LOGAN HEALTH - WHITEFISH: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- LOGAN HEALTH - WHITEFISH (EIN 81-0247969)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-12
- IRS object ID
- 201611339349305571
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-12T16:30:38-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200079326 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN AVE | AddressLine1Txt |
| City | SPOKANE VALLEY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 992066130 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810247969 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH VALLEY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 4068633500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 HOSPITAL WAY | AddressLine1Txt |
| City | WHITEFISH | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59937 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON SPRING | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4068633500 | PhoneNum |
| Signature | 2016-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS DINGUS | PreparerPersonNm |
| PTIN | P00951009 | PTIN |
| Phone | 5092420874 | PhoneNum |
| Preparation | 2016-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON SPRING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 HOSPITAL WAY | AddressLine1Txt |
| City | WHITEFISH | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59937 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $46,393,409 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NVHOSP.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 480 | TotalEmployeeCnt |
| Total Volunteers | 47 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,451,693 | PYContributionsGrantsAmt |
| CY Contributions Grants | $516,354 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $42,941,428 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $45,089,106 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,506,460 | PYInvestmentIncomeAmt |
| CY Investment Income | $61,291 | CYInvestmentIncomeAmt |
| PY Other Revenue | $468,937 | PYOtherRevenueAmt |
| CY Other Revenue | $676,869 | CYOtherRevenueAmt |
| PY Total Revenue | $48,368,518 | PYTotalRevenueAmt |
| CY Total Revenue | $46,343,620 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,295,376 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,205,075 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $209,839 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,973,220 | PYOtherExpensesAmt |
| CY Other Expenses | $24,722,690 | CYOtherExpensesAmt |
| PY Total Expenses | $47,268,596 | PYTotalExpensesAmt |
| CY Total Expenses | $48,927,765 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,099,922 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,584,145 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $52,740,944 | TotalAssetsBOYAmt |
| Total Assets EOY | $49,452,188 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,866,642 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,135,789 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,874,302 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $21,316,399 | NetAssetsOrFundBalancesEOYAmt |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $39,706,714 | ExpenseAmt |
| Revenue | $45,089,106 | RevenueAmt |
| Desc | 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 7,558 ER VISITS, 4,552 DAYS OF PATIENT SERVICES, 80,333 OUTPATIENT VISITS WHICH INCLUDES 24,628 CLINIC VISITS, AND 541 BIRTHS FOR THE YEAR ENDED JUNE 30, 2015. 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 2,286,418 FOR CHARITY CARE, 2,107,454 FOR MEDICAID, 7,489,722 FOR MEDICARE, AND 8,316,370 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR ENDED JUNE 30, 2015. | Desc |
| Total Program Service Expenses | $39,706,714 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 104 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 480 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MT | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RANDY NIGHTENGALE | PersonNm |
| Phone | 4068639826 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 HOSPITAL WAY | AddressLine1Txt |
| City | WHITEFISH | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59937 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|---|
