CENTRAL MONTANA MEDICAL FACILITIES INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL MONTANA MEDICAL FACILITIES INC (EIN 23-7169043)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-10
- IRS object ID
- 201631319349301203
- 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 D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-10T10:14:03-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | 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 | 237169043 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Facilities Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 4065387711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Alan R Aldrich | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4065386243 | PhoneNum |
| Signature | 2016-05-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2016-05-02 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Robert M Dowdy | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,706,847 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cmmccares.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | The mission of CMMC is to be the leader in assuring community based quality healthcare. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 418 | TotalEmployeeCnt |
| Total Volunteers | 176 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,557,044 | PYContributionsGrantsAmt |
| CY Contributions Grants | $406,018 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $27,768,741 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,383,651 | CYProgramServiceRevenueAmt |
| PY Investment Income | $390,573 | PYInvestmentIncomeAmt |
| CY Investment Income | $219,840 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$11,159 | PYOtherRevenueAmt |
| CY Other Revenue | $321,616 | CYOtherRevenueAmt |
| PY Total Revenue | $29,705,199 | PYTotalRevenueAmt |
| CY Total Revenue | $28,331,125 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,680,805 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,995,662 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $91,302 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,287,313 | PYOtherExpensesAmt |
| CY Other Expenses | $11,495,171 | CYOtherExpensesAmt |
| PY Total Expenses | $28,968,118 | PYTotalExpensesAmt |
| CY Total Expenses | $27,490,833 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $737,081 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $840,292 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,851,619 | TotalAssetsBOYAmt |
| Total Assets EOY | $26,821,656 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,384,973 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,883,571 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,466,646 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,938,085 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Central Montana Medical Center is to be the leader in assuring community based quality healthcare. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $2,493,047 | ExpenseAmt |
| Revenue | $2,508,747 | RevenueAmt |
| Desc | Hospital Inpatient Services:Number of beds: 25Provided 1,829 acute days of care and 697 swing bed days of care for 27.69% occupancy rate. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,764,160 | ExpenseAmt |
| Revenue | $1,955,570 | RevenueAmt |
| Desc | Skilled Nursing Care/Long-Term Care Rehabilitation or Long-Term Nursing Services:Provided 7,695 days of care for a 59.17% occupancy rate. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,125,307 | ExpenseAmt |
| Revenue | $4,003,338 | RevenueAmt |
| Desc | Emergency Services:Provided for 5,267 Emergency visits.24 hour Physician coverage available. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,927,792 | ExpenseAmt |
| Revenue | $18,915,996 | RevenueAmt |
| Desc | Community care and services are also provided through the many reduced price services and free clinics, fairs, and programs offered throughout the year. These include but are not limited to the following (all costs are estimates):1.Twenty-five foot clinics were held in 2014-2015 in Denton and the Hobson communities. A total of 366 people were served, all received discounted health care. Total community benefits expense of $9,134.2.One health fair was held in 2014-2015, serving 565 people in Fergus and surrounding counties. All received discounted health care. Total community benefits expense of $2,845.3.CMMC educated locals with a babysitting class (24 people served, 1 class offered, total community benefit $303)4.EMS Education for surrounding communities served 14 people with an expense of $41.5.CMMC gave cash donations to three different organizations in 2014-2015 totaling $343.The facilities maintain records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone for services provided under the Facilities charity care policy were approximately $1,138,000 for the fiscal year. Total direct and indirect costs related to these foregone charges were $685,000 based on an average ratio of cost to gross charges. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $14,927,792 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $18,915,996 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $21,310,306 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 35 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 418 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alan R Aldrich | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4065357711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Ave | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 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 |
|---|---|---|---|---|---|---|---|
| Dave Phillips | |||||||
| President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Doug Flament | |||||||
| Vice President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nancy Wilson | |||||||
| Secretary/Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Carl Seilstad | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Francis Weinheimer | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Russel Spika CPA | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Josh Webber | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Greg Smith | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Ann Econom | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kevin Taylor | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jennifer Saunders | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Roy Kohler MD | |||||||
| Member | 1.00 | Yes (X) | $18,520 | $0 | $0 | ||
| Laura Bennett MD | |||||||
| Member | 40.00 | Yes (X) | $205,194 | $0 | $24,461 | ||
| Michael Sura | |||||||
| Member | 40.00 | Yes (X) | $232,761 | $0 | $22,185 | ||
| Robert Mike Dowdy | |||||||
| CEO (starting June) | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Christopher Noland | |||||||
| Interim CEO (Thru June 2014) | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Alan R Aldrich | |||||||
| CFO | 40.00 | Yes (X) | $130,750 | $0 | $17,756 | ||
| Delilah Duffy | |||||||
| CNO | 40.00 | Yes (X) | $95,084 | $0 | $13,474 | ||
| Aaron Humphreys | |||||||
| Orthopedic Surgeon | 40.00 | $374,984 | $0 | $10,977 | Yes (X) | ||
| James Fox | |||||||
| CRNA | 40.00 | $234,455 | $0 | $9,402 | Yes (X) | ||
| Amy A LePage | |||||||
| Emergency Medicine | 40.00 | $264,372 | $0 | $29,032 | Yes (X) | ||
| Rene DeGuzman | |||||||
| CRNA | 40.00 | $201,891 | $0 | $25,231 | Yes (X) | ||
| Barbara Miller | |||||||
| General Surgeon | 40.00 | $212,274 | $0 | $15,665 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,970,285 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $168,183 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QHR | |||||
| 105 Continental Place | Brentwood | TN | 37027 | Management services | $531,672 |
| Birdwell Builders | |||||
| PO Box 592 | Lewistown | MT | 59457 | Constuction of new ER/lab | $423,635 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $33,549 | FundraisingAmt |
| Government Grants | $216,994 | GovernmentGrantsAmt |
| All Other Contributions | $155,475 | AllOtherContributionsAmt |
| Total Contributions | $406,018 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 622110 | $25,923,341 | $25,923,341 |
| Special Programs | 900099 | $1,209,700 | $1,209,700 |
| Cafeteria | 722210 | $250,610 | $250,610 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,383,651 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $202,751 | TotalRevenueColumnAmt |
| Exclusion | $202,751 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $483,726 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $163,256 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $320,470 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $320,470 | TotalRevenueColumnAmt |
| Exclusion | $320,470 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $222,400 | SecuritiesAmt |
| Other | $133 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $205,444 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,956 | SecuritiesAmt |
| Other | $133 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,089 | TotalRevenueColumnAmt |
| Exclusion | $17,089 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $8,168 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $33,549 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,022 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,146 | TotalRevenueColumnAmt |
| Exclusion | $1,146 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,331,125 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,383,651 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $541,456 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,145 | TotalAmt |
| Program Services | $276,011 | ProgramServicesAmt |
| Management And General | $324,134 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,335 | TotalAmt |
| Program Services | $62,335 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,464,475 | TotalAmt |
| Program Services | $10,015,266 | ProgramServicesAmt |
| Management And General | $2,410,253 | ManagementAndGeneralAmt |
| Fundraising | $38,956 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,933 | TotalAmt |
| Program Services | $274,707 | ProgramServicesAmt |
| Management And General | $57,668 | ManagementAndGeneralAmt |
| Fundraising | $1,558 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,656,921 | TotalAmt |
| Program Services | $1,354,115 | ProgramServicesAmt |
| Management And General | $291,819 | ManagementAndGeneralAmt |
| Fundraising | $10,987 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $877,853 | TotalAmt |
| Program Services | $702,282 | ProgramServicesAmt |
| Management And General | $173,112 | ManagementAndGeneralAmt |
| Fundraising | $2,459 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $489,650 | TotalAmt |
| Program Services | $293,790 | ProgramServicesAmt |
| Management And General | $195,860 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,432 | TotalAmt |
| Management And General | $66,432 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,925 | TotalAmt |
| Management And General | $44,925 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,970,443 | TotalAmt |
| Program Services | $1,552,774 | ProgramServicesAmt |
| Management And General | $416,815 | ManagementAndGeneralAmt |
| Fundraising | $854 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,440 | TotalAmt |
| Program Services | $38,220 | ProgramServicesAmt |
| Management And General | $9,962 | ManagementAndGeneralAmt |
| Fundraising | $28,258 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,903,130 | TotalAmt |
| Program Services | $566,825 | ProgramServicesAmt |
| Management And General | $1,333,178 | ManagementAndGeneralAmt |
| Fundraising | $3,127 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $972,347 | TotalAmt |
| Program Services | $766,665 | ProgramServicesAmt |
| Management And General | $203,882 | ManagementAndGeneralAmt |
| Fundraising | $1,800 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,739 | TotalAmt |
| Program Services | $34,739 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,089 | TotalAmt |
| Program Services | $78,160 | ProgramServicesAmt |
| Management And General | $16,929 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,394 | TotalAmt |
| Program Services | $71,255 | ProgramServicesAmt |
| Management And General | $24,139 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,261,564 | TotalAmt |
| Program Services | $966,601 | ProgramServicesAmt |
| Management And General | $294,433 | ManagementAndGeneralAmt |
| Fundraising | $530 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,638 | TotalAmt |
| Program Services | $639,241 | ProgramServicesAmt |
| Management And General | $27,397 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $2,269,325 | $2,269,325 | |
| Bad Debt Allowance | $878,007 | $878,007 | |
| Equipment Rental and Ma | $290,052 | $244,801 | $45,251 |
| Taxes and Licenses | $221,640 | $68,604 | $153,036 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,356 | TotalAmt |
| Program Services | $156,583 | ProgramServicesAmt |
| Fundraising | $2,773 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,490,833 | TotalAmt |
| Program Services | $21,310,306 | ProgramServicesAmt |
| Management And General | $6,089,225 | ManagementAndGeneralAmt |
| Fundraising | $91,302 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,276,392 | BOYAmt |
| EOY | $1,171,756 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,376,130 | BOYAmt |
| EOY | $4,337,449 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,565 | BOYAmt |
| EOY | $3,761 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,128 | BOYAmt |
| EOY | $500,706 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,379 | BOYAmt |
| EOY | $232,788 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $38,198,534 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,883,763 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,314,187 | BOYAmt |
| EOY | $13,314,771 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,962,232 | BOYAmt |
| EOY | $3,757,752 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,140 | BOYAmt |
| EOY | $21,105 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,926,466 | BOYAmt |
| EOY | $3,481,568 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,851,619 | BOYAmt |
| EOY | $26,821,656 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,924,596 | BOYAmt |
| EOY | $2,818,038 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,481 | BOYAmt |
| EOY | $116,987 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,486,959 | BOYAmt |
| EOY | $4,406,407 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,797,937 | BOYAmt |
| EOY | $1,542,139 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,384,973 | BOYAmt |
| EOY | $8,883,571 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,596,875 | BOYAmt |
| EOY | $15,356,325 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $882,116 | BOYAmt |
| EOY | $1,317,918 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $987,655 | BOYAmt |
| EOY | $1,263,842 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,466,646 | BOYAmt |
| EOY | $17,938,085 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,851,619 | BOYAmt |
| EOY | $26,821,656 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $840,292 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$80,842 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $711,989 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $4,445 | BeginningBalanceAmt |
| Additions During Year | $8,054 | AdditionsDuringYearAmt |
| Distributions During Year | $12,499 | DistributionsDuringYearAmt |
| Ending Balance | $0 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $103,009 | OtherCostOrOtherBasisAmt |
| Book Value | $103,009 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,827,353 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,078,641 | DepreciationAmt |
| Book Value | $9,748,712 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,700,536 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,052,840 | DepreciationAmt |
| Book Value | $2,647,696 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,567,636 | OtherCostOrOtherBasisAmt |
| Depreciation | $752,282 | DepreciationAmt |
| Book Value | $815,354 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,314,771 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Long-Term Prepaid Expenses | $542,302 |
| Due from Foundation | $2,581,760 |
| Other Receivables | $323,493 |
| Estimated Third-Party Payor Settlements | $34,013 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,481,568 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $27,524,275 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$878,007 | OtherRevenueAmt |
| Revenue Not Reported | -$878,007 | RevenueNotReportedAmt |
| Revenue Subtotal | $28,402,282 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$71,157 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$71,157 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $28,331,125 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $26,776,082 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $163,256 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $163,256 | ExpensesNotReportedAmt |
| Expenses Subtotal | $26,612,826 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $878,007 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $878,007 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $27,490,833 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 1b: | The Organization is a custodian for resident trust funds. A sub-register is used and listed by resident. The SNC Biller makes fund distribution as residents request funds be paid. The SNC was leased to EmpRes effective 1/1/15. |
| Part X, Line 2: | The Facilities is organized as a Montana nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Facilities is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Facilities are 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 990-T) with the IRS to report its unrelated business taxable income. The Facilities 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 financial statements. The Facilities 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. The Facilities' Form 990-T filings are no longer subject to federal tax examinations by tax authorities for years before 2012. |
| Part XI, Line 2d - Other Adjustments: | Provision for Bad Debts recorded in Revenue for F/S -878,007. |
| Part XI, Line 4b - Other Adjustments: | Contributions for Specific Purposes recorded in Fund Balance for F/S 92,099. Rental Expenses recorded in Expenses for F/S -163,256. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses recorded in Expenses for F/S 163,256. |
| Part XII, Line 4b - Other Adjustments: | Provision for Bad Debts recorded in Revenue for F/S 878,007. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Tree of Lights | Event1Nm |
| Gross Receipts Event1 | $10,510 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $9,856 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $654 | GrossRevenueEvent1Amt |
| Event2 | Golf Tourney | Event2Nm |
| Gross Receipts Event2 | $11,075 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $8,303 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $2,772 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $450 | CashPrizesEvent2Amt |
| Food And Beverage Event2 | $540 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $1,290 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $20,132 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $15,390 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $4,742 | GrossRevenueOtherEventsAmt |
| Food And Beverage Other Events | $3,242 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $1,500 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $41,717 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $33,549 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $8,168 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $450 | CashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $3,782 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,790 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,022 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $1,146 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 249 | PersonsServedCnt |
| Total Community Benefit Expns | $685,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $685,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02570 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 249 | PersonsServedCnt |
| Total Community Benefit Expns | $685,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $685,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02570 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 2990 | PersonsServedCnt |
| Total Community Benefit Expns | $16,945 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,925 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,141,306 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,207,541 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $933,765 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03510 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 151 | PersonsServedCnt |
| Total Community Benefit Expns | $843 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $843 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Persons Served | 3141 | PersonsServedCnt |
| Total Community Benefit Expns | $2,159,094 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,211,466 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $947,628 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03560 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Persons Served | 3390 | PersonsServedCnt |
| Total Community Benefit Expns | $2,844,094 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,211,466 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,632,628 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06130 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 200 | PersonsServedCnt |
| Total Community Benefit Expns | $2,623 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,623 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 200 | PersonsServedCnt |
| Total Community Benefit Expns | $2,623 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,623 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $878,007 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,639,936 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,643,898 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,962 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| 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 | Central Montana Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendall Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cmmccares.com | WebsiteAddressTxt |
| State License | 12894 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Home Health / Hospice | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Facilities Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.cmmccares.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.cmmccares.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.cmmccare.org | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 3j: Secondary Data: County Profile, Demographic Trends and Economic Impacts |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 5: The hospital formed a steering committee, consulting with community members from various organizations. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 6b: The Needs Assessment was conjoined with the Central Montana Community Health Center in Lewistown. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 7d: The Needs Assessment is available at the Community Relations Office at Central Montana Medical Center as well as on the hospital website. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 11: Respondents indicated a need for more specialists, and more primary care providers. CMMC already offers a number of primary care and specialty services to the community, and continues to recruit/retain providers. Respondents indicated a need for a walk-in clinic. Providing a walk-in clinic is outside of CMMC's capacity and financial resources. A need for dialysis was also indicated. Dialysis services are beyond CMMC's capacity due to investment required in equipment and specialized staff. One of the top three concerns was alcohol abuse. This is beyond CMMC's scope of work. Other resources are available in the community to meet this community need. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 13h: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 16i: A summary of the financial assistance policy is also posted in the hospital facility's emergency room, waiting rooms, and admissions offices. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| Central Montana Medical Facilities, Inc. Part V, Section B, line 16a website: | www.cmmccare.org |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Central Montana Medical Center - DME | ||||
| 202 4th Avenue South | Lewistown | MT | 59457 | HME/DME Services |
| Central Montana Medical Center | ||||
| Nursing Center 408 Wendell Avenue | Lewistown | MT | 59457 | Skilled Nursing Facility |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. |
| Part I, Line 6a: | The Organization's community benefit report can be found on its website at: www.cmmccares.org. |
| Part I, Line 7: | The Organization used an average overall ratio of costs to gross charges which addresses all patient segments in order to calculate charity care. Community health improvement services and cash and in-kind contributions were based on expenses recorded in the general ledger. Subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare cost report. |
| Part I, Ln 7 Col(f): | The amount of bad debt expense removed from the denominator of the calculation was $878,007. |
| Part II, Community Building Activities: | Community Building activities promoted the health of the communities served by providing service and donations for a healthy, active, and educated public. Central Montana Medical Center staff donated time to community boards, such as LEPC (Lewistown Emergency Preparedness Community), Central Montana Youth Challenge, EPI Committing Meeting, and the DUI Task Force. By being a part of these community meetings CMMC staff provides a range of knowledge to the community members with a foundation on health and medical needs. CMMC provides EMS education to surrounding smaller volunteer EMS staff, CMMC provided Foot Clinics to Denton and Hobson area communities, and held our annual REACH Camp for high school students interested in healthcare fields. All of these programs benefit central Montana area and promote health and wellness. |
| Part III, Line 2: | Bad debt expense is reported at charges as recorded by the organization.Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. |
| Part III, Line 4: | Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 7 of the attached audit report. |
| Part III, Line 8: | 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.All of the Medicare shortfall should be treated as a community benefit. The Organization treats individuals regardless of the ability to pay. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. |
| Part III, Line 9b: | Patients deemed by CMMC to be unable to pay at any time during the revenue cycle may be eligible to receive available financial assistance. Patients must complete an application. Our collection practice is to refrain from collection efforts until financial assistance is determined. Normal collection efforts would resume if the application is not returned timely or after the write-off is complete and the patient owes a balance. |
| Part VI, Line 2: | Currently, CMMC assesses the health care needs of the community by the number of responses to ads and articles released through the local media. CMMC monitors the attendance at annual events such as health fairs. Also tracked were the kinds of support requested of CMMC such as children's safety, wellness initiatives and healthcare assessments. In the past, CMMC completed an official Community Needs Assessment with the help of Montana State University. Mail and phone surveys were completed and "town hall" type meetings were held in Lewistown as well as most of the surrounding smaller communities. |
| Part VI, Line 3: | CMMC has financial assistance signage posted in the admissions areas and the ER waiting area. A pamphlet explaining our financial assistance program, the application process and contact information is available at all hospital registration areas. The Charity Care policy and application along with a checklist and contact information is posted on our website on the internet. Prior to discharge someone from discharge planning discusses with the patient the availability of various government benefits, such as Medicaid, and assists the patient with qualifications for such programs, where applicable. Assistance with filling out the Charity Care application is also provided at this time. Private Pay in-patients are informed of Charity Care either prior to scheduled admission by physician referral or prior to discharge from the facility. We also send out information with first time statements. All other patients are informed upon inquiry. |
| Part VI, Line 4: | Lewistown is an agricultural community and the county seat for Fergus County Montana. Lewistown is located in the center of Montana and is surrounded by five mountain ranges: the Snowies, the Judiths, the Moccasins, the Belts and the Highwoods. Lewistown's elevation is 3,963 feet with 3,102 people per square mile (average).The city of Lewistown and the surrounding rural towns are supported by one hospital, Central Montana Medical Center. Fergus County is located in a federally designated medically underserved area. As of the census of 2013, the population of Lewistown MT is 5,902 with a 2014 estimate of 5,867 people. There is an estimate of 2,844 males compared to 3,058 females. The median resident age is 46.7 years old for males and 39.6 years old for females. For the population 25 years and over 92.7% have high school or higher education, 27.6% have a bachelor's degree or higher, 7.7% have a graduate or professional degree and 6.0% are unemployed. Mean travel time to work is 14 minutes. Lewistown's racial makeup is 94.1% white, 2.1% Hispanic, 1.6% American Indian, 0.4% Asian and 0.2% Black.Lewistown's cost of living index in 2013 was 83.8 (less than average, U.S. average is 100). An estimated median household income in 2013 as $34,863 compared to $46,972 in the State of Montana. Estimated median house or condo value in 2013 was $103,719 compared to $66,900 in 2000 and $190,100 in the state of Montana for 2013. Median gross rent in 2013 was $556.Information obtained from www.city-data.com/city/Lewistown-Montana.html |
| Part VI, Line 5: | The CMMC Governing Board consists of 14 volunteer community members including residents from Grass Range, Stanford, Denton and Judith Gap. CMMC extends medical staff privileges to qualified physicians based upon community needs.Surplus funds, when available, are applied to patient care needs, equipment and building maintenance and medical education requirements. The expenditure of these funds is approved by the Governing Board which meets on a monthly basis. |
| Part VI, Line 6: | N/A |
| Part VI, Line 7, Reports Filed With States | MT |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Laura Bennett MD | ||||||||||||||
| Member | $205,194 | $0 | $0 | $0 | $0 | $0 | $5,630 | $0 | $18,832 | $0 | $229,656 | $0 | $0 | $0 |
| Michael Sura | ||||||||||||||
| Member | $232,761 | $0 | $0 | $0 | $0 | $0 | $3,353 | $0 | $20,331 | $0 | $256,445 | $0 | $0 | $0 |
| Alan R Aldrich | ||||||||||||||
| CFO | $130,750 | $0 | $0 | $0 | $0 | $0 | $5,564 | $0 | $20,198 | $0 | $156,512 | $0 | $0 | $0 |
| Aaron Humphreys | ||||||||||||||
| Orthopedic Surgeon | $374,984 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,977 | $0 | $385,961 | $0 | $0 | $0 |
| James Fox | ||||||||||||||
| CRNA | $234,455 | $0 | $0 | $0 | $0 | $0 | $9,402 | $0 | $1,499 | $0 | $245,356 | $0 | $0 | $0 |
| Amy A LePage | ||||||||||||||
| Emergency Medicine | $264,372 | $0 | $0 | $0 | $0 | $0 | $10,200 | $0 | $18,832 | $0 | $293,404 | $0 | $0 | $0 |
| Rene DeGuzman | ||||||||||||||
| CRNA | $201,891 | $0 | $0 | $0 | $0 | $0 | $6,399 | $0 | $20,331 | $0 | $228,621 | $0 | $0 | $0 |
| Barbara Miller | ||||||||||||||
| General Surgeon | $212,274 | $0 | $0 | $0 | $0 | $0 | $8,607 | $0 | $8,557 | $0 | $229,438 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Housing was provided to the Interim CEO. The annual dues for membership in local service organizations are paid for the CEO and the CCO. |
| Part I, Line 3 | The Organization did not pay compensation to the Interim CEO directly. The Interim CEO was compensated by an unrelated management company, Quorum Health Resources LLC. He was compensated for services provided to Central Montana Medical Facilities, Inc. The management company based the Interim CEO's salary on compensation surveys for the area. The Board of Directors approves the contract with the management company. As of June 1st, 2015, the CEO is an employee of the Organization. |
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 | Fergus County Montana | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 816001358 | BondIssuerEIN |
| Bond Issued | 2014-05-01 | BondIssuedDt |
| Issue Price | $4,500,000 | IssuePriceAmt |
| Purpose | Emergency and laboratory expansion and remodel of existing facility | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $93,593 | RetiredAmt |
| Total Proceeds | $4,500,000 | TotalProceedsAmt |
| Capital Expenditures | $4,500,000 | CapitalExpendituresAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Amy LePage MD | PersonNm |
| Relationship With Org | Employee | RelationshipWithOrgTxt |
| Loan Purpose | Recruiting | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $31,000 | OriginalPrincipalAmt |
| Balance Due | $3,761 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $3,761 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Annie Davis | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family Member of Board Member | RelationshipDescriptionTxt |
| Transaction | $62,335 | TransactionAmt |
| Transaction | Payment of Compensation | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 3 | Long Term Skilled Nursing Care- leased SNC Operations to EmpRes effective 1/1/2015. |
| Form 990, Part VI, Section A, line 1 | The Executive Committee includes the President or Chair, Vice President or Vice Chair, Secretary and Treasurer and 2 members-at-large and their authority is similar to that of the full governing board. |
| Form 990, Part VI, Section A, line 2 | Russel Spika, CPA, Greg Smith, and Alan R. Aldrich have a business relationship. |
| Form 990, Part VI, Section A, line 3 | The organization delegated control over management duties customarily performed by or under direct supervision of officers, directors, trustees, or key employees to the CEO who is employed by a management company, Quorum Health Resources LLC (QHR). QHR assists with the management and supervision of the organization under the policies and direction of the governing board. Compensation paid to QHR for Christopher Noland services as Interim CEO was $193,526. As of June 1, 2015 Quorum Health Resources LLC (QHR) is no longer our management company however we do have a month to month agreement with QHR, mostly for Group purchasing and some consulting. The CEO is an employee of the organization as of June 1st, 2015. |
| Form 990, Part VI, Section A, line 6 | The organization's members consist of residents of the Central Montana area who are at least 18 years of age and who have or shall indicate their interest in the maintenance of adequate medical facilities and high standards of medical care in the area. Members of the organization must attend and sign the register at the organization's annual meeting. |
| Form 990, Part VI, Section A, line 7a | Members of the organization may vote on matters being addressed at the annual meetings. Each member is entitled to one vote on any question or action with the exception of the election of Directors of the corporation. For the election of Directors, the members shall vote for one nominee for each vacant board position. |
| Form 990, Part VI, Section B, line 11 | Draft copy of Form 990 is reviewed by the CFO and Board of Directors prior to its filing. |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by discussing at the Board of Director Meetings and obtaining signed statements from members. All officers, board members, and key employees are covered by the policy. The board determines whether conflicts exist and all potential conflicts are reviewed by the board. Any person with a conflict is not allowed to vote on conflicted issues. |
| Form 990, Part VI, Section B, line 15 | The Interim CEO was employed by Quorum Health Resources LLC (QHR), a hospital management corporation. QHR determined the Interim CEO's compensation based on independent data and comparisons. The information was then presented to the Board of Directors for review and approval. This process is completed on an annual basis and was completed in fiscal year ending 6/30/15. Compensation of the CEO is determined by the compensation Committee, and then approved by the Governing Board. Compensation of the CFO is determined by the CEO. |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. A copy may be requested by calling, emailing, walk-in or via mail. |
| Form 990, Part XI, line 9: | Interest in Central Montana Foundation 711,989. |