CENTRAL MONTANA MEDICAL FACILITIES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL MONTANA MEDICAL FACILITIES INC (EIN 23-7169043)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-10
- IRS object ID
- 201311309349302386
- Schema version
- 2011v1.5
- 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) |
|---|---|---|
| Timestamp | 2013-05-10T14:04:28-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 NICOLLET MALL STE 1300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554027033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237169043 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL MONTANA MEDICAL FACILITIES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CENT | NameControl |
| Phone | 4065387711 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 WENDELL AVENUE | AddressLine1 |
| City | LEWISTOWN | City |
| State | MT | State |
| ZIP Code | 59457 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ALAN R ALDRICH | Name |
| Title | CFO | Title |
| Phone | 4065386243 | Phone |
| Date Signed | 2013-05-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KIM C HUNWARDSEN | Name |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | Phone |
| Date Prepared | 2013-05-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL MONTANA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LEE RHODES | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 WENDELL AVENUE | AddressLine1 |
| City | LEWISTOWN | City |
| State | MT | State |
| ZIP Code | 59457 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 26809703 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CMMCCARES.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1971 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF CMMC IS TO BE THE LEADER IN ASSURING COMMUNITY BASED QUALITY HEALTHCARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 441 | TotalNbrEmployees |
| Total Nbr Volunteers | 250 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 140928 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 180603 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24480464 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 26032781 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 21398 | InvestmentIncomePriorYear |
| Investment Income Current Year | 101698 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4660 | OtherRevenuePriorYear |
| Other Revenue Current Year | -13978 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24647450 | TotalRevenuePriorYear |
| Total Revenue Current Year | 26301104 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 14754925 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 15813633 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 58505 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10552851 | OtherExpensePriorYear |
| Other Expenses Current Year | 10491129 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 25307776 | TotalExpensesPriorYear |
| Total Expenses Current Year | 26304762 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -660326 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3658 | RevenuesLessExpensesCY |
| Total Assets BOY | 20642912 | TotalAssetsBOY |
| Total Assets EOY | 20497551 | TotalAssetsEOY |
| Total Liabilities BOY | 5536887 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4926941 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15106025 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 15570610 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF CENTRAL MONTANA MEDICAL CENTER IS TO BE THE LEADER IN ASSURING COMMUNITY BASED QUALITY HEALTHCARE. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 2472063 | Expense |
| Revenue | 2264925 | Revenue |
| Description | HOSPITAL INPATIENT SERVICES:NUMBER OF BEDS: 25PROVIDED 1,892 ACUTE DAYS OF CARE AND 846 SWING BED DAYS OF CARE FOR 30% OCCUPANCY RATE. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3690715 | Expense |
| Revenue | 3912028 | Revenue |
| Description | SKILLED NURSING CARE/LONG-TERM CARE REHABILITATION OR LONG-TERM NURSING SERVICES:PROVIDED 18,670 DAYS OF CARE FOR A 60.01% OCCUPANCY RATE. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1693788 | Expense |
| Revenue | 2607585 | Revenue |
| Description | EMERGENCY SERVICES:PROVIDED FOR 5,040 EMERGENCY VISITS.24 HOUR PHYSICIAN COVERAGE AVAILABLE. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 13487431 | Expense |
