2018-11-12T15:30:31-06:00 2017-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2017-01-01 810232121 Bozeman Deaconess Health Services BOZE 4064145000 915 Highland Boulevard Bozeman MT 59715 Brad Ludford Current CFO 4064145000 2018-11-06 1 Kim Hunwardsen CPA P00484560 6122536500 2018-11-06 72.175.213.18 2018-11-06 15:02:07 MS P B1517DAAED479AA3B0236E79C14EA2E11B9BE589 B602D594AFD2B0B327E07A06F36CA6A7E42546D0 2017 2019-02-21 02:37:17Z Bozeman Health John Hill 915 Highland Boulevard Bozeman MT 59715 92099552 0 X www.bozemanhealth.org X 1911 MT To improve community health and quality of life for residents and visitors of the Bozeman, MT area. 11 10 524 281 286225 -201152 1543224 317090 78771445 91618113 2759 32505 160507 126563 80477935 92094271 468139 81000 0 0 52508538 60285412 0 0 0 28203127 35039821 81179804 95406233 -701869 -3311962 111101357 107551674 57635766 57386340 53465591 50165334 X To improve community health and quality of life. 1 0 34959369 32992122 Bozeman Health Medical Group employs physicians under the Bozeman Health system umbrella. This group of providers compassionately serves the patients of Bozeman Health Deaconess Hospital, Big Sky Medical Center and Bozeman Health Urgent Care. 9388800 8469438 In efforts to reach our community and surrounding area in multiple facets of healthcare, the Bozeman Health system operates additional healthcare facilities which allows more access and levels of care.Big Sky Medical Center had 42 admissions, 34 surgeries and saw over 3,100 patients in the Emergency Room and over 4,100 in the clinic in 2017. The net revenue yield on these operations was only 55.6%, or $768 per equivalent ER visit. With challenging core staffing and related costs, the operating expense (excluding interest, taxes and depreciation) was $1,491 per equivalent ER visit. This resulted in a $5.5M operating loss for the year. Bozeman Health is committed to providing access and patient care to the Big Sky community in spite of the financial operational challenges the facility continues to face.Bozeman Health also continues to operate our Main Street Urgent Care as an outpatient healthcare access point. With a 56% yield on $5M of patient charges and operating costs of $4.2M, the Urgent Care netted a loss of ($1.4M) in 2017. 31097891 81000 50156553 Bozeman Health serves as the parent company of the Bozeman Health system. As the corporate parent, management, general and administrative services are centralized here and provided to the operating units caring for our patients. These administrative and support services aim to optimize executive, organizational and financial responsibilities to allow the health system to continue to grow and serve the population. In this past year, Bozeman Health had 18,399 inpatient days, 187,297 outpatient hospital visits, 243,039 outpatient clinic visits, 34,670 emergency room visits and performed 8,985 surgeries. 75446060 1 1 0 1 0 0 0 0 0 1 1 0 1 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 0 0 0 0 0 0 1 1 1 1 0 0 1 111 0 1 524 1 1 1 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X Carrie Morasko 4064145039 915 Highland Blvd Bozeman MT 59715 Brian Brown - 1st Vice Chair (Jan-June)/Chair (July-Dec) 1.00 1.00 X X 0 0 0 Julie Jackson Chair (Jan-June) 1.00 1.00 X X 0 0 0 Katie Daughenbaugh - 2nd Vice Chair (Jan-Jun)/1st V.C. (July-Dec) 1.00 1.00 X X 0 0 0 Dr Dane Sobek - Cardiologist Sec. (Jan-June)/2nd V.C. (July-Dec) 50.00 1.00 X X 629591 0 66871 Robert Watson - Director (Jan-June)/Secretary (July-Dec) 1.00 1.00 X X 0 0 0 Dennis Munson Treasurer 1.00 1.00 X X 0 0 0 Kerri Brown Director 1.00 1.00 X 0 0 0 Peter Buerhaus Director (July-Dec) 1.00 1.00 X 0 0 0 Jerry Cashman Director 1.00 1.00 X 0 0 0 Rev Dave McConnell Director 1.00 1.00 X 0 0 0 Kerry Petitt Director 1.00 1.00 X 0 0 0 Walt Sales Director 1.00 1.00 X 0 0 0 John Hill President/CEO 35.00 15.00 X 573117 0 40442 Gordon Davidson CFO 15.00 35.00 X 418121 0 66485 Elizabeth Lewis COO 50.00 0.00 X 349915 0 62118 Annie Castillo MD Oncology 50.00 0.00 X 548559 0 16200 Blair Erb MD Cardiology 50.00 0.00 X 578542 0 46061 Andrew Gentry MD Gastroenterologist 50.00 0.00 X 534267 0 38973 Hugh Hetherington MD Otolaryngology/Plastic Sur 50.00 0.00 X 539413 0 68682 Ken May MD Oncology 50.00 0.00 X 526712 0 49192 John Robbins MD Former Officer 50.00 0.00 X 127805 0 64229 4826042 0 519253 133 1 1 0 Absaroka Emergency Physicians 1184 N 15th Street Suite 1 Bozeman MT 59715 ER Physicians Fee 6060381 Drinker Biddle & Reath LLP One Logan Square Ste 2000 Philadelphia PA 191036996 