2019-11-15T10:15:44-06:00 2018-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-01-01 474717998 Bozeman Health Deaconess Hospital BOZE 4064145000 915 Highland Blvd Bozeman MT 59715 Brad Ludford CFO 4064145000 2019-11-13 1 Kim Hunwardsen CPA P00484560 6122536500 2019-11-11 216.147.181.47 2019-11-13 13:44:33 MS P B1517DAAED479AA3B0236E79C14EA2E11B9BE589 EE7B44BF798B4EF79D5DDE03D0EF16CE53CA0C32 2018 2020-03-31 21:24:44Z Brad Ludford 915 Highland Blvd Bozeman MT 59715 373690147 0 X www.bozemanhealth.org X 2015 MT To improve community health and quality of life for residents and visitors of Southwest Montana. 3 2 2039 285 760729 0 1547864 473226 292255233 316753481 9463267 10734001 676233 999036 303942597 328959744 0 60000 0 0 87968965 92757558 0 0 0 193566443 219251409 281535408 312068967 22407189 16890777 364510562 435688580 84511597 152292989 279998965 283395591 X To improve community health and quality of life. 0 0 92967477 60000 89704719 The Bozeman Health Deaconess Hospital clinics consists of our departments that provide physician services to outpatients. The number of Medicare and Medicaid patients seen increased by about 9% from 2017 to 2018. Revenue for these patients totaled 54% of all clinic revenue. Total net operating revenues were $89,704,719 with associated operating expenses of $92,967,477. The loss of $3,262,758 is reflective of our commitment to provide access to all patients regardless of their ability to pay. 34245236 107687719 Bozeman Health Deaconess Hospital's Surgical Services strives to offer a wide array of surgical options using state of the art technology. Of the 9,090 inpatient and outpatient surgeries, about 54% were Medicare and Medicaid patients, which comprised 53% ($57,476,957) of total revenue from these services ($107,687,719). Over 61% of the Medicare/Medicaid revenues were unreimbursed ($35,216,112) and written off, along with another $10,789,501 from other payors. Our surgical services also recorded $29,000,268 in operating expenses plus another $5,244,968 of indirect overhead. 12440903 32841886 The Emergency Room at Bozeman Health Deaconess Hospital is one of the busiest departments in our organization, with just over 31,000 visits in 2018. Approximately 47% of these visits were from Medicare and Medicaid patients, comprising $15,783,910 of the $32,841,886 gross revenue. Over 63% of the Medicare/Medicaid revenue were unreimbursed ($10,082,445) and written off, along with 30% of the remaining revenue ($5,208,112). Direct and indirect expenses incurred in supporting the operation of this emergency room accumulated to $12,440,903. 128366100 86519157 Bozeman Health Deaconess Hospital operates an 86 bed hospital facility (Hospital), along with a 43 unit assisted living home and a 115 unit independent living home (Hillcrest Senior Living or HSL). All patient and resident service revenue from these operations are used to provide health care services, health care promotion, and health care education to Bozeman and the surrounding communities. 128366100 86519157 268019716 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 174 0 1 2039 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 1 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X Carrie Morasko 4064141036 915 Highland Blvd Bozeman MT 59715 Brian Brown Chair 1.00 1.00 X X 0 0 0 Katie Daughenbaugh 1st Vice Chair 1.00 1.00 X X 0 0 0 Dane Sobek MD 2nd Vice Chair (Jan) 1.00 50.00 X X 0 632566 41257 Robert Watson Secretary (Jan) 1.00 1.00 X X 0 0 0 Dennis Munson Treasurer (Jan) 1.00 1.00 X X 0 0 0 Kerri Brown Director (Jan) 1.00 1.00 X 0 0 0 Peter Buerhaus Director (Jan) 1.00 1.00 X 0 0 0 Jerry Cashman Director (Jan) 1.00 1.00 X 0 0 0 Dave McConnell Director (Jan) 1.00 1.00 X 0 0 0 Kerry Petitt Director (Jan) 1.00 1.00 X 0 0 0 Walt Sales Director (Jan) 1.00 1.00 X 0 0 0 John Hill Sec/Treasurer (Feb-Dec)/CEO 15.00 35.00 X X 0 709521 104484 Gordon Davidson CFO (Jan-Apr) 35.00 15.00 X 0 444410 39899 Brad Ludford CFO (Sep-Dec) 35.00 15.00 X 0 109708 20028 Elizabeth Lewis COO 25.00 25.00 X 0 328129 72526 Mike Bertagnolli Pharmacy System Manager 50.00 0.00 X 188938 0 38585 Alan Brayton Pharmacy Supervisor 50.00 0.00 X 171606 0 34307 LeRoy Wilson Senior Living Administrator 50.00 0.00 X 166388 0 29258 Theodore Preiss Physician Assistant 50.00 0.00 X 152835 0 19941 James Wiley Physician Assistant 50.00 0.00 X 142636 0 31472 822403 2224334 431757 50 0 1 0 Montana Linen Supply LLC 20900 E Frontage Rd Ste A Belgrade MT 59730 Linen Cleaning 1041738 ROI Healthcare Solutions 1595 Peachtree Pkwy Cumming GA 30041 IT Implementation Services 1029124 The Noliwhite Group LLC PO Box 680217 Franklin TN 370680217 Construction Management Services 