2026-05-12T07:58:58-05:00 2025-06-30 393647910 WIPFLI ADVISORY LLC 105 E PINE ST UPPER FLOOR MISSOULA MT 59802 990 2024-07-01 810405434 ROSEBUD COMMUNITY HOSPITAL INC ROSE 4063462161 383 N 17TH AVENUE FORSYTH MT 59327 MINDY PRICE CEO 4063462161 2026-05-06 1 1 SAM BRUNSON CPA P01696998 4067281800 2026-05-06 2024 2025-03-06 01:10:19Z ROSEBUD HEALTH CARE CENTER MINDY PRICE 383 N 17TH AVENUE FORSYTH MT 59327 12956715 0 X WWW.ROSEBUDHCC.ORG X 1980 MT THE FACILITY PROVIDES EMERGENCY ROOM, IN-PATIENT SKILLED CARE, LABORATORY SERVICES, RADIOLOGY (INCLUDING ULTRASOUND AND CT), RESPITE CARE, PHYSICAL THERAPY, LONG TERM CARE, AND OUT-PATIENT CLINIC SERVICES. 9 6 143 15 0 0 30251 55621 11064209 12034296 8635 19044 0 847754 11103095 12956715 0 0 0 0 6594062 7248456 0 0 0 4761420 5104664 11355482 12353120 -252387 603595 6625768 7213421 2746966 2731024 3878802 4482397 X EMPLOYEES OF RHCC ARE COMMITTED TO HIGH QUALITY, EFFICIENT AND PATIENT-CENTERED CARE FOR OUR FAMILY, FRIENDS AND COMMUNITY. IN FULFILLMENT OF THIS MISSION, ROSEBUD HEALTH CARE CENTER: -WILL PROVIDE INPATIENT, OUTPATIENT AND EMERGENCY SERVICES IN ADDITION TO EXTENDED AND RESPITE CARE.-WILL PROMOTE THE OVERALL WELLBEING OF THE AREA RESIDENTS BY WORKING WITH AREA ORGANIZATIONS AND AGENCIES TO ENSURE THAT THE PUBLIC'S NEEDS ARE MET IN HEALTH RELATED SERVICES AND EDUCATION PROGRAMS.-RECOGNIZE EVERY INDIVIDUAL'S DIGNITY AND VALUE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, DISABILITY, CREED OR SOCIAL STATUS.-WILL SERVE ALL INDIVIDUALS THAT SEEK CARE REGARDLESS OF ABILITY TO PAY.-WILL MAINTAIN A DEDICATED, PROFESSIONAL STAFF THROUGH CONTINUING EDUCATION, IN-SERVICE TRAINING, COMPETITIVE WAGES AND OTHER MEANS OF RECOGNITION TO PROMOTE GROWTH AND SATISFACTION WITH THE STAFF. 0 0 8886843 0 12034296 ROSEBUD HEALTH CARE CENTER IS A COMBINED CRITICAL ACCESS HOSPITAL, LONG TERM CARE FACILITY, AND CLINIC PROVIDING QUALITY HEALTH CARE, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND EDUCATION. IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, THE FOLLOWING WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXISTS: FREE CARE AND/OR SUBSIDIZED CARE (CHARITY CARE) CHARGES OF $30,201.43 THROUGH JUNE 30, 2025; CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, FREE HEALTH FAIRS, LOW COST LAB HEALTH FAIRS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. RHCC PROVIDED 6,689 DAYS OF HOSPITAL/SWING BED SERVICES, 5,002 DAYS OF NURSING HOME CARE, AND 5,961 RURAL HEALTH CLINIC VISITS DURING THE YEAR ENDED JUNE 30, 2025. 