Legal Services 2401573 Gallatin Valley Anesthesia PO Box 328 Bozeman MT 59771 Anesthesia Services 1517801 Cumberland Consulting Group 720 Cool Springs Blvd Ste 550 Franklin TX 37067 Project Management 842325 Porter Consulting LLC 486 North V St Washougal WA 98671 Consulting Services 455831 14 317090 317090 Hlth System Corp Servi 900099 46283654 46283654 Hlth System Physician 622110 32992123 32992123 Patient Service Revenu 622110 7960552 7960552 Pharmacy Revenue 446110 448255 162030 286225 3933529 3933529 91618113 37786 37786 126563 0 126563 126563 126563 5281 -5281 -5281 -5281 92094271 91331888 286225 159068 X 81000 81000 2210966 697437 1513529 48909646 44296122 4613524 1982284 1854611 127673 4669519 3617982 1051537 2512997 2125559 387438 3071874 97010 2974864 118916 118916 61800 61800 10669522 5960893 4708629 992274 907422 84852 323211 253468 69743 1243146 901012 342134 148156 59509 88647 98771 39673 59098 1507315 1507315 5017522 5017522 2429422 47902 2381520 Equipment Rent & Mainte 5532167 5359748 172419 Goodwill Impairment 1029528 1029528 Medical Supplies 972887 971098 1789 Provision for Bad Debts 927420 927420 895890 604441 291449 95406233 75446060 19960173 0 14411732 15202322 8116201 4961259 33478 165849 256339 251595 1153203 991157 79230182 26010633 54050592 53219549 3955714 6093851 13356233 12007327 9725021 8695493 6042844 5963272 111101357 107551674 18459364 19594578 22063092 21784590 9050000 8884748 8063310 7122424 57635766 57386340 X 52357699 49045737 1107892 1119597 53465591 50165334 111101357 107551674 X -3311962 11705 X 0 1 X 1 0 X 0 1 0 0 0 0 1 56400 0 1 5400 61800 0 Part II-B, Line 1: Hired consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. Bozeman Deaconess Health Services reimburses certain professional membership dues of employees, a portion of such membership dues are used by the professional associations for lobbying activities. These are dues for MHA and AHA. 14747913 223082 2235283 377878 16828400 13928221 122889 843418 146615 14747913 13788550 99933 216493 176755 13928221 12396438 785403 619492 12783 13788550 10913019 15645 1686800 219026 12396438 0.73000 0.14530 0.12470 0 1 1 8653091 8653091 27053229 1889860 25163369 42354467 24120773 18233694 1169395 1169395 53219549 Investment in Affiliated Organizations 12007327 F 12007327 Due from affiliates 4608613 Other Assets 235061 Interest in net assets of Foundation 1119598 5963272 Deposits 14788 Capitalized Lease Obligation 7107636 7122424 X 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 the Bozeman Deaconess 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. 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 consists of Montana nonprofit organizations 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 0 1 1 467109 1295 465814 0.00490 1953928 842752 1111176 0.01180 2421037 844047 1576990 0.01670 353884 8758 345126 0.00370 7000 7000 0.00010 4246343 2782306 1464037 0.01550 215373 215373 0.00230 4822600 2791064 2031536 0.02160 7243637 3635111 3608526 0.03830 1 927420 0 2451181 4800847 -2349666 X 1 1 1 Rocky Mountain Surgical Center LLC Outpatient Surgical Center 0.51010 0.00000 0.48990 2 Deaconess Intercity Imaging LLC Radiology 0.77500 0.00000 0.20920 3 Spanish Peaks Plaza LLC Real Estate 0.69940 0.00000 0.30060 1 1 Big Sky Medical Center 334 Town Center Ave Big Sky MT 59716 www.bigskymedicalcenter.com 13563 X X X Big Sky Medical Center LLC 1 0 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 https://www.bigskymedicalcenter.org/documents/2018.2020_BSMC_CBSP_FINAL.pdf 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 Big Sky Medical Center, LLC 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 68 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 68 invited, 40 participated. The following is a full list of participating organizations:Alcohol and Drug Services of Gallatin County o AWARE o Big Sky Community Food Bank o Big Sky Fire Department o Big Sky Medical Center o Big Sky School District o Big Sky Youth Empowerment o Bozeman Health Deaconess Hospital o Cancer Support Community Montana o Community Health Partners o Community West Outreach o Gallatin City-County Health Department o Gallatin Early Childhood Community Council o Gallatin Valley Land Trust o Help Center 211 o Hospice of Bozeman Health Frontier Home Health o Human Resource Development Council o NAMI o Thrive o Town of West Yellowstone o West Yellowstone Police Department o West Yellowstone School o West Yellowstone Social Services o Willing Workers Ladies Aid o Youth DynamicsInput was gathered from several