2016-05-10T11:16:14-05:00 2015-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2014-07-01 810384618 BIG HORN HOSPITAL ASSOCIATION BIGH 4066652310 17 NORTH MILES AVENUE HARDIN MT 59034 KRISTI GATRELL CEO 4066652310 2016-04-26 1 ROBERT E SCHILE P00369682 6123764500 2014 2016-08-17 19:52:53Z TERRY BULLIS 17 NORTH MILES AVENUE HARDIN MT 59034 15507460 0 X WWW.BIGHORNHOSPITAL.ORG X 1980 MT TO PROVIDE QUALITY MEDICAL AND HEALTH SERVICES IN BIG HORN COUNTY AND SURROUNDING AREAS. 7 6 234 17 0 0 219531 298898 13784431 14881434 62453 93006 80064 92880 14146479 15366218 68003 64514 0 0 8133295 8249176 0 0 12638 6265696 6513998 14466994 14827688 -320515 538530 12622964 12916733 3584489 3437478 9038475 9479255 X BIG HORN HOSPITAL ASSOCIATION, ALONG WITH ITS AFFILIATED STAFF, WILL WORK TOGETHER TO PROVIDE QUALITY MEDICAL AND HEALTH SERVICES IN BIG HORN COUNTY AND SURROUNDING AREAS. 0 1 13177130 64514 14863914 BIG HORN HOSPITAL ASSOCIATION IS COMPRISED OF BIG HORN HOSPITAL AND HERITAGE ACRES. BIG HORN HOSPITAL IS A 25-BED ACUTE CARE HOSPITAL. HERITAGE ACRES IS A 36-BED NURSING CARE FACILITY AND A 10-UNIT ASSISTED LIVING AND 10-UNIT INDEPENDENT LIVING. DURING THE YEAR ENDED JUNE 30, 2015, BIG HORN COUNTY MEMORIAL HOSPITAL PROVIDED 680 DAYS OF PATIENT SERVICES, 7,750 OUTPATIENT VISITS (INCLUDING 4,223 ER VISITS) AND 3,681 DAYS OF RESIDENT SERVICES; HERITAGE ACRES PROVIDED 10,796 DAYS OF LONG TERM CARE RESIDENT SERVICES AND 3,148 DAYS OF ASSISTED LIVING RESIDENT SERVICES. BIG HORN HOSPITAL ASSOCIATION PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDED CARE TO THESE PATIENTS WAS $288,158 FOR THE YEAR ENDED JUNE 30, 2015. 13177130 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 30 0 234 1 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X ROXIE CAIN CONTROLLER 4066659222 17 N MILES AVENUE HARDIN MT 59034 TERRY BULLIS CHAIRMAN 0.40 0.20 X X 0 0 0 C WILLIAM FISHER VICE CHAIRMAN 0.40 0.20 X X 0 0 0 COLLEEN SCHAAK TREASURER AND VICE CHAIRMAN 0.40 0.20 X X 0 0 0 JAMES SEYKORA SECRETARY 0.40 0.20 X X 0 0 0 CHAD FENNER MEMBER 0.40 0.00 X 0 0 0 GARY OSTAHOWSKI MD MEMBER 0.40 0.00 X 0 0 0 MATT TORSKE MEMBER 0.40 0.00 X 0 0 0 THOR TORSKE MEMBER 0.40 0.20 X 0 0 0 KRISTI GATRELL CEO 39.00 1.00 X 110397 0 17222 ROXIE CAIN CONTROLLER 39.00 1.00 X 88733 0 19777 PAULA SMALL-PLENTY HERITAGE ACRES ADMINISTRATOR 40.00 0.00 X 102242 0 19932 ANGELA SMITH PROVIDER 40.00 0.00 X 111135 0 4124 LINDA TROYER PROVIDER 40.00 0.00 X 102384 0 4331 LARRY CURTIS CRNA 40.00 0.00 X 179233 0 5000 CYNTHIA HUGS RN 40.00 0.00 X 103002 0 19908 797126 0 90294 6 0 1 0 HEALTHLAND INC PO BOX 856554 