTRICT 623000 146923 146923 INCOME/LOSS FROM INSUR 623000 20283 20283 151287 151287 318493 8925989 8533377 0 -39950 X 3626063 2840908 785155 73252 60793 12459 812298 694017 118281 278966 249807 29159 1325349 468941 856408 30817 164 30653 36944 19579 17365 163428 148381 15047 55974 14234 41740 125 125 3148 3148 171786 171786 123167 2933 120234 CONTRACTUAL ALLOWANCES 741789 699412 42377 MEDICAL SUPPLIES AND PH 493966 493966 OTHER SUPPLIES 180323 173471 6852 REPAIRS AND MAINTENANCE 157436 155191 2245 333218 240971 92247 8608049 6434679 2173370 0 334881 319780 139525 330999 954037 1439138 436827 138923 199525 177444 82514 72049 6037069 5150620 709227 886449 221077 283302 3077613 3648084 986026 1033011 0 145996 223187 282737 1209213 1461744 X 1868400 1997877 188463 1868400 2186340 3077613 3648084 317940 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13500 13500 3803232 3295750 507482 2115017 1827981 287036 105320 26889 78431 886449 RESIDENT CASH 2813 SUBSCRIBERS EQUITY IN INSURANCE CAPTIVE 226429 BED TAX RECEIVABLE 54060 283302 GUARANTEE OF PATIENT LOANS 131923 COST REPORT SETTLEMENT PAYABLE 148001 RESIDENT TRUST FUND 2813 282737 X 8066712 0 8066712 859277 859277 8925989 7748772 0 7748772 859277 859277 8608049 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 2015 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRACTUAL ALLOWANCES & DISCOUNTS 741,789. BAD DEBT EXPENSE 117,488. PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRACTUAL ALLOWANCES & DISCOUNTS 741,789. BAD DEBT EXPENSE 117,488. 1 1 1 X 1 X 1 1 0 0 47856 47856 0.00560 1319253 1319253 0.15330 1367109 1367109 0.15890 66731 26656 40075 0.00470 121700 121700 0.01410 3975 3975 0.00050 192406 26656 165750 0.01930 1559515 26656 1532859 0.17820 1 112697 84523 4534965 4560282 -25317 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 X 0 1 X X 1 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X WWW.DANIELSMEMORIALHEALTHCARE.ORG X WWW.DANIELSMEMORIALHEALTHCARE.ORG X X X X X 1 X 0 X X X X 1 0 0 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: 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. 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: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED ON LINE 7 IS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART III, LINE 2: BAD DEBT EXPENSE IS THE THE BAD DEBT EXPENSE LESS BAD DEBT RECOVERY FROM THE INCOME STATEMENT. PART III, LINE 3: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS ESTIMATED BY THE PATIENT ACCOUNTS MANAGER BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND THE PATIENT POPULATION. THIS YEAR, ABOUT 75% OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: SEE NOTE 1 PATIENT ACCOUNTS RECEIVABLES AND CREDIT POLICY STARTING ON PAGE 6 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COSTS OF CARE REPORTED ON LINE 6 ARE FROM THE COST REPORT. 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. THERE ARE LESS THAN SIX PEOPLE PER SQUARE MILE, THE TOWN HAS 960 PEOPLE, THE COUNTY HAS 1,406 PEOPLE, WE ARE FIVE HOURS AWAY FROM A TERTIARY HOSPITAL, AND THREE HOURS AWAY FROM A SECONDARY HOSPITAL. PART VI, LINE 5: THROUGH THE TELEMEDICINE NETWORK, PATIENTS CAN SEE SPECIALISTS FIVE HOURS AWAY RIGHT HERE. SEVERAL FREE TELEMEDICINE NETWORK SERVICES ARE OFFERED. FOR EXAMPLE, CARDIOLOGY, DIABETES, BABY-SITTING CLASSES WITH DIPLOMA, MENTAL HEALTH, AND CHEMICAL DEPENDENCY ARE ALL FREE TO THE PUBLIC AND GROUPS. 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 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 589. MANAGEMENT AND GENERAL EXPENSES 37,126. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,715. CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 468,352. MANAGEMENT AND GENERAL EXPENSES 819,282. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,287,634. 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 DANIELS MEMORIAL HOSPITAL FOUNDATION C 131882 N/A - CASH