8886843 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 143 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MINDY PRICE 4063462161 383 N 17TH AVENUE FORSYTH MT 59327 MINDY PRICE CEO 40.00 X X 159391 0 33060 DR GERALD KILLEN CHAIRPERSON 1.00 X X 0 0 0 GAYLE HOLLAND VICE CHAIRPERSON 1.00 X X 0 0 0 ROB JOHNSTONE DIRECTOR 1.00 X 0 0 0 BOB LEE DIRECTOR 1.00 X 0 0 0 NANCY NILE DIRECTOR 1.00 X 0 0 0 CHERYL SCHWARZKOPH DIRECTOR 1.00 X 0 0 0 JEANNE MACIAG DIRECTOR/DON 40.00 X 135446 0 21923 DR HUNTER CROSE DIRECTOR/MEDICAL DIRECTOR 2.00 X 36500 0 0 CLAY REDDING DIRECTOR (TERMED 8.8.24) 1.00 X 0 0 0 SHELLEY RICKETT PHYSICIAN ASSISTANT 40.00 X 149371 0 25748 DERRICK WOODS PHYSICIAN ASSISTANT 40.00 X 134163 0 23170 KRISTINA KLEINOW PHYSICIAN ASSISTANT 40.00 X 128208 0 12274 CHERYL ALLISON REGISTERED NURSE 40.00 X 131727 0 10731 874806 0 126906 13 0 1 0 406 NURSING LLC 78 STADEL LANE COLUMBUS MT 59109 TRAVEL STAFF NURSES AND CNAS 538892 TRUBRIDGE PO BOX 11407 BIRMINGHAM AL 35246 EHR 305589 ABUNDANT LIFE NURSING LLC 1925 GRAND AVE STE 127 BILLINGS MT 59102 TRAVEL STAFF NURSES AND CNAS 268264 ANDERS GROUP LLC PO BOX 650823 DALLAS TX 75265 TRAVEL STAFF RADIOLOGY TECH 199348 BAUER CONSTRUCTION 3333 2ND AVE N SUITE 240 BILLINGS MT 59101 CONSTRUCTION 149111 6 51321 4300 55621 NET PATIENT SERVICE REVENUE 621400 11236065 11236065 PHARMACY REVENUE 456110 700987 700987 97244 97244 12034296 12134 12134 6910 0 6910 6910 6910 DIETARY REVENUE 722514 23634 23634 824120 824120 847754 12956715 12034296 0 866798 X 245856 245856 5818983 4469288 1349695 127369 97612 29757 612895 427893 185002 443353 329219 114134 2402356 1530455 871901 6154 6154 183944 149960 33984 39390 22372 17018 20056 9609 10447 52285 50521 1764 520762 424616 96146 189454 154476 34978 MEDICAL SUPPLIES 1143881 799309 344572 BAD DEBT EXPENSE 219244 219244 TAXES AND LICENSES 142993 135217 7776 EQUIPMENT RENTAL 52907 49176 3731 131238 17876 113362 12353120 8886843 3466277 0 0 908 2872813 2256571 426814 1730261 141942 176135 0 32151 9152002 6618400 2682949 2533602 501250 483793 6625768 7213421 994622 1269197 1526133 1461827 226211 0 2746966 2731024 X 3829446 4482397 49356 0 3878802 4482397 6625768 7213421 603595 0 X 0 1 X 0 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6405461 4088444 2317017 2746541 2529956 216585 2533602 OTHER ASSETS 483793 483793 12737471 0 12737471 219244 219244 12956715 12133876 0 12133876 219244 219244 12353120 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 219,244. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 219,244. 