| Revenue | 17248243 | Revenue |
| Description | 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.THIRTY-TWO FOOT CLINICS WERE HELD IN 2011-2012 IN DENTON, HOBSON AND LEWISTOWN MT. A TOTAL OF 410 PEOPLE WERE SERVED, ALL RECEIVED DISCOUNTED HEALTH CARE. TOTAL COMMUNITY BENEFITS EXPENSE OF $4,111.2.ONE HEALTH FAIR WAS HELD IN 2011-2012, SERVING 2,290 PEOPLE IN FERGUS AND SURROUNDING COUNTIES. ALL RECEIVED DISCOUNTED HEALTH CARE. TOTAL COMMUNITY BENEFITS EXPENSE OF $4,350.3.DIABETES EDUCATION HELD SUPPORT GROUPS THROUGHOUT 2011-2012, SERVING 28 PEOPLE AND TOTALING A COMMUNITY BENEFIT EXPENSE OF $449.4.CMMC EDUCATED LOCALS WITH A BABYSITTING CLASS (24 PEOPLE SERVED, 1 CLASS OFFERED, TOTAL COMMUNITY BENEFIT $1,144), AND SEVERAL COMMUNITY BOARDS WERE SERVED ON IN 2011-2012 FOR A TOTAL OF $4,565.5.EMS EDUCATED LOCAL COMMUNITY AND SURROUNDING COUNTIES THROUGHOUT 2011-2012, SERVING 145 PEOPLE AND TOTALING A COMMUNITY BENEFIT EXPENSE OF $5,307.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, BASED ON ESTABLISHED RATES, WAS $660,355 FOR THE CURRENT YEAR. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 13487431 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 17248243 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 21343997 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 42 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 441 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALAN R ALDRICH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4065357711 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 WENDELL AVE | AddressLine1 |
| City | LEWISTOWN | City |
| State | MT | State |
| ZIP Code | 59457 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| WAYNE EDWARDS | |||||||
| PRESIDENT (THRU 10/2011) | 2.00 | X | X | 0 | 0 | 0 | |
| MIKE ZACHER | |||||||
| PRESIDENT (10/2011-PRESENT) | 2.00 | X | X | 0 | 0 | 0 | |
| NANCY WILSON | |||||||
| SECRETARY/TREASURER | 2.00 | X | X | 0 | 0 | 0 | |
| JOHN JENSEN | |||||||
| MEMBER (THRU 10/2011) | 1.00 | X | 0 | 0 | 0 | ||
| DOUG FLAMENT | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ALTA PALLETT | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DAVE PHILLIPS | |||||||
| VICE PRESIDENT (10/2011-PRESENT) | 2.00 | X | X | 0 | 0 | 0 | |
| RUSSELL SPIKA CPA | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MIKE DELANEY | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| FRANCIS WEINHEIMER | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| LAURA BENNETT MD | |||||||
| MEMBER | 1.00 | X | 35900 | 0 | 0 | ||
| CHRISTINE VOLF | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ROY KOHLER MD | |||||||
| MEMBER | 1.00 | X | 7581 | 0 | 0 | ||
| JOSH WEBBER | |||||||
| MEMBER (10/2011-PRESENT) | 1.00 | X | 0 | 0 | 0 | ||
| CARL SEILSTAD | |||||||
| MEMBER (10/2011-PRESENT) | 1.00 | X | 0 | 0 | 0 | ||
| LEE RHODES | |||||||
| CEO | 40.00 | X | 0 | 0 | 0 | ||
| ALAN R ALDRICH | |||||||
| CFO | 40.00 | X | 125321 | 0 | 33302 | ||
| DIANNE SCOTTEN | |||||||
| CCO | 40.00 | X | 119973 | 0 | 15107 | ||
| AARON HUMPHREYS | |||||||
| ORTHOPEDIC SURGEON | 40.00 | 242907 | 0 | 11948 | X | ||
| JAMES FOX | |||||||
| CRNA | 40.00 | 207423 | 0 | 18746 | X | ||
| RENE DEGUZMAN | |||||||
| CRNA | 40.00 | 183471 | 0 | 27498 | X | ||
| RONALD SKIPPER | |||||||
| SURGEON | 40.00 | 304389 | 0 | 43955 | X | ||
| RICHARD TAYLOR JR | |||||||
| INTERNAL MEDICINE PHYSICIAN | 40.00 | 195596 | 0 | 12763 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1422561 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 163319 | TotalOtherCompensation |
| Number Individuals GT100 K | 12 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| QUORUM HEALTH RESOURCES LLC | |||||
| 105 CONTINENTIAL PLACE | BRENTWOOD | TN | 37027 | FACILITY MANAGEMENT & CEO SERVICES | 423890 |
| CPSI | |||||
| PO BOX 850309 | MOBILE | AL | 366850309 | COMPUTER TECHNOLOGY | 106760 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Fundraising Events | 126659 | FundraisingEvents |
| Government Grants | 35237 | GovernmentGrants |
| All Other Contributions | 18707 | AllOtherContributions |
| Total Contributions | 180603 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | 25031811 | 25031811 |
| SPECIAL PROGRAMS | 900099 | 869179 | 869179 |
| CAFETERIA | 722210 | 130538 | 130538 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1253 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1253 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 26032781 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107682 | TotalRevenueColumn |
| Exclusion | $107,682 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 275463 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 289441 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -13978 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -13978 | TotalRevenueColumn |
| Exclusion | -$13,978 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 180279 | Securities |
| Other | 5538 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 185052 | Securities |
| Other | 6749 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -4773 | Securities |
| Other | -1211 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -5984 | TotalRevenueColumn |
| Exclusion | -$5,984 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 27357 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 126659 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 27357 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26301104 | TotalRevenueColumn |
| Related Or Exempt Function Income | 26032781 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $87,720 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245281 | Total |
| Program Services | 119973 | ProgramServices |
| Management And General | 125308 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12836251 | Total |
| Program Services | 10269001 | ProgramServices |
| Management And General | 2547894 | ManagementAndGeneral |
| Fundraising | 19356 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 251170 | Total |
| Program Services | 200936 | ProgramServices |
| Management And General | 49653 | ManagementAndGeneral |
| Fundraising | 581 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1576789 | Total |
| Program Services | 1261431 | ProgramServices |
| Management And General | 309406 | ManagementAndGeneral |
| Fundraising | 5952 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 904142 | Total |
| Program Services | 723314 | ProgramServices |
| Management And General | 179583 | ManagementAndGeneral |
| Fundraising | 1245 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 369705 | Total |
| Program Services | 221823 | ProgramServices |
| Management And General | 147882 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43090 | Total |
| Management And General | 43090 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34200 | Total |
| Management And General | 34200 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 988216 | Total |
| Program Services | 747889 | ProgramServices |
| Management And General | 236927 | ManagementAndGeneral |
| Fundraising | 3400 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64525 | Total |
| Program Services | 32263 | ProgramServices |
| Management And General | 8898 | ManagementAndGeneral |
| Fundraising | 23364 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1512370 | Total |
| Program Services | 1187620 | ProgramServices |
| Management And General | 322246 | ManagementAndGeneral |
| Fundraising | 2504 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 792946 | Total |
| Program Services | 576469 | ProgramServices |
| Management And General | 214677 | ManagementAndGeneral |
| Fundraising | 1800 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38065 | Total |
| Program Services | 38065 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71028 | Total |
| Program Services | 55746 | ProgramServices |
| Management And General | 15282 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133470 | Total |
| Program Services | 104107 | ProgramServices |
| Management And General | 29363 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1369396 | Total |
| Program Services | 1068129 | ProgramServices |
| Management And General | 300964 | ManagementAndGeneral |
| Fundraising | 303 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 665120 | Total |
| Program Services | 634677 | ProgramServices |
| Management And General | 30443 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 2192499 | 2192499 | |
| BAD DEBT ALLOWANCE | 578610 | 578610 | |
| EQUIPMENT RENTAL AND MA | 272874 | 240734 | 32140 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1365015 | Total |
| Program Services | 1090711 | ProgramServices |
| Management And General | 274304 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26304762 | Total |
| Program Services | 21343997 | ProgramServices |
| Management And General | 4902260 | ManagementAndGeneral |
| Fundraising | 58505 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 576615 | BOY |
| EOY | 1065863 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3339910 | BOY |
| EOY | 3710400 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 151572 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 476943 | BOY |
| EOY | 505418 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 144684 | BOY |
| EOY | 166265 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 30351689 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 21442995 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9474307 | BOY |
| EOY | 8908694 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4011332 | BOY |
| EOY | 3056929 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 251996 | BOY |
| EOY | 68428 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2367125 | BOY |
| EOY | 2863982 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20642912 | BOY |
| EOY | 20497551 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2052036 | BOY |
| EOY | 2004705 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 916227 | BOY |
| EOY | 488458 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2056795 | BOY |
| EOY | 2433778 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 443500 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68329 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5536887 | BOY |
| EOY | 4926941 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13325124 | BOY |
| EOY | 13322780 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 980947 | BOY |
| EOY | 1341503 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 799954 | BOY |
| EOY | 906327 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15106025 | BOY |
| EOY | 15570610 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20642912 | BOY |
| EOY | 20497551 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -3658 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 468243 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 1 | AgentTrusteeEtc |
| Beginning Balance | 5434 | BeginningBalance |
| Additions During Year | 20766 | AdditionsDuringYear |
| Distributions During Year | 20748 | DistributionsDuringYear |
| Ending Balance | 5452 | EndingBalance |
| Included On FS | 0 | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 103009 | OtherCostOrOtherBasis |
| Book Value | 103009 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17176108 | OtherCostOrOtherBasis |
| Depreciation | 11546867 | Depreciation |
| Book Value | 5629241 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12159591 | OtherCostOrOtherBasis |
| Depreciation | 9254192 | Depreciation |
| Book Value | 2905399 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 912981 | OtherCostOrOtherBasis |
| Depreciation | 641936 | Depreciation |
| Book Value | 271045 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8908694 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| LONG-TERM PREPAID EXPENSES | 278751 |
| DUE FROM FOUNDATION | 2247830 |
| OTHER RECEIVABLES | 269389 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | 68012 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2863982 | TotalBookValueOtherAssets |
| Total Revenue | 26301104 | TotalRevenue |
| Total Expenses | 26304762 | TotalExpenses |
| Excess Or Deficit For Year | -3658 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 1314 | NetUnrealizedGLOnInvestments |
| Other | $466,929 | OtherAmount |
| Total Adjustments | 468243 | TotalAdjustments |
| Excess Or Deficit Per FS | 464585 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 26570227 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -1611 | OtherRevenues |
| Revenue Not Rptd F990 | -1611 | RevenueNotRptdF990 |
| Revenue Subtotal | 26571838 | RevenueSubtotal |
| Other Revenues Not Included | -270734 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -270734 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 26301104 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 26592592 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 289441 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 289441 | ExpensesNotRptdF990 |
| Expenses Subtotal | 26303151 | ExpensesSubtotal |
| Other Expenses Not Included | 1611 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1611 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 26304762 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 1B: | THE RESIDENT TRUST FUNDS ARE LISTED ON THE BALANCE SHEET AS AN ESCROW ACCOUNT LIABILITY. A SUB-REGISTER IS USED AND LISTED BY RESIDENT. THE SNC BILLER MAKES FUND DISTRIBUTION AS RESIDENT REQUESTS. | |
| PART X: | 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 990T) 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' FEDERAL FORM 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| INTEREST IN CENTRAL MONTANA FOUNDATION 466,929. | PART XI, LINE 8 - OTHER ADJUSTMENTS: | |
| FEES RECORDED IN REVENUE FOR FINANCIAL STATEMENTS -1,611. | PART XII, LINE 2D - OTHER ADJUSTMENTS: | |
| CONTRIBUTIONS FOR SPECIFIC PURPOSES RECORDED IN FUND BALANCE FOR F/S 18,707. RENTAL EXPENSES RECORDED IN EXPENSES FOR FINANCIAL STATEMENTS -289,441. | PART XII, LINE 4B - OTHER ADJUSTMENTS: | |
| RENTAL EXPENSES RECORDED IN EXPENSES FOR FINANCIAL STATEMENTS 289,441. | PART XIII, LINE 2D - OTHER ADJUSTMENTS: | |
| FEES RECORDED IN REVENUE FOR FINANCIAL STATEMENTS 1,611. | PART XIII, LINE 4B - OTHER ADJUSTMENTS: |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | EMERGENCY DEPT. GALA | NameOfEvent1 |
| Gross Receipts Event1 | 116185 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 100439 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 15746 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 863 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 10563 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 748 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 3572 | OtherDirectExpensesEvent1 |
| Name Of Event2 | CHRISTMAS MEMORIES | NameOfEvent2 |
| Gross Receipts Event2 | 17126 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 12535 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 4591 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 3120 | RentFacilityCostsEvent2 |
| Other Direct Expenses Event2 | 1471 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 2 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 20705 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 13685 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 7020 | GrossRevenueOtherEvents |
| Non Cash Prizes Other Events | 800 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 2144 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 830 | FoodAndBeverageOtherEvents |
| Other Direct Expenses Other Events | 3246 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 154016 | GrossReceiptsTotal |
| Charitable Contributions Total | 126659 | CharitableContributionsTotal |
| Gross Revenue Total Events | 27357 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 800 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 6127 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 11393 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 748 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 8289 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 27357 | DirectExpenseSummaryEvents |
| Net Income Summary | 0 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 604 | PersonsServed |
| Total Community Benefit Expense | 660355 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 660355 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02570 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 604 | PersonsServed |
| Total Community Benefit Expense | 660355 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 660355 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02570 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Persons Served | 5677 | PersonsServed |
| Total Community Benefit Expense | 26847 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4232 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 22615 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 246 | PersonsServed |
| Total Community Benefit Expense | 170 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 170 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 85 | PersonsServed |
| Total Community Benefit Expense | 3935699 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3189655 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 746044 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02900 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 1550 | PersonsServed |