436461 Bridger Orthopedic & Sports 1450 Ellis St Ste 201 Bozeman MT 59715 Physician Services 320086 Sequoia Construction PO Box 797 Waitsburg WA 99361 Construction Contractor Services 311394 12 473226 473226 Net Patient Revenue 622110 309028206 309028206 Pharmacy Revenue 446110 2096743 1971055 125688 Cafeteria Revenue 722210 1828391 1825775 2616 3800141 3167716 632425 316753481 6199977 6199977 1541773 542737 999036 999036 999036 48341790 379900 44074020 113646 4267770 266254 4534024 4534024 328959744 315992752 760729 11733037 60000 60000 60909 60909 73205525 66166247 7039278 3272013 2957443 314570 10701738 9672462 1029276 5517373 4987224 530149 732450 732450 16808479 11522119 5286360 285393 158448 126945 3744392 1275888 2468504 2552529 466729 2085800 361469 338151 23318 240979 225434 15545 2227677 2227677 12827067 12827067 1067990 943656 124334 Medical Supplies 68328633 68295075 33558 Health System Shared Se 56405799 36151002 20254797 Health System Physician 36411982 35679470 732512 Provision for Bad Debts 9116184 9116184 8140386 4888531 3251855 312068967 268019716 44049251 0 36142258 4175770 42857721 48498228 7323283 7942424 842448 1036191 288847506 155913200 128817118 132934306 131112638 189909378 2915 1019760 2209240 2103756 1798133 1798133 13404808 46270634 364510562 435688580 17390809 19648740 915904 953912 34242024 104660395 7724537 6614317 20491721 20115625 3746602 300000 84511597 152292989 X 269469271 271124024 8298537 9912074 2231157 2359493 279998965 283395591 364510562 435688580 X 16890777 -14075262 581111 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 16828400 335927 -723008 169014 16272305 14747913 223082 2235283 377878 16828400 13928221 122889 843418 146615 14747913 0.71630 0.16770 0.11600 0 1 1 2972690 2972690 189842636 99325144 90517492 82544800 53329744 29215056 13487380 3258312 10229068 132934306 Investment in Foundation 14960610 Due from Affiliates 31310024 46270634 Estimated Payments to Third Party Payors 300000 300000 X Part IV, Line 2b: The organization holds resident funds on behalf of its residents, as well as security deposits. Part V, Line 4: Each endowment fund is privy to a separate agreement. Donations made for each purpose shall be received, held, and invested by Bozeman Health Foundation according to established policies governing gift acceptance, investment, and distribution. The principal of the fund shall be retained in perpetuity. The interest income is utilized for the greatest needs of the designated department. Policy says the organization can use a portion of interest for operations. The endowment fund reported in Line 1 is currently being held by a related organization, Bozeman Health Foundation, and benefits Bozeman Health and related system entities listed on Schedule R. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. Part X, Line 2: The Organization is a Montana nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Organization is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Organization is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Organization files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 1 0 0 4883236 1683957 3199279 0.01060 32110654 18709755 13400899 0.04420 36993890 20393712 16600178 0.05480 239606 79530 160076 0.00050 28107 28107 0.00010 41460217 31785441 9674776 0.03190 201180 201180 0.00070 41929110 31864971 10064139 0.03320 78923000 52258683 26664317 0.08800 1957 1957 0.00000 1957 1957 0.00000 1 9116184 0 46419273 66301371 -19882098 X 1 1 1 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 www.bozemanhealth.org 12933 X X X Bozeman Health Deaconess Hospital 1 1 0 1 X X X X X X X X X 17 1 1 1 1 X See Part V, Section B, Line 7d X 1 17 1 See Part V, Section B, Line 7d 0 1 X 150.000000000000 250.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Bozeman Health Deaconess Hospital Part V, Section B, Line 5: To solicit feedback from key community stakeholders, we utilized an Online Key Informant Survey and collected responses in March and April of 2017. We asked the Key Informants to rate the degree to which various health issues are a problem in their community. Follow-up questions asked them to describe why they identify problem areas as such, and how theses might be better addressed. In total, we invited 284 Key Informants via email including physicians and advanced practice clinicians, public and community health representatives, health professionals, social service providers, and community leaders to participate. Of the 284 invited, 114 participated. Input was gathered from several individuals whose organizations work with low-income, minority populations, or other medically underserved populations. These populations