individuals whose organizations work with low-income, minority populations, or other medically underserved populations. These populations include: African-Americans, domestic violence victims, elderly, English as a second language, foreign visitors to Yellowstone, those with geographic barriers, Hispanic, homeless, immigrants, LGBTQ, low-income, Medicare/Medicaid recipients, mentally ill, Native Americans, non-English speaking, seasonal workers, undocumented immigrants, uninsured/underinsured, veterans, women and children Big Sky Medical Center, LLC Part V, Section B, Line 6a: Bozeman Health Deaconess Hospital Big Sky Medical Center, LLC Part V, Section B, Line 6b: Community Health Partners Gallatin City-County Health Department Big Sky Medical Center, LLC Part V, Section B, Line 7d: Hospital Website: https://www.bigskymedicalcenter.org/documents/2017_PRC_CHNA_Report_BSMC.pdf Big Sky Medical Center, LLC Part V, Section B, Line 11: Based on the CHNA and community / stakeholder input, BHDH adopted the following priority areas: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 Although the CHNA was conducted and approved in 2017, the resulting implementation strategy will not be approved and implemented until early 2018. Within the above priority areas, BSMC plans to actively work to achieve the following over the next few years:1.1 Develop, refine and implement a system-wide Bozeman Health BehavioralHealth Strategic Plan1.2 Increase community education initiatives1.3 Strengthen community capacity and collaboration1.4 Implement evidence-based suicide prevention strategies targeting youth1.5 Reduce use and exposure of tobacco among youth and adults2.1 Grow the HealthCare Connections mobile outreach program2.2 Increase the number of people reached through community health events2.3 Collaborate with community to provide access to health related resources, expand health literacy efforts, and increase health education opportunities2.4 Explore and address barriers faced by minority and medically underserved populations2.5 Grow the Telehealth program3.1 Expand nutrition and physical activity opportunities and access to educational programs for children, youth, and families3.2 Continue to foster, promote and support community and workplace initiatives3.3 Increase stroke education initiatives targeting adults, youth, and community4.1 Promote personal - protective behaviors, including safe motor vehicle practices4.2 Explore and implement evidence-based fall prevention programs4.3 Work with community organizations and coalitions to shift social norms about the acceptability and experience of violence, including domestic and sexual violenceRationale for Unaddressed Needs: Three of the community-prioritized needs were not selected as BSMC priority areas. In order to best impact health outcomes, BSMC 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 through BSMC priority area strategies, programs, and efforts: Cancer: screenings for certain cancers will remain a key strategy under the area of Access to Health Services Tobacco Use: decreasing tobacco use will be a focus outlined under the area of Behavioral HealthDementias, Including Alzheimer's Disease: BSMC providers are currently engaged in providing care in this area. We will continually assess and be responsive to opportunities to expand partnerships, programming and/or outreach Big Sky Medical Center, LLC 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. Big Sky Medical Center, LLC 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. Big Sky Medical Center, LLC 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: www.bigskymedicalcenter.org/For-Patients-Visitors/Financial- Services/Financial-Assistance-Program.aspx 6 1 - Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Imaging Center 2 - Rocky Mountain Surgery Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 Outpatient Surgical Center 3 - Hospice of Southwest Montana LLC 3810 Valley Commons Dr Ste 1 Bozeman MT 59715 Hospice Services 4 - Bozeman Health Urgent Cares LLC 106 W Main Bozeman MT 59715 Outpatient Health Care 5 - Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 Contracted Physician Services 6 - Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Health Care 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 6a: The organization's community benefit report can be found on its website at http://www.bigskymedicalcenter.org/For-Community.aspx Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care, Medicaid, and Other Means-Tested Programs. 