| PENNI CHISHOLM | ||||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEVE STAHLBERG | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DEBBIE MELBY | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARK JOHNSON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MATT BAILEY MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HAP HASELDEN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SUZANNE DANIELL MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RANDY BEACH MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LIZ MARCHI | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TODD BERGLAND MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TROY BOWMAN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JANE KARAS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JASON SPRING | ||||||||
| CEO | 40.00 | Yes (X) | $324,096 | $0 | $72,988 | |||
| WESLEY WHITE | ||||||||
| CFO | 40.00 | Yes (X) | $177,334 | $0 | $45,752 | |||
| LINDA HITCHCOCK | ||||||||
| PHYSICIAN | 40.00 | $259,018 | $0 | $13,471 | Yes (X) | |||
| JASON DEFLUITER | ||||||||
| PHYSICIAN | 40.00 | $172,663 | $0 | $22,151 | Yes (X) | |||
| MICHELLE MARTIN-THOMPSON | ||||||||
| PHYSICIAN | 40.00 | $172,465 | $0 | $22,151 | Yes (X) | |||
| MARY ANN CARLSON | ||||||||
| PHYSICIAN | 40.00 | $141,762 | $0 | $7,614 | Yes (X) | |||
| ELIZABETH WHITE | ||||||||
| PHYSICIAN | 40.00 | $140,415 | $0 | $3,221 | Yes (X) | 1.00 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,387,753 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $187,348 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 22 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| KALISPELL REGIONAL MEDICAL CENTER | |||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | HEALTH CARE SVS | $2,218,912 |
| NORTHERN ROCKIES ANESTHESIA | |||||
| 1075 MARTIN CREEK LANE | WHITEFISH | MT | 59937 | ANESTHESIA SVS | $1,545,256 |
| QUORUM HEALTH RESOURCES | |||||
| 105 CONTINENTAL PLACE | BRENTWOOD | TN | 37027 | MANAGEMENT SVS | $1,129,546 |
| EMERGENCY PHYSICIANS INTEGRATED CAR | |||||
| PO BOX 96348 | SALT LAKE CITY | UT | 84102 | ER MGMT SVS | $580,247 |
| THOMAS MANAGEMENT CORPORATION | |||||
| 700 EAST FRANKLIN ROAD | MERIDIAN | ID | 83642 | DIET & HK MGMT | $579,260 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $452,177 | RelatedOrganizationsAmt |
| Government Grants | $35,015 | GovernmentGrantsAmt |
| All Other Contributions | $29,162 | AllOtherContributionsAmt |
| Total Contributions | $516,354 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET HEALTHCARE SERVICES | 624100 | $45,069,765 | $45,069,765 |
| RENTAL INCOME | 621110 | $19,341 | $19,341 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $45,089,106 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,471 | TotalRevenueColumnAmt |
| Exclusion | $21,471 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $85,609 | SecuritiesAmt |
| Other | $4,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $49,789 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $85,609 | SecuritiesAmt |
| Other | -$45,789 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,820 | TotalRevenueColumnAmt |
| Exclusion | $39,820 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER REVENUE | 722210 | $266,238 | $266,238 |
| CAFETERIA | 900099 | $245,534 | $245,534 |
| REBATES | 900099 | $165,097 | $165,097 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $676,869 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,343,620 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,089,106 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $738,160 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $618,041 | TotalAmt |
| Management And General | $618,041 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,480,001 | TotalAmt |
| Program Services | $14,572,279 | ProgramServicesAmt |
| Management And General | $3,794,416 | ManagementAndGeneralAmt |
| Fundraising | $113,306 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $724,704 | TotalAmt |
| Program Services | $571,460 | ProgramServicesAmt |
| Management And General | $148,800 | ManagementAndGeneralAmt |
| Fundraising | $4,444 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,773,604 | TotalAmt |
| Program Services | $2,187,107 | ProgramServicesAmt |
| Management And General | $569,492 | ManagementAndGeneralAmt |
| Fundraising | $17,005 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,608,725 | TotalAmt |
| Program Services | $1,268,549 | ProgramServicesAmt |
| Management And General | $330,312 | ManagementAndGeneralAmt |
| Fundraising | $9,864 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,270 | TotalAmt |
| Management And General | $304,270 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,545 | TotalAmt |
| Management And General | $43,545 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,392 | TotalAmt |
| Management And General | $79,392 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,891,072 | TotalAmt |