include: abused children, African-Americans, Arabs, children, construction laborers, crime victims, disabled, domestic violence victims, elderly, English as a second language, geographic barriers, Head Start participants, high school dropouts, Hispanics, HIV patients, HMK (Healthy Montana Kids) patients, homeless, immigrants, international students and families, LGBT, low-income, Medicare/Medicaid, mentally ill, migrant workers, minority students, Native Americans, non-English speaking, nursing home residents, pre-release clients, recent arrivals to the community, rural population, seasonal workers, service workers, students, substance abusers, teenagers, undocumented immigrants, uneducated, unemployed, uninsured/underinsured, veterans, women Bozeman Health Deaconess Hospital Part V, Section B, Line 6a: Bozeman Health Big Sky Medical Center, LLC Bozeman Health Deaconess Hospital Part V, Section B, Line 6b: Community Health Partners (CHP)Gallatin City-County Health Department Bozeman Health Deaconess Hospital Part V, Section B, Line 7d: CHNA:https://www.bozemanhealth.org/About-Us/Community-Benefit.aspxImplementation Strategy:https://www.bozemanhealth.org/About-Us/Community-Benefit.aspx Bozeman Health Deaconess Hospital Part V, Section B, Line 11: The priority areas that emerged from our 2017 CHNA, and adopted by BHDH are: 1. Behavioral Health (Mental Health + Substance Abuse)2. Access to Health Services 3. Healthy Lifestyles (Nutrition, Physical Activity & Weight + Heart Disease & Stroke)4. Injury & Violence During 2018, BHDH worked in each priority area:1.Behavioral Health * Education initiatives o We began implementing Mental Health First Aid classes to our community. o We hosted parenting education series to foster positive protective factors in young boys and men. * Community Collaboration o We sent at least one representative to multiple community workgroups, coalitions and steering committees centered around behavioral health. * School-Based Support o We started a multi-year partnership with an area high school to offer the evidence-based suicide prevention program, Youth Aware of Mental Health to 9th grade youth. * We supported community initiatives - including Tobacco Free Parks and an amendment to the Clean Indoor Air Act - to reduce the use of and exposure to tobacco.2. Access to Health Services * We continued to operate our mobile screening program, HealthCare Connections, and reached over 1,100 people in our service area with free preventive health services. * We hosted two health fairs to offer free and low cost preventive services and screenings to our community, reaching around 650 people. * We partnered with community organizations to host health literacy education for low income families. * We began offering trainings to our care teams on providing LGBTQ+ affirming care to begin to correct the disparities experienced by this community in our service area.3. Healthy Lifestyles * Nutrition and Physical Activity Opportunities o We generated over 1.6 million minutes of physical activity in the school setting for middle school youth through our continued partnership with GoNoodle. o We worked with community partners to offer 15 cooking education classes to families, including low income families. o We successfully piloted a Tokens for Produce program with a community farmer's market in a rural community near BHDH. * Community Initiatives o We convened and facilitated the Nutrition and Physical Activity coalition. 4. Injury and Violence *Community Commitment o We began planning, with community partners, a Relationship Violence Symposium (to be hosted in 2019) with a focus on bridging the gap between identification and connection to resources for domestic and relationship violence survivors. Rationale for Unaddressed Needs: Several of the need identified in the 2017 CHNA were not selected as BHDH priority areas. In order to best impact health outcomes, BHDH focused on prioritizing health issues for which there are existing internal and/or external resources and feasibility to affect change. Additionally, in recognition of comorbidities, and in a strategic effort to consolidate, many of the community-prioritized needs will be addressed thorough BHDH priority area strategies, programs, and efforts: Diabetes: decreasing both incidence and prevalence will be addressed under the area of Healthy Lifestyles Cancer: screenings for certain cancers will remain a key strategy under the area of Access to Health ServicesTobacco Use: decreasing tobacco use will be a focus under the area of Behavioral Health Potentially Disabling Conditions: many disabling conditions occur with other chronic conditions such as diabetes, heart