MINNEAPOLIS MN 554856554 SOFTWARE MAINTENANCE AND SUPPORT 403800 NXC IMAGING 2118 4TH AVENUE SOUTH MINNEAPOLIS MN 55404 EQUIPMENT MAINTENANCE 258723 ANGEL TRAVELERS 100 HILLCREST DRIVE HAMILTON MT 59840 TEMPORARY STAFF - NURSING 252673 BILLINGS CLINIC PO BOX 30977 BILLINGS MT 59107 RAD READING FEES & IS MAINTENANCE 166448 4 21068 204077 73753 298898 PATIENT REVENUE 621110 14863914 14863914 OTHER PATIENT REVENUE 900099 17520 17520 14881434 106069 106069 183632 128179 55453 55453 55453 13063 -13063 -13063 -13063 CAFETERIA 722210 37427 37427 37427 15366218 14863914 0 203406 X 63514 63514 1000 1000 235297 222659 12638 6626592 6136020 490572 163661 146604 17057 743933 641572 102361 479693 386113 93580 26601 26601 83205 83205 1682206 1507927 174279 38806 1037 37769 335990 285099 50891 29264 19660 9604 255831 255831 96670 85801 10869 55106 55106 1223714 1179989 43725 144981 144981 BAD DEBT 1217984 1217984 MEDICAL SUPPLIES 514528 514528 FOOD 242803 242803 OTHER EXPENSES 209366 147987 61379 356943 343661 13282 14827688 13177130 1637920 12638 1169948 1572882 1513192 2279097 2297131 2665797 188026 181025 197884 344505 100848 80375 19165953 13372989 6674724 5792964 481211 88 12622964 12916733 1555820 1912069 72001 56001 400000 305000 41604 39266 1345522 1125142 169542 0 3584489 3437478 X 8859790 9302546 178685 176709 9038475 9479255 12622964 12916733 538530 -97750 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 818 818 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE MONTANA HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AND LEADING AGE (FORMERLY AAHSA) ARE USED FOR LOBBYING PURPOSES. 1 1 X 420491 420491 13636213 9946102 3690111 4983259 3426887 1556372 125990 125990 5792964 PART IV, LINE 2B: THE HOSPITAL ACTS AS A CUSTODIAN FOR THE FUNDS OF THE NURSING HOME RESIDENTS. THOSE FUNDS APPEAR AS RESTRICTED CASH AND ACCOUNTS PAYABLE IN THE BALANCE SHEET. 1 1 X 1 X 1 X 1 1 1 0 0 203709 203709 0.01500 1993100 1344167 648933 0.04770 2196809 1344167 852642 0.06270 2196809 1344167 852642 0.06270 1 1217984 0 4791505 4840525 -49020 X 1 0 1 1 BIG HORN HOSPITAL ASSOCIATION 17 NORTH MILES AVENUE HARDIN MT 59034 WWW.BIGHORNHOSPITAL.ORG 98140 X X X BIG HORN HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X WWW.BIGHORNHOSPITAL.ORG/WP-CONTENT/UPLOADS/2012/HARDIN-TOWNMEETING-NEWSL... X 1 12 0 0 0 1 X 150.000000000000 300.000000000000 X X 1 1 X X X 1 X X X X X 1 X 0 X X X X 1 X 0 0 BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: THE HOSPITAL CONTRACTED WITH MONTANA STATE UNIVERSITY - BOZEMAN TO CONDUCT A SURVEY ON THE HOSPITAL'S BEHALF. MSU - BOZEMAN SENT A COMMUNITY HEALTH SURVEY TO A RANDOM SAMPLE OF BIG HORN COUNTY RESIDENTS. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 2: BIG HORN HOSPITAL ASSOCIATION ("BHHA") FUNDED THE EDUCATION OF A STAFF MEMBER WHO BECAME A REGISTERED DIETICIAN IN MAY 2015. THIS WAS CALLED OUT IN STRATEGY 2.1 OF BHHA'S IMPLEMENTATION STRATEGY. BHHA CONTINUES TO MAINTAIN A TRAUMA LEVEL 4 STATUS TO PROVIDE THE BEST CARE DURING EMERGENCIES. THIS WAS IDENTIFIED IN STRATEGY 3.1 OF THE IMPLEMENTATION STRATEGY. BHHA ALSO ATTEMPTED TO DEVELOP A FACILITY MASTER PLAN THAT WOULD HAVE INCLUDED HERITAGE ACRES AND THERFORE SENIOR LIVING OPTIONS. THIS WAS CALLED OUT IN STRATEGY 4.1 OF THE IMPLEMENTATION STRATEGY. DUE TO A VERY POOR FINAL PRODUCT RECEIVED FROM THE ARCHITECTS, BHHA WILL CONTINUE TRYING TO DEVELOP THIS PLAN IN THE COMING FISCAL YEAR. BHHA ALSO OFFERED A LIFESTYLE BALANCE CLASS TO THE STAFF AND PUBLIC TO ENCOURAGE COMMUNITY MEMBERS TO MAKE HEALTHIER CHOICES. THIS WAS COORDINATED WITH BILLINGS CLINIC AND WAS OFFERED VIA TELE-WEB. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16I: WHEN OUR PATIENT ACCOUNTS REPRESENTATIVE BECOMES AWARE OF A PATIENT'S POTIENTAL FINANCIAL HARDSHIP AND/OR SELF PAY STATUS, A COMMUNITY CARE APPLICATION IS SENT TO THAT INDIVIDUAL. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 22D: ROCKY MOUNTAIN HEALTH NETWORK NEGOTIATES COMMERCIAL PAYER CONTRACTS ON BEHALF OF BIG HORN HOSPITAL ASSOCIATION. ROCKY MOUNTAIN HEALTH NETWORK NEGOTIATES A 5% DISCOUNT FOR MOST OF OUR COMMERCIAL PAYERS, SO THAT IS OUR ESTIMATE OF AMOUNTS GENERALLY BILLED. WHEN AN INDIVIDUAL QUALIFIES FOR FINANCIAL ASSISTANCE, WE PROVIDE A 5% ADJUSTMENT THEN PROVIDE AN ADDITIONAL FINANCIAL ASSISTANCE DISCOUNT TO ENSURE THAT NO FAP-ELIGIBLE INDIVIDUAL EVER PAYS MORE THAN AMOUNTS GENERALLY BILLED. 1 HERITAGE ACRES 200 NORTH MITCHELL AVENUE HARDIN MT 59034 NURSING HOME WITH ASSISTED LIVING AND INDEPENDENT LIVING UNITS PART I, LINE 7: A COST-TO-CHARGE RATIO DERIVED USING WORKSHEET 2 FROM THE IRS WAS USED TO CALCULATE THE AMOUNTS IN PART I, LINE 7. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE EQUAL TO $1,217,984 INCLUDED IN FORM 990, PART IX, LINE 25 WAS EXCLUDED IN CALCULATING THE PERCENT OF TOTAL EXPENSE IN SCHEDULE H, PART I, LINE 7, COLUMN F. PART III, LINE 2: BIG HORN HOSPITAL ASSOCIATION ESTIMATES THE BAD DEBT ALLOWANCE BASED ON THE USUAL PERCENTAGE PAID PER PAYOR TYPE AND THE AGE OF THE ACCOUNT. PART III, LINE 3: BIG HORN HOSPITAL ASSOCIATION CANNOT REASONABLY ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DID NOT COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE" PARAGRAPH IN NOTE 1 ON PAGE 15 OF THE FINANCIAL STATEMENTS FOR A DESCRIPTION OF BIG HORN HOSPITAL ASSOCIATION'S BAD DEBT EXPENSE. PART III, LINE 8: BIG HORN HOSPITAL ASSOCIATION IS A CRITICAL ACCESS HOSPITAL WHICH IS REIMBURSED BY MEDICARE AT 101% OF COST. HOWEVER, THERE IS A MEDICARE SHORTFALL IN THE CURRENT YEAR DUE TO FEDERAL SEQUESTRATION PAYMENT REDUCTIONS.THE MEDICARE ALLOWABLE COSTS REPORTED ON PART III, LINE 6 WERE DERIVED USING THE 6/30/2015 FILED MEDICARE COST REPORT. PART VI, LINE 2: THE HOSPITAL HAS DONE A MAIL SURVEY TO HELP ASSESS THE NEEDS OF THE COMMUNITY. BHHA ALSO USES COMMUNICATION WITH THE PHYSICIAN PRACTICE AS TO WHAT WOULD BE USEFUL AND NEEDED BY THEIR PATIENT POPULATION. PART VI, LINE 3: THE FACILITY KEEPS FORMS ON HAND THAT ARE AVAILABLE (IN PLAIN SIGHT) FOR DIFFERENT GOVERNMENT PROGRAMS SUCH AS HEALTH MT KIDS. THE PATIENT ACCOUNTS REPRESENTATIVE WILL INFORM ANY PRIVATE PAY PATIENT OF OUR COMMUNITY CARE AND WILL ALSO RELAY THIS INFORMATION TO CUSTOMERS WHEN DISCUSSING PAYMENT OPTIONS FOR OUTSTANDING BILLS. PART VI, LINE 4: BHHA SERVERS A HIGH POVERTY LEVEL. THEY ARE ON THE EDGE OF THE CROW INDIAN RESERVATION AND HAVE A LOT OF CUSTOMERS WHO UTILIZE INDIAN HEALTH SERVICES AS A PAYOR SOURCE FOR HEALTH CARE. THEIR POPULATION HAS A LARGE POPULATION OF MEDICARE AND MEDICAID CUSTOMERS. AS THEY SERVE A SMALL TOWN IN MONTANA, THE POPULATION CONSISTS OF A LOT OF CHILDREN AS WELL AS ELDERLY, BOTH OF WHICH UTILIZE OUR HEALTHCARE SYSTEM. PART VI, LINE 5: BHHA DOES HAVE A COMMUNITY BOARD TO HELP NOT ONLY "RUN" THE FACILITY WITH POLICIES AND PROCEDURES, BUT TO GIVE INPUT TO THE MANAGEMENT TEAM ABOUT THE NEEDS THEY SEE FOR THE COMMUNITY IN WHICH THEY LIVE. BHHA IS DEVELOPING MORE EDUCATIONAL PROGRAMS FOR ITEMS SUCH AS WOMEN'S HEALTH, DIABETES MANAGMENT AND SMOKING CESSATION.BHHA USES THE LOCAL PAPERS AS AN OUTLET FOR GIVING THE PUBLIC INFORMATION ON DIFFERENT TYPE OF HEALTH CONCERNS, SUCH AS DIABETES, WEIGHT LOSS, ETC. THEIR PUBLIC HEALTH EDUCATOR IS DEVELOPING A HEALTH COUNCIL TO HELP EDUCATE AND SHARE IDEAS WITH OTHER HEALTH PROVIDERS IN THE COMMUNITY AS TO THE TYPE OF SERVICES NEEDED IN THE AREA AND HOW TO GET THOSE SERVICES TO THE POPULATION. 1 BIG HORN COUNTY HOSPITAL AND HEALTH CARE FOUNDATION 17 NORTH MILES AVENUE HARDIN MT 59034 810504410 501(C)(3) 32814 TO SUPPORT GENERAL OPERATIONS HERITAGE ACRES AUXILIARY LIMITED PO BOX 474 HARDIN MT 59034 810444017 501(C)(3) 15350 TO SUPPORT GENERAL OPERATIONS BIG HORN COUNTY MEMORIAL HOSPITAL AUXILIARY HC 36 BOX 2065 HARDIN MT 59034 810428249 501(C)(3) 15350 TO SUPPORT GENERAL OPERATIONS 3 0 PART I, LINE 2: THE GRANTS MADE WERE AN EQUITY TRANSFER AND PASSING ALONG DONATIONS TO RELATED ORGANIZATIONS. THESE FUNDS ARE TRACKED THROUGH THE ORGANIZATION'S INTERNAL FINANCIAL REPORTING PROCESS. X X 0 0 0 0 0 0 0 0 0 LARRY CURTIS CRNA 179233 0 0 0 0 0 5000 0 0 0 184233 0 0 0 VERA OSTAHOWSKI EMPLOYEE'S SPOUSE IS A BOARD MEMBER 44645 EMPLOYEE OF BIG HORN HOSPITAL ASSOCIATION 0 FORM 990, PART III, LINE 3 DURING THE FISCAL YEAR, THE HOSPITAL STOPPED PERFORMING PLANNED DELIVERIES. FORM 990, PART VI, SECTION A, LINE 7A THE CHAIR OF THE BIG HORN COUNTY COMMISSIONERS IS AUTOMATICALLY DEEMED A MEMBER OF THE BOARD OF DIRECTORS OF BIG HORN HOSPITAL ASSOCIATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED IN DETAIL BY THE CONTROLLER AND CEO. THE FORM 990 WAS PRESENTED TO THE BOARD MEMBERS AT A BOARD MEETING AFTER BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C REGULAR COMPLIANCE MEETINGS DISCUSS ANY ACTUAL CONFLICTS OR POTENTIAL CONFLICTS. THERE IS ALSO A HOTLINE NUMBER TO CALL FOR COMPLIANCE OR HIPAA ISSUES THAT IS OPERATED BY MONTANA HOSPITAL ASSOCIATION, NOT BIG HORN HOSPITAL ASSOCIATION. BOARD MEMBERS SIGN YEARLY CONFLICT OF INTEREST STATEMENTS AND IF A CONFLICT OCCURS ON A SPECIFIC ITEM, THEY ABSTAIN FROM THE VOTE ON THAT ITEM. THERE ARE TWO BOARD MEMBERS THAT HAVE SPOUSES EMPLOYED BY BIG HORN HOSPITAL ASSOCIATION. THEY ABSTAIN FROM ANY VOTES THAT WOULD AFFECT WAGES AND BENEFITS FOR EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15A BIG HORN HOSPITAL ASSOCIATION UTILIZES THE MONTANA STATE SALARY SURVEY TO MAKE SURE EMPLOYEE WAGES ARE COMPARABLE TO SIMILAR JOBS IN SIMILAR AREAS. EXPERIENCE IS ALSO A FACTOR IN THE WAGE. THIS PROCESS WAS LAST DONE IN 2014. THE BOARD REVIEWS AND APPROVES THE CEO'S COMPENSATION. THIS WAS LAST DONE IN 2014. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABE TO THE PUBLIC UPON REQUEST TO THE BUSINESS OFFICE. FORM 990, PART IX, LINE 11G MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,507,927. MANAGEMENT AND GENERAL EXPENSES 174,279. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,682,206. BIG HORN COUNTY MEMORIAL HOSPITAL AND HEALTHCARE FOUNDATION 17 N MILES AVENUE HARDIN MT 59034 810504410 HOSPITAL FUNDRAISING MT 501(C)(3) LINE 11A, I BIG HORN HOSPITAL ASSOCIATION 1 BIG HORN COUNTY MEMORIAL HOSPITAL AUXILIARY HC 36 BOX 2065 HARDIN MT 59034 810428249 FUNDS TO BENEFIT BIG HORN COUNTY MEMORIAL HOSPITAL MT 501(C)(3) LINE 11B, II N/A 0 HERITAGE ACRES AUXILIARY LIMITED PO BOX 474 HARDIN MT 59034 810444017 FUNDS TO BENEFIT HERITAGE ACRES NURSING HOME MT 501(C)(3) LINE 11B, II N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0