2019-02-14T15:20:22-06:00 2018-03-31 810497523 JORDAHL & SLITER PLLC PO BOX 8600 KALISPELL MT 599041600 990 2017-04-01 810247969 NORTH VALLEY HOSPITAL INC NORT 4068633500 1600 HOSPITAL WAY WHITEFISH MT 59937 DAVID RICHHART CFO 4068639826 2019-02-13 1 JUSTIN P SLITER P00188996 4067521040 2019-02-01 208.123.199.66 2019-02-13 12:56:16 MS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 621B3885DD7E6B86DF61721CBE6EF10A03979B56 2017 2019-02-21 02:37:17Z DAVID RICHHART 1600 HOSPITAL WAY WHITEFISH MT 59937 74128526 0 X WWW.NVHOSP.ORG X 1955 MT NORTH VALLEY HOSPITAL PROVIDES HOSPITAL AND REHABILITATIVE SERVICES, OTHER HEALTH CARE SERVICES AS NECESSARY AND ADVISABLE, AND SERVES AS A STIMULUS FOR THE PROVISION OF HEALTH CARE SERVICES IN THE AREA. 13 12 535 52 0 0 98522 457330 67330362 71019022 38494 331698 1072519 1606817 68539897 73414867 0 0 0 0 20742413 31422172 0 0 285633 45127378 31279217 65869791 62701389 2670106 10713478 60552158 70802592 29645499 28868792 30906659 41933800 NORTH VALLEY HOSPITAL PROVIDES HOSPITAL AND REHABILITATIVE SERVICES, OTHER HEALTH CARE SERVICES AS NECESSARY AND ADVISABLE, AND SERVES AS A STIMULUS FOR THE PROVISION OF HEALTH CARE SERVICES IN THE AREA. 0 0 50303108 71019022 NORTH VALLEY HOSPITAL OPERATES A 25-BED ACUTE CARE HOSPITAL WHICH PROVIDES EMERGENCY, INPATIENT, OUTPATIENT, ACUTE CARE AND SUBACUTE SERVICES IN HOSPITAL AND CLINIC SETTINGS. THE HOSPITAL PROVIDED 8,462 ER VISITS, 4,805 DAYS OF PATIENT SERVICES, 96,426 OUTPATIENT VISITS WHICH INCLUDES 46,022 CLINIC VISITS, AND 566 BIRTHS FOR THE PERIOD APRIL 1, 2017 THROUGH MARCH 31, 2018.THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $1,011,503 FOR CHARITY CARE, $9,960,248 FOR MEDICAID, $12,164,737 FOR MEDICARE, AND $5,092,220 FOR OTHER THIRD PARTY PAYORS FOR THE PERIOD APRIL 1, 2017 THROUGH MARCH 31, 2018. 50303108 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 1 1 0 0 1 120 0 1 535 1 0 0 0 0 0 0 0 0 X 13 12 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DAVID RICHHART 4068639826 1600 HOSPITAL WAY WHITEFISH MT 59937 JANE KARAS CHAIR 1.00 X X 0 0 0 MIRNA BOWDEN MD VICE CHAIR 1.00 X X 0 0 0 TROY BOWMAN SECRETARY 1.00 X X 0 0 0 STEVE STAHLBERG FINANCE CHAIR 1.00 X X 0 0 0 JOSH AKEY MEMBER 1.00 X 0 0 0 LIN AKEY MEMBER 1.00 X 0 0 0 MATT BAILEY MD MEMBER 1.00 X 0 0 0 BARBRA BENNETT MEMBER 1.00 X 0 0 0 TODD BERGLAND MD MEMBER 1.00 X 0 0 0 DAVID DITTMAN MEMBER 1.00 X 0 0 0 MARC DUCHARME MEMBER 1.00 X 0 0 0 JOHN FLINK MEMBER 1.00 X 0 0 0 RYAN GUNLIKSON MD MEMBER 40.00 X 282432 0 21568 MICHAEL HENSON MEMBER 1.00 X 0 0 0 MARK JOHNSON MEMBER 1.00 X 0 0 0 AMY MAY MEMBER 1.00 X 0 0 0 TORI REICH MEMBER 1.00 X 0 0 0 CARL TINLIN MEMBER 1.00 X 0 0 0 TATE KREITINGER CHEIF EXECUTIVE OFFICER 24.00 26.00 X 0 491568 25326 JASON SPRING CHEIF EXECUTIVE OFFICER 10.00 X 0 335571 29598 CHRIS THOMAS CHEIF EXECUTIVE OFFICER 40.00 X 267419 0 30141 RANDY NIGHTENGALE CHEIF FINANCIAL OFFICER 40.00 X 101699 0 8957 DAVID RICHHART CHEIF FINANCIAL OFFICER 40.00 X 103581 0 6562 JASON COHEN MD CHIEF MEDICAL OFFICER 20.00 X 280173 0 24526 AMY VENTERPOOL CHIEF CLINICAL OFFICER 40.00 X 107116 0 28308 CAMERON GARDNER MD PHYSICIAN 40.00 X 234888 0 17438 DEREK GEDLAMAN DO OPTOMETRIST 40.00 X 283214 0 5000 BRADLEY KASAVANA MD PHYSICIAN 25.00 X 207101 0 11673 JOHN MUIR MD PHYSICIAN 40.00 X 320854 0 20722 JONATHAN TORGERSON MD PHYSICIAN 25.00 X 253521 0 5000 2441998 827139 234819 27 0 1 0 KALISPELL REGIONAL MEDICAL CENTER 310 SUNNYVIEW LANE KALISPELL MT 59901 HEALTH CARE SERVICES 3146350 NORTHERN ROCKIES ANESTHESIA 1075 MARTIN CREEK LANE WHITEFISH MT 59937 ANESTHESIA SERVICES 1679677 CJ'S CLEANING 639 HWY 2 EAST COLUMBIA FALLS MT 59912 CLEANING SERVICES 198191 ALPINE WOMEN'S CENTER 2002 HOSPITAL WAY WHITEFISH MT 59937 PHYSICIAN CALL COVERAGE & OFFICE LEASE 191043 LANDCASTLE LTD 150 LOGAN MEADOWS WHITEFISH MT 59937 LANDSCAPING & SNOW REMOVALE 172170 13 457330 457330 MEDICAL SERVICE REVENUE 621990 71019022 71019022 71019022 