disease, and obesity. As such, strategies addressing these conditions will appear under the area of Healthy Lifestyles. Respiratory Disease: BHDH providers are currently engaged in providing care in this area. We will continually assess and be responsive to opportunities to expand programming and/or outreach. Bozeman Health Deaconess Hospital Part V, Section B, Line 13h: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but they must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Bozeman Health Deaconess Hospital Part V, Section B, Line 16j: Medical Advocacy Services in Healthcare (MASH) will give out our financial application after determining patient is ineligible for federal and state programs.A summary of the financial assistance policy is attached to billing invoices, posted in patient admissions area, and provided to patient on admission to the hospital facility. Bozeman Health Deaconess Hospital Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be billed gross charges on elective procedures. Schedule H, Part V, Section B, Line 16a-16c: https://www.bozemanhealth.org/patients-and-visitors/financial-services/ financial-assistance/ 3 1 - Hillcrest Senior Living 1201 Highland Blvd Bozeman MT 59715 Independent and assisted living facility 2 - Bozeman Health Belgrade Clinic 206 Alaska Frontage Rd Belgrade MT 59714 Ambulatory healthcare services 3 - Bozeman Health Clinical Research 950 Stoneridge Dr 1 Bozeman MT 59715 Outpatient healthcare research Part I, Line 3c: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but they must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care and Medicaid. All net benefit expenses were calculated using direct costs and revenue with reasonable indirect overhead allocation methods. Benefits are allocated at 23% of payroll dollars. For Subsidized Services, other indirect overhead costs are allocated based on historical reasonableness of 15% of total expenses. Our internal system does record patient revenues based on type (inpatient vs. outpatient vs. emergency) and payor (Medicaid, Medicare, Commercial, Self-Pay, etc.). Related costs are then determined based on the pro-rated share as a percentage of the total. For example, if Medicaid comprises 7% of a department's revenue, Medicaid expenses are calculated at 7% of the total as well.Lines 7e, 7f, 7i are based on actual expenses. Part I, Line 7g: Amount of cost attributable to a physician clinic is $41,460,217. All costs associated with a provider-based clinic operational department were considered part of this total. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 9,116,184. Part II, Community Building Activities: BHDH is represented through participation in the Bozeman Kiwanis Club, an organization dedicated to community service and improving the holistic health of children. Part III, Line 2: Bad debt is reported at charges as recorded by the organization.Bad debt is reported based upon actual bad debt expense net of discounts and contractual adjustments, less recoveries. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expense is located in Footnote 1 on page nine of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents costs absorbed by the Hospital as a result of providing care to Medicare patients. The contract driving this loss is a nondiscretionary contract, as is providing the services to this population of individuals. The cost of providing this benefit to the community should be reportable as such.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: Bozeman Health's Financial Assistance Policy explains the patient notification practice that includes providing the patient, either directly or through its contracted collection agency with at least one written notice informing the patient about the Extraordinary Collection Actions that we intend to take if the patient does not submit an Application for Financial Assistance or pay the amount due by at least thirty days following the date of the notice. The notice will include a copy of the plain language summary and will not be mailed or delivered to a patient earlier than 30 days prior to the end of the Notification Period. No Extraordinary Collection Actions will be undertaken during the 120 day Notification Period, during which time we will take reasonable efforts to determine whether the patient is eligible for Financial Assistance. After the 120 day Notification Period, an Extraordinary Collection Action will be undertaken only if the patient has received the 30 day written notice described above. Extraordinary Collection Actions are defined as those actions that may be taken in the event of non-payment following the expiration of the