| Program Services | $6,720,549 | ProgramServicesAmt |
| Management And General | $1,142,133 | ManagementAndGeneralAmt |
| Fundraising | $28,390 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,089 | TotalAmt |
| Program Services | $4,593 | ProgramServicesAmt |
| Management And General | $214,496 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,778,163 | TotalAmt |
| Program Services | $2,203,823 | ProgramServicesAmt |
| Management And General | $558,357 | ManagementAndGeneralAmt |
| Fundraising | $15,983 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,104,527 | TotalAmt |
| Program Services | $734,979 | ProgramServicesAmt |
| Management And General | $369,548 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,218,487 | TotalAmt |
| Program Services | $1,074,061 | ProgramServicesAmt |
| Management And General | $140,516 | ManagementAndGeneralAmt |
| Fundraising | $3,910 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,012 | TotalAmt |
| Program Services | $32,865 | ProgramServicesAmt |
| Management And General | $45,749 | ManagementAndGeneralAmt |
| Fundraising | $3,398 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,500 | TotalAmt |
| Program Services | $69,592 | ProgramServicesAmt |
| Management And General | $92,337 | ManagementAndGeneralAmt |
| Fundraising | $4,571 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,815 | TotalAmt |
| Program Services | $174,815 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,614,072 | TotalAmt |
| Program Services | $3,629,743 | ProgramServicesAmt |
| Management And General | $981,099 | ManagementAndGeneralAmt |
| Fundraising | $3,230 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $408,767 | TotalAmt |
| Program Services | $188,124 | ProgramServicesAmt |
| Management And General | $220,643 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $3,800,760 | $3,800,760 | ||
| REPAIRS AND MAINTENANCE | $1,170,078 | $972,365 | $197,713 | |
| OTHER EXPENSES | $667,141 | $483,954 | $181,590 | $1,597 |
| INDIRECT COST CTR ALLOCAT | $1,017,096 | -$1,021,237 | $4,141 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,927,765 | TotalAmt |
| Program Services | $39,706,714 | ProgramServicesAmt |
| Management And General | $9,011,212 | ManagementAndGeneralAmt |
| Fundraising | $209,839 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $243,351 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,251,322 | BOYAmt |
| EOY | $7,245,515 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $206,885 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,662,491 | BOYAmt |
| EOY | $5,666,365 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $951,111 | BOYAmt |
| EOY | $1,042,237 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $897,243 | BOYAmt |
| EOY | $957,841 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $61,811,590 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,585,730 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,260,564 | BOYAmt |
| EOY | $30,225,860 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,756,853 | BOYAmt |
| EOY | $1,018,177 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,961,360 | BOYAmt |
| EOY | $2,845,957 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,740,944 | BOYAmt |
| EOY | $49,452,188 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,351,626 | BOYAmt |
| EOY | $5,996,185 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,009,849 | BOYAmt |
| EOY | $21,382,410 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,505,167 | BOYAmt |
| EOY | $757,194 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,866,642 | BOYAmt |
| EOY | $28,135,789 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,874,302 | BOYAmt |
| EOY | $21,316,399 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,874,302 | BOYAmt |
| EOY | $21,316,399 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,740,944 | BOYAmt |
| EOY | $49,452,188 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,584,145 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $26,242 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $748 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $748 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,154,523 | OtherCostOrOtherBasisAmt |
| Book Value | $2,154,523 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,140,775 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,872,294 | DepreciationAmt |
| Book Value | $14,268,481 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,155,498 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,903,490 | DepreciationAmt |
