2018-05-11T14:11:52-06:00 2017-06-30 GREEN HEALTH GROUP PC 110 5TH ST S SUITE 106 GLASGOW MT 592302338 990 2016-07-01 810226578 NORTHEAST MONTANA HEALTH SERVICES NORT 4066536500 315 KNAPP STREET WOLF POINT MT 59201 MARGARET NORGAARD CEO 4066536500 2018-05-10 true DANIEL GREEN P01311679 4062632615 2018-05-11 2016 2022-09-23 18:48:47Z MARGARET NORGAARD 315 KNAPP STREET WOLF POINT MT 59201 26673810 false X WWW.NEMHS.NET X 1948 MT TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. 6 5 508 12 1137883 -34654 1002636 627784 24100851 25465763 926400 222666 364885 357597 26394772 26673810 0 0 15268974 15863660 0 60755 10258762 11099476 25527736 26963136 867036 -289326 36583670 36979769 12766911 13452336 23816759 23527433 TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. false false 21676160 25465763 PROVIDE QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO THE PATIENTS THAT WE SERVE. 21676160 true true false true false false false false false false true true false true false true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 30 0 true 508 true true true false false false false false false false false false X 6 5 false false false false false false false true true false false true true true true true true true true false X DEMI WILKINSON 4066536500 315 KNAPP ST WOLF POINT MT 59201 X MARK ZILKOSKI MD MEDICAL STAF 1.00 40.00 X 0 245734 120381 SHARON BRAVARD CHAIRWOMAN 2.00 X 0 0 0 SHANE GIBSON VICE CHAIRMA 1.00 X 0 0 0 STEVE HACKLEY DIRECTOR 1.00 X 0 0 0 DALLAS O'CONNOR DIRECTOR 1.00 X 0 0 0 RJ DOORNEK DIRECTOR 1.00 X 0 0 0 MARGARET NORGAARD CEO 40.00 X 154218 0 24387 RICHARD GOERTZ CFO 40.00 X 77529 0 12510 VICKI HOUSTON RN 40.00 X 163340 0 9342 MARK ZYGMOND CRNA 20.00 X 142593 0 3796 ELAINE LONG RN-VP NURSIN 40.00 X 130218 0 10721 JO ANN HIBL RN-DON 40.00 X 127109 0 11482 LORI COLLINS RN 40.00 X 117347 0 9020 912354 245734 201639 6 false true false DALE PLUMBING & HEATING PO BOX 527 GLASGOW MT 59230 BOILER SYSTEM 711836 BIG SKY LOCUMS 2025 LAKE HILLS DRIVE BILLINGS MT 59105 ER PROVIDERS 309882 BILLINGS CLINIC PO BOX 30277 BILLINGS MT 59107 COMPUTER SUPP 289984 DRAGE FAMILY PRACTICE 1912 E HICKORY POINT CIRCLE SANDY UT 84092 ER PROVIDER SVC 266224 CERNER PO BOX 959156 ST LOUIS MO 63195 EHR SERVICES 243940 5 25368 43703 558713 627784 PATIENT REVENUE 621500 22479572 22479572 RETAIL PHARMACIES 446110 2986191 1848308 1137883 25465763 222666 222666 HOSPITAL DISTRICT TAX 900099 357447 357447 GAIN ON SALE OF ASSETS 900099 150 150 357597 26673810 24908143 1137883 310004 310004 13255407 11769608 1436984 48815 97498 79618 17755 125 1131501 893645 229658 8198 1069250 775656 290098 3496 95505 95505 81905 81905 2625955 2625955 21367 21367 756316 416727 339571 18 227011 227011 251594 251594 101769 88451 13265 53 29310 24843 4417 50 402952 3439 399513 1108349 1108349 274692 274692 MEDICAL SUPPLIES 2980364 2977001 3363 COGS 824286 824286 REPAIRS & MAINTENANCE 739003 429154 309849 FOOD & DIETARY SUPPLIES 317406 317406 261692 198777 62915 26963136 21676160 5226221 60755 3758430 5334965 250690 7100044 5787058 920469 831777 278183 313746 28433889 19620432 9238698 8813457 5545058 5995848 9492098 9902918 36583670 36979769 3170047 3356818 9534445 9322698 62419 772820 12766911 13452336 X 23150026 22891229 666733 636204 23816759 23527433 36583670 36979769 -289326 