notification period. These may include the reporting of adverse information about the individual to consumer credit reporting agencies or credit bureaus, garnishment of an individual's wages, and/or commencement of a legal civil action against an individual. As part of Bozeman Health collection practices, any patient account placed in collections will be pulled back from collections should that patient apply for financial assistance within 240 days of receiving their initial patient statement. Part VI, Line 2: In addition to the CHNA, Bozeman Health Deaconess Hospital (BHDH) assesses community health care needs in a number of ways. The Hospital sends representatives to community meetings and conversations related to health and heath care to hear directly from community members - patients, clients, stakeholders, etc. - about their needs. In a related fashion, the Hospital also convenes community members - patients, clients, stakeholders, etc. - to solicit feedback about health and health care needs. Finally, the Hospital looks at and considers 3rd party projections about health care needs and available local and national trend data when making health care delivery and health improvement decisions. Part VI, Line 3: Bozeman Health Deaconess Hospital (BHDH) is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. BHDH posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BHDH will attempt to determine whether a patient has third party coverage for any part of the hospital services provided. If a patient does not have third party coverage, a patient advocate from the Medical Advocacy Services in Healthcare (MASH) program will screen all inpatient cases and any outpatient cases exceeding $1,000 in total charges to determine if the patient qualifies for third party funding. If not, the patient advocate will explain the Financial Assistance Policy and give the patient an application if desired. In circumstances where payment in full will cause financial hardship that will significantly harm the patient or patient's family, the applicant may be asked to visit with Consumer Credit Counseling Services to further review their financial situations. Upon request, patients may be asked to complete an application for Medicaid participation or for coverage by other governmental payment programs. Patient bills also contain billing information explaining financial options and provide contact information to the appropriate resources. Part VI, Line 4: Bozeman Health Deaconess Hospital (BHDH) primarily serves Gallatin, Park, and Madison Counties. 84.6% of 2018 inpatient admissions were of patients originating from these three counties (Gallatin: 77.28%, Park 4.68%, and Madison 3.67%). The population of the tri-county region was an estimated 133,274 in 2018 (IBM Watson Health). Bozeman (in Gallatin County) was listed in the 2017 ACS as a Micropolitan area whereas Belgrade (Gallatin County), Four Corners (Gallatin County), and Livingston (Park County) were listed as Urban Clusters in the 2010 Census. As of 2017, 12.9% of the population was below the poverty level in the tri-county region-ranging from 13.4% in Park County, 13.0% in Gallatin County, and 10.6% in Madison (2017 ACS 5yr estimates). Median household income was an estimated $59,397 in Gallatin County followed by Madison ($47,900) and Park ($44,920) (2017 ACS 5 Year Estimates). Estimates suggest that about 13.4% of residents in the tri-county area were insured by Medicaid, roughly 14.1% were insured by Medicare, and about 6.67% were uninsured in 2018 (IBM Watson Health, 2018). About 17.3% of BHDH inpatients were insured under Medicaid in 2018.BHDH's tri-county service area houses five hospitals-of which, three are critical access hospitals (CAH): Bozeman Health Deaconess Hospital (Bozeman, MT), Bozeman Health Big Sky Medical Center (Big Sky, MT), Livingston HealthCare-CAH (Livingston, MT), Madison Valley Medical Center-CAH (Ennis, MT), and Ruby Valley Hospital-CAH (Sheridan, MT).As listed on the MT DPPHS webpage, low income populations in Gallatin and Park Counties and total geographic populations in Madison County are designated Mental Health Care Health Professional Shortage Areas (HPSAs). Additionally, low income populations in Gallatin, Park, and Madison Counties are designated Primary Care HPSAs as of 2019. (https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations). Part VI, Line 5: The governing body of BHDH is comprised of individuals who represent our community and live in our primary service area, most of whom are independent of the organization. To ensure immediate access to care, BHDH has an open medical staff and requires each medical staff member to care