1 1 1 X 1 X 1 1 0 1 1 31606 31606 0.00260 668645 462081 206564 0.01670 700251 462081 238170 0.01930 481269 271220 210049 0.01700 1355136 1027328 327808 0.02650 1836405 1298548 537857 0.04350 2536656 1760629 776027 0.06280 0 45889 0 3516116 3619299 -103183 X 1 1 1 1 ROSEBUD COMMUNITY HOSPITAL 383 N 17TH AVENUE FORSYTH MT 59327 WWW.ROSEBUDHCC.ORG 13096 X X X X RURAL HEALTH CLINIC ROSEBUD COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X ROSEBUDHCC.ORG/WP-CONTENT/UPLOADS/2023/06/FORSYTH_2023_FINAL-CHNA-REPORT.PD X X 1 22 1 ROSEBUDHCC.ORG/COMMUNITY-HEALTH-SURVEY/ 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X X 1 X SEE PART V, PAGE 8, 16J X SEE PART V, PAGE 8, 16J X SEE PART V, PAGE 8, 16J X X X X X X X 1 X 0 X X X X 1 X 0 0 ROSEBUD COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: ROSEBUD HEALTH CARE CENTER PROVIDED A LIST OF OUTPATIENT AND INPATIENT ADMISSIONS. THOSE ZIP CODES WITH THE GREATEST NUMBER OF ADMISSIONS WERE SELECTED TO BE INCLUDED IN THE SURVEY. A RANDOM LIST OF 800 RESIDENTS WAS THEN SELECTED WITH THE ASSISTANCE OF THE MSU HELPS LAB. RESIDENCE WAS STRATIFIED IN THE INITIAL SAMPLE SELECTION SO THAT EACH AREA WOULD BE REPRESENTED IN PROPORTION TO THE OVERALL SERVED POPULATION AND THE PROPORTION OF PAST ADMISSIONS. TEN KEY INFORMANT INTERVIEWS WERE CONDUCTED TO IDENTIFY IMPORTANT LOCAL HEALTHCARE ISSUES, HOW TO IMPROVE THE HEALTH OF THE COMMUNITY AND GAPS IN HEALTH SERVICES. IT WAS INTENDED THAT THIS RESEARCH WOULD HELP DETERMINE THE AWARENESS OF LOCAL PROGRAMS AND SERVICES, AS WELL AS THE LEVEL OF SATISFACTION WITH LOCAL SERVICES, PROVIDERS, AND FACILITIES. ROSEBUD COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: THE 2023 (TAX YEAR 2022) CHNA WAS CONDUCTED WITH ROSEBUD COUNTY PUBLIC HEALTH DEPARTMENT. ROSEBUD COMMUNITY HOSPITAL PART V, SECTION B, LINE 7D: WWW.ROSEBUDHCC.ORG/WP-CONTENT/UPLOADS/2023/06/FORSYTH_2023_FINAL-CHNA-REPORT.PDF ROSEBUD COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: THE FOLLOWING SUMMARY BRIEFLY REPRESENTS THE GOALS AND CORRESPONDING STRATEGIES AND ACTIVITIES WHICH THE FACILITY WILL EXECUTE TO ADDRESS THE PRIORITIZED HEALTH NEEDS.GOAL 1: IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES IN ROSEBUD COUNTY.STRATEGY 1.1: CONTINUE TO EXPAND CAPACITY AND AVAILABILITY OF MENTAL HEALTH SERVICES OFFERED THROUGH RHCC1.1.1. EXPLORE TELEPSYCH FOR CHILDREN IN PARTNERSHIP WITH CHARLIE HEALTH.1.1.2. OFFER ON-SITE MENTAL HEALTH SERVICES WITH A CERTIFIED PROVIDER.1.1.3. WORK TO CONTINUE IMPLEMENTING AN INTEGRATED BEHAVIORAL HEALTH (CARE MANAGEMENT PROGRAM) AT RHCC. SPECIFICALLY WORKING ON BILLING PROCESSES AND OUTREACH.1.1.4. CREATE A NEW OUTREACH CAMPAIGN TO EDUCATE COMMUNITY ON AVAILABLE TELE-PSYCH AND COUNSELING SERVICES AVAILABLE LOCALLY.STRATEGY 1.2: COORDINATE WITH COMMUNITY PROGRAMS THAT ADDRESS MENTAL AND BEHAVIORAL HEALTH1.2.1. PARTNER WITH LOCAL SCHOOLS TO CREATE AND IMPLEMENT A SCHOOL-BASED PREVENTION PROGRAM (SUICIDE PREVENTION, ANTI-BULLING CURRICULUM).1.2.2. REVIEW STATE RESOURCES/TRAININGS RELATED TO MENTAL AND BEHAVIORAL HEALTH (MT AHEC)GOAL 2: ENGAGE ROSEBUD