137272 137272 109182 0 109182 109182 109182 908085 713659 194426 194426 194426 OTHER REVENUE 900099 968839 968839 CAFETERIA 722210 528796 528796 1497635 73414867 71019022 0 1938515 X 1239201 308073 931128 23920366 18399333 5380785 140248 1115702 858188 250972 6542 3368990 2591397 757840 19753 1777913 1367555 399934 10424 91728 91728 6509 6509 62560 62560 9370039 6455301 2861797 52941 67823 51528 14660 1635 3800070 1809659 1961436 28975 1199870 875414 324456 1289397 1082172 203171 4054 134043 62657 57080 14306 126304 71540 51447 3317 22380 20185 2195 3796002 3150682 645320 293787 227685 66102 MEDICAL SUPPLIES AND DR 8309959 8309959 BAD DEBTS 2796409 2796409 OTHER EXPENSES 2386942 1865371 518133 3438 HOME OFFICE ALLOCATION -2474605 -2474605 62701389 50303108 12112648 285633 13679528 26424277 7807851 6771274 2993005 2777039 1271107 1563956 1260979 1278808 68972765 38722712 32170323 30250053 1204672 1360686 371916 164693 4583 60552158 70802592 9508107 10039902 19714964 18594668 422428 234222 29645499 28868792 X 29956028 40983169 567622 567622 383009 383009 30906659 41933800 60552158 70802592 X 10713478 -29489 343152 X 0 1 X 1 0 X 0 0 0 0 0 1 26677 0 0 1 603 27280 0 PART II-B, LINE 1: LINE F. THE HOSPITAL MADE A GRANT TO THE MONTANA HOSPITAL ASSOCIATION SUPPORT BALLOT INITIATIVE I-185, THE TOBACCO TAX. LINE I. THE HOSPITAL DOES NOT DIRECTLY PERFORM LOBBYING ACTIVITIES BUT PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS, WHICH USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 950631 950631 950631 950631 0.40290 0.59710 0 1 1 7692098 7692098 36129773 18888631 17241142 24717575 19834081 4883494 433319 433319 30250053 LEASES PAYABLE 234222 234222 X 72791223 -29489 2484454 2454965 70336258 3078609 3078609 73414867 61764082 2474605 2474605 59289477 3411912 3411912 62701389 PART X, LINE 2: THE CORPORATION ADOPTED THE PROVISIONS OF ACCOUNTING STANDARDS CODIFICATION 740, INCOME TAXES. ASC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE ASC AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT STANDARD FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE CORPORATION HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED NO RESERVES ARE REQUIRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: CONSOLIDATING ADJUSTMENT 9,849. HOME OFFICE REIMBURSEMENT 2,474,605. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION BY AFFILIATE 282,200. BAD DEBT EXPENSE 2,796,409. PART XII, LINE 2D - OTHER ADJUSTMENTS: HOME OFFICE REIMBURSEMENT 2,474,605. PART XII, LINE 4B - OTHER ADJUSTMENTS: CONSOLIDATING ADJUSTMENT 333,303. BAD DEBT EXPENSE 2,796,409. RECLASSIFICATION BY AFFILIATE 282,200. 1 1 1 X 1 X 1 1 1 0 1 1 644116 644116 0.01030 13456102 17510269 0 0.00000 14100218 17510269 644116 0.01030 152863 7500 145363 0.00230 235318 1480 233838 0.00370 62605 1147 61458 0.00100 450786 10127 440659 0.00700 14551004 17520396 1084775 0.01730 6503 6503 0.00010 65219 65219 0.00100 17602 17602 0.00030 89324 89324 0.00140 1 2796409 20430084 22575692 -2145608 X 1 1 1 1 NORTH VALLEY HOSPITAL 1600 HOSPITAL WAY WHITEFISH MT 59937 X X X X NORTH VALLEY HOSPITAL 1 0 0 1 X X X X X X X X 15 1 1 1 1 X WWW.KRH.ORG/NVH X 1 15 1 WWW.KRH.ORG/NVH 0 1 X 100.000000000000 400.000000000000 X 1 1 X 1 X WWW.KRH.ORG/NVH/SERVICES/PATIENT-PORTAL-AND-RESOURCES/ X WWW.KRH.ORG/NVH/SERVICES/PATIENT-PORTAL-AND-RESOURCES/ X WWW.KRH.ORG/NVH/SERVICES/PATIENT-PORTAL-AND-RESOURCES/ X X X 1 0 X X 1 X 0 0 NORTH VALLEY HOSPITAL PART V, SECTION B, LINE 5: KALISPELL REGIONAL HEALTHCARE SERVICES, THE FLATHEAD CITY-COUNTY HEALTH DEPARTMENT, AND NORTH VALLEY HOSPITAL COLLABORATED TO ARRANGE QUALITATIVE DATA COLLECTION DESIGNED TO ADDRESS HEALTHCARE ISSUES IN THE COMMUNITY. THREE FOCUS GROUP INVERVIEWS, TEN KEY INFORMANT INTERVIEWS, AND ONE SURVEY WERE CONDUCTED IN AN EFFORT TO OBTAIN THE BEST INFORMATION REGARDING THE HEALTH NEEDS OF ALL INDIVIDUALS IN THE COMMUNITY. FOCUS GROUPS WERE DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF HEALTHCARE,INCLUDING SENIOR CITIZENS, THE PHYSICALLY CHALLENGED, AND LOCAL COMMUNITY MEMBERS. KEY INFORMANTS CONSISTED OF COMMUNITY LEADERS PROVIDING HEALTH SERVICES TO FLATHEAD COUNTY RESIDENTS.IN JUNE 2015, SURVEYS WERE MAILED OUT TO THE RESIDENTS IN FLATHEAD COUNTY. THE SURVEY WAS BASED ON A DESIGN THAT HAS BEEN USED EXTENSIVELY IN THE STATES OF WASHINGTON, WYOMING, ALASKA, MONTANA, AND IDAHO. THE SURVEY WAS DESIGNED TO PROVIDE EACH FACILITY WITH INFORMATION FROM LOCAL RESIDENTS REGARDING:- DEMOGRAPHICS OF RESPONDENTS- HOSPITALS, PRIMARY CARE PROVIDERS, AND SPECIALISTS USED PLUS REASONS FOR SELECTION- LOCAL HEALTHCARE PROVIDER USAGE- SERVICES PREFERRED LOCALLY- PERCEPTION AND SATISFACTION OF LOCAL HEALTHCARE NORTH VALLEY HOSPITAL PART V, SECTION B, LINE 6A: KALISPELL REGIONAL HEALTHCARE SYSTEM, KALISPELL, MT NORTH VALLEY HOSPITAL PART V, SECTION B, LINE 6B: FLATHEAD CITY-COUNTY HEALTH DEPARTMENT NORTH VALLEY HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL DID NOT ADDRESS AREAS IDENTIFIED AS LOWER PRIORITY/RESPONSIBILITY, SUCH AS LOW INCOME SENIOR HOUSING AND PROVIDING PREVENTATIVE DENTAL CARE BECAUSE THEY ARE VIEWED AS BEYOND THE MISSION OF THE HOSPITAL, AND OTHER GROUPS ARE BETTER SUITED TO ADDRESS THESE NEEDS. NORTH VALLEY HOSPITAL PART V, SECTION B, LINE 13H: PATIENTS ARE BILLED THE GROSS CHARGE FOR ALL SERVICES RECEIVED. IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE BILL IS ADJUSTED AS DETERMINED BY OUR CHARITY CARE POLICY GUIDELINES. 8 1 - NORTH COUNTRY MEDICAL CLINIC 1343 HWY 93 NORTH EUREKA MT 59917 OUTPATIENT CLINIC 2 - THE BASE LODGE CLINIC 3840 BIG MOUNTAIN ROAD WHITEFISH MT 59937 OUTPATIENT CLINIC 3 - COLUMBIA FALLS CLINIC PROFESSIONAL 2165 9TH STREET WEST COLUMBIA FALLS MT 59912 OUTPATIENT CLINIC 4 - GLACIER MATERNITY & WOMENS CENTER 195 COMMONS LOOP ROAD SUITE D KALISPELL MT 59901 OUTPATIENT CLINIC 5 - WEST GLACIER CLINIC 100 REA ROAD WEST GLACIER MT 59936 OUTPATIENT CLINIC 6 - GLACIER ENT HEAD AND NECK SURGERY 711 E 13TH STREET WHITEFISH MT 59937 OUTPATIENT CLINIC 7 - NORTH VALLEY PHYSICAL THERAPY 1343 HWY 93 N EUREKA MT 59917 OUTPATIENT CLINIC 8 - NORTH VALLEY HOSPITAL IMAGING 1111 BAKER AVENUE WHITEFISH MT 59937 DIAGNOSTIC CENTER PART I, LINE 7: THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES, TOTAL COMMUNITY BENEFIT AND TOTAL COMMUNITY BUILDING EXPENSES). PART I, LINE 7G: THE HOSPITAL HAS NOT INCLUDED ANY COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G. PART I, LN 7 COL(F): TOTAL BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN COLUMN (F) IS $1,176,504. PART II, COMMUNITY BUILDING ACTIVITIES: LEADERSHIP AT THE HOSPITAL ARE ACTIVE MEMBERS OF AREA CHAMBERS OF COMMERCE, UNITED WAY, EMERGENCY MEDICAL SERVICES BOARD, WHITEFISH AFFORDABLE HOUSING TASK FORCE, WHITEFISH HEALTHY COMMUNITIES COMMITTEE, MOUNTAIN PACIFIC SPECIAL IMPROVEMENT PROJECT ON CARE TRANSITIONS, AND MORE. IN ADDITION, THE HOSPITAL SPONSORS A STAFF MEMBER EACH YEAR TO ATTEND LEADERSHIP FLATHEAD: A TWO-YEAR LEADERSHIP TRAINING AND COMMUNITY COLLABORATION PROGRAM IN THE FLATHEAD VALLEY INCORPORATING LEADERSHIP IN A PROJECT THAT FULFILLS A NEED IN THE COMMUNITY. THE HOSPITAL MANAGEMENT AND STAFF HAVE DEVELOPED RELATIONSHIPS WITH AREA HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO PROMOTE HEALTHCARE RELATED FIELDS AND HOSTING INTERNS AND JOB SHADOWS. THE HOSPITAL HUMAN RESOURCES STAFF CONTRIBUTE TIME TO CAREER COUNSELING AND ARE ACTIVE PARTICIPANTS IN THE LOCAL CHAPTERS OF HOSA (HEALTHCARE OCCUPATION STUDENTS OF AMERICA) AND GRADUATION MATTERS. HOSPITAL STAFF PROVIDE A FORUM FOR THE PERFORMANCE IMPROVEMENT NETWORK, WHICH PROVIDES QUALITY ASSURANCE FOR FUTURE HEALTH CARE. WE PARTICIPATED IN HOSPITAL ACQUIRED INFECTION LEARNING AREA NETWORK THROUGH THE MOUNTAIN PACIFIC QUALITY IMPROVEMENT ORGANIZATION,AHA HOSPITAL ENGAGEMENT NETWORK, AND THE NATIONAL RURAL ACCOUNTABLE CARE ORGANIZATION PROMOTING CARE COORDINATION, PREVENTION AND