2014-11-05T10:50:06-06:00 2014-06-30 810446334 DOUGLAS WILSON & COMPANY PC 1000 FIRST AVENUE SOUTH GREAT FALLS MT 59401 990 2013-07-01 810291695 BIG SANDY MEDICAL CENTER INC BIGS 4063782188 PO BOX 530 BIG SANDY MT 59520 LEAH GRUBB CEO 4063782188 2014-10-28 1 MICHAEL A DIEKHANS P00039905 4067614645 2013 2015-11-30 17:44:51Z LEAH GRUBB PO BOX 530 BIG SANDY MT 59520 3535314 0 X BSMC.ORG X 1963 MT TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS AT THE MOST REASONABLE COST IN A COMPETENT, PROFESSIONAL MANNER. 5 5 70 0 0 0 919146 349163 2759787 3158152 23234 19228 120070 8771 3822237 3535314 0 0 0 0 2364647 2325104 0 0 0 862495 932985 3227142 3258089 595095 277225 4652280 4874423 247135 192053 4405145 4682370 TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS AT THE MOST REASONABLE COST IN A COMPETENT, PROFESSIONAL MANNER. 0 0 2744771 3165723 BIG SANDY MEDICAL CENTER PROVIDES HOSPITAL AND LONG-TERM MEDICAL CARE FOR THE TOWN OF BIG SANDY AND NORTHERN CHOUTEAU COUNTY, MONTANA. 2744771 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 1 70 1 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X NORA GRUBB 4063782188 PO BOX 530 BIG SANDY MT 59520 GORDON MOES CHAIRMAN 1.00 X 0 0 0 DIANNA WEBSTER VICE-CHAIRMAN 1.00 X 0 0 0 ROBERT NELSON DIRECTOR 1.00 X 0 0 0 SHARON ROBERTSON SECRETARY 1.00 X 0 0 0 HARVEY KELLER DIRECTOR 1.00 X 0 0 0 HARRY BOLD CEO 40.00 X 94549 0 21864 NORA GRUBB FINANCE DIRECTOR 40.00 X 42607 0 952 SAM ALLEN INTERIM CEO 40.00 X 8231 0 0 CHLOE MASILANG EMPLOYEE 40.00 X 126623 0 0 272010 0 22816 1 0 0 0 0 289630 59533 349163 PATIENT SERVICES 622110 3158152 3158152 3158152 19228 19228 1200 0 1200 1200 1200 CAPITAL CREDITS 622110 7571 7571 7571 3535314 3165723 0 20428 145387 145387 1753738 1595902 157836 16063 14617 1446 202327 184118 18209 207589 188906 18683 20153 20153 10469 10469 197441 197441 53642 53642 REPAIRS & SUPPLIES 398406 362550 35856 UTILITIES 72526 65999 6527 NURSING FACILITY BED TA 54531 54531 OTHER 49973 49973 75844 27065 48779 3258089 2744771 513318 0 476618 1319916 1581233 1599071 1183913 692749 865 34055 36041 3602034 2477575 1280980 1124459 94616 102187 4652280 4874423 247135 192053 247135 192053 X 4405145 4682370 4405145 4682370 4652280 4874423 277225 0 X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22544 22544 1268684 936002 332682 1127471 817469 310002 1148720 712799 435921 34615 11305 23310 1124459 3535314 0 3535314 0 3535314 3258089 0 3258089 0 3258089 1 1 0 1 X 1 0 0 1193 1193 0.00040 737841 634244 103597 0.03180 50358 40484 9874 0.00300 789392 674728 114664 0.03520 789392 674728 114664 0.03520 0 1193 949191 1204251 -255060 X 1 0 1 1 BIG SANDY MEDICAL CENTER PO BOX 530 BIG SANDY MT 59520 BSMC.ORG X X 8 BED CRITICAL ACCESS HOSPITAL WITH 24 HOUR ER BIG SANDY MEDICAL CENTER 1 1 X X X X X X X X 12 1 0 1 X X X X X X 0 0 0 0 0 0 0 0 0 0 1 0 0 BIG SANDY MEDICAL CENTER PART V, SECTION B, LINE 3: A STEERING COMMITTEE WAS CONVENED. THE MEMBERS WERE A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY. ALSO CONSULTED WITH THE CHOUTEAU COUNTY PUBLIC HEALTH NURSE WHO WAS A MEMBER OF THE 13-PERSON STEERING COMMITTEE. BIG SANDY MEDICAL CENTER PART V, SECTION B, LINE 7: SOME OF THE NEEDS ARE NOT FINANCIALLY OR GEOGRAPHICALLY FEASIBLE FOR A FACILITY THIS SIZE (I.E. MORE SPECIALISTS, INTERPRETER SERVICES). WITH LARGER FACILITIES WITHIN 35 MILES IT IS SOMETIMES MORE PRACTICAL TO REFER PATIENTS TO THE LARGER FACILITY. PART I, LINE 7: BSMC TRACKS REVENUES AND EXPENSES BY PAYER AND DEPARTMENT. THIS INFORMATION ALLOWS THE HOSPITAL TO REPORT THE AMOUNT OF HOSPITAL SERVICES PROVIDED FOR MEDICAID, HEALTHY MONTANA KIDS, CHIP & INDIAN HEALTH SERVICES DURING THE FISCAL YEAR. PART III, LINE 8: BSMC USES THE AMOUNTS FROM MEDICARE PROVIDER STATISTICAL REIMBURSEMENT (PS&R) TO DETERMINE THE MEDICARE ALLOWABLE COSTS. PART VI - 2 NEEDS ASSESSMENT BSMC SENDS OUT SATISFACTION SURVEYS AND ASKS FOR INPUT ON ANY CHANGES PATIENTS WOULD LIKE TO SEE. ALSO, ONCE A YEAR, AN ANNUAL PUBLIC MEETING IS HELD AND INPUT IS SOLICITED AS WELL AS A REPORT ON HOSPITAL ACTIVITIES GIVEN. THIS PUBLIC MEETING IS WELL ADVERTISED IN THE LOCAL PRESS. PART VI - 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE A NOTICE OF PATIENT ELIGIBILITY IS POSTED IN ALL WAITING AREAS AND ON THE WEBSITE. PART VI - 4 COMMUNITY INFORMATION THE COMMUNITY IS MOSTLY AGRICULTURAL WITH LARGE WHEAT FARMS AND LARGE CATTLE RANCHES. THOSE WHO DO NOT WORK AT THESE AGRICULTURAL BUSINESS SITES USUALLY WORK IN A BUSINESS THAT SUPPORTS THE WHEAT AND CATTLE OPERATIONS. UNEMPLOYMENT IN THE COUNTY AND AREA IS VERY LOW, USUALLY IN THE 2-3% RANGE. MOST PATIENTS HAVE AVERAGE TO NORMAL PAYING JOBS WITH AVERAGE BENEFITS. PART VI - 7 STATE FILING OF COMMUNITY BENEFIT REPORT MONTANA FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS EMAILED TO AND REVIEWED BY MANAGEMENT AND THE BOARD OF DIRECTORS BEFORE BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE MADE AWARE OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION AND DISCUSSES SUCH ONCE A YEAR AT A REGULAR BOARD MEETING FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS WILL REFER TO THE ANNUAL MONTANA HOSPITAL ASSOCIATION ANNUAL SALARY SURVEY FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.