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. Part I, Line 7g: Amount of cost attributable to a physician clinic is $4,246,343. The Urgent Care disregarded entity was reported as a subsidized services, pulling out the financial assistance and Medicaid to report separately as appropriate. 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 $ 927,420. Part III, Line 2: Bad debt is reported at charges as recorded by the organization and included joint ventures. 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 expenses is located in Footnote 1 on page 9 of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents a cost 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.For the Joint Ventures, Net Medicare Revenue was used as the revenue received, and that percentage of total revenues was applied against operating expenses to determine related costs. The Joint Venture portion of the shortfall is $1,562,087. 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 Big Sky Medical Center (BSMC) 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 is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. As a hospital operating in the Bozeman Health system, Big Sky Medical Center (BSMC) posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BSMC 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 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 primarily serves Gallatin, Park, and Madison Counties. 86.6% of 2017 inpatient admissions were of patients originating from these three counties (Gallatin: 78.6%, Park 4.7%, and Madison 3.4%). The population of the tri-county region was an estimated 129,049 in 2017 (Truven Health Analytics). Bozeman (in Gallatin County) was listed in the 2016 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 2016, 5.9% of the families were below the poverty level in the tri-county region-ranging from 6.0% in Gallatin County to 4.7% in Park County and 7.0% in Madison County (2016 ACS 5yr estimates). Average per capita income was an estimated $30,924 in Gallatin County followed by Madison ($27,346) and Park ($27,346) (2016 ACS 5 Year Estimates). Estimates suggest that about 14.2% of residents in the tri-county area were insured by Medicaid, roughly 13.5% were insured by Medicare, and about 5.82% were uninsured in 2017 (Truven Health Analytics 2017). About 16.8% of Bozeman Health inpatients were insured under Medicaid in 2017.Bozeman Health'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 Park and Madison Counties are designated Primary Care HPSAs (note Gallatin County is under review). (https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations). Part VI, Line 5: As a sole community hospital, Bozeman Health Big Sky Medical Center (BSMC) is committed to providing quality care and promoting health to the very community that supports us. BSMC governing body is represented by individuals of our community, with all but one being independent to our organization. To ensure immediate access to care, BSMC has an open medical staff and requires each medical staff member to care for anyone presenting a need for care in the Emergency Department. We also devote a significant amount of surplus funds to maintaining a high level of patient care through quality initiatives and technology 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 Deaconess Health Services owned a majority interest in Deaconess Intercity Imaging, LLC and Rocky Mountain Surgery Center in 2017. Although these joint ventures are not licensed hospitals, these organizations hold similar policies regarding providing care to all members of the community and offering financial assistance as determined by ability to pay. 1 Greater Gallatin United Way 945 Technology Blvd 101F Bozeman MT 59718 810384820 501(c)(3) 50000 Support human service needs within our service area Cancer Support Community 102 S 11th Ave Bozeman MT 59715 810542266 501(c)(3) 6900 Support cancer support services within our service area Haven PO Box 752 Bozeman MT 59771 810389914 501(c)(3) 5000 Support domestic violence programs within our service area 3 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. Involvement of Bozeman Deaconess Health Services staff and/or administration as volunteers in the activities being supported also ensures proper usage of funds. X 1 0 X X X 0 0 0 0 0 0 0 0 0 Dr Dane Sobek - Cardiologist Sec. (Jan-June)/2nd V.C. (July-Dec) 573370 0 55300 0 921 0 44676 0 23170 0 697437 0 0 0 John Hill President/CEO 510667 0 52083 0 10367 0 17993 0 23829 0 614939 0 0 0 Gordon Davidson CFO 317472 0 59071 