WELLENSESS.AN INCIDENT MANAGEMENT SYSTEM WITH HOSPITAL COMMAND CENTER IS ESTABLISHED AT THE HOSPITAL FOR EMERGENCY PREPAREDNESS. INTERNALLY, THE MEMBERS REGULARLY EXECUTE DRILLS AND REVIEW EMERGENCY MEASURES FOR IMPROVEMENT AS WELL AS ASSESS RESOURCE NEEDS. HOSPITAL REPRESENTATIVES PARTICIPATE IN A COALITION INCLUDING OTHER EMERGENCY, MEDICAL AND CITY/COUNTY SERVICES WHO MEET REGULARLY TO PREPARE FOR FLATHEAD VALLEY'S LARGER POTENTIAL DISASTERS. MANAGEMENT STAFF HAS OBTAINED ADVANCED TRAINING IN EMERGENCY COMMUNICATIONS EFFECTIVENESS, RESPONSE AND COORDINATION.QUALIFIED COMMUNITY BENEFITS UNDER THIS QUESTION:COMMUNITY SUPPORT DONATIONS (ACCOUNTED FOR IN CBISA UNDER CASH DONATIONS) - TO INTERMOUNTAIN INTEGRATED MENTAL HEALTH SERVICES, DRUG-FREE GRADUATION PARTY SPONSORSHIPS, SHEPHERD'S HAND FREE CLINIC,SCHOOL SPORTS AND BOOSTER CLUB ASSOCIATIONS, FINANICAL SUPPORT FOR WINGS AND ALERT MEDICAL TRANSPORT HELICOPTER, UNITED WAY, SAVE A SISTER MAMMOGRAM INITIATIVE, RELAY FOR LIFE, SPECIAL OLYMPICS, PROSTATE CANCER AWARENESS FOUNDATION, FLATHEAD CANCER AID, FLATHEAD BREASTFEEDING COALITION, THE ALZHEIMERS ASSOCIATION, AND MARCH OF DIMES.ECONOMIC DEVELOPMENT - MONTANA WEST ECONOMIC DEVELOPMENT, CHAMBER OF COMMERCE BOARDS AND COMMITTEES, WHITEFISH AFFORDABLE HOUSING TASK FORCE, LEADERSHIP FLATHEAD, WHITEFISH CONVENTION AND VISITOR BUREAU.WORKFORCE DEVELOPMENT - MENTORING AND JOB SHADOWING, CAREER COUNSELING, HEALTH OCCUPATIONS STUDENT ORGANIZATION, FLATHEAD VALLEY COMMUNITY COLLEGE NURSING PROGRAM, MONTANA STATE UNIVERSITY NURSING PROGRAM.COALITION BUILDING - PERFORMANCE IMPROVEMENT NETWORK, HEALTH OCCUPATIONS STUDENT ASSOCIATION, SUICIDE PREVENTION/INTERVENTION/POSTVENTION, COLLEGES FOR NURSING PROGRAMS, HEALTH PROVIDER PRECEPTORS AND MEETINGS, STUDENT RECRUITMENT, CRITICAL ACCESS NETWORK, CARE TRANSITIONS COALITION, HEALTHY COMMUNITIES COALITION, BEST BEGINNINGS EARLY CHILD DEVELOPMENT COALITION,AND DISASTER PREPAREDNESS.THE HOSPITAL CONTINUES ITS SENIOR MENTAL HEALTH PROGRAM (NORTH VALLEY EMBRACE HEALTH) TARGETED AT ADULTS 55 YEARS OLD AND OLDER TO ADDRESS ISSUES OF DEPRESSION, LOSS, WITHDRAWAL, ETC. IT IS THE FIRST STRUCTURED OUTPATIENT PROGRAM OF ITS KIND IN NORTHWEST MONTANA. IT ALSO LAUNCHED NORTH VALLEY BEHAVIORAL HEALTH, PROVIDING PSYCHIATRY FOR CHILDREN, ADOLESCENTS AND ADULTS. ADDICTION AND SUBSTANCE ABUSE COUNSELING, PLAY THERAPY FOR CHILDREN, AND SENIOR FOCUSED TREAMTENTS WERE ADDED TO INCREASE REACH AND BREADTH OF SERVICES.NORTH VALLEY GERIATRIC SPECIALTY SERVICES WAS ESTABLISHED IN 2013 TO PROVIDE GERIATRIC MEDICINE AND ASSESSMENT. THE MEDICAL STAFF PROVIDE CARE TO SENIORS IN LOCAL SENIOR LIVING FACILITIES AND COORDINATES CARE.NORTH VALLEY SCHOOL BASED CLINIC IN COLUMBIA FALLS LAUNCHED IN SEPTEMBER 2016 TO IMPROVE ACCESS TO AFFORDABLE HEALTHCARE FOR HIGH SCHOOL STUDENTS AND STAFF. BOTH PHYSICAL AND MENTAL HEALTH SERVICES ARE PROVIDED ON SITE AT THE HIGH SCHOOL IN CONJUNCTION WITH THE SCHOOL NURSE. PART III, LINE 2: THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2 INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE. PART III, LINE 3: BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE THE HOSPITAL IDENTIFIES PATIENTS ELGIBLE FOR CHARITY CARE UP FRONT PRIOR TO TURNING THE BALANCE OVER TO THE COLLECTIONS AGENCY. THE COLLECTION AGENCY ATTEMPTS TO COLLECT FROM THE PATIENT UNTIL DEEMED UNCOLLECTIBLE OR ELGIBLE FOR FINANCIAL ASSISTANCE AT WHICH POINT THE ACCOUNT IS CLOSED AND RETURNED TO THE HOSPITAL. PATIENTS ARE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE FOR A PERIOD OF 240 DAYS DURING WHICH TIME EXTRAORDINARY COLLECTION ACTIVITY WILL CEASE. IF THE PATIENT ACCOUNT IS DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE THE BAD DEBT ACCOUNT IS RETURNED TO THE HOSPITAL AND THE ACCOUNT IS WRITTEN OFF ACCORDING TO THE HOSPITAL FINANCIAL ASSISTANCE POLICY. HOSPITAL FINANCIAL COUNSELORS AND OR THE EXTENDED BUSINESS OFFICE WILL ATTEMPT OTHER