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1939 1939 false SCHEDULE C, PART II-B, LINE 1 0.33 PERCENT OF MHA DUES PAID TO MHA, WHICH WAS 80, 21.78 PERCENT OF DUES PAID TO MHA FOR AHA, WHICH WAS 1,835, AND 1.70 PERCENT OF DUES PAID TO MHA FOR LEADING AGE WHICH WAS 24 (1939 COMBINED) WERE USED FOR LOBBYING EXPENSES BY MHA. 28950 28950 15107298 9773865 5333433 13297641 9846567 3451074 8813457 5002556 C BOND FUNDS 993292 F 5995848 RECEIVABLE-WOLF POINT CLINIC ASSOC 6314068 RECEIVABLE-RIVERSIDE FAMILY CLINIC 3508850 WORK COMP TRUST DEPOSIT 80000 9902918 X 26673810 26673810 26673810 26963136 26963136 26963136 SCHEDULE D, PAGE 3, PART X IT IS THE OPINION OF MANAGEMENT THAT THE COMPANY HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. SEE PAGE 8 IN THE NORTHEAST MONTANA HEALTH SERVICES, INC. AND AFFILIATES NOTES TO CONSOLIDATED FINANCIAL STATEMENTS JUNE 30, 2017 AND 2016. true true X true X true X true true false false 580467 580467 0.02150 11331193 11102105 229088 0.00850 11911660 11102105 809555 0.03000 3336810 2204749 1132061 0.04200 8400 8400 0.00030 3345210 2204749 1140461 0.04230 15256870 13306854 1950016 0.07230 53100 53100 0.00200 53100 53100 0.00200 true 446535 4718140 4641272 76868 X true true 2 1 NEMHS - TRINITY HOSPITAL 315 KNAPP STREET WOLF POINT MT 59201 WWW.NEMHS.NET X X X X 2 NEMHS - POPLAR COMMUNITY HOSPITAL 211 H STREET EAST POPLAR MT 59255 WWW.NEMHS.NET X X X X NEMHS - TRINITY HOSPITAL 1 false false true X X X X X X X X X 15 true true false true X WWW.NEMHS.NET X X true 15 true WWW.NEMHS.NET false false true X 100.000000000000 200.000000000000 X X X true true X X X true X WWW.NEMHS.NET X WWW.NEMHS.NET X WWW.NEMHS.NET X X X X X true X false X X X X true X X false false NEMHS - POPLAR COMMUNITY HOSPITAL 2 false false true X X X X X X X X X 15 true true false true X WWW.NEMHS.NET X X true 15 true WWW.NEMHS.NET false false true X 100.000000000000 200.000000000000 X X X true true X X X true X WWW.NEMHS.NET X WWW.NEMHS.NET X WWW.NEMHS.NET X X X X true X false X X X X true X X false false FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 5 IN THE SPRING OF 2016, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND ADVERTISED THROUGH FACEBOOK AND BULLETINS POSTED AROUND WOLF POINT AND POPLAR. OF THE 300 SURVEYS SENT, 228 RESULTED IN A RESPONSE. FIVE FOCUS GROUPS WERE HELD IN WOLF POINT AND POPLAR DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, VARIOUS MEDICAL PROVIDERS, AND AREA CEOS FROM NEIGHBORING HOSPITALS VIA TELECONFERENCING. ALSO, SIX KEY INFORMANT INTERVIEWS WHICH INCLUDED THE PUBLIC HEALTH NURSE WERE CONDUCTED ON BEHALF OF NEMHS BY THE MONTANA OFFICE OF RURAL HEALTH. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 6A NORTHEAST MONTANA HEALTH SERVICES - POPLAR COMMUNITY HOSPITAL FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 7D THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 11 NEMHS AND ASSOCIATES IDENTIFIED 14 NEEDS TO ADDRESS. THREE GOALS WITH STRATEGIES AND ACTIVITES WERE DEVELOPED TO ADDRESS A VARIATION OF THOSE 14 NEEDS. NEMHS AND ASSOCIATES IDENTIFIED 4 OF THOSE NEEDS THAT COULD NOT BE ADDRESSED. NEEDS TO BE ADDRESSED: 1. HEALTHY COMMUNITY INCLUDING ACCESS TO HEALTHCARE AND OTHER SERVICES, HEALTHY BEHAVIORS AND LIFESTYLES, AND STRONG FAMILY LIFE. 2. RESPONDENTS DELAYED OR DID NOT GET NEEDED HEALTHCARE SERVICES. 