| Book Value | $9,252,008 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,360,794 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,809,946 | DepreciationAmt |
| Book Value | $4,550,848 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,225,860 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| THIRD-PARTY SETTLEMENTS | $1,425,225 |
| DUE FROM SALE OF MUTUAL INSURANCE CO | $798,933 |
| OTHER RECEIVABLES, NET | $284,808 |
| UNAMORTIZED BOND ISSUE COSTS | $172,170 |
| EHR INCENTIVE | $164,821 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,845,957 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DSH PROGRAM PAYABLE | Desc |
| Amt | $757,194 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $757,194 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE HOSPITAL EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2015 AND 2014, THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,357,687 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $96,532 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,261,155 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04620 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,689,790 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,689,790 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,047,477 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,786,322 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,261,155 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 124571 | PersonsServedCnt |
| Total Community Benefit Expns | $111,050 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,605 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $107,445 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 14 | PersonsServedCnt |
| Total Community Benefit Expns | $74,219 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $74,219 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 3952 | PersonsServedCnt |
| Total Community Benefit Expns | $25,687 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,195 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,492 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 128537 | PersonsServedCnt |
| Total Community Benefit Expns | $210,956 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,800 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $205,156 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 128537 | PersonsServedCnt |
| Total Community Benefit Expns | $9,258,433 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,792,122 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,466,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05040 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $6,365 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,365 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 680 | PersonsServedCnt |
| Total Community Benefit Expns | $38,443 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $38,443 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 30 | PersonsServedCnt |
| Total Community Benefit Expns | $1,162 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,162 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 710 | PersonsServedCnt |
| Total Community Benefit Expns | $45,970 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $45,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,836,954 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,904,690 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,036,998 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$132,308 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct |
|---|---|
| ALPINE WOMENS CENTER | |
| PHYSICIAN GROUP | 0.33000 |
| GLACIER MEDICAL ASSO | |
| PHYSICIAN GROUP | 0.25000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH VALLEY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 HOSPITAL WAY | AddressLine1Txt |
| City | WHITEFISH | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59937 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH VALLEY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.NVHOSP.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.NVHOSP.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWWNVHOSPORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWWNVHOSPORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWWNVHOSPORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, NORTH VALLEY HOSPITAL - PART V, LINE 5 | IN 2012/2013 NORTH VALLEY HOSPITAL (THE HOSPITAL) PARTNERED WITH KALISPELL REGIONAL HEALTHCARE AND THE FLATHEAD CITY-COUNTY HEALTH DEPARTMENT TO CONDUCT A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT. SECONDARY RESEARCH WAS COMPILED COMPARING LOCAL, STATE AND US HEATLH STATISTICS TO DETERMINE TRENDS AND AREAS OF SIGNIFICANCE. PRIMARY RESEARCH WAS CONDUCTED TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE UNDERSERVED AND THE COMMUNITY AS A WHOLE BY GAINING INSIGHTS FROM COMMUNITY SUBJECT MATTER EXPERTS AND UNDERSERVED CITIZENS. QUALITATIVE RESEARCH WAS CONDUCTED WITH COMMUNITY LEADERS AND REPRESENATIVES FROM 27 HEALTHCARE, EDUCATION AND SOCIAL SERVICE AGENCIES BETWEEN MAY 29 AND JUNE 27, 2012. SURVEYS WERE CONDUCTED WITH THE HOMELESS OR AT RISK RESIDENTS ON JUNE 6 AND 7, 2012. FOUR FOCUS GROUPS WERE HELD TO GATHER INPUT FROM VARIOUS HEALTH, MENTAL HEALTH, AND SOCIAL SERVICE PROVIDERS FROM ACROSS THE COUNTY. PARTICIPANTS WERE RECRUITED BASED ON THEIR ORGANIZATIONAL TYPE AND GEOGRAPHY. THE PARTNERS COLLECTIVELY DEVELOPED POTENTIAL INVITEE LISTS AND MAILED OUT 203 INVITATIONS. OF THE 203 INVITATIONS, 48 WERE ACCEPTED AND, IN TURN, ATTENDED ONE OF THE FOUR FOCUS GROUPS. PARTICIPANTS INCLUDED REPRESENTATIVE OF SOCIAL SERVICE AND PUBLIC HEALTH PROVIDERS, PHYSICIANS AND CLINICAL STAFF, SCHOOL NURSES, SCHOOL COUNSELORS, GERIATRIC AND MENTAL HEALTH PROVIDERS. FOCUS GROUP QUESTIONS WERE DETERMINED BY CONSENSUS OF THE COLLABORATING ORGANIZATIONS, AND WERE PRESENTED BY A FACILITATOR/CONSULTANT. ADDITIONAL FOLLOW-UP QUESTIONS WERE ASKED BY THE FACILITATOR FOR CLARIFICATION OR EXPANSION OF IDEAS. THE SESSIONS LASTED BETWEEN 90 MINUTES AND 2 HOURS IN LENGTH AND WERE ELECTRONICALLY RECORDED AND THEN TRANSCRIBED. RESPONSES WERE NOT ATTRIBUTED TO THE PARTICIPANT SPEAKING, TO GIVE ANONYMITY. IN ADDITION TO THE FOCUS GROUPS, THE COLLABORATORS CONDUCTED TWO PUBLIC SURVEYS. THE FIRST SURVEY WAS CONDUCTED ON JUNE 7 AND 8, 2012 AT PROJECT HOMELESS CONNECT. IT CONSISTED OF FIVE QUESTIONS AND 40 INDIVIDUALS WHO WERE HOMELESS OR AT RISK PARTICIPATED IN THE SURVEY. THE SECOND SURVEY WAS CONDUCTED FROM JUNE 26, 2012 TO JUNE 29, 2012 AT FLATHEAD JOB SERVICE. IT SURVEYED 60 INDIVIDUALS WHO WERE SEARCHING OR HELPING OTHERS SEARCH FOR JOBS PARTICIPATED IN THE SURVEY. THE PARTNERS REVIEWED THE FINDINGS FROM THE PRIMARY AND SECONDARY DATA TO IDENTIFY TRENDS AND MAJOR NEEDS GROUPS. THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND HOSPITAL IMPMEMENTATION PLAN WAS APPROVED BY THE HOSPTIAL BOARD OF DIRECTORS ON JUNE 25, 2013 AND PLACED ON THE HOSPITAL WEBSITE ON JUNE 28, 2013. |
| FACILITY 1, NORTH VALLEY HOSPITAL - PART V, LINE 6A | THE HOSPITAL PARTNERED WITH KALISPELL REGIONAL HEALTHCARE AND THE FLATHEAD CITY-COUNTY HEALTH DEPARTMENT TO CONDUCT A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT. |
| FACILITY 1, NORTH VALLEY HOSPITAL - PART V, LINE 6B | SEE PART V, LINE 6A |
| FACILITY 1, NORTH VALLEY HOSPITAL - PART V, LINE 11 | THE HOSPITAL DID NOT ADDRESS AREAS IDENTIFIED AS LOWER PRIORITY/RESPONSIBILITY, SUCH MOTOR VEHICLE ACCIDENTS 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. |
| FACILITY 1, NORTH VALLEY HOSPITAL - PART V, 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. |
| FACILITY 1, NORTH VALLEY HOSPITAL - PART V, LINE 22D | THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP ELIGIBLE INDIVIDUALS IS THE HOSPITAL'S USUAL AND CUSTOMARY RATES THAT APPLY TO ALL PATIENTS REGARDLESS OF PAYOR CLASS. THE HOSPITAL DEFINES COLLECTION PRACTICES AS AMOUNTS GENERALLY BILLED, USING A LOOK BACK DETERMINATION. FAP ELIGIBLE INDIVIDUALS THEN HAVE THE CHARGES REDUCED BASED ON INCOME CRITERIA. PATIENTS AT 400% OF THE FPG ARE ELIGIBLE FOR A 44% REDUCTION WHILE PATIENTS AT 100% OF THE FPG ARE ELIGIBLE FOR A 100% REDUCTION. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 8 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| NORTH COUNTRY MEDICAL CLINIC | ||||
| 1343 HWY 93 NORTH | EUREKA | MT | 59917 | OUTPATIENT CLINIC |
| THE BASE LODGE CLINIC | ||||
| 3840 BIG MOUNTAIN ROAD | WHITEFISH | MT | 59937 | OUTPATIENT CLINIC |
| COLUMBIA FALLS CLINIC PROFESSIONAL | ||||
| 2165 9TH STREET WEST | COLUMBIA FALLS | MT | 59912 | OUTPATIENT CLINIC |
| GLACIER MATERNITY & WOMENS CENTER | ||||
| 195 COMMONS LOOP ROAD SUITE D | KALISPELL | MT | 59901 | OUTPATIENT CLINIC |
| WEST GLACIER CLINIC | ||||
| 100 REA ROAD | WEST GLACIER | MT | 59936 | OUTPATIENT CLINIC |
| GLACIER ENT HEAD AND NECK SURGERY | ||||
| 711 E 13TH STREET | WHITEFISH | MT | 59937 | OUTPATIENT CLINIC |
| NORTH VALLEY HOSPITAL PHYSICAL THER | ||||
| 1343 HWY 93 N | EUREKA | MT | 59917 | OUTPATIENT CLINIC |
| NORTH VALLEY HOSPITAL IMAGING | ||||
| 1111 BAKER AVENUE | WHITEFISH | MT | 59937 | DIAGNOSTIC CENTER |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | THE HOSPITAL HAS NOT INCLUDED ANY COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | 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 II - COMMUNITY BUILDING ACTIVITIES | LEADERSHIP AT THE HOSPITAL ARE ACTIVE MEMBERS OF AREA CHAMBERS OF COMMERCE, MONTANA WEST ECONOMIC DEVELOPMENT, WHITEFISH CONVENTION AND VISITORS BUREAU, UNITED WAY, EMERGENCY MEDICAL SERVICES BOARD, AERO BOARD AND MORE. IN ADDITION, 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. HOSPTIAL STAFF PROVIDE A FORUM FOR THE PERFORMANCE IMPROVEMENT NETWORK, WHICH PROVIDES QUALITY ASSURANCE FOR FUTURE HEALTH CARE. WE PARTICIPATED IN ED TRANSFER COMMUNICATIONS STUDY, HOSPITAL ACQUIRED INFECTION LEARNING AREA NETWORK THROUGH THE MOUNTAIN PACIFIC QUALITY IMPROVEMENT ORGANIZATION, AHA HOSPITAL ENGAGEMENT NETWORK, FRONTIER MEDICINE HOSPITAL IMPROVEMENT PROGRAM WORKING TO ACHIEVE THE "TRIPLE AIM" OF POPULATION HEALTH, COST EFFECTIVENESS AND QUALITY. 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 TAMARACK GRIEF RESOURCE CENTER, MARCH OF DIMES, DRUG-FREE GRADUATION PARTY SPONSORSHIPS, SHEPHERD'S HAND CLINIC, BOYS AND GIRLS CLUB, SCHOOL SPORTS AND BOOSTER CLUB ASSOCIATIONS, WINGS FINANCIAL SUPPORT, UNITED WAY, SAVE A SISTER MAMMOGRAM INITIATIVE, RELAY FOR LIFE, SPECIAL OLYMPICS, PROSTATE CANCER AWARENESS FOUNDATION, FLATHEAD CANCER AID, FLATHEAD BREASTFEEDING COALITION, HABITAT FOR HUMANITY, THE ALZHEIMERS ASSOCIATION,AND LOUISE BURKE BREAST CANCER FOUNDATION. ECONOMIC DEVELOPMENT - MONTANA WEST ECONOMIC DEVELOPMENT, CHAMBER OF COMMERCE BOARDS, LEADERSHIP FLATHEAD, WHITEFISH CONVENTION AND VISITOR BUREAU, AERO (AIRLINE ENHANCEMENT AND RETENTION ORGANIZATION). 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, FRONTIER MEDICINE BETTER HEALTH PARTNERSHIP, 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. NORTH VALLEY GERIATRIC SPECIALTIY SERVICES WAS ESTABLISHED IN 2013 TO PROVIDE GERIATRIC MEDICINE AND ASSESSMENT. THE CLINIC MEDICAL STAFF PROVIDE CARE TO SENIORS IN LOCAL SENIOR LIVING FACILITIES AND COORDINATES CARE. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | 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 3 DAYS 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 THE PATIENT 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 3,000 IS 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. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE FY2015 AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 3, ON PAGE 14, OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS ALSO INCLUDED IN FOOTNOTE 3 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | 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 - COLLECTION PRACTICES EXPLANATION | SEE SCHEDULE H, PART III, LINE 3. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | BOTH ON-GOING QUALITATIVE AND QUANTITATIVE FEEDBACK IS TAKEN INTO ACCOUNT TO ASSESS COMMUNITY HEALTH CARE NEEDS. A QUANTITATIVE AND QUALITATIVE NEEDS ASSESSMENT WAS CONDUCTED IN 2012, WITH ANALYSIS AND PUBLICATION COMPLETED IN 2013, 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: HTTP://WWW.NVHOSP.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ QUALITATIVE INFORMATION IS GAINED REGULARLY THROUGH PARTNERSHIPS WITH THE CITY GOVERNMENT, AREA SCHOOL DISTRICTS, FEDERAL AND LOCAL LEGISLATORS AND FLATHEAD CITY/COUNTY HEALTH DEPARTMENT. ADDITIONALLY, THE HOSPITAL'S PHYSICIANS 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 HAS PARTICIPATED IN THE AVATAR INTERNATIONAL, A THIRD-PARTY PATIENT FEEDBACK SYSTEM, SINCE 2002. THE COMMENTS MADE WITHIN THIS PROCESS ARE REVIEWED AND CONSIDERED FOR NEW PROGRAMS BOTH IN THE COMMUNITY AND AT THE HOSPITAL. LIKEWISE, INFORMATION GAINED FROM THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) IS REVIEWED FOR OPPORTUNITIES TO ADDRESS COMMUNITY HEALTHCARE NEEDS. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE IS PRESENTED WHEN PATIENTS REGISTER AT THE HOSPITAL AND THEY ARE COUNSELED ON THE CHARITY PROGRAMS AVAILABLE TO THEM. THROUGH THE REGISTRATION PROCESS, EVERY PATIENT IS OFFERED A PRINTED HANDBOOK THAT DESCRIBES PATIENT RIGHTS AND OPTIONS. THE HANDBOOK ALSO IS AVAILABLE IN A PDF FORMAT ON THE HOSPITAL WEBSITE. A 'GUIDE TO YOUR BILL' IS AVAILABLE AT EACH REGISTRATION AREA, AS WELL AS DISTRIBUTED THROUGHOUT THE YEAR AT THE HOSPITAL CLINICS, LOCAL CHAMBER OF COMMERCE, AND SHEPHERD'S HAND. IN ADDITION, PUBLIC NOTICE WILL BE POSTED SEMI-ANNUALLY IN THE LOCAL NEWSPAPERS AND ALL MONTHLY STATEMENTS CONTAIN LANGUAGE RELATED TO FINANCIAL ASSISTANCE AND APPLICABLE PHONE NUMBERS FOR ASSISTANCE. THE HOSPITAL ALSO HAS SEVERAL FINANCIAL COUNSELORS AND AS OF MARCH 2015, CERTIFIED APPLICATON COUNSELORS, WHO ASSIST PATIENTS DURING AND AFTER THEIR VISIT TO HELP GUIDE THEM THROUGH THE PROCESS OF OBTAINING CHARITY CARE. PATIENTS ARE OFTEN REFERRED TO APPLICABLE 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 CLINIC AND FLATHEAD CITY/COUNTY HEALTH DEPARTMENT. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | 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 51 PERCENT. MEDICARE CONSTITUTES 37 PERCENT OF THE HOSPITAL'S PAYERS AND MEDICAID/PHS IS 14 PERCENT. 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. 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 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 ESRI FORECAST FOR 2011) WHITEFISH POPULATION 6,357, MEDIAN AGE 40.1, AVERAGE HOUSEHOLD 2.1 PEOPLE, PER CAPITA INCOME 26,711 (2011 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME 41,957, LARGELY WHITE POPULATION 95.8%, HOUSEHOLDS WITH INCOME LESS THAN OR EQUAL TO 25,000 29%. COLUMBIA FALLS POPULATION 4,688, MEDIAN AGE 35.6, AVERAGE HOUSEHOLD 2.47 PEOPLE, PER CAPITA INCOME 18,923 (2011 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME 44,491, LARGELY WHITE POPULATION 94.4%, NEXT IS AMERICAN INDIAN 1.8%, HOUSEHOLDS WITH INCOME LESS THAN OR EQUAL TO 25,000 25.7%. KALISPELL POPULATION 16,065, MEDIAN AGE 39.9, AVERAGE HOUSEHOLD 2.27 PEOPLE, PER CAPITA INCOME 19,801 (2011 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME 37,752, LARGELY WHITE POPULATION 94.5%, NEXT IS HISPANIC 3.4%, HOUSEHOLDS WITH INCOME LESS THAN OR EQUAL TO 25,000 31.8%. FLATHEAD COUNTY TOTAL POPULATION 90,959, MEDIAN AGE 41.7, PER CAPITA INCOME 19,885 (2011 DOLLARS) WITH MEDIAN HOUSEHOLD INCOME 41,027, LARGELY WHITE POPULATION 95.0%, NEXT IS HISPANIC 3.2%, HOUSEHOLDS WITH INCOME LESS THAN OR EQUAL TO 25,000 27.3%. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | 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 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 FOR RESIDENTS WHO NEED TO TRAVEL OUTSIDE OF THE AREA FOR MEDICAL SERVICES: WHITEFISH WINTER CLASSIC (FAMILIES OF SICK CHILDREN), AND WINGS (CANCER PATIENTS). 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 ARE DRUG AND ALCOHOL FREE. THESE INCLUDE CHILDREN'S SPORTS ASSOCIATIONS, SCHOOL BOOSTER CLUBS, BOYS AND GIRLS CLUB OF GLACIER COUNTRY, HEALTH OCCUPATION STUDENT ASSOCIATION AND CIVIC ORGANIZATIONS THAT PROMOTE THESE SAME IDEALS SUCH AS ROTARY. STAFF WAS ACTIVE ON MANY BOARDS SUCH AS UNITED WAY; AREA AGENCY ON AGING/EAGLE TRANSIT TO PROVIDE A VOICE FOR SUBSIDIZED RIDES TO MEDICAL FACILITIES; AMERICAN CANCER SOCIETY AND 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, WHITEFISH CONVENTION AND VISITORS BUREAU AND MONTANA WEST ECONOMIC DEVELOPMENT. 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 HEALTH- RELATED COMMUNITY EDUCATION PROGRAMS ON TOPICS SUCH AS NUTRITION, PRE AND POSTNATAL HEALTH, DIABETES PREVENTION, BALANCE AND FALLS PREVENTION, OSTEOPOROSIS, MEN'S AND WOMEN'S HEALTH. A FREE COMMUNITY-WIDE CELEBRATION, THE PLANETREE FESTIVAL, WAS HELD TO PROVIDE HEALTH INFORMATION, PREVENTATIVE SCREENINGS AND GUIDANCE ON LIVING WILLS, ADVANCED DIRECTIVES, ETC. SUICIDE AWARENESS AND PREVENTION WORKSHOPS WERE HOSTED BY THE HOSPITAL FOR PROVIDERS AND THE PUBLIC. THE HOSPITAL COMMUNITY HEALTH NURSE TEACHES A MONTHLY 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 PARTICIPATES IN EVENTS THROUGHOUT THE YEAR PROVIDING FREE OR REDUCED HEALTH SCREENINGS, AND 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 NON- PROFITS ARE TO HEALTH-RELATED ORGANIZATIONS. QUALIFIED COMMUNITY BENEFITS UNDER THIS QUESTION: BOARD POSITIONS INCLUDE: AREA AGENCY ON AGING/EAGLE TRANSIT, UNITED WAY, WHITEFISH AND COLUMBIA FALLS CHAMBER OF COMMERCE, AERO BOARD, EMS BOARD, SHEPHERDS HAND CLINIC BOARD. ACTIVE MEMBERSHIPS INCLUDE: WHITEFISH ROTARY, CHAMBERS OF COMMERCE, WHITEFISH CONVENTION AND VISITOR BUREAU, BEST BEGINNINGS, CARE TRANSITIONS COALITION, HEALTHY COMMUNITIES COALITION, FRONTIER MEDICINE BETTER HEALTH IMPROVEMENT PARTNERSHIP. PREVENTION PROGRAMS: SAVE A SISTER MAMMOGRAMS, SCHOOL ATHLETIC TRAINERS, EDUCATION (PROVIDER HEALTH RELATED COMMUNITY EDUCATION, PRE AND POST-NATAL, CPR/FIRST AID, SCREENINGS, NUTRITION, SUPPORT GROUPS, BALANCE AND FALLS PREVENTION CLASSES, DIABETES PREVENTION PROGRAMS, COMMUNITY HEALTH LIBRARY. IN-KIND DONATIONS TO: AARP, EUREKA BREAST CANCER LUNCHEON, ROTARY EVENTS FOR THE NEEDY IN THE COMMUNITY, SHEPHERD'S HAND CLINIC. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | N/A |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | MONTANA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| JASON SPRING | ||||
| CEO | $254,096 | $70,000 | $72,988 | $397,084 |
| WESLEY WHITE | ||||
| CFO | $177,334 | $45,752 | $223,086 | |
| LINDA HITCHCOCK | ||||
| PHYSICIAN | $259,018 | $13,471 | $272,489 | |
| JASON DEFLUITER | ||||
| PHYSICIAN | $172,663 | $22,151 | $194,814 | |
| MICHELLE MARTIN-THOMPSON | ||||
| PHYSICIAN | $172,465 | $22,151 | $194,616 | |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 1A | THE BOARD OF DIRECTORS AUTHORIZES NORTH VALLEY HOSPITAL TO PAY FOR THE CEO'S MEMBERSHIP IN THE WHITEFISH ROTARY CLUB. ROTARY INTERNATIONAL IS A VOLUNTEER ORGANIZATION OF BUSINESS AND PROFESSIONAL LEADERS WHO PROVIDE HUMANITARIAN SERVICE, AND HELP TO BUILD GOODWILL AND PEACE IN THE WORLD. ROTARY CLUBS EXIST TO IMPROVE COMMUNITIES THROUGH A RANGE OF HUMANITARIAN INTERCULTURAL, AND EDUCATIONAL ACTIVITIES. |
| SCHEDULE J, PAGE 1, PART I, LINE 6A | 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. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTANA FACILITY FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 364615155 | BondIssuerEIN |
| Bond Issued | 2012-01-30 | BondIssuedDt |
| Issue Price | $25,000,000 | IssuePriceAmt |
| Purpose | REFINANCING NEW HOSPITAL | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $25,000,000 | TotalProceedsAmt |
| In Reserve Fund | $2,020,237 | InReserveFundAmt |
| Working Capital Expenditures | $22,979,763 | WorkingCapitalExpendituresAmt |
| Substantial Completion | 2007 | SubstantialCompletionYr |
| Current Refunding | false | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (true) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.02000 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.02000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (true) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| RANDY BEACH MD | |||
| BOARD MEMBER | $222,865 | PHYS. GROUP PARTNER | false |
| SUZANNE DANIELL MD | |||
| BOARD MEMBER | $143,173 | PHYS. GROUP PARTNER | false |
| MATT BAILEY MD | |||
| BOARD MEMBER | $257,068 | PHYS. GROUP PARTNER | false |
| TODD BERGLAND MD | |||
| BOARD MEMBER | $143,173 | PHYS. GROUP PARTNER | false |
| RYAN GUNLIKSON | |||
| FAMILY MEMBER | $52,785 | EMPLOYMENT | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 2 | TODD BERGLAND SUZANNE DANIELLS BOARD MEMBER BOARD MEMBER BUSINESS RELATIONSHIP |
| FORM 990, PAGE 6, PART VI, 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, PAGE 6, PART VI, LINE 7B | GLACIER BANK HAS THE AUTHORITY TO VETO ANY MAJOR PURCHASE OR SERVICE AGREEMENT DECISIONS MADE BY THE BOARD, REGARDLESS OF WHETHER IT RELATES TO THE USE OF THE HOSPITAL'S REAL ESTATE LOAN. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CFO WHO REVIEWS THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | A CONFLICT OF INTEREST STATEMENT IS COMPLETED ANNUALLY BY THE BOARD OF DIRECTORS DISCLOSING ANY POSSIBLE CONFLICTS OF INTEREST. THE BOARD REVIEWS ALL MEMBERS' STATEMENTS AND IF POTENTIAL ISSUES ARISE, THE MEMBER IN QUESTION MAY BE ASKED TO LEAVE THE ROOM WHILE THE REST OF THE BOARD DISCUSSES AND VOTES ON THE MATTER. BOARD MEMBERS WITH A POTENTIAL CONFLICT OF INTEREST WHO ARE PRESENT FOR A VOTE WILL CAST AN ABSTAINING VOTE. ALL BOARD MEMBERS ANNUALLY REVIEW AND SIGN A CONFLICT OF INTEREST POLICY UNDER THE HOSPITAL'S COMPLIANCE STANDARDS. ALL EMPLOYEES ARE REQUIRED TO REPORT TO THEIR SUPERVISOR OR THE COMPLIANCE OFFICER ANY POTENTIAL INSTANCES THAT CREATE A CONFLICT OF INTEREST SITUATION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS REVIEW AND APPROVE MANAGEMENT WAGES EACH YEAR DURING THE BUDGET PROCESS. SOURCES UTILIZED BY THE BOARD WHEN REVIEWING FAIR MARKET VALUE IN COMPENSATION INCLUDE MARKET SURVEYS AND SALARY RANGES PROVIDED BY THE MANAGEMENT COMPANY. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE BOARD OF DIRECTORS REVIEW AND APPROVE OFFICERS WAGES EACH YEAR DURING THE BUDGET PROCESS. SOURCES UTILIZED BY THE BOARD WHEN REVIEWING FAIR MARKET VALUE IN COMPENSATION INCLUDE MARKET SURVEYS AND SALARY RANGES PROVIDED BY THE MANAGEMENT COMPANY. |
| FORM 990, PAGE 6, PART VI, 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 | 6,720,549 1,142,133 28,390 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH VALLEY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 HOSPITAL WAY | AddressLine1Txt |
| City | WHITEFISH | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59937 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810526541 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 11C | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Business Name Line2 | N/A | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTH VALLEY HOSPITAL FOUNDATION | ||
| C | $452,177 | ACTUAL |
| NORTH VALLEY HOSPITAL FOUNDATION | ||
| O | $113,306 | ACTUAL |
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