for anyone presenting in the Emergency Department. As an organization, we devote a significant amount of surplus funds into maintaining a high level of patient care through quality initiatives as well as technology and community investments.Various employees, physicians, administrators, and board members of the Hospital are actively involved in volunteer roles including community board positions in numerous other activities, groups, and organizations that actively promote the health of the community.In 2017, Bozeman Health hired a FTE dedicated to community involvement. The System Program Manager for Community Health Improvement and Partnerships works to align Bozeman Health Deaconess Hospital health improvement initiatives with the needs and desires of the communities served by BHDH. This includes, among other things, representing BHDH at community meetings, and planning and implementing programs with community partners to address needs highlighted in the CHNA. Part VI, Line 6: Bozeman Health Deaconess Hospital is a nonprofit public benefit corporation with a sole corporate member, Bozeman Deaconess Health Services d/b/a Bozeman Health. 1 Cancer Support Community Montana 102 S 11th Ave Bozeman MT 59715 810542266 501(c)(3) 60000 Support cancer support services within our service area 1 0 Part I, Line 2: Recipients of grants and assistance prepare informational reports substantiating the use of the funds that were earmarked to support community health programs. X X X 1 1 0 0 0 0 0 0 0 Dane Sobek MD 2nd Vice Chair (Jan) 0 571538 0 60000 0 1028 0 16500 0 25732 0 674798 0 0 John Hill Sec/Treasurer (Feb-Dec)/CEO 0 539749 0 159902 0 9870 0 80371 0 25493 0 815385 0 0 Gordon Davidson CFO (Jan-Apr) 0 178884 0 55884 0 209642 0 33159 0 7146 0 484715 0 0 Elizabeth Lewis COO 0 274819 0 49536 0 3774 0 54650 0 18851 0 401630 0 0 Mike Bertagnolli Pharmacy System Manager 170454 0 1000 0 17484 0 11775 0 27552 0 228265 0 0 0 Alan Brayton Pharmacy Supervisor 157421 0 0 0 14185 0 10739 0 24154 0 206499 0 0 0 LeRoy Wilson Senior Living Administrator 126807 0 27486 0 12095 0 10451 0 19289 0 196128 0 0 0 Theodore Preiss Physician Assistant 140261 0 2500 0 10074 0 9289 0 11120 0 173244 0 0 0 James Wiley Physician Assistant 131981 0 0 0 10655 0 8928 0 23227 0 174791 0 0 0 Part I, Line 3 The CEO is paid by Bozeman Deaconess Health Services (BDHS), a related organization. The BDHS Board of Directors uses the methods selected in Line 3 to determine the CEO compensation. The Board of Directors of the filing organization also serves on the BDHS Board of Directors. Part I, Lines 4a-b Line 4a: Gordon Davidson received severance payments in the amount of $207,441 in 2018 from the related party, Bozeman Deaconess Health Services. Line 4b: Schedule J, Part II, column (c) reflects payments received by individuals from a 457(f) plan. The following individuals received payments in 2018. John Hill: $71,761 Brad Ludford: $16,152 Elizabeth Lewis: $22,848 A Montana Facility Finance Authority 810302402 61204MAS6 2011-09-28 20680164 To fund structure and equipment of new ER, acquisition of Legacy condos 0 0 0 B Montana Facility Finance Authority 364615155 2015-09-10 19522471 Refinance 2005 bond issued 12/1/2015 0 0 0 C Montana Facility Finance Authority 364615155 2015-01-09 15700000 Portion for MOB V addition 0 0 0 D Montana Facility Finance Authority 364615155 61204MDA2 2018-04-24 74139881 Master Facility Plan, Lawson, DaVinci Surgical Robot 0 0 0 A 5612810 20693206 11797 401295 20278869 1246 2013 0 0 1 1 B 2654151 19522471 243567 19278904 2015 1 0 1 1 C 689764 15700000 37689 15662311 2016 0 0 1 1 D 120553 74941606 801725 808710 8769630 64560541 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 1 D 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 06/01/2014 Heidi Watson Spouse of Board Member 60909 Employee Compensation 0 Form 990, Part VI, Section A, line 4 The bylaws were amended and effective February 2018. The filing organization reduced the Board of Directors to three individuals. Form 990, Part VI, Section A, line 6 Bozeman Deaconess Health Services, dba Bozeman Health, is the sole member of the organization. Form 990, Part VI, Section A, line 7a Bozeman Deaconess Health Services, dba Bozeman Health, is the sole member of BHDH. Bozeman Health appoints the board members. The Bozeman Health Board Chair, Vice Chair and CEO serve as the board members of BHDH. The Yellowstone Conference of the Methodist Church confirms the Board Members for Bozeman Health and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Bozeman Health has the authority over the following items: 1) approval of mission, vision and values 2) approval of the strategic plans 