3. DELAYS IN RECEIVING HEALTHCARE INCLUDING TOO LONG TO WAIT FOR AN APPOINTMENT, IT COSTS TOO MUCH, AND COULD NOT GET AN APPOINTMENT. 4. HEALTHCARE WORKFORCE SHORTAGE. 5. MOST COMMUNITY MEMBERS CONSIDER THE COMMUNITY TO BE UNHEALTHY. 6. NEED FOR MORE EXERCISE WITHIN THE COMMUNITY AS 1/3 OF COMMUNITY EXERCISES 20 MINUTES OR LESS ONE TO TWO TIMES A MONTH OR LESS. 7. HEALTH CONCERNS: ALCOHOL/SUBSTANCE ABUSE, CHILD ABUSE/NEGLECT, AND DIABETES. 8. RESPONDENTS REPORTED THEY EXPERIENCED PERIODS OF DEPRESSION FOR AT LEAST THREE MONTHS. 9. NEED FOR GREATER ACCESS TO AND QUALITY MENTAL HEALTH TREATMENT. 10. LACK OF SUBSTANCE ABUSE SERVICES AND THE AMOUNT OF DRUG AND ALCOHOL ABUSE. 11. ADDRESSING CHRONIC DISEASES IN COMMUNITY SUCH AS DIABETES, OBESITY, AND HEART DISEASE. 12. NEED TO REDUCE PERCENTAGE OF DIABETICS IN ROOSEVELT COUNTY AS IT IS DOUBLE THE STATE AVERAGE AND HIGHER THAN THE NATIONAL AVERAGE. 13. NEED FOR LOCAL DENTAL, MRI, AND DERMATOLOGY SERVICES. 14. NEED FOR LOCAL PHYSICAL THERAPY SERVICES. GOALS, STRATEGIES, AND ACTIVITIES TO ADDRESS NEEDS: 1. IMPROVE ACCESS TO HEALTHCARE SERVICES IN NEMHS SERVICE AREA. STRATEGIES FOR IMPLEMENTATION: 1.1 - ENHANCE WORKFORCE DEVELOPMENT OUTREACH THROUGH PIPELINE PROGRAMS, SUCH AS MILES CITY COMMUNITY COLLEGE AND FORT PECK COMMUNITY COLLEGE NURSING PROGRAMS. NEMHS IS PARTICIPATING IN DISCUSSIONS BETWEEN FORT PECK COMMUNITY COLLEGE AND MILES CITY COMMUNITY COLLEGE TO ALLOW STUDENTS AT FPCC TO PARTICIPATE IN MILES CITY COMMUNITY COLLEGE'S NURSING PROGRAM. NEMHS WOULD PROVIDE CLINICAL TRAINING TO STUDENTS IN THE PROGRAM OVER THE COURSE OF TWO YEARS. 1.2 - EXPAND WORKFORCE RECRUITMENT EFFORTS BY ATTENDING VARIOUS RECRUITMENT FAIRS, CONFERENCES, RESIDENCY PROGRAM "MEET AND GREETS" TO EDUCATE POTENTIAL EMPLOYEES ABOUT NEMHS. THE DIRECTOR OF NURSING HAS BEEN ATTENDING NURSING JOB FAIRS TO RECRUIT NEW GRADUATES TO COME WORK AT NEMHS. ALSO, THE TRINITY EMS DIRECTOR TEACHES CLASSES IN THE FALL TO TRAIN COMMUNITY MEMBERS IN EMERGENCY AID WITH THE GOAL TO RECRUIT MEMBERS TO EMS AFTER THE TRAINING IS COMPLETE. 1.3 - IMPROVE ACCESS TO MENTAL HEALTH SERVICES BY IDENTIFYING LOCAL MENTAL HEALTH PROGRAMS AND STAKEHOLDERS; CATALOGUE AVAILABLE RESOURCES. 2. IMPROVE COMMUNITY HEALTH AND WELLNESS IN ROOSEVELT COUNTY. STRATEGIES FOR IMPLEMENTATION: 2.1 - INCREASE HEALTH AND WELLNESS OPPORTUNITIES AND RESOURCES FOR NEMHS STAFF BY WORKING WITH THE FFCC WELLNESS PROGRAM STAFF. 2.2 - IMPROVE ACCESS TO HEALTH AND WELLNESS OPPORTUNITIES FOR NEMHS COMMUNITY BY SPONSORING/HOLDING COMMUNITY HEALTH EVENTS SUCH AS A COLOR RUN. 2.3 - NEMHS IS IN TALKS WITH THE ROOSEVELT COUNTY JAIL TO OFFER CORRECTIONAL HEALTH SERVICES TO INMATES PREVENTING THE NEED FOR THE OFFICERS TO BRING INMATES TO THE HOSPITAL OR CLINIC. 3. IMPROVE ACCESS TO PHYSICAL THERAPY SERVICES IN ROOSEVELT COUNTY. STRATEGY FOR IMPLEMENTATION: 3.1 - ENHANCE PHYSICAL THERAPY SERVICES AVAILABLE THROUGH NEMHS BY CONDUCTING A FEASIBILITY STUDY FOR DEVELOPMENT OF PHYSICAL THERAPY SERVICES AT NEMHS - ASSESS FUNDING NEEDS AND POTENTIAL BARRIERS. THIS PROCESS BEGAN IN FY2017 BY INTERVIEWING PHYSICAL THERAPIST CANDIDATES ABOUT STARTING TO OFFER THIS SERVICE IN THE WOLF POINT AREA AND PULLING TOGETHER A COMMITTEE TO IDENTIFY THE BEST LOCATION FOR THE DEPARTMENT. NEEDS THAT COULD NOT BE ADDRESSED: 1. STRONG FAMILY LIFE, CHILD ABUSE/NEGLECT, CRIME AND SAFE NEIGHBORHOODS, AND SAFE WALKING TRAILS/PATHS - NEMHS WORKS AND REFERS INCIDENTS TO FAMILY RESOURCES CENTER AND CHILD PROTECTIVE SERVICES BUT IS UNABLE TO PROVIDE HELP ON THE SCOPE THE COMMUNITY WANTS. 