COLLECTION ACTIONS, SUCH AS SUBSEQUENT BILLINGS/MONTHLY STATEMENTS, AND TELEPHONE CALLS. A SUMMARY BILL IS SENT TO THE PATIENT 3DAYS AFTER DISCHARGE OR WHEN ALL APPLICABLE CRITERIA IS MET. STATEMENTS WITH FINANCIAL ASSISTANCE MESSAGES ARE SENT 30, 60, 90, AND 120 DAYS. AN ACCOUNT IS CONSIDERED FOR BAD DEBT DETERMINATION ONCE THE DEBT REMAINS UNPAID MORE THAN 120 DAYS AND IF A PAYMENT PLAN IS ESTABLISHED WITH THEPATIENT AND THE PATIENT MISSES TWO PAYMENTS, THE REMAINING BALANCE WILL BE PLACED TO BAD DEBT. ONCE AN ACCOUNT IS DETERMINED TO BE BAD DEBT, IT IS SUBMITTED TO THE PATIENT FINANCIAL SERVICES SUPERVISOR WHO REVIEWS, APPROVES, AND RECORDS THE BAD DEBT AMOUNT. ANY WRITE-OFF EXCEEDING $3,000IS ALSO REVIEWED BY THE CFO.THE HOSPITAL DOES NOT HAVE ANY BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. THE HOSPITAL IDENTIFIES ALL THOSE ELIGIBLE FOR CHARITY CARE UPFRONT OR THROUGH THE EXTENDED BUSINESS OFFICE BEFORE ANY AMOUNTS ARE WRITTEN OFF TO BAD DEBT. PART III, LINE 4: THE FOOTNOTE REGARDING BAD DEBT EXPENSE IS INCLUDED ON PAGES 16 THROUGH 18 OF THE ORGANIZATIONS'S FINANCIAL STATEMENTS. PART III, LINE 8: ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. PART III, LINE 9B: SEE SCHEDULE H, PART III, LINE 3. PART VI, LINE 2: BOTH ON-GOING QUALITATIVE AND QUANTITATIVE FEEDBACK IS TAKEN INTO ACCOUNTTO ASSESS COMMUNITY HEALTH CARE NEEDS. A QUANTITATIVE AND QUALITATIVE NEEDS ASSESSMENT WAS CONDUCTED IN 2015, WITH ANALYSIS AND PUBLICATION COMPLETED IN 2016, TO GAIN INSIGHTS FROM AREA RESIDENTS AND COMMUNITY LEADERS AS TO THEIR HEALTHCARE ISSUES AND THEIR PERCEPTIONS REGARDING NEEDS IN THE COMMUNITY. HARD COPIES OF THE REPORT ARE AVAILABLE AND ALSO POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL:WWW.KRH.ORG/NVH/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTQUALITATIVE INFORMATION IS GAINED REGULARLY THROUGH PARTNERSHIPS WITH THECITY GOVERNMENT, AREA SCHOOL DISTRICTS, FEDERAL AND LOCAL LEGISLATORS ANDFLATHEAD CITY/COUNTY HEALTH DEPARTMENT. ADDITIONALLY, THE HOSPITAL'SPHYSICIANS AND EMPLOYEES PROVIDE FEEDBACK FROM THEIR EXPERIENCE ON THE JOB AND WITHIN THE COMMUNITY. WRITTEN FEEDBACK FROM THE COMMUNITY IS REQUESTED TO BE SENT TO THE COMMUNITY RELATIONS DEPARTMENT. THE HOSPITAL SPONSORED COMMUNITY EDUCATION PRESENTATIONS ARE FOLLOWED BY A REQUEST FOR FEEDBACK FROM ATTENDEES ON THE VALUE OF THE PRESENTATION AND THEIR INTEREST IN OTHER HEALTH TOPICS.THE HOSPITAL PARTICIPATED IN AVATAR INTERNATIONAL AND PRESS GANEYINTERNATIONAL, THIRD-PARTY PATIENT FEEDBACK SYSTEMS. THE COMMENTS MADEWITHIN THIS PROCESS ARE REVIEWED AND CONSIDERED FOR NEW PROGRAMS BOTH INTHE COMMUNITY AND AT THE HOSPITAL. LIKEWISE, INFORMATION GAINED FROM THEHOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS)IS REVIEWED FOR OPPORTUNITIES TO ADDRESS COMMUNITY HEALTHCARE NEEDS. PART VI, LINE 3: COMMUNICATIONS TO THE PUBLIC ON FINANCIAL ASSISTANCE INCLUDES THE NORTHVALLEY HOSPTIAL WEBSITE, FACILITY SIGNAGE, FINANCIAL COUNSELORS ANDCERTIFIED APPLICATION COUNSELORS, PATIENT HANDBOOK, GUIDE TO YOUR BILLBROCHURE, AND PATIENT/VISITOR GUIDE. PATIENTS ARE OFTEN REFERRED TOAPPLICABLE NON-PROFITS AND STATE CHARITY CARE SERVICES SUCH AS SAVE-A SISTER ORGANIZATION (AN ORGANIZATION THAT ASSISTS LOW INCOME WOMEN WITH FREE MAMMOGRAM SCREENINGS), CHIPS, MONTANA BREAST PROGRAM, SHEPHERD'S HAND FREE CLINC AND FLATHEAD CITY-COUNTY HEATLH DEPARTMENT. NOTICES OF FINANCIAL AID AVAILABILITY ARE AVAILABLE AT THE FLATHEAD UNITED WAY COMMUNITY CENTER. PART VI, LINE 4: THE HOSPITAL SERVES A WIDE VARIETY OF PATIENTS, MANY OF WHOM ARE SELF-EMPLOYED, YOUNG FAMILIES, UNEMPLOYED, SEASONAL WORKERS OR HAVE MINIMUM-WAGE JOBS AND CAN'T AFFORD INSURANCE. MEDICARE AND MEDICAID MADE UP THE MAJORITY OF THE HOSPITAL'S PAYERS AT APPROXIMATELY 60 PERCENT.THE HOSPITAL PROVIDES SERVICES TO RESIDENTS FROM EUREKA IN THE NORTH, TO WEST GLACIER IN THE EAST, AND LAKESIDE/SOMERS TO THE SOUTH. THE DEMOGRAPHICS OF THE HOSPITAL'S PRIMARY SERVICE AREAS OF WHITEFISH, COLUMBIA FALLS AND KALISPELL ARE AS FOLLOWS: (SOURCES: US CENSUS 2010 AND 2015 PROJECTIONS).WHITEFISH: 6.43 SQUARE MILES. POPULATION 7,073, MEDIAN AGE 40, AVERAGE HOUSEHOLD 2.16 PEOPLE, PER CAPITA INCOME $31,410 (2015 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME $51,122, LARGELY WHITE POPULATION 95.8%, PERSONS OVER 65 YEARS OLD = 14.3%.COLUMBIA FALLS: 2.04 SQUARE MILES. POPULATION 5,093, MEDIAN AGE 35.6, AVERAGE HOUSEHOLD 2.44 PEOPLE, PER CAPITA INCOME $21,284 (2015 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME $47,352,LARGELY WHITE POPULATION 94.4%, NEXT IS AMERICAN INDIAN 1.8%, PERSONS OVER 65 YEARS OLD = 13.2%.KALISPELL: 11.64 SQURE MILES. POPULATION 22,052, MEDIAN AGE 39.9, AVERAGE HOUSEHOLD 2.27 PEOPLE, PER CAPITA INCOME $22,782 (2015 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME $41,097, LARGELY WHITE POPULATION 94.5%, NEXT IS HISPANIC 2.9%, PERSONS OVER 65 YEARS OLD = 15.4%.FLATHEAD COUNTY: TOTAL POPULATION 98,082, MEDIAN AGE 41.7, PER CAPITA INCOME $26,388 (2015 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME $41,851, LARGELY WHITE POPULATION 95.5%, NEXT IS HISPANIC 2.3%, PERSONS OVER 65 YEARS OLD = 17.7%. PART VI, LINE 5: THE HOSPITAL PROVIDES RESOURCES AND FINANCIAL ASSISTANCE TO OTHER NON-PROFITS AND HEALTH-RELATED ENTITIES TO IMPROVE THE WELL-BEING OF THE COMMUNITY.THE HOSPITAL HAS BEEN INSTRUMENTAL IN PROVIDING RURAL AREAS WITH PRIMARY,WELLNESS AND WALK-IN CARE THROUGH CLINICS IN EUREKA AND COLUMBIA FALLS YEAR-ROUND AND SEASONALLY WHEN TOURISM DEFINES THE EXTRA NEED AT WHITEFISH MOUNTAIN RESORT AND WEST GLACIER.EUREKA CLINIC PROVIDES DIGITAL X-RAYS, CLIA-CERTIFIED LAB SERVICES AND ULTRASOUND; COLUMBIA FALLS OFFERS X-RAY AND LAB SERVICES. THE EUREKA AND COLUMBIA FALLS CLINICS ARE DESIGNATED RURAL HEALTH CLINICS PROVIDING A SLIDING FEE SCALE FOR THOSE FINANCIALLY QUALIFIED. SCHOOL BASED HEALTHCLINIC IN COLUMBIA FALLS HIGHSCHOOL PROVIDES PHYSICAL AND MENTAL HEALTH SERVICES FOR STUDENTS AND STAFF. THE SEASONAL CLINICS ARE OPEN DAILY IN THEIR RESPECTIVE LOCATIONS TO PROVIDE WELLNESS AND URGENT CARE TO AREA RESIDENTS AND VISITORS. AVAILABLE ARE PHARMACEUTICALS, DIGITAL X-RAYS AND CLIA-CERTIFIED LABS. IN HOSPITAL CLINICS, AS WELL AS THE HOSPITAL, THE PICTURE ARCHIVING COMPUTER SYSTEM (PACS) IS USED TO QUICKLY SHARE DATA WITH OTHER MEDICAL FACILITIES. ELECTRONIC MEDICAL RECORDS SYSTEM WAS LAUNCHED ON DECEMBER 9, 2013 WITH PATIENT PORTAL ACCESSIBLE VIA THE HOSPITAL WEBSITE IN MARCH 2014. INPATIENTS AND OUTPATIENTS RECEIVE A BROCHURE AND INSTRUCTIONS REGARDING THE PATIENT PORTAL WITH EACH ADMISSION. THE BROCHURE IS ALSO AVAILABLE ON THE WEBSITE.THE HOSPITAL HELPS SUPPORT THE SHEPHERD'S HAND FREE CLINIC IN WHITEFISH WITH FREE TESTING AND SERVICES THAT THE CLINIC IS UNABLE TO PROVIDE ON ITS OWN. MANY OF THE HOSPITAL PHYSICIANS AND NURSING STAFF VOLUNTEER THEIR OWN TIME CONTRIBUTING TO THIS CLINIC. THE HOSPITAL ALSO PROVIDED FINANCIAL AND PERSONNEL RESOURCES TO WINGS CANCER SUPPORT FOR RESIDENTS WHO NEED TO TRAVEL OUTSIDE OF THE AREA FOR MEDICAL SERVICES. THE HOSPITAL ALSO ASSISTS WITH SUPPORTING THE ALERT MEDICAL HELICOPTER. THE HOSPITAL DONATES TO PROGRAMS THAT ENCOURAGE CHILDREN TO LEAD POSITIVE LIVES, STAY IN SCHOOL, AND PARTICIPATE IN CONSTRUCTIVE ACTIVITIES THAT AREDRUG AND ALCOHOL FREE. THESE INCLUDE CHILDREN'S SPORTS ASSOCIATIONS, SCHOOL BOOSTER CLUBS, HEALTH OCCUPATION STUDENT ASSOCIATIONS AND CIVIC ORGANIZATIONS THAT PROMOTE THESE SAME IDEALS SUCH AS ROTARY.STAFF WAS ACTIVE ON MANY BOARDS SUCH AS UNITED WAY, CANCER SERVICES INCLUDING RELAY FOR LIFE,TO RAISE AWARENESS AND MONEY FOR RESEARCH; EMS TO STREAMLINE SERVICES; MARCH OF DIMES TO PROVIDE PRE AND POST-NATAL EDUCATION AND SUPPORT, AND MORE. OTHER ACTIVE MEMBERSHIPS INCLUDE ROTARY, WHITEFISH AND COLUMBIA CHAMBER OF COMMERCE BOARDS.THE HOSPITAL FOCUSES ON HEALTH EDUCATION, EARLY DETECTION AND PREVENTION. THE HOSPITAL HAS A COMMUNITY HEALTH LIBRARY HOUSING HEALTH- RELATED BOOKS AND PUBLIC ACCESS TO THE INTERNET. STAFF AND PHYSICIANS PROVIDE HEALTHRELATED COMMUNITY EDUCATION PROGRAMS ON TOPICS SUCH AS NUTRITION, PRE AND POSTNATAL HEALTH, DIABETES PREVENTION, BALANCE AND FALLS PRVENTION, MEN'S AND WOMEN'S HEALTH. A FREE COMMUNITY-WIDE CELEBRATION, THE PLANETREE FESTIVAL, WAS HELD TO PROVIDE HEALTH AND WELLNESS INFORMATION, PREVENTATIVE SCREENINGS, DRIVING SAFETY RESOURCES, SUICIDE PREVENTION, AND MUCH MORE. POSTPARTUM DEPRESSION WORKSHOPS FOR THE PUBLIC AND MEDICAL PROVIDERS WERE HOSTED.THE HOSPITAL COMMUNITY HEALTH NURSE TEACHES A CPR AND CPR/FIRST AID CLASS. THE HOSPITAL HAS AN EMPHASIS ON EXERCISE BY SUPPORTING ATHLETIC TRAINERS IN WHITEFISH AND COLUMBIA FALLS SCHOOLS. THE HOSPITAL CONTRIBUTES RESOURCES FOR FUNDRAISERS SUCH AS SAVE A SISTER, WHICH PROVIDES FREE MAMMOGRAMS TO QUALIFIED WOMEN IN THE FLATHEAD VALLEY. THE HOSPITAL OFFERS FREE SUPPORT GROUPS THOSE WHO HAVE HAD A MISCARRIAGE, STILLBIRTH OR NEONATAL LOSS. A FREE MOM/BABY SUPPORT GROUP FACILITATED BY A REGISTERED NURSE IS OFFERED WEEKLY TO HELP NEW PARENTS ADJUST TO THEIR NEW FAMILY DYNAMICS AND TO WEIGH THEIR BABIES TO MONITOR GROWTH. THE HOSPITAL ALSO PROVIDES A LOCATION FOR AARP CLASSES. IN-KIND GOODS TO AREA NONPROFITS ARE PROVIDED TO A VARIETY OF HEALTH-RELATED LOCAL ORGANIZATIONS.QUALIFIED COMMUNITY BENEFITS UNDER THIS QUESTION:BOARD POSITIONS INCLUDE: UNITED WAY, WHITEFISH AND COLUMBIA FALLS CHAMBER OF COMMERCE, EMS BOARD, SHEPHERDS HAND CLINIC BOARD, MONTANA HEALTH INFORAMATION EXCHANGE.ACTIVE MEMBERSHIPS INCLUDE:WHITEFISH ROTARY, CHAMBERS OF COMMERCE, WHITEFISH CONVENTION AND VISITOR BUREAU, BEST BEGINNINGS, CARE TRANSITIONS COALITION, HEALTHY COMMUNITIES COALITION, MOUNTAIN PACIFIC SPECIAL IMPROVEMENT PROJECT CARE TRANSITIONS, WHITEFISH AFFORDABLE HOUSING COMMITTEE.PREVENTION PROGRAMS:SAVE A SISTER MAMMOGRAMS, SCHOOL ATHLETIC TRAINERS, EDUCATION (PROVIDER HEALTH RELATED COMMUNITY EDUCATION, PRE AND POST-NATAL CLASSES, CPR/FIRST AID, SCREENINGS, NUTRITION COUNSELING, SUPPORT GROUPS, BALANCE AND FALLS PREVENTION CLASSES, DIABETES PREVENTION PROGRAMS, ASTHAMA PRVENTIONEDUCATIONIN-KIND DONATIONS TO:AARP, ROTARY EVENTS FOR THE NEEDY IN THE COMMUNITY, SHEPHERD'S HAND CLINIC. PART VI, LINE 7, REPORTS FILED WITH STATES MT X 1 1 X X X 0 0 0 0 0 1 0 0 0 RYAN GUNLIKSON MD MEMBER 281991 0 441 0 0 0 5000 0 16568 0 304000 0 0 0 TATE KREITINGER CHEIF EXECUTIVE OFFICER 0 299998 0 90000 0 101570 0 0 0 25326 0 516894 0 0 JASON SPRING CHEIF EXECUTIVE OFFICER 0 278225 0 57346 0 0 0 3970 0 25628 0 365169 0 0 CHRIS THOMAS CHEIF EXECUTIVE OFFICER 229417 0 38002 0 0 0 14030 0 16111 0 297560 0 0 0 JASON COHEN MD CHIEF MEDICAL OFFICER 230842 0 27500 0 21831 0 3000 0 21526 0 304699 0 0 0 CAMERON GARDNER MD PHYSICIAN 232188 0 2700 0 0 0 5000 0 12438 0 252326 0 0 0 DEREK GEDLAMAN DO OPTOMETRIST 283214 0 0 0 0 0 5000 0 0 0 288214 0 0 0 BRADLEY KASAVANA MD PHYSICIAN 193768 0 13333 0 0 0 4085 0 7588 0 218774 0 0 0 JOHN MUIR MD PHYSICIAN 316464 0 4390 0 0 0 5000 0 15722 0 341576 0 0 0 JONATHAN TORGERSON MD PHYSICIAN 253521 0 0 0 0 0 5000 0 0 0 258521 0 0 0 PART I, LINE 1A THE BOARD OF DIRECTORS AUTHORIZES NORTH VALLEY HOSPITAL TO PAY FOR THE CEO'S MEMBERSHIP IN THE WHITEFISH ROTARY CLUB. PART I, LINE 6 THE CEO AND CFO MAY BE PAID A BONUS THROUGH THE MANAGEMENT COMPANY BASED ON QUALITATIVE RESULTS, BUT CONTINGENT ON POSITIVE FINANCIAL RESULTS OF THE HOSPITAL. A MONTANA FACILITY FINANCE AUTHORITY 364615155 2012-01-30 25000000 REFINANCE NEW HOSPITAL 0 0 0 B MONTANA FACILITY FINANCE AUTHORITY 364615155 2016-08-01 20507000 REFUND 2012 SERIES BOND 0 0 0 A 25000000 2024288 25000000 2007 0 0 1 1 B 20507240 105414 20401826 1 0 1 1 A 0 1 0 0 0.02000 0.02000 1 0 1 B 0 1 0 0 0.02000 0.02000 1 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 1 B 1 LINDSAY TINLIN FAMILY RELATIONSHIP WITH CURRENT TRUSTEE 85375 SALARY 0 FORM 990, PART VI, SECTION A, LINE 2 JOSUA AKEY AND LIN AKEY HAVE A FAMILY RELATIONSHIP. RYAN GUNLIKSON AND JASON SPRING HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL CONTRACTS WITH QUORUM HEALTH RESOURCES, LLC (QHR), AN UNRELATED MANAGEMENT COMPANY, FOR MANAGEMENT SERVICES AND UTILIZES AN EMPLOYEE OF QHR AS ITS CHIEF EXECUTIVE OFFICER AND ITS CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION A, LINE 6 EFFECTIVE MAY 1, 2016, KALISPELL REGIONAL HEALTHCARE SYSTEM INC (KRHS) BECAME THE HOSPITAL'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE AFFILIATION AGREEMENT BETWEEN THE HOSPITAL AND KRHS, KRHS WILL APPOINT TWO OF KRHS TRUSTEES TO THE HOSPITAL'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS REGARDING CHANGING THE HOSPITAL'S ACUTE CARE OFFERINGS, SELLING, DISPOSING, ASSIGNING OR EXCHANGING ANY PROPERTY OR ASSETS, ENTERING INTO ANY NEW DEBT, AND ENTERING INTO OTHER TRANSACTIONS ARE SUBJEC TO THE APPROVAL OF KRHS. GLACIER BANK HAS THE AUTHORITY TO VETO ANY MAJOR PURCHASE OR SERVICE AGREEMENT THAT THE HOSPITAL'S BOARD APPROVES, REGARDLESS OF WHETHER THE AGREEMENT AFFECTS THE HOSPITAL'S REAL ESTATE LOAN. FORM 990, PART VI, SECTION B, LINE 11B THE HOSPITAL'S CFO AND BOARD OF DIRECTORS REVIEW AND APPROVE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER ANNUALLY COMPLETES A CONFLICT OF INTEREST STATEMENT DISCLOSING ANY POSSIBLE CONFLICTS OF INTEREST. THE BOARD REVIEWS EACH MEMBER'S STATEMENT AND, IF POTENTIAL ISSUES ARISE, THE BOARD MAY ASK THE MEMBER IN QUESTION TO LEAVE THE ROOM WHILE THE REST OF THE BOARD DISCUSSES AND VOTES ON THE MATTER. A BOARD MEMBER WITH A POTENTIAL CONFLICT OF INTEREST PRESENT FOR A VOTE WILL CAST AN ABSTAINING VOTE. EACH KEY EMPLOYEE IS REQUIRED TO REPORT TO THE SUPERVISOR OR THE COMPLIANCE OFFICER ANY POTENTIAL CONFLICTS OF INTEREST SITUATION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD ANNUALLY REVIEWS AND APPROVES MANAGEMENT, OFFICERS, AND KEY EMPLOYEES' WAGES DURING THE BUDGET PROCESS, USING MARKET SURVEYS AND SALARY RANGES PROVIDED BY THE MANAGEMENT COMPANY TO DETERMINE FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 NORTH VALLEY HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 6,455,301. MANAGEMENT AND GENERAL EXPENSES 2,861,797. FUNDRAISING EXPENSES 52,941. TOTAL EXPENSES 9,370,039. FORM 990, PART XI, LINE 9: CONSOLIDATING ADJUSTMENT 343,152. NORTH VALLEY HOSPITAL FOUNDATION 1600 HOSPITAL WAY WHITEFISH MT 59937 810526541 SUPPORTING ORGANIZATION MT 501(C)(3) LINE 12D, III-O NORTH VALLEY HOSPITAL INC 0 KALISPELL REGIONAL HEALTHCARE SYSTEM 310 SUNNYVIEW LANE KALISPELL MT 59901 810406485 SUPPORT SUBSIDIARY TAX EXEMPT ORGANIZATIONS MT 501(C)(3) LINE 12C, III-FI N/A 0 KALISPELL REGIONAL HEALTHCARE FOUNDATION 310 SUNNYVIEW LANE KALISPELL MT 59901 311703013 SUPPORTING ORGANIZATION MT 501(C)(3) LINE 12B, II KALISPELL REGIONAL MEDICAL CENTER 1 NORTHWEST HORIZONS INC 310 SUNNYVIEW LANE KALISPELL MT 59901 810420653 OPERATE LONG TERM AMBULATORY FACILITY MT 501(C)(3) LINE 11 KALISPELL REGIONAL HEALTHCARE SYSTEM 1 THE SUMMIT MEDICAL FITNESS CENTER 310 SUNNYVIEW LANE KALISPELL MT 59901 237293874 COMMUNITY HEALTH & WELLNESS CENTER MT 501(C)(3) 10 KALISPELL REGIONAL HEALTHCARE SYSTEM 1 KALISPELL REGIONAL MEDICAL CENTER VOLUNTEERS 310 SUNNYVIEW LANE KALISPELL MT 59901 273866474 SUPPORTING ORGANIZATION MT 3 LINE 11 KALISPELL REGIONAL MEDICAL CENTER 1 KALISPELL REGIONAL MEDICAL CENTER 310 SUNNYVIEW LANE KALISPELL MT 59901 237293874 OPERATE ACUTE CARE HOSPITAL MT 501(C)(3) LINE 3 KALISPELL REGIONAL HEALTHCARE SYSTEM 0 ASSIST-FLATHEAD VALLEY 310 SUNNYVIEW LANE KALISPELL MT 59901 462669324 WELLNESS RESOURCE PROVIDER MT 501(C)(3) LINE 7 1 1 0 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 NORTH VALLEY HOSPITAL FOUNDATION C 514288 ACTUAL PAYMENT NORTH VALLEY HOSPITAL FOUNDATION O 152277 ACTUAL PAYMENT KALISPELL REGIONAL MEDICAL CENTER A 42026 ACTUAL PAYMENT KALISPELL REGIONAL MEDICAL CENTER L 2943071 ACTUAL PAYMENT KALISPELL REGIONAL HEALTHCARE SYSTEM M 68810 ACTUAL PAYMENT