0 41578 0 51190 0 16270 0 485581 0 0 0 Elizabeth Lewis COO 270293 0 53602 0 26020 0 47023 0 16070 0 413008 0 0 0 Annie Castillo MD Oncology 490006 0 56394 0 2159 0 16200 0 975 0 565734 0 0 0 Blair Erb MD Cardiology 513487 0 61445 0 3610 0 34270 0 12766 0 625578 0 0 0 Andrew Gentry MD Gastroenterologist 468010 0 65523 0 734 0 16200 0 23748 0 574215 0 0 0 Hugh Hetherington MD Otolaryngology/Plastic Sur 483490 0 53123 0 2800 0 41002 0 28656 0 609071 0 0 0 Ken May MD Oncology 469066 0 57144 0 502 0 34608 0 15558 0 576878 0 0 0 John Robbins MD Former Officer 98187 0 29039 0 579 0 47737 0 17021 0 192563 0 0 0 Part I, Line 1a Per contract, the CEO was reimbursed $2,500 per month for housing for up to six months from hire. In 2017 he was reimbursed a total of $2,500. This benefit is reported as taxable compensation. The housing allowance was agreed upon as part of the compensation determination and employment agreement of the CEO, and therefore the organization does not require the CEO to submit a receipt for this allowance. A Montana Facility Finance Authority 364615155 61240MBM8 2014-11-05 23005852 Refinance 2004 bond issued 3/4/2004 & fund add'n of Big Sky Medical Facility 0 0 0 B Montana Facility Finance Authority 364615155 2015-01-09 6300000 Portion for Big Sky Medical Facility 0 0 0 A 863797 23008884 3032 377976 17500000 5127876 2015 1 0 0 1 B 129918 6300000 15123 6284877 2016 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 0 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 Schedule K, Part I, Line A(e): Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Form 990, Part III, line 2 Bozeman Health Convenience Care, LLC was formed in 2017, although clinic operations in serving patients did not open until Jan 2018. Form 990, Part VI, Section A, line 7a The Yellowstone Conference of the Methodist Church confirms the Board Members and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Changing 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, as well as the CFO. The full Board will be provided a copy of the Form 990 before filing with the IRS. 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 disclosures 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 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 2016 to determine 2017 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 IX, line 11g Other Fees: Program service expenses 5,960,893. Management and general expenses 4,708,629. Fundraising expenses 0. Total expenses 10,669,522. Form 990, Part XI, line 9: Change in Temp & Perm Restricted Investment of Foundation 11,705. Big Sky Medical Center LLC 334 Town Center Ave Big Sky MT 59716 474718253 Healthcare - Inpatient and Outpatient Servcies MT 5442240 30855020 Bozeman Deaconess Health Services Bozeman Health Urgent Cares LLC 915 Highland Blvd Bozeman MT 59715 465318746 Healthcare - Physician Outpatient Care MT 2784499 1546985 Bozeman Deaconess Health Services Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 475126599 Physician Employment & Contract to Bozeman Health System MT 35113771 2056409 Bozeman Deaconess Health Services Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 822848277 Healthcare-Ambulatory Clinic Outpatient Care MT 0 1201773 Bozeman Deaconess Health Services 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 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 474717998 Healthcare - Inpatient and Outpatient Services MT 501(c)(3) Line 3 Bozeman Deaconess Health Services 1 Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT Bozeman Deaconess Health Services Related 1499894 2893939 0 1 0.77500 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT Bozeman Deaconess Health Services Related 3200976 4280518 0 0 0.51010 Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT Bozeman Deaconess Health Services Related 17947 283372 0 1 0.69940 Bozeman Deaconess Real Estate Development Corp PO Box 10490 Bozeman MT 59719 205496567 Sale of real estate property and residences to seniors MT Bozeman Deaconess Health Services C -314345 8661887 1.00000 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 Deaconess Intercity Imaging LLC M 54877 General ledger and corp. records Deaconess Intercity Imaging LLC S 1671985 General ledger and corp. records Bozeman Deaconess Foundation C 317090 General ledger and corp. records Bozeman Deaconess Foundation Q 68453 General ledger and corp. records Rocky Mountain Surgical Center LLC S 3073578 General ledger and corp. records Bozeman Health Deaconess Hospital L 79258196 General ledger and corp. records