2. SURVEY RESPONDENTS DELAYED OR DID NOT RECEIVE NEEDED MEDICAL SERVICES BECAUSE IT COSTS TOO MUCH - NEMHS CURRENTLY OFFERS A SLIDING FEE SCHEDULE AND A FINANCIAL ASSISTANCE PROGRAM TO ASSIST PATIENTS WITHIN THE 200% POVERTY GUIDELINES. AGING SERVICES HAS A REPRESENTATIVE AVAILABLE AT NEMHS TO PROVIDE ASSISTANCE WITH THE INSURANCE EXCHANGE AND BOTH INDIAN HEALTH AND NEMHS HAVE REPRESENTATIVES AVAILABLE TO ASSIST WITH MEDICAID APPLICATIONS. 3. SURVEY RESPONDENTS INDICATED A DESIRE FOR BETTER ACCESS TO DENTAL SERVICES - HP/DP PROVIDES DENTAL SERVICES FOR THOSE TRIBAL COMMUNITY MEMBERS. RECRUITING ADDITIONAL DENTAL PROVIDERS WOULD NOT BE FEASIBLE FOR NEMHS DUE TO FINANCIAL, STAFFING, AND LOGISTICAL BARRIERS. 4. MRI AND DERMATOLOGY WERE TWO SPECIALTY SERVICES IDENTIFIED AS A NEEDED SERVICE BY SURVEY RESPONDENTS - NEMHS HAS BEEN WORKING ON EXPANDING BOTH MRI AND DERMATOLOGY SERVICES. MRI HAS PROVEN TO BE TOO RESOURCE AND STAFF INTENSIVE FOR OUR FACILITY AT THIS TIME. ADDITIONALLY, DERMATOLOGY VIA TELEMEDICINE HAS BEEN ATTEMPTED BUT THUS FAR WE HAVE BEEN UNSUCCESSFUL IN SECURING A DERMATOLOGIST TO PROVIDE SERVICES. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 5 IN THE SPRING OF 2016, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND ADVERTISED THROUGH FACEBOOK AND BULLETINS POSTED AROUND WOLF POINT AND POPLAR. OF THE 300 SURVEYS SENT, 228 RESULTED IN A RESPONSE. FIVE FOCUS GROUPS WERE HELD IN WOLF POINT AND POPLAR DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, VARIOUS MEDICAL PROVIDERS, AND AREA CEOS FROM NEIGHBORING HOSPITALS VIA TELECONFERENCING. ALSO, SIX KEY INFORMANT INTERVIEWS WHICH INCLUDED THE PUBLIC HEALTH NURSE WERE CONDUCTED ON BEHALF OF NEMHS BY THE MONTANA OFFICE OF RURAL HEALTH. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 6A NORTHEAST MONTANA HEALTH SERVICES - TRINITY HOSPITAL FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 7D THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 11 NEMHS AND ASSOCIATES IDENTIFIED 14 NEEDS TO ADDRESS. THREE GOALS WITH STRATEGIES AND ACTIVITES WERE DEVELOPED TO ADDRESS A VARIATION OF THOSE 14 NEEDS. NEMHS AND ASSOCIATES IDENTIFIED 4 OF THOSE NEEDS THAT COULD NOT BE ADDRESSED. NEEDS TO BE ADDRESSED: 1. HEALTHY COMMUNITY INCLUDING ACCESS TO HEALTHCARE AND OTHER SERVICES, HEALTHY BEHAVIORS AND LIFESTYLES, AND STRONG FAMILY LIFE. 2. RESPONDENTS DELAYED OR DID NOT GET NEEDED HEALTHCARE SERVICES. 3. DELAYS IN RECEIVING HEALTHCARE INCLUDING TOO LONG TO WAIT FOR AN APPOINTMENT, IT COSTS TOO MUCH, AND COULD NOT GET AN APPOINTMENT. 4. HEALTHCARE WORKFORCE SHORTAGE. 5. MOST COMMUNITY MEMBERS CONSIDER THE COMMUNITY TO BE UNHEALTHY. 6. NEED FOR MORE EXERCISE WITHIN THE COMMUNITY AS 1/3 OF COMMUNITY EXERCISES 20 MINUTES OR LESS ONE TO TWO TIMES A MONTH OR LESS. 7. HEALTH CONCERNS: ALCOHOL/SUBSTANCE ABUSE, CHILD ABUSE/NEGLECT, AND DIABETES. 8. RESPONDENTS REPORTED THEY EXPERIENCED PERIODS OF DEPRESSION FOR AT LEAST THREE MONTHS. 9. NEED FOR GREATER ACCESS TO AND QUALITY OF MENTAL HEALTH TREATMENT. 