COUNTY IN HEALTH, WELLNESS AND PREVENTION.STRATEGY 2.1: PROMOTE HEALTH AND WELLNESS THROUGH PROGRAMMATIC ACTIVITIES AT RHCC.2.1.1. PROMOTE HOSPITAL-BASED PROGRAMS THAT PROMOTE DISEASE PREVENTION BY OFFERING LUNCH AND LEARNS WITH LOCAL ORGANIZATIONS.2.1.2. ENGAGE WITH COMMUNITY (AT LEAST ONCE A QUARTER) THROUGH VARIOUS MEDIA CHANNELS (NEWSLETTERS, SOCIAL MEDIA, RADIO, ETC.) PROMOTING HEALTHY LIFESTYLES AND HEALTHY LIVING.2.1.3. WORK WITH HEALTH SYSTEM PARTNERS TO ENHANCE SCREENING OFFERINGS AT RHCC (MAMMOGRAPHY BUS, COLOGAURD, HEALTH FAIR LABS, LOW DOSE CT SCANS).STRATEGY 2.2: SUPPORT COMMUNITY EVENTS AND PROGRAMS THAT PROMOTE HEALTH, WELLNESS AND PREVENTION.2.2.1. PARTNER WITH COMMUNITY RESOURCES (PUBLIC HEALTH, MSU EXTENSION) TO CATALOGUE AND CREATE OUTREACH MATERIALS TO EDUCATE COMMUNITY ON AVAILABLE PREVENTION PROGRAMS AND SCREENING OPPORTUNITIES.GOAL 3: ENHANCE ACCESS TO LOCAL HEALTHCARE SERVICES AND RESOURCES.STRATEGY 3.1: SUPPORT COMMUNITY EVENTS AND PROGRAMS THAT PROMOTE HEALTH, WELLNESS, AND PREVENTION.3.1.1. CREATE HEALTH SERVICES AND RESOURCE PAGE FOR PROVIDERS TO SUPPORT WITH PATIENT REFERRALS (INCLUDING MENTAL HEALTH).3.1.2. CREATE OUTREACH TO EDUCATE THE COMMUNITY ON PRIMARY CARE SERVICES AND PROVIDER TYPES (SCOPE OF PRACTICE). INTEGRATE WITH NEWSLETTER OR OTHER ONGOING OUTREACH MATERIALS.3.1.3. CONTINUE TO PROVIDE TRANSPORTATION SERVICES ASSISTING COMMUNITY MEMBERS IN ACCESSING LOCAL AND OUT OF TOWN APPOINTMENTS, FOOD/GROCERIES, ETC. FOR A NOMINAL FEE.3.1.4. EXPLORE FEASIBILITY OF PARTNERING WITH LOCAL PROGRAMS TO HOST A COMMUNITY HEALTH FAIR TO PROVIDE EDUCATION, RESOURCES, AND ENHANCE KNOWLEDGE OF AVAILABLE LOCAL SERVICES.STRATEGY 3.2: ADVANCE PROGRAMS THAT ASSIST SENIORS TO ACCESS CARE AND SERVICES NEEDED TO AGE IN PLACE.3.2.1. CREATE EDUCATION AND OUTREACH TO DESCRIBE WHAT PROGRAMS OR SERVICES ARE AVAILABLE (HOME HEALTH, PALS, OTHER).3.2.2. EXPLORE AGE FRIENDLY RESOURCES TO IMPROVE PATIENT EXPERIENCES AND OUTCOMES (RESOURCE: IHI, AGE-FRIENDLY HEALTH SYSTEMS).NEEDS NOT ADDRESSED AND JUSTIFICATION:1. 46.5% OF SURVEY RESPONDENTS FEEL "AFFORDABILITY OF SERVICES" WOULD IMPROVE THE COMMUNITY'S ACCESS TO HEALTHCARE SERVICES. 34.2% OF RESPONDENTS WHO DELAYED OR DID NOT GET CARE WHEN NEEDED WAS DUE TO "IT COST TOO MUCH."- RHCC SOCIAL SERVICES DEPARTMENT WILL ASSIST PATIENTS WITH APPLYING FOR MEDICAID.- OUR BUSINESS OFFICE PROMOTES PAYMENT PLANS FOR THOSE WHO AREN'T ABLE TO PAY THE FULL STATEMENT AMOUNT.- WE PARTICIPATE IN MEDICARE BAD DEBT- WE ENCOURAGE PATIENTS TO COMPLETE CHARITY CARE APPLICATIONS IF THEY FEEL THEY WOULD QUALIFY.2. 51.1% OF SURVEY RESPONDENTS DESIRE AN "ASK A NURSE" SERVICE AVAILABLE LOCALLY.- UNABLE TO STAFF AN "ASK A NURSE" POSITION.