2014-11-10T16:26:46-06:00 2013-12-31 ERNST & YOUNG US LLP 178 SOUTH RIO GRANDE ST SUITE 400 SALT LAKE CITY UT 84101 990 2013-01-01 810231792 HOLY ROSARY HEALTHCARE % SHARON OWENS HOLY 4062373318 2600 WILSON STREET Suite MILES CITY MT 59301 Paul Lewis CEO 2014-11-06 2013 2015-11-30 17:44:51Z PAUL LEWIS CEO 2600 WILSON STREET MILES CITY MT 59301 41842118 false 0928 X WWW.HRH-MT.ORG X 1997 MT SEE SCHEDULE O. 10 9 428 70 179 0 1469666 42952231 39830383 4377 46355 398694 491442 43355302 41837846 32740 26390 0 0 20977711 19993993 0 0 0 19704959 22090609 40715410 42110992 2639892 -273146 22726122 24474041 1621772 3642837 21104350 20831204 WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. false false 24609959 26390 34020523 HOLY ROSARY HEALTHCARE PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO THE POPULATIONS OF EASTERN MONTANA. THESE SERVICES INCLUDE SURGICAL, ONCOLOGY, AND MATERNITY SERVICES, AS WELL AS 24-HOUR EMERGENCY ROOM AND DIAGNOSTIC AND THERAPEUTIC SERVICES. 2474822 0 3434285 HOLY ROSARY HEALTHCARE'S EXTENDED CARE UNIT PROVIDES SHORT-TERM TRANSITIONAL CARE AFTER ILLNESS, INJURY, OR SURGERY, AS WELL AS LONG-TERM CARE FOR THOSE UNABLE TO LIVE INDEPENDENTLY. 3983414 0 2752582 HOLY ROSARY HEALTHCARE CLINIC PROVIDES PRIMARY CARE SERVICES. THE CLINIC ALSO MAKES AVAILABLE VARIOUS SPECIALTY SERVICES OFFERED BY VISITING PROVIDERS. 0 0 0 31068195 true true false true false false false false false true true false false true false false false true false false false false false false false false true true true false true false false false false false false false true false false false false false true true true false false true 85 0 true 428 true false false false false false false false false false false X 10 9 false true false false true true true true true false false true true true true true true false false false X SHARON OWENS 3038135280 2480 W 26TH AVE SUITE 200B DENVER CO 80211 Rachel Armstrong Vice Chair 1.0 0.0 X X 0 0 0 Sister Katherine Franchett Board Member 1.0 0.0 X 0 0 0 Ronald Hathaway Board Member 1.0 0.0 X 0 0 0 Stefani Hicswa thru 42013 Board Member 1.0 0.0 X 0 0 0 Srs Judith Jackson thru 413 Board Member 1.0 0.0 X 0 0 0 Paul Lewis CEO 40.0 0.0 X X 0 239700 57544 Donovan McComb thru 62013 Secretary 1.0 1.0 X X 0 0 0 Tammie McFarland Board Member 1.0 0.0 X 0 0 0 Roger Muggli thru 102013 Board Member 1.0 0.0 X 0 0 0 Niki Munroe Started 72013 Board Member 1.0 0.0 X 0 0 0 Bill Oftedal Chair 1.0 0.0 X X 0 0 0 Polly Petersen PhD Board Member 1.0 0.0 X 0 0 0 Jim Regan Started 72013 Board Member 1.0 0.0 X 0 0 0 Traci Schell Board Member 1.0 0.0 X 0 0 0 Jason Barker CEO - Montana Region 40.0 0.0 X 0 606536 75737 Carey Calvin CFO 40.0 1.0 X 0 156306 38247 Darren Walker VP Human Resources 1.0 1.0 X 0 199948 41340 Lisa Sanford VP Patient Care Services 1.0 0.0 X 0 171114 44122 Christopher Lieb MD VP Medical Affairs 40.0 0.0 X 188242 0 36570 Jeffery Williams MD Physician Family Practice 40.0 0.0 X 305112 0 25236 Rande Short MD ED Med Director Physician 40.0 0.0 X 298266 0 19940 Dorothy Bradbury MD ED Med Director Physician 40.0 0.0 X 290466 0 12556 Lisa Ross MD Physician Family Practice 40.0 0.0 X 173050 0 3157 Raylene Starck Pharmacy Manager 40.0 0.0 X 154309 0 30866 1409445 1373604 385315 14 false true false Synaptic Healthcare 2600 Wilson St Miles City MT 59301 Clinical Staff 1411693 Weatherby Healthcare PO Box 972633 Dallas TX 75397 Contract labor 365167 Husch Blackwell PO Box 802765 Kansas City MO 64180 Legal services 313742 Medefis PO Box 5068 New York NY 10087 Contract labor 230363 Yellowstone Anesthesia Associates PO Box 1576 Miles City MT 59301 Anesthesia 182160 8 402539 1067127 1469666 NET PATIENT SERVICES REVENUE 621110 39830383 39830383 0 0 39830383 50627 50627 0 0 114256 114256 0 114256 114256 4272 -4272 -4272 -4272 0 0 0 FOOD SERVICES 722320 320003 319824 179 0 MANAGEMENT FEES 900099 6000 6000 0 0 ALL OTHER REVENUE 51183 51183 0 0 377186 41837846 40207390 179 160611 26390 26390 0 0 0 0 0 0 1855406 1577095 278311 0 0 0 0 0 14257520 12205710 2051810 0 636637 636637 0 0 2182616 1877050 305566 0 1061814 903488 158326 0 4341398 80000 4261398 0 1672365 0 1672365 0 5000 0 5000 0 680 0 680 0 0 0 0 0 0 0 4144805 3826845 317960 0 164391 7355 157036 0 133049 85462 47587 0 0 0 0 0 0 0 0 0 647133 74145 572988 0 177273 87239 90034 0 0 0 0 0 11546 9734 1812 0 0 0 0 0 0 0 0 0 1865810 1865810 0 0 401191 362959 38232 0 MEDICAL SUPPLIES 3695621 3670525 25096 0 BAD DEBT 3095197 3095197 0 FOOD SUPPLIES 439569 438607 962 0 NON-MEDICAL SUPPLIES 340427 218865 121562 0 955154 19082 936072 42110992 31068195 11042797 0 0 1615576 1511176 111242 111242 0 0 5767375 5714848 0 0 0 0 9051 49295 885693 855677 602795 733594 42424389 30518015 12140089 11906374 178820 0 0 0 0 0 0 0 1415481 3591835 22726122 24474041 1621772 3642837 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1621772 3642837 X 21104350 20831204 0 0 0 0 21104350 20831204 22726122 24474041 -273146 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false 0 false 0 false 0 false 0 false false 0 true 680 680 false LOBBYING ACTIVITY EXPLANATION HOLY ROSARY HEALTHCARE PAYS DUES TO THE MONTANA HOSPITAL ASSOCIATION OF WHICH $680 IS CHARGED FOR LOBBYING. 170833 2888 10213 3000 33241 529 147164 157436 2655 13771 2500 529 170833 152032 8504 2500 600 157436 170256 -15721 2500 3 152032 126507 46785 3000 36 170256 1.00000 false true true 135510 135510 13714642 7472889 6241753 9477692 7411180 2066512 16700687 14198981 2600706 2296858 1434965 861893 11906374 COST REPORT SETTLEMENT REC. 1254466 OTHER RECEIVABLE 1951448 ACCRUED INTEREST ON INVESTMENT 1129 NET INTERCOMPANY RECEIVABLES 384792 3591835 Intended use of endowment funds THE INTENDED USE FOR THE KENNETH HOM TRUST ENDOWMENT FUND IS TO PROVIDE NURSING SCHOLARSHIPS. EACH YEAR A SCHOLARSHIP IS AWARDED TO AN INDIVIDUAL WITH EASTERN MONTANA TIES WHO IS PURSUING HIS OR HER NURSING EDUCATION. IN 2013 ONE SCHOLARSHIP WAS AWARDED. ENDOWMENT FUNDS ARE HELD BY THE HOLY ROSARY HEALTHCARE FOUNDATION. true true X true X true X true true false true true 576658 576658 0.01490 2819847 3863078 -1043231 3396505 3863078 -466573 0.00000 168217 13537 154680 0.00400 119009 119009 0.00310 2819735 2104320 715415 0.01850 2364 2364 0.00010 21083 21083 0.00050 3130408 2117857 1012551 0.02620 6526913 5980935 545978 0.01400 1269 1269 0.00000 585 585 0.00000 442 442 0.00000 3902 3902 0.00000 164 164 0.00000 299214 299214 0.00580 305576 305576 0.00780 true 1896287 11508311 11045823 462488 X true true 1 1 HOLY ROSARY HEALTHCARE 2600 WILSON STREET MILES CITY MT 59301 WWW.HRH-MT.ORG 13512 X X X HOLY ROSARY HEALTHCARE 1 true X X X X X X X 11 true false true X http://www.holyrosaryhealthcare.org X X X X X X false false true true 200. true 400. true X X X true true X X true false X X X X true X false false FORM 990, SCHEDULE H, PART V, LINE 3 THE MOST RECENT SURVEY WAS CONDUCTED IN 2011. THIS ASSESSMENT STUDIED MILES CITY, MONTANA, AND THE NINE-COUNTY SURROUNDING AREA SERVED BY HOLY ROSARY. THE ASSESSMENT, COMPLETED BY A THIRD-PARTY FIRM SPECIALIZING IN RURAL COMMUNITY RESEARCH, INCLUDED COLLABORATIVE PARTNERSHIPS WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES AND THE CUSTER COUNTY PUBLIC HEALTH NURSING OFFICE; COMBINING EFFORTS WITH OTHER LOCAL HOSPITALS AND HEALTH CARE ORGANIZATIONS; AND CONDUCTING SURVEYS, FOCUS GROUPS, AND ASSESSMENTS WITH THE ASSISTANCE OF THE MONTANA OFFICE OF RURAL HEALTH AND THE NATIONAL RURAL HEALTH RESOURCE CENTER. COMMUNITY EDUCATION WAS COMPLETED UTILIZING THE MEDIA, INTERNET, AND MAILINGS TO BUILD AWARENESS AND ENCOURAGE PARTICIPATION IN THIS PROJECT. RESULTS WERE RECEIVED IN EARLY 2012, INFORMATION WAS SHARED WITH KEY STAKEHOLDER GROUPS IN THE COMMUNITY AND REGION, RESPECTIVE PRIORITIES WERE IDENTIFIED AND ACTION PLANS WERE PURSUED. TO OBTAIN INPUT FROM THE COMMUNITY, HOLY ROSARY PROVIDED THE NATIONAL RURAL HEALTH RESOURCE HEALTH CENTER WITH A LIST OF INPATIENT AND OUTPATIENT ADMISSIONS. ZIP CODES WITH THE GREATEST NUMBER OF ADMISSIONS WERE SELECTED TO BE INCLUDED IN THE SURVEY. A RANDOM LIST OF 575 RESIDENTS WAS SELECTED FROM PRIME NET DATA SOURCE. RESIDENCE WAS STRATIFIED IN THE INITIAL SAMPLE SELECTION SO THAT EACH AREA WOULD BE REPRESENTED IN PROPORTION TO THE OVERALL SERVICE POPULATION AND THE PROPORTION OF PAST ADMISSIONS. IN ADDITION ANOTHER 300 SURVEYS WERE HAND-DISTRIBUTED IN THE COMMUNITY TO BOOST THE RESPONSE RATE. THUS A TOTAL OF 875 SURVEYS WERE DISTRIBUTED AMONGST THE HOLY ROSARY SERVICE AREA. TWO FOCUS GROUPS WERE HELD TO IDENTIFY THE MOTIVES OF LOCAL RESIDENTS WHEN SELECTING HEALTH CARE PROVIDERS AND DISCOVER REASONS WHY PEOPLE MAY LEAVE THE SERVICE AREA TO SEEK HEALTH CARE SERVICES. IT WAS INTENDED THAT THIS INFORMATION WOULD HELP DETERMINE GAPS IN SERVICE, INCREASE AWARENESS OF LOCAL PROGRAMS AND SERVICES, AND IMPROVE SATISFACTION WITH LOCAL SERVICES PROVIDERS AND FACILITIES, WHICH RELATES TO UNDERSTANDING THE HEALTH NEEDS OF THE COMMUNITY. FORM 990, SCHEDULE H, PART V, LINE 7 THE COMMUNITY BENEFIT COMMITTEE ("CBC") OF THE HOLY ROSARY BOARD OF DIRECTORS WAS CHARGED WITH ADDRESSING THE TOP NEEDS DISCOVERED IN THE COMMUNITY HEALTH NEEDS ASSESSEMENT ("CHNA"). THE TOP COMMUNITY NEEDS AND PRIORITIES WERE: 1. ALCOHOL ABUSE, 2. OVERWEIGHT/OBESITY, 3. CANCER, 4. DRUG ABUSE (INCLUDING PRESCRIPTION), AND 5. LACK OF EXERCISE. TO ADDRESS SUCH NEEDS, A GRANT PROGRAM WAS MADE AVAILABLE TO COMMUNITY ORGANIZATIONS TO SPECIFICALLY ADDRESS THE TOP NEEDS. THE CBC HELD QUARTERLY MEETINGS TO REVIEW AND APPROVE OR DENY THE GRANT APPLICATIONS RECEIVED FROM THE SOUTHEASTERN MONTANA COMMUNITIES WITHIN THE HOLY ROSARY PRIMARY AND SECONDARY SERVICE AREAS. IN 2013,THE FOLLOWING GRANTS WERE CONTINUED: -EASTERN MONTANA VETERANS STAND DOWN, -CUSTER COUNTY FAMILY TREATMENT COURT, -SACRED HEART SCHOOL, -ASHLAND COMMUNITY HEALTH CENTER, -MILES CITY FIRE RESCUE, -GLOBAL HEALTH EQUITY FOUNDATION AND -FIRST UNITED METHODIST CHURCH. HOLY ROSARY PROVIDED FUNDING FOR COMMUNITY PROGRAMS TO DEAL WITH FOUR OF THE TOP CONCERNS/NEEDS: ALCOHOL/DRUG ABUSE, OBESITY, CANCER AND MENTAL HEALTH ISSUES. THESE NEEDS WERE ADDRESSED BY HOLY ROSARY'S SUPPORT OF A STUDENT LUNCH PROGRAM FOR HIGH SCHOOL STUDENTS THAT PROVIDE A HEALTHY-APPROACH BALANCED NOON MEAL; A FOOD, CLOTHING AND SUPPLIES DONATION PROGRAM FOR THE EASTERN MONTANA VETERANS STAND DOWN PROJECT; "LET'S TALK MILES CITY" SUICIDE PREVENTION PROGRAM; AND A REWARD INCENTIVE PROGRAM FOR THE CUSTER COUNTY FAMILY TREATMENT COURT PROGRAM. HOLY ROSARY PROVIDED OFFICE SPACE FOR AN ONCOLOGIST AND AN INFUSION CENTER AT THE HOSPITAL WHICH IS AVAILABLE TO ANY COMMUNITY PATIENT, REGARDLESS OF INSURANCE OR HOSPITAL AFFILIATION. AS A SMALL RURAL COMMUNITY, NOT ALL NEEDS CAN BE ADDRESSED BY HOLY ROSARY. OF THOSE, CANCER WAS NOT SPECIFICALLY ADDRESSED DUE TO THE LACK OF RESOURCES IN PEOPLE AND FUNDING. A LOCAL NON-PROFIT GROUP NOT AFFILIATED WITH OUR HOSPITAL OR HEALTH SYSTEM AGREED TO ADDRESS PERSONAL NEEDS SUCH AS FUEL, FOOD, AND HOTEL OF INDIVIDUALS AND THEIR FAMILIES IN EASTERN MONTANA WHO ARE UNDERGOING CANCER TREATMENT. HOLY ROSARY IS PART OF THE DIABETES PREVENTION PROGRAM GRANT AS FUNDED BY THE CENTERS FOR DISEASE CONTROL. UNDER THAT GRANT, PERSONS IN OUR SERVICE AREA ARE PARTICIPATING IN PROGRAMS THAT ADDRESS PRE-DIABETES THROUGH NUTRITION AND WEIGHT CONTROL PROGRAMS. OVER 100 PERSONS HAVE BEEN SERVED IN 2013, INCLUDING THOSE IN REMOTE AREAS USING TELEMEDICINE. 1 POWDER RIVER MEDICAL CLINIC 507 NORTH LINCOLN AVENUE BROADUS MT 59317 AMBULATORY CARE CLINIC FORM 990, SCHEDULE H, PART I, LINE 7G PHYSICIAN CLINICS ACCOUNT FOR $630,658 OF TOTAL SUBSIDIZED SERVICE EXPENSE; THIS IS A CLINIC IN A REMOTE RURAL AREA WITH NO OTHER ACCESS TO HEALTHCARE WITHIN AN 80 MILE RADIUS. FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE DELETED FROM THE DENOMINATOR BEFORE CALCULATING PERCENTAGES IN COLUMN (F) IS $3,095,197. FORM 990, SCHEDULE H, PART I, LINE 7 COST TO CHARGE RATIO IS USED FOR ALL REMAINING CATEGORIES OF COMMUNITY BENEFIT. THE COST TO CHARGE RATIO USED WAS DERIVED FROM WORKSHEET 2. FORM 990, SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES COMMUNITY BUILDING ACTIVITIES, THOSE THAT ENHANCE EXISTING EFFORTS OR FILL GAPS OF COMMUNITY NEED, INCLUDE PROGRAMS THAT SUPPORT THOSE IN THE COMMUNITY WHO ARE LIVING AT OR BELOW POVERTY. HOLY ROSARY HEALTHCARE ADMINISTRATIVE LEADERSHIP AND ITS EMPLOYEES PERFORMED CIVIC ACTIVITIES IN WHICH THE HEALTH OF THE COMMUNITY WAS ADVOCATED AS A PRIORITY BY THE HOSPITAL. IN 2013, HOLY ROSARY ADMINISTRATION AND EMPLOYEES PARTICIPATED IN THE ECONOMIC DEVELOPMENT COUNCIL AND PARTNERED WITH THE DIVISION OF CRIMINAL INVESTIGATION AND DEA FOR THE NATIONAL DRUG TAKE BACK DAYS. HOLY ROSARY STAFF SIT ON SEVERAL COMMUNITY BOARDS INCLUDING: KIWANIS CLUB, MONTANA HEALTH NETWORK BOARD, AND ROTARY CLUB AND PROVIDE ADVOCACY FOR THE COUNCIL FOR MENTAL HEALTH. TO ASSURE ACCESS TO SERVICES, THEY PROVIDE PHYSICIAN RECRUITMENT TO THIS MEDICALLY UNDERSERVED AREA. FORM 990, SCHEDULE H, PART III, LINE 1 THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE TO HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. FORM 990, SCHEDULE H, PART III, LINE 2 THE ALLOWANCE FOR BAD DEBT IS BASED UPON THE ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT COST. THE COST TO CHARGE RATIO USED TO CALCULATE BAD DEBT AT COST WAS DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART III, LINE 4 THE ALLOWANCE FOR BAD DEBT IS BASED UPON THE ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE ORGANIZATIONS FINANCIAL STATEMENTS THAT DESCRIBE THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL COLLECTION EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS INCLUDES A RESERVE FOR BOTH UNINSURED PATIENTS AND BALANCE AFTER INSURANCE ACCOUNTS RECEIVABLE. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. FORM 990, SCHEDULE H, PART III, LINE 8 THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS. TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. FORM 990, SCHEDULE H, PART III, LINE 9B AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. FORM 990, SCHEDULE H, PART VI, QUESTION 2 NEEDS ASSEMENT AS PART OF OUR ORGANIZATIONAL MISSION TO RESPOND TO THE HEALTH NEEDS OF THE PEOPLE AND COMMUNITIES SERVED, WE TAKE STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. HOLY ROSARY HAS REGULARLY PARTICIPATED IN COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. THE MOST RECENT SURVEY WAS CONDUCTED IN 2011. THIS ASSESSMENT STUDIED MILES CITY, MONTANA, AND THE NINE-COUNTY SURROUNDING AREA SERVED BY HOLY ROSARY. THE ASSESSMENT, COMPLETED BY A THIRD-PARTY FIRM SPECIALIZING IN RURAL COMMUNITY RESEARCH, INCLUDED COLLABORATIVE PARTNERSHIPS WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES AND THE CUSTER COUNTY PUBLIC HEALTH NURSING OFFICE; COMBINING EFFORTS WITH OTHER LOCAL HOSPITALS AND HEALTH CARE ORGANIZATIONS; AND CONDUCTING SURVEYS, FOCUS GROUPS, AND ASSESSMENTS WITH THE ASSISTANCE OF THE MONTANA OFFICE OF RURAL HEALTH AND THE NATIONAL RURAL HEALTH RESOURCE CENTER. COMMUNITY EDUCATION WAS COMPLETED UTILIZING THE MEDIA, INTERNET, AND MAILINGS TO BUILD AWARENESS AND ENCOURAGE PARTICIPATION IN THIS PROJECT. RESULTS WERE RECEIVED IN EARLY 2012, INFORMATION WAS SHARED WITH KEY STAKEHOLDER GROUPS IN THE COMMUNITY AND REGION, RESPECTIVE PRIORITIES WERE IDENTIFIED AND ACTION PLANS WERE PURSUED. TO OBTAIN INPUT FROM THE COMMUNITY, HOLY ROSARY PROVIDED THE NATIONAL RURAL HEALTH RESOURCE HEALTH CENTER WITH A LIST OF INPATIENT AND OUTPATIENT ADMISSIONS. ZIP CODES WITH THE GREATEST NUMBER OF ADMISSIONS WERE SELECTED TO BE INCLUDED IN THE SURVEY. A RANDOM LIST OF 575 RESIDENTS WAS SELECTED FROM PRIME NET DATA SOURCE. RESIDENCE WAS STRATIFIED IN THE INITIAL SAMPLE SELECTION SO THAT EACH AREA WOULD BE REPRESENTED IN PROPORTION TO THE OVERALL SERVICE POPULATION AND THE PROPORTION OF PAST ADMISSIONS. IN ADDITION ANOTHER 300 SURVEYS WERE HAND-DISTRIBUTED IN THE COMMUNITY TO BOOST THE RESPONSE RATE. THUS A TOTAL OF 875 SURVEYS WERE DISTRIBUTED AMONGST THE HOLY ROSARY SERVICE AREA. TWO FOCUS GROUPS WERE HELD TO IDENTIFY THE true HOLY ROSARY FOUNDATION 2600 WILSON MILES CITY MT 59301 202270238 501(c)(3) 26390 ASSIST IN CHARITY EXEMPT PURPOSES 1 Form 990, Schedule I, Part I, Line 2 GRANTS ARE MONITORED THROUGH THE HOLY ROSARY HEALTHCARE FOUNDATION. THE FOUNDATION FOLLOWS A TWO-STEP PROCESS IN PREPARING THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA). THE GRANT PROJECT DIRECTOR IS RESPONSIBLE TO SUBMIT THE INVOICES FOR EACH MONTH'S ACTIVITY TO THE FOUNDATION DIRECTOR. THESE ARE THEN REVIEWED FOR COMPLIANCE WITH FEDERAL STANDARDS AND GUIDELINES AND ARE SUBMITTED TO THE FEDERAL GOVERNMENT FOR REIMBURSEMENT OR APPLIED TO GRANT IF AWARDED UPFRONT. THE AMOUNTS ARE THEN DRAWN DOWN BY THE FOUNDATION ADMINISTRATOR AND THE MONEY IS WIRED TO THE FOUNDATION'S BANK ACCOUNT OR REIMBURSED TO THE HOSPITAL IF THE EXPENDITURES WERE PAID BY THE HOSPITAL AND THE FUNDS MADE AVAILABLE TO THE FOUNDATION IN ADVANCE. THIS INFORMATION IS COMPILED QUARTERLY BY THE DIRECTOR OF FINANCE AND IS TRACKED BY GRANT NAME AND CEDA NUMBER. THE FOUNDATION DIRECTOR ALSO PROVIDES THE FINANCE DIRECTOR WITH THE AWARD LETTER AND ANY COMMUNICATIONS RELATED TO THE GRANT AS WELL AS SUPPORTING INVOICES AND EXPENDITURES. AT THE END OF THE YEAR, QUARTERLY WORKSHEETS ARE USED TO PREPARE THE SEFA. THE SEFA IS PREPARED BY THE DIRECTOR OF FINANCE, REVIEWED BY THE GRANTS ADMINISTRATOR AND FORWARDED TO THE SYSTEM OFFICE. false true false false false false false true false Paul Lewis CEO 0 185183 0 42442 0 12075 0 34965 0 22579 0 297244 0 0 Jason Barker CEO - Montana Region 0 441730 0 151297 0 13509 0 59133 0 16604 0 682273 0 0 Carey Calvin CFO 0 139161 0 16435 0 710 0 18703 0 19544 0 194553 0 0 Darren Walker VP Human Resources 0 181009 0 11549 0 7390 0 22697 0 18643 0 241288 0 0 Lisa Sanford VP Patient Care Services 0 140568 0 27408 0 3138 0 26229 0 17893 0 215236 0 0 Christopher Lieb MD VP Medical Affairs 181654 0 0 0 6588 0 14999 0 21571 0 224812 0 0 0 Jeffery Williams MD Physician Family Practice 298855 0 5000 0 1257 0 17515 0 7721 0 330348 0 0 0 Rande Short MD ED Med Director Physician 238386 0 59309 0 571 0 0 0 19940 0 318206 0 0 0 Dorothy Bradbury MD ED Med Director Physician 252610 0 35727 0 2129 0 5134 0 7422 0 303022 0 0 0 Lisa Ross MD Physician Family Practice 127154 0 45000 0 896 0 0 0 3157 0 176207 0 0 0 Raylene Starck Pharmacy Manager 139764 0 13749 0 796 0 11140 0 19726 0 185175 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 SEE FORM 990, SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINES 15A & B REGARDING THE PROCESS USED BY SCLHS TO DETERMINE EXECUTIVE COMPENSATION WHICH IS RELIED UPON BY THIS ORGANIZATION. FORM 990, SCHEDULE J, PART I, LINE 4B PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIRMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE IRS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2013 WERE: NONE IN ADDITION, VESTED AMOUNTS ARE PAYABLE UPON END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENTS W-2. THE AMOUNTS WITHDRAWN FROM THE PLAN IN 2013 WERE: NONE. FORM 990, SCHEDULE J, PART I, LINE 7 (NON-FIXED PAYMENTS) SCLHS HAS MANAGEMENT INCENTIVE PLANS WHICH ARE BASED ON A COMBINATION OF MEASURES. MANAGEMENT AND SENIOR LEADERSHIP ARE ELIGIBLE FOR THE INCENTIVE COMPENSATION. PERFORMANCE CATEGORIES ARE MADE UP OF A COMBINATION OF CLINICAL QUALITY MEASURES AND OPERATING INCOME. THE OPERATING INCOME CATEGORY IS GENERALLY RELATED TO THE NET EARNINGS OF THE CARE SITE IN WHICH THE INDIVIDUAL WORKS, OR IN THE CASE OF SCLHS SENIOR MANAGEMENT, THE NET EARNINGS OF SCLHS. FORM 990 SCHEDULE J, PART II AND FORM 990 PART VII THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING HOLY ROSARY HEALTHCARE (HOLY ROSARY) IN MILES CITY, MONTANA. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. THE COMPENSATION REFLECTED IN PART VII, IS THAT OF OTHER RESPONSIBILITIES TO A RELATED ORGANIZATION AND NOT FOR PARTICIPATING ON THE BOARD. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE. YELLOWSTONE ANESTHESIA ASSOC INC SEE PART V 182385 SEE PART V false FORM 990, SHCEUDLE L, PART IV BOARD MEMBER, RACHEL ARMSTRONG'S SPOUSE OWNS A THIRD OF YELLOWSTONE ANESTHESIA ASSOCIATES, INC. FORM 990 PART I, PART I WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. FORM 990 PART VI, SEC A, LINE 3 Delegation of control of management duties MANAGEMENT COMPANIES MANAGEMENT DUTIES DELEGATED BY HOLY ROSARY HEALTHCARE TO MANAGEMENT COMPANIES WERE IN THE FOLLOWING AREAS: (1) ARAMARK CORPORATION: FOOD SERVICES (2) BROADLANE; SUPPLY CHAIN MANAGEMENT Form 990, Part VI, Line 6, 7A & 7B THE SOLE MEMBER AND CONTROLLING MEMBER OF THE HOLY ROSARY HEALTHCARE (HRH) CORPORATION IS THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC (SCLHS), A KANSAS NON-FOR-PROFIT CORPORATION. SOME OF THE EXCLUSIVE POWERS OF SCLHS INCLUDE: - TO APPOINT, AFTER CONSULTATION WITH THE HRH CORPORATE BOARD, THE BOARD OF DIRECTORS OF HRH AND APPOINT MEMBERS OF SCLHS TO THE HRH BOARD OF DIRECTORS; - TO REMOVE, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE HRH CORPORATE BOARD, ANY MEMBER OF THE HRH BOARD OF DIRECTORS; - TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER AND THE CHIEF ADMINISTRATIVE OFFICER OF HRH; - TO IMPLEMENT CORPORATE GOALS, POLICIES, AND PROCEDURES OF HRH; - TO APPROVE FOR HRH THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS, OR THE LEASE, SALE, TRANSFER, ASSUMPTION, OR ENCUMBERING OF HRH ASSETS; - TO APPROVE THE MERGER, DISSOLUTION, OR CORPORATE RESTRUCTURING OF HRH; AND - TO APPROVE HRH ANNUAL STRATEGIC PLANS AND OPERATING AND CAPITAL BUDGETS. THE HRH BOARD OF DIRECTORS HAVE THE POWERS TO EXERCISE GENERAL MANAGEMENT AND CONTROL OF THE BUSINESS AFFAIRS OF HRH WITH DUE REGARD FOR THE POWERS RESERVED BY SCLHS. THE POWERS OF THE HRH BOARD OF DIRECTORS INCLUDE NOMINATION OF BOARD MEMBERS FOR APPOINTMENT BY SCLHS. Form 990, Part VI, Line 11b Process used to review the Form 990 THE 990 FOR HOLY ROSARY HEALTHCARE WILL BE REVIEWED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM AND THE HOLY ROSARY HEALTHCARE BOARD MEETINGS BEFORE THE RETURN IS FILED WITH THE IRS. THE 990 TAX RETURN IS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. Form 990, Part VI, Line 12c Monitoring and enforcement of compliance with conflict of interest policy ALL HOLY ROSARY HEALTHCARE EXECUTIVES, DIRECTORS, AND MANAGERS, BOARD MEMBERS AND BOARD COMMITTEE MEMBERS, MEDICAL EXECUTIVE COMMITTEE (MEC)MEMBERS AND OTHER PHYSICIANS IN DECISION MAKING ROLES OR SERVING ON HRH COMMITTEES, COMPLETE A NEW CONFLICT OF INTEREST (COI) DISCLOSURE FORM ANNUALLY. A COPY OF THE POLICY IS DISTRIBUTED ALONG WITH THE COI FORMS. IN THE EVENT OF A CHANGE OF CIRCUMSTANCE, EACH INDIVIDUAL WHO HAS ALREADY SIGNED A COI IS EXPECTED TO NOTIFY THE ORGANIZATION OF THE CHANGE AND UPDATE THE CONFLICT OF INTEREST INFORMATION. THE STATEMENTS ARE REVIEWED AND COI ISSUES ARE ADDRESSED BY THE ORGANIZATIONS RESPONSIBILITY OFFICE (ORO) AND LEADERSHIP AT THE APPROPRIATE LEVEL: - BOARD BY BOARD CHAIR - PHYSICIANS BY THE MEC PRESIDENT - HRH DIRECTORS AND MANAGERS BY THE HRH ADMINISTRATION - HRH EXECUTIVES BY THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM THE SIGNED COI FORMS ARE MAINTAINED IN HRH ADMISTRATION. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS FOR HRH EXECUTIVES ARE MAINTAINED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AT THE BEGINNING OF BOARD AND BOARD COMMITTEE MEETINGS, THE QUESTION OF COI IS ASKED OF THOSE IN ATTENDANCE. WHEN AN ACTUAL CONFLICT IS IDENTIFIED, THE INDIVIDUAL ASKS TO BE EXCUSED FROM PARTICIPATING IN THE DISCUSSIONS AND DECISION-MAKING. FORM 990, PART VI, LINES 15A & B SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -WRITTEN EMPLOYMENT CONTRACTS -COMPENSATION SURVEYS AND STUDIES -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. FORM 990 PART VI, SEC C, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE AT HOSPITAL ADMINISTRATION UPON REQUEST. THE SISTERS OF CHARITY CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON THE SISTERS OF CHARITY WEBSITE WWW.SCLHEALTHSYSTEM.ORG. 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true false true true false false false false false false false false false false false true false false false HOLY ROSARY FOUNDATION c 332203 GENERAL LEDGER HOLY ROSARY FOUNDATION b 26390 GENERAL LEDGER SISTERS OF CHARITY LEAVENWORTH Health System p 4261398 FMV