10. LACK OF SUBSTANCE ABUSE SERVICES AND THE AMOUNT OF DRUG AND ALCOHOL ABUSE. 11. ADDRESSING CHRONIC DISEASES IN COMMUNITY SUCH AS DIABETES, OBESITY, AND HEART DISEASE. 12. NEED TO REDUCE PERCENTAGE OF DIABETICS IN ROOSEVELT COUNTY AS IT IS DOUBLE THE STATE AVERAGE AND HIGHER THAN THE NATIONAL AVERAGE. 13. NEED FOR LOCAL DENTAL, MRI, AND DERMATOLOGY SERVICES. 14. NEED FOR LOCAL PHYSICAL THERAPY SERVICES. GOALS, STRATEGIES, AND ACTIVITIES TO ADDRESS NEEDS: 1. IMPROVE ACCESS TO HEALTHCARE SERVICES IN NEMHS SERVICE AREA. STRATEGIES FOR IMPLEMENTATION: 1.1 - ENHANCE WORKFORCE DEVELOPMENT OUTREACH THROUGH PIPELINE PROGRAMS, SUCH AS MILES CITY COMMUNITY COLLEGE AND FORT PECK COMMUNITY COLLEGE NURSING PROGRAMS. NEMHS IS PARTICIPATING IN DISCUSSIONS BETWEEN FORT PECK COMMUNITY COLLEGE AND MILES CITY COMMUNITY COLLEGE TO ALLOW STUDENTS AT FPCC TO PARTICIPATE IN MILES CITY COMMUNITY COLLEGE'S NURSING PROGRAM. NEMHS WOULD PROVIDE CLINICAL TRAINING TO STUDENTS IN THE PROGRAM OVER THE COURSE OF TWO YEARS. 1.2 - EXPAND WORKFORCE RECRUITMENT EFFORTS BY ATTENDING VARIOUS RECRUITMENT FAIRS, CONFERENCES, RESIDENCY PROGRAM "MEET AND GREETS" TO EDUCATE POTENTIAL EMPLOYEES ABOUT NEMHS. THE DIRECTOR OF NURSING HAS BEEN ATTENDING NURSING JOB FAIRS TO RECRUIT NEW GRADUATES TO COME WORK AT NEMHS. 1.3 - IMPROVE ACCESS TO MENTAL HEALTH SERVICES BY IDENTIFYING LOCAL MENTAL HEALTH PROGRAMS AND STAKEHOLDERS; CATALOGUE AVAILABLE RESOURCES. 2. IMPROVE COMMUNITY HEALTH AND WELLNESS IN ROOSEVELT COUNTY. STRATEGIES FOR IMPLEMENTATION: 2.1 - INCREASE HEALTH AND WELLNESS OPPORTUNITES AND RESOURCES FOR NEMHS STAFF BY WORKING WITH THE FFCC WELLNESS PROGRAM STAFF. 2.2 - IMPROVE ACCESS TO HEALTH AND WELLNESS OPPORTUNITIES FOR NEMHS COMMUNITY BY SPONSORING/HOLDING COMMUNITY HEALTH EVENTS SUCH AS A COLOR RUN. POPLAR COMMUNITY HOSPITAL HOLDS A COLOR RUN IN JUNE TO ADVOCATE EXERCISE TO CHILDREN AND THEIR FAMILY MEMBERS. 2.3 - NEMHS IS IN TALKS WITH ROOSEVELT COUNTY JAIL TO OFFER CORRECTIONAL HEALTH SERVICES TO INMATES PREVENTING THE NEED FOR THE OFFICERS TO BRING INMATES TO THE HOSPITAL OR CLINIC. 3. IMPROVE ACCESS TO PHYSICAL THERAPY SERVICES IN ROOSEVELT COUNTY. STRATEGY FOR IMPLEMENTATION: 3.1 - ENHANCE PHYSICAL THERAPY SERVICES AVAILABLE THROUGH NEMHS BY CONDUCTING A FEASIBILITY STUDY FOR DEVELOPMENT OF PHYSICAL THERAPY SERVICES AT NEMHS - ACCESS FUNDING NEEDS AND POTENTIAL BARRIERS. THIS PROCESS BEGAN IN FY2017 BY INTERVIEWING PHYSICAL THERAPIST CANDIDATES ABOUT STARTING TO OFFER THIS SERVICE AT THE POPLAR HOSPITAL FOR THE SWING BED UNIT AND OTHER COMMUNITY MEMBERS. NEEDS THAT COULD NOT BE ADDRESSED: 1. STRONG FAMILY LIFE, CHILD ABUSE/NEGLECT, CRIME AND SAFE NEIGHBORHOODS, AND SAFE WALKING TRAILS/PATHS - NEMHS WORKS AND REFERS INCIDENTS TO FAMILY RESOURCES CENTER AND CHILD PROTECTIVE SERVICES BUT IS UNABLE TO PROVIDE HELP ON THE SCOPE THE COMMUNITY WANTS. 2. SURVEY RESPONDENTS DELAYED OR DID NOT RECEIVE NEEDED MEDICAL SERVICES BECAUSE IT COSTS TOO MUCH - NEMHS CURRENTLY OFFERS A SLIDING FEE SCHEDULE AND A FINANCIAL ASSISTANCE PROGRAM TO ASSIST PATIENTS WITHIN THE 200% POVERTY GUIDELINES. AGING SERVICES HAS A REPRESENTATIVE AVAILABLE AT NEMHS TO PROVIDE ASSISTANCE WITH THE INSURANCE EXCHANGE AND BOTH INDIAN HEALTH AND NEMHS HAVE REPRESENTATIVES AVAILABLE TO ASSIST WITH MEDICAID APPLICATIONS. 