| Total Community Benefit Expense | 13511 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13511 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Persons Served | 7558 | PersonsServed |
| Total Community Benefit Expense | 3976227 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3193887 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 782340 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Persons Served | 8162 | PersonsServed |
| Total Community Benefit Expense | 4636582 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3193887 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1442695 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05610 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $578,610 | BadDebtExpenseAmount |
| Amount Attributable To | 15539 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6192838 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6125496 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 67342 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL MONTANA MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 WENDALL AVENUE | AddressLine1 |
| City | LEWISTOWN | City |
| State | MT | State |
| ZIP Code | 59457 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | HOME HEALTH / HOSPICE | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL MONTANA MEDICAL FACILITIES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| 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 |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 3C: ELIGIBILITY IS BASED ON PATIENT'S FAMILY SIZE, FAMILY GROSS INCOME, PERSONAL ASSETS, AND OTHER MEDICAL DEBTS. | |
| PART I, LINE 7: CHARITY CARE WAS CONVERTED TO COST USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. UNREIMBURSED MEDICAID WAS CONVERTED TO COST USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. 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, LINE 7G: $7,316 OF COSTS ARE ATTRIBUTABLE TO A PROVIDER BASED CLINIC. | |
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR OF THE CALCULATION WAS $578,610. | |
| PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION.THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BY USING CHARITY CARE AS A % OF GROSS PATIENT SERVICES REVENUE. AS A PORTION OF REVENUE IS CONSIDERED CHARITY CARE, IT IS ASSUMED THAT A PERCENTAGE OF BAD DEBT EXPENSE WOULD ALSO BE CONSIDERED CHARITY CARE.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.FINANCIAL STATEMENT NOTE: THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS AND THIRD PARTY PAYORS. MANAGEMENT REVIEWS PATIENT AND RESIDENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND RESIDENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE BAD DEBT PROVISION. | |
| 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 CMS. | |
| 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 V, SECTION B, LINE 13G: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS ALSO POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM, WAITING ROOMS, AND ADMISSIONS OFFICES. | CENTRAL MONTANA MEDICAL FACILITIES, INC. |
| 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. CMMC WILL BE DOING ANOTHER COMMUNITY NEEDS ASSESSMENT IN THE NEXT YEAR. | |
| 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. THE CITY OF LEWISTOWN AND THE SURROUNDING RURAL TOWNS ARE SUPPORTED BY ONE HOSPITAL, CENTRAL MONTANA MEDICAL CENTER. FERGUS COUNTY HAS A PRIMARY CARE LOW INCOME HPSA DESIGNATION WITH A SCORE OF 17. FERGUS COUNTY IS LOCATED IN A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA. AS OF 2012, THERE WERE 5,901 PEOPLE RESIDING IN THE CITY. THE POPULATION DENSITY WAS 1,109.4 PEOPLE PER SQUARE MILE. ALSO 10.6% OF THE RESIDENTS WERE BELOW THE POVERTY LEVEL.THERE WERE 2,761 HOUSEHOLDS OUT OF WHICH 66.9% OWNED THEIR HOME. THE MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS WAS $99,100 WITH A 2.16 AVERAGE PERSONS PER HOUSEHOLD. IN THE CITY, THE POPULATION SPREAD WAS 20.4% UNDER THE AGE OF 18, 5.9% UNDER THE AGE OF 5, AND 21.7% OF THE POPULATION IS 65 YEARS AND OVER. THE FEMALE POPULATION CONSISTED OF 50.8%.THE MEDIAN INCOME FOR A HOUSEHOLD IN THE CITY WAS $34,089 COMPARED TO THE STATE MEDIAN INCOME AT $45,324. | |
| PART VI, LINE 5: THE CMMC GOVERNING BOARD CONSISTS OF 13 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 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALAN R ALDRICH | |||||||||||||