3) adoption of annual capital and operating budgets 4) oversight of financial operations, including the consolidated audit 5) incurrance of any long-term debt 6) establishment of policies specifying the level of internal authority 7) approval of annual quality plan and aoption of policies and procedures regarding healthcare services and law and regulation 8) appointment and removal of board members and officers 9) approval of any affiliations, mergers, and dissolutions 10) approval of closures of medical staffs and services 11) approval of any amendment of the Articles or Bylaws Due to Bozeman Health governing documents any changes in the Articles of Incorporation in relationship to the process of selecting board membership must be approved by the Yellowstone Conference of the United Methodist Church. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Planning and Finance Committee will review Form 990 in detail and will make a recommendation to the full Board for approval before filing of the Form 990. The CFO reviews the Form 990 at a higher level with the board before approval is granted. Form 990, Part VI, Section B, line 12c Annual Disclosure Statement is obtained from the Board, Operating Committee, and Executive Team Members. Disclosures are reviewed with the Conflict of Interest (COI) Panel (Compliance Officer, Board Compliance Committee Chair, Chief Executive Officer, & Chief Legal Officer). The COI Panel assesses the disclosure, develops an acknowledgement and management plan. The management plan is reviewed with the affected member, if the COI Panel and the member are unable to resolve the disclosure, the disclosure is reported to the Board Compliance Committee for further review. Conflicts are addressed annually in writing and verbally during meetings. If a COI exists, the member shall not participate in any deliberations or vote regarding the transaction or arrangement at issues, and shall not be present in the meeting room for any part of the deliberations or vote relating to the transaction or arrangement. Form 990, Part VI, Section B, line 15 Bozeman Deaconess Health Services, parent company and sole member of the BHDH, compensates the CEO and CFO. The Executive Compensation Committee receives a formal presentation by an independent compensation consultant (as selected by the Board) qualified to perform compensation reviews including usage of comparability data. This person presents recommendations to the Compensation Committee of the Board. The Compensation Committee makes recommendations to the full Board on an annual basis for Officers and Senior Administration. This annual process was performed in fall 2017 to determine 2018 compensation. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy, and all tax related information required to be available for public inspection are available via walk-in, telephone call, e-mail, and/or mail-in request. The audited financial statements are required to be attached to the Form 990 and provided to the Municipal Securities Rulemaking Board, which is our tax-exempt bonds trustee, via an on-line, central filing location called Electronic Municipal Market Access (EMMA). The financial statements can be obtained by the general public at the EMMA website. Form 990, Part XI, line 9: Transfer of Net Assets From Related Party -1,160,762. Change in Temp & Perm Restricted Investment of Foundation 1,741,873. Form 990, Part XI: Inconsistent Treatment of Partnership Investments: The following partnership incorrectly reports the EIN of the partner as Bozeman Deaconess Health Services Depreciation Alternative Investment (EIN 81-0232121). The investment and income are actually held and reported on the Bozeman Health Deaconess Hospital (EIN 47-4717998). All tax reporting will be made on the Bozeman Health Deaconess Hospital Form 990. Coast Access LLC (EIN 16-1662779) Bozeman Deaconess Health Services (dba Bozeman Health) 915 Highland Blvd Bozeman MT 59715 810232121 Hospital and Healthcare Services MT 501(c)(3) Line 3 N/A 0 Bozeman Deaconess Foundation dba Bozeman Health Foundation 931 Highland Blvd Suite 3200 Bozeman MT 59715 841407943 Raise Funds to Support Bozeman Deaconess Health Services MT 501(c)(3) Line 7 Bozeman Deaconess Health Services 0 Deaconess Intercity Imagining LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT N/A Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT N/A Spanish Peaks Plaza LLC 120 N 15th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT N/A Bozeman Deaconess Real Estate Development PO Box 10490 Bozeman MT 59719 205496567 Sale of Real Estate Property and Residences to Seniors MT N/A C 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1