3. SURVEY RESPONDENTS INDICATED A DESIRE FOR BETTER ACCESS TO DENTAL SERVICES - HP/DP PROVIDES DENTAL SERVICES FOR THOSE TRIBAL COMMUNITY MEMBERS. RECRUITING ADDITIONAL DENTAL PROVIDERS WOULD NOT BE FEASIBLE FOR NEMHS DUE TO FINANCIAL, STAFFING, AND LOGISTICAL BARRIERS. 4. MRI AND DERMATOLOGY WERE TWO SPECIALTY SERVICES IDENTIFIED AS A NEEDED SERVICE BY SURVEY RESPONDENTS - NEMHS HAS BEEN WORKING ON EXPANDING BOTH MRI AND DERMATOLOGY SERVICES. MRI HAS PROVEN TO BE TOO RESOURCE AND STAFF INTENSIVE FOR OUR FACILITY AT THIS TIME. ADDITIONALLY, DERMATOLOGY VIA TELEMEDICINE HAS BEEN ATTEMPTED BUT THUS FAR WE HAVE BEEN UNSUCCESSFUL IN SECURING A DERMATOLOGIST TO PROVIDE SERVICES. 2 WOLF POINT CLINIC ASSOCIATION 301 KNAPP STREET WOLF POINT MT 59201 RURAL HEALTH CLINIC RIVERSIDE FAMILY CLINIC PO BOX 629 POPLAR MT 59255 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 169,847. PHYSICIAN CLINIC COSTS ARE NOT INCLUDED IN SUBSIDIZED HEALTH CARE SERVICES. 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, COMMUNITY BENEFIT, AND WORKFORCE DEVELOPMENT EXPENSE. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. PART II - COMMUNITY BUILDING ACTIVITIES THE STAFF AT NEMHS DESIGNATES TIME FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. THESE ACTIVITIES/INITIATIVES OFTEN TARGET ENVIRONMENTAL STRATEGIES, ECONOMIC DEVELOPMENT AND LEADERSHIP, ADVOCACY AND SUPPORT THAT INDIRECTLY AFFECT THE HEALTH OF THE COMMUNITY. PART II, LINE 8: NEMHS IS LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA AND SPENT 53,100 TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS NEEDED IN THE COMMUNITY. THE COST IS COMPRISED OF PAYMENTS TO RECRUITING FIRMS, NEWSPAPER AND PERIODICALS ADVERTISING, LEGAL FEES FOR FOREIGN PROFESSIONALS, AND TRAVEL AND LODGING FOR SITE VISITS. TRINITY HOSPITAL ALSO HELD FREE EMT COURSES TO ENGAGE THE LOCAL COMMUNITY AND TRAIN ATTENDEES IN HOW TO RESPOND IN EMERGENCY SITUATIONS. THE COURSE ALSO ACTS AS A RECRUITMENT TOOL FOR THE HOSPITAL EMS SERVICES SO THEY MIGHT GROW THEIR EMERGENCY RESPONDER STAFF TO BETTER SERVE THE LOCAL COMMUNITY. THE HOSPITAL, WITH THE HELP OF THE POLICE AND FIRE DEPARTMENT, ALSO ENGAGED THE LOCAL YOUTH BY HOLDING A LIVE DEMONSTRATION OF A TEXTING AND DRIVING ACCIDENT AND THE LOCAL EMERGENCY RESPONSE TO SUCH AN ACCIDENT. 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 7 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 - MEDICARE EXPLANATION THERE IS NO MEDICARE SHORTFALL. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE COSTS BASED ON THE AMBULANCE COST-TO-CHARGE RATIO ON THE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE REVENUE FROM THE MEDICARE PS&R REPORT. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, AND ALSO 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 UNLESS THE PATIENT QUALIFIES FOR DISCOUNTED CARE AND THEN DEFAULTS ON THE PAYMENT PLAN ON THE BALANCE OF THE ACCOUNT. THIS IS A SPECIFIC POLICY FOR PATIENTS QUALIFYING FOR FREE OR DISCOUNTED CARE. PART VI, LINE 2 - NEEDS ASSESSMENT PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, NEMHS ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT PLAN AND AN IMPLEMENTATION STRATEGY DURING FISCAL YEARS 2016 AND 2013 (TAX YEARS 2015 AND 2012). THESE ARE A CONTINUATION AND EXPANSION OF WHAT WE ARE ALREADY DOING TO BETTER SERVE OUR COMMUNITY. WE ARE DILIGENTLY TRACKING LOCAL TRENDS IN HEALTH CARE NEEDS THROUGH AN CUSTOM SURVEY SOLUTIONS PATIENT SATISFACTION SURVEY GIVEN TO ALL INPATIENTS AS WELL AS THE USE OF OUR INTERNAL BALANCED SCORE CARD. A SELECTED TEAM OF MANAGERS MEET QUARTERLY TO DISCUSS OUTCOMES FROM OUR SURVEY REPORTS AND BALANCED SCORE CARD FINDINGS. HERE IS ONE OF OUR PAST FINDINGS: PATIENTS EXPRESSED THEIR DISSATISFACTION WITH HAVING TO TRAVEL TO BILLINGS OR SIDNEY TO HAVE SLEEP STUDIES PERFORMED. WE WERE ABLE TO TRACK THE RISE IN SLEEP STUDY REFERRALS BY OUR PROVIDERS IN THE PAST COUPLE OF YEARS. A GROUP OF MANAGERS WAS BROUGHT TOGETHER TO DO A FEASIBILITY STUDY ON BRINGING SLEEP STUDY SERVICES TO NEMHS, AND WERE ABLE TO COME UP WITH SEVERAL SOLUTIONS. INSTEAD OF IMPLEMENTING A FULL-TIME SLEEP STUDY DEPARTMENT AT NEMHS, COMPLETE WITH QUALIFIED EMPLOYEES AND EQUIPMENT, NEMHS FOUND IT MORE FEASIBLE TO BRING IN A THIRD PARTY COMPANY THAT COULD PERFORM SLEEP STUDIES. NOW WHEN THE PROVIDERS HAVE THREE OR MORE STUDIES, THE THIRD PARTY COMPANY WILL COME IN FOR TWO TO FOUR NIGHTS AND PERFORM THE STUDIES, THUS PATIENTS DO NOT HAVE TO TRAVEL OUT OF THE COMMUNITY TO HAVE THEM PERFORMED. NEMHS MAKES INVESTMENTS TO DELIVER SERVICES NEEDED IN THE COMMUNITY. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE NORTHEAST MONTANA HEALTH SERVICES EMPLOYS TWO SOCIAL SERVICE EMPLOYEES TO ASSIST PATIENTS WITH THEIR FINANICAL NEEDS AND OPTIONS. COMMUNITY ADVERTISEMENT IS USED TO EDUCATE PATIENTS AND SUPPORT IS GIVEN ON A ONE-ON-ONE BASIS TO ASSIST COMMUNITY MEMBERS. PATIENTS ARE NOTIFIED BY THE BILLING DEPARTMENT OF OUR POLICY FOR FINANCIAL ASSISTANCE AND ARE SENT A SIMPLE APPLICATION. OUR WEBSITE PROVIDES DETAILS OF OUR FINANCIAL ASSISTANCE POLICY AND THE FINANCIAL ASSISTANCE AVAILABLE. PART VI, LINE 4 - COMMUNITY INFORMATION THE ORGANIZATION OPERATES ON THE FORT PECK RESERVATION. GEOGRAPHICALLY THIS IS A REMOTE LOCATION WHERE ACCESS TO OTHER HEALTH FACILITIES IS AT LEAST 50 MILES AWAY. WITH SEVERE WEATHER CONDITIONS OFTEN RESULTING IN BLIZZARDS AND IMPASSABLE ROADS, NORTHEAST MONTANA HEALTH SERVICES IS THE FRONTLINE OF CARE FOR THE COMMUNITY. THE POPULATION OF SIOUX AND ASSINIBOINE TRIBAL MEMBERS MAKE UP OUR HIGHEST CONCENTRATION OF PATIENTS WITH DISPARITIES THAT INCLUDE CULTURAL BARRIERS, LOW HOUSEHOLD INCOME, HIGH UNEMPLOYMENT RATES, HIGHER RATES OF TOBACCO, ALCOHOL AND ILLEGAL DRUG USE, AS WELL AS HIGHER THAN AVERAGE RATES OF HEART DISEASE, DIABETES, FETAL ALCOHOL SYNDROME, AND SUICIDE. AS WE CONTINUE OUR EFFORTS TO SERVE THE PUBLIC THROUGH HEALTHCARE AND EDUCATION, THERE IS PROGRESS BEING MADE TO IMPROVE THE QUALITY OF LIFE FOR COMMUNITY MEMBERS. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH NORTHEAST MONTANA HEALTH SERVICES IS GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY MEMBERS REPRESENTING THE GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. OUR HOSPITALS PROVIDE 24/7 EMERGENCY SERVICE COVERAGE TO TREAT PATIENTS, INCLUDING THOSE THAT ARE UNABLE TO PAY. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM TWO AFFILIATED RURAL HEALTH CLINICS, WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC, PROVIDE PROFESSIONAL PHYSICIAN AND OTHER PROVIDER SERVICES WHILE NORTHEAST MONTANA HEALTH SERVICES PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND SKILLED NURSING SERVICES. THE TWO RURAL HEALTH CLINICS ARE OPERATED, AND SUBSIDIZED IF NEEDED, BY NORTHEAST MONTANA HEALTH SERVICES. ADDITIONAL INFORMATION PART V: WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC ARE RURAL HEALTH CLINICS THAT ARE OPERATED AND SUBSIDIZED BY NORTHEAST MONTANA HEALTH SERVICES. THEIR REVENUE AND EXPENSES ARE NOT INCLUDED ON NORTHEAST MONTANA HEALTH SERVICES' FORM 990. PART I, LINE 7I: NEMHS CONTRIBUTED 8,400 TO RURAL HEALTH DEVELOPMENT, INC. TO SUPPORT AND INFLUENCE THE EVOLUTION OF HEALTHCARE ORGANIZATION BY PROVIDING ADDITIONAL FUNDING FOR SMALLER FACILITIES IN CENTRAL AND EASTERN MONTANA FOR CAPITAL PURCHASES, QUALITY IMPROVEMENTS, AND CREATING COST SAVINGS AND OPERATIONAL EFFICIENCIES. X false true false false false false false false false MARK ZILKOSKI MD MEDICAL STAFF REP 245734 120381 366115 MARGARET NORGAARD CEO 154218 2763 21624 178605 VICKI HOUSTON RN 163340 1225 8117 172682 SCHEDULE J, PAGE 1, PART I, LINE 4 MARK ZILKOSKI, MD 0 117,924 0 SCHEDULE J, PART III THE COMPENSATION OF MARK ZILKOSKI, MD IS AN EXPENSE OF WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY. A MT FACILITY FINANCE AUTHORITY BONDS 364615155 2017-01-31 9820000 REFUNDING OF 2007B REVENUE BONDS false false false A 9820000 794798 8827353 196400 1449 2017 true false true true A false false false false false false true A false false false false false false false false false A false FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED AND APPROVED BY THE CEO AND CFO AND IS DISTRIBUTED TO THE GOVERNING BOARD FOR REVIEW PRIOR TO BEING FILED. FORM 990, PAGE 6, PART VI, LINE 12C THE MEMBERS OF THE GOVERNING BOARD SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY IN WHICH THEY ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT DOES EXIST, THE BOARD CHAIRWOMAN WILL REMIND MEMBERS AND ASK THEM TO ABSTAIN FROM VOTING. THESE CONFLICTS ARE DULY NOTED IN THE MINUTES. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD APPROVES THE WAGES OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS IN THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 15B THE CEO APPROVES THE WAGES OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE AVAILABLE FROM CFO UPON REQUEST. FORM 990, PART VII THE MEDICAL STAFF REPRESENTATIVE ON THE GOVERNING BOARD, MARK ZILKOSKI, M.D., IS EMPLOYED BY WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY, AS A FULL TIME PHYSICIAN WHICH IS INCLUDED AS 40 HOURS PER WEEK. RIVERSIDE FAMILY CLINIC PO BOX 629 POPLAR MT 59255 810474760 CLINIC MT 501C3 3 NEMHS true WOLF POINT CLINIC ASSOCIATION 301 KNAPP STREET WOLF POINT MT 59201 810386812 CLINIC MT 501C3 3 NEMHS true NEMHS CHARITABLE FOUNDATION INC PO BOX 341 POPLAR MT 59255 383732814 SUPPORT MT 501C3 7 N/A false NE MT STAT AIR AMB COOP 519 PLEASANT STREET MILES CITY MT 59301 204748673 AIR AMBUL MT 501C3 12B N/A false FAITH LUTHERAN HOME FOUNDATION INC 1000 6TH AVE N WOLF POINT MT 59201 810483586 SUPPORT MT 501C3 PF N/A false false false true false false false false false false false false false false false false false false true true NEMHS CHARITABLE FOUNDATION C 16054 CASH GIFTS FAITH LUTHERAN HOME FOUNDATION C 9314 CASH GIFTS RIVERSIDE FAMILY CLINIC S 279930 DECREASE IN RECEIVABLE WOLF POINT CLINIC ASSOCIATION R 690750 INCREASE IN RECEIVABLE