| 125321 | 0 | 0 | 0 | 0 | 0 | 17516 | 0 | 16857 | 0 | 159694 | 0 | 0 | 0 |
| AARON HUMPHREYS | |||||||||||||
| 242907 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12193 | 0 | 255100 | 0 | 0 | 0 |
| JAMES FOX | |||||||||||||
| 207423 | 0 | 0 | 0 | 0 | 0 | 18746 | 0 | 1369 | 0 | 227538 | 0 | 0 | 0 |
| RENE DEGUZMAN | |||||||||||||
| 183471 | 0 | 0 | 0 | 0 | 0 | 11711 | 0 | 16949 | 0 | 212131 | 0 | 0 | 0 |
| RONALD SKIPPER | |||||||||||||
| 304389 | 0 | 0 | 0 | 0 | 0 | 28168 | 0 | 15885 | 0 | 348442 | 0 | 0 | 0 |
| RICHARD TAYLOR JR | |||||||||||||
| 195596 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12763 | 0 | 208359 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | HOUSING ALLOWANCE WAS PAID TO AN ORTHOPEDIC SURGEON, AS PART OF A RECRUITING PACKAGE. THE ANNUAL DUES FOR MEMBERSHIP IN LOCAL SERVICE ORGANIZATIONS ARE PAID FOR THE CEO AND THE CCO. | |
| PART III | PART I, QUESTION 3: THE ORGANIZATION DOES NOT PAY COMPENSATION TO THE CEO DIRECTLY. THE CEO IS COMPENSATED BY AN UNRELATED MANAGEMENT COMPANY. THE BOARD OF DIRECTORS APPROVES THE CONTRACT WITH THE MANAGEMENT COMPANY. PART II: THE CEO, LEE RHODES, IS COMPENSATED BY AN UNRELATED MANAGEMENT COMPANY, QUORUM HEALTH RESOURCES LLC. HE IS COMPENSATED FOR SERVICES PROVIDED TO C.M. MEDICAL FACILITIES, INC. THE MANAGEMENT COMPANY BASES THE CEO'S SALARY ON COMPENSATION SURVEYS FOR THE AREA. THE BOARD OF DIRECTORS APPROVES THE SALARY OR MAKES RECOMMENDATIONS BACK TO THE MANAGEMENT COMPANY. | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FERGUS COUNTY MONTANA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 816001358 | IssuerEIN |
| Date Issued | 2003-07-31 | DateIssued |
| Issue Price | 1980000 | IssuePrice |
| Description Of Purpose | TO REFINANCE BONDS ISSUED JULY 6, 1993 | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 1554724 | AmountRetired |
| Total Proceeds | 1980000 | TotalProceeds |
| Other Spent Proceeds | 1980000 | OtherSpentProceeds |
| Year Of Subst Completion | 2003 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K, PART II, LINE 11: | Identifier |
| Explanation | THE AMOUNT REPORTED ON LINE 11 REPRESENTS THE AMOUNT USED TO REFUND THE PRIOR BONDS. | Explanation |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | AARON G HUMPHREYS MD | NamePerson |
| Purpose Of Loan | RECRUITING | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $220,000 | OriginalPrincipalAmount |
| Balance Due | 151572 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 151572 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| ANNIE DAVIS | |||
| FAMILY MEMBER OF BOARD MEMBER | 48646 | PAYMENT OF COMPENSATION | 0 |
| YELLOWSTONE INSURANCE | |||
| CEO OF ORGANIZATION IS ALSO A DIRECTOR FOR YELLOWSTONE INSURANCE | 540490 | PAYMENT FOR SERVICES | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | THE ORGANIZATION BEGAN OFFERING PULMONARY REHABILITATION SERVICES IN MARCH 2012. |
| CHANGES IN PROGRAM SERVICES | FORM 990, PART III, LINE 3 | SERVICES AT THE BASIN MEDICAL CLINIC WERE DISCONTINUES AS OF 6/30/11. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE INCLUDES THE PRESIDENT, VICE PRESIDENT, SECRETARY AND TREASURER AND THEIR AUTHORITY IS SIMILAR TO THAT OF THE FULL GOVERNING BOARD. | |
| FORM 990, PART VI, SECTION A, LINE 2 | RUSSELL SPIKA 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. | |
| 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 PERSONS WITH A CONFLICT ARE NOT ALLOWED TO VOTE ON CONFLICTED ISSUES. | |
| THE CEO IS EMPLOYED BY QUORUM HEALTH RESOURCES LLC (QHR), A HOSPITAL MANAGEMENT CORPORATION. QHR DETERMINES THE CEO'S COMPENSATION BASED ON INDEPENDENT DATA AND COMPARISONS. THE INFORMATION IS 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 6/30/12. 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 VII AND PART IX LINE 5 AND LINE 11A | THE CEO IS PAID BY A MANAGEMENT COMPANY FOR SERVICES PROVIDED TO THE ORGANIZATION. THE COMPENSATION PAID TO THE MANAGEMENT COMPANY FOR HIS SERVICES IS DISCLOSED ON PART VII, SECTION A AND ALSO INCLUDED IN THE AMOUNT PAID TO THE MANAGEMENT COMPANY IN PART VII SECTION B. PART IX LINE 11A INCLUDES COMPENSATION PAID TO THE MANAGEMENT COMPANY FOR MANAGEMENT AND CEO SERVICES. LINE 5 INCLUDES COMPENSATION PAID TO THE CFO AND THE CCO FOR SERVICES AS AN EMPLOYEE. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 1,314. INTEREST IN CENTRAL MONTANA FOUNDATION 466,929. TOTAL TO FORM 990, PART XI, LINE 5: 468,243. |