- HCC HAS A HOSPITAL NURSE AVAILABLE 24/7 FOR EMERGENT QUESTIONS3. 6.8% OF SURVEY RESPONDENTS WORRIED ABOUT HAVING ENOUGH FOOD TO EAT, WHICH MORE THAN DOUBLED IN THE PAST THREE YEARS. - TRANSPORTATION IS AVAILABLE TO THE FOOD BANK.- SENIOR CITIZEN CENTER HAS LUNCH AVAILABLE FOR A MINIMAL FEE.- MEALS ON WHEELS IS AVAILABLE FOR THOSE COMMUNITY MEMBERS WHO QUALIFY.- RHCC WILL SUPPORT THE FOOD BANK THROUGH ADVERTISING AND PROVIDING FOOD WHEN NEEDED. ROSEBUD COMMUNITY HOSPITAL PART V, SECTION B, LINE 16J: FAP URL: HTTPS://WWW.ROSEBUDHCC.ORG/WP-CONTENT/UPLOADS/2017/02/FINANCIAL-ASSISTANCE-BO-201-3-UPDATED-1-16-19.PDFFAP APPLICATION URL: HTTPS://WWW.ROSEBUDHCC.ORG/WP-CONTENT/UPLOADS/2017/02/FINANCIAL-ASSISTANCE-APP-JAN-2019.PDFFAP PLAIN LANGUAGE SUMMARY URL: HTTPS://WWW.ROSEBUDHCC.ORG/WP-CONTENT/UPLOADS/2019/04/FINANCIAL-ASSISTANCE-BROCHURE-2019-REV-2.PDF 2 1 - ROSEBUD COMMUNITY HOSPITAL 383 N 17TH AVENUE FORSYTH MT 59327 SKILLED NURSING FACILITY 2 - ROSEBUD COMMUNITY HOSPITAL 383 N 17TH AVENUE FORSYTH MT 59327 RURAL HEALTH CLINIC PART I, LINE 7: THE COST-TO-CHARGE RATIO USED WAS DERIVED BASED ON THE RATIO OF PATIENT CARE COST-TO-CHARGES WORKSHEET. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE THE RURAL HEALTH CLINIC COSTS. THE CLINIC TOTAL COMMUNITY BENEFIT EXPENSE IS $1,355,136, THE DIRECT OFFSETTING REVENUE IS $1,027,328, AND THE NET COMMUNITY BENEFIT EXPENSE IS $327,808. PART II, COMMUNITY BUILDING ACTIVITIES: ROSEBUD COMMUNITY HOSPITAL HAS A HEALTH FAIR PROMOTION THAT PROVIDES LAB TESTS AT REDUCED RATES TO PEOPLE; THEY PARTICIPATE IN THE RESOURCE FAIR OFFERED WITHIN THE COMMUNITY, PROVIDING HEALTH AND MEDICAL INFORMATION; THEY PARTICIPATE IN THE MONTANA BREAST AND CERVICAL HEALTH PROGRAM, OFFERING FREE MAMMOGRAMS AND PAP TESTS FOR UNINSURED PATIENTS; THEY CONTINUE TO OFFER A CONCUSSION PROGRAM, PROVIDING SCREENING FOR YOUNG ATHLETES IN OUR COMMUNITY; THEY PROVIDE A COLON SCREENING PROGRAM; THEY PARTICIPATE IN AND PROMOTE HEALTHY MONTANA KIDS, A PROGRAM OFFERING HEALTH CARE "INSURANCE" TO UNINSURED, LOW INCOME CHILDREN; THEY OFFER A HEALTHY LIFESTYLES PROGRAM TO COMMUNITY MEMBERS, A PROGRAM FOCUSING ON EXERCISE AND GOOD NUTRITION AND WEIGHT LOSS; THEY ARE HELPING FUND WAGES FOR THE STARTUP OF A DAYCARE THAT IS NEEDED IN THE COMMUNITY.DUE TO THE DIFFICULTY IN TRACKING COSTS TO THESE SPECIFIC COMMUNITY BUILDING ACTIVITIES, THE FACILITY DOES NOT CURRENTLY TRACK THESE COSTS. HOWEVER, THE FACILITY DOES INCUR COSTS FOR THESE COMMUNITY BUILDING ACTIVITIES AND PLANS TO TRACK THE COSTS IN FUTURE YEARS TO BE REPORTED ON SCHEDULE H, PART II. PART III, LINE 2: THE COSTING METHODOLOGY USED TO DETERMINE THE COST OF BAD DEBT IS BASED ON THE FACILITY'S CALCULATED COST-TO-CHARGE RATIO. PART III, LINE 3: THE FACILITY TOOK A SAMPLE OF PATIENT ACCOUNTS TO DETERMINE WHAT PERCENTAGE OF THE BAD DEBT REPORTED AT COST WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FACILITY'S CHARITY CARE POLICY. THE CALCULATED PERCENTAGE WAS APPLIED TO THE BAD DEBT AT COST TO DETERMINE THE COST ATTRIBUTABLE TO ELIGIBLE PATIENTS. PART III, LINE 8: THE FACILITY'S JUNE 30, 2025 MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNT OF MEDICARE SHORTFALL REPORTED. ROSEBUD COMMUNITY HOSPITAL IS A DESIGNATED CRITICAL ACCESS HOSPITAL AND THEREFORE REIMBURSED FROM MEDICARE ON A COST BASIS. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE THE HOSPITAL IS REIMBURSED ON MEDICARE ALLOWABLE COSTS. THE MEDICARE ALLOWABLE COSTS WE DEFINED BY MEDICARE AND DO NOT NECESSARILY CAPTURE ALL COSTS OF THE HOSPITAL PROVIDING SERVICES TO THE COMMUNITY. PART III, LINE 9B: PATIENTS UNABLE TO MEET PAYMENT PLAN REQUIREMENTS WILL BE ASKED TO COMPLETE A FINANCIAL WORK SHEET TO DETERMINE ALTERNATE PAYMENT OPTIONS. PATIENTS MAY BE ASKED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND/OR OTHER RELATED FORMS IN ORDER TO QUALIFY FOR ASSISTANCE UNDER THIS POLICY. THE PATIENT OR AUTHORIZED REPRESENTATIVE MAY BE REQUESTED TO APPLY FOR MEDICAID OR OTHER PUBLIC ASSISTANCE PROGRAMS AND TAKE REASONABLE ACTIONS NECESSARY TO OBTAIN SUCH ASSISTANCE. IF PATIENTS ARE FOUND TO BE ELIGIBLE FOR BENEFITS FROM MEDICAID OR OTHER GOVERNMENT SPONSORED FUNDING, ALL EFFORTS TO COLLECT FROM THAT PATIENT WILL CEASE AT THE TIME DETERMINATION IS MADE. FINANCIAL ASSISTANCE OUTLINED IN THIS POLICY SHALL NOT APPLY. PART VI, LINE 2: ROSEBUD HEALTH CARE CENTER IS OPEN TO HEARING THE NEEDS OF THE COMMUNITY THROUGH VARIOUS WAYS OTHER THAN WITH THE COMMUNITY HEALTH NEEDS ASSESSMENT. AS THE COMMUNITY UTILIZES THE FACILITY FOR SHORT TERM RECOVERY OR LONGER TERM CARE, THEY USUALLY GIVE SUGGESTIONS AS TO WHAT SERVICES COULD BE ADDED OR WHAT SERVICES NEED TO BE ADDRESSED. RHCC ALSO SENDS OUT CONTINUAL SURVEYS TO PATIENTS BEING DISCHARGED FROM EITHER THE HOSPITAL OR OUTPATIENT SERVICES INCLUDING CLINIC AND OUTPATIENT VISITS. THESE FOLLOW UP SURVEYS ALSO PROVIDE GUIDANCE IN THE DIRECTION AND NEEDED SERVICES THE COMMUNITY IS SUGGESTING. PART VI, LINE 3: THE FACILITY HAS ONE FULL TIME BUSINESS OFFICE REPRESENTATIVE ASSIGNED TO SELF-PAY ACCOUNTS AND HAS ESTABLISHED A PROCEDURE FOR IMMEDIATE CONTACT WITH ALL SELF-PAY PATIENTS. FOLDERS HAVE BEEN PUT TOGETHER THAT INCLUDE OUR POLICIES AND INFORMATION ON FINANCIAL ASSISTANCE, HELP LOANS, PAYMENT PLANS AND CHARITY CARE. THESE FOLDERS ARE AT THE REGISTRATION DESK IN THE CLINIC AND AT THE NURSES STATION IN THE HOSPITAL TO BE DISCUSSED WITH AND DISTRIBUTED TO ANY SELF PAY PATIENTS THAT COME IN FOR TREATMENT. ADDITIONALLY, THE BUSINESS OFFICE REPRESENTATIVE FOLLOWS UP WITH EACH PATIENT THAT RECEIVED THE INFORMATION VIA TELEPHONE AND A LETTER. STATEMENTS ARE SENT OUT MONTHLY WITH A LETTER FOR THOSE SELF-PAY ACCOUNTS THAT CONTACT HAS NOT BEEN MADE PERSONALLY BY THE BUSINESS OFFICE REPRESENTATIVE ADVISING OF THE OPTIONS WE HAVE AVAILABLE TO ASSIST WITH FINANCIAL NEEDS. FOLLOW UP CALLS ARE ALSO MADE ON A REGULAR BASIS. WE WORK CLOSELY WITH THE SOCIAL SERVICES DIRECTOR IN ASSISTING PATIENTS COMPLETE PAPERWORK TO DETERMINE IF THEY QUALIFY FOR ANY FEDERAL, STATE OR LOCAL GOVERNMENT POLICIES. THE SOCIAL SERVICES DIRECTOR ASSISTS WITH THE NURSING HOME AND/OR POTENTIAL NURSING HOME RESIDENTS AND THE BUSINESS OFFICE REPRESENTATIVE ASSISTS WITH THE NON- NURSING HOME PATIENTS. PART VI, LINE 4: ROSEBUD HEALTH CARE CENTER PROVIDES SERVICES FOR RESIDENTS IN BOTH ROSEBUD COUNTY AS WELL AS TREASURE COUNTY. THESE COUNTIES INCLUDE THE TOWNS OF FORSYTH, COLSTRIP, LAME DEER, ROSEBUD, ASHLAND, INGOMAR, ANGELA AND HYSHAM. TOTAL INDIVIDUALS SERVED: 9091ROSEBUD HEALTH CARE CENTER, IS THE ONLY HOSPITAL AND NURSING HOME IN ROSEBUD AND TREASURE COUNTY. RHCC HAS BEEN SERVING THE MEDICAL NEEDS OF ROSEBUD AND TREASURE COUNTIES DATING BACK TO THE EARLY 1920S, UTILIZING THE THREE FACILITIES THAT PROVIDE HOSPITAL CARE, EXTENDED CARE, AND CLINICAL OUTPATIENT CARE. THROUGHOUT THESE 95 YEARS, THERE HAS BEEN GROWTH, CHANGES, DEVELOPMENTS AND DISCOVERIES WITHIN MEDICAL SERVICES IN RHCC AS WELL AS IN THE UNITED STATES.ROSEBUD HEALTH CARE CENTER IS A PRIMARY CARE MEDICAL FACILITY THAT IS OPERATED AND MANAGED BY THE PEOPLE IT SERVES WITHIN ROSEBUD AND TREASURE COUNTIES. FORSYTH IS THE COUNTY SEAT AND IS HOME TO SEVERAL COAL MINERS, RAILROAD EMPLOYEES, WORKERS (COLSTRIP POWER PLANTS), CONSTRUCTION WORKERS, SMALL BUSINESS OWNERS, EDUCATORS, AND A GROWING NUMBER OF RETIRED RESIDENTS. PART VI, LINE 5: ROSEBUD HEALTH CARE CENTER'S BOARD OF DIRECTORS IS COMPRISED OF AN 11 PERSON SELF-APPOINTED BOARD. 8 MEMBERS ARE FROM THE COMMUNITY RHCC SERVES AND 3 ARE HOSPITAL EMPLOYEES, CEO, DON AND MEDICAL DIRECTOR. EXCEPT FOR THE CEO AND MEDICAL DIRECTOR, EACH PERSON IS ON A 3 YEAR ROTATION WITH THE OPTION TO BE REAPPOINTED OR STEP DOWN AFTER THE END OF THE 3 YEARS.RHCC AND ROSEBUD PUBLIC HEALTH HAVE A VERY GOOD WORKING RELATIONSHIP. PUBLIC HEALTH OCCUPIES A BUILDING THAT IS CONNECTED TO RHCC. THIS RELATIONSHIP HAS PROVIDED FOR OUR PROVIDERS TO SEE PATIENTS AT NO COST IN THE PUBLIC HEALTH SETTING WHICH PROVIDES FOR HEALTHCARE AT NO COST TO THE PATIENT. OUR PROVIDERS ARE PARTNERS WITH THE PUBLIC HEALTH TO PROVIDE SERVICES TO OUR FEMALE POPULATION UNDER TITLE X.ANOTHER BENEFIT RHCC PROVIDES TO OUR COMMUNITY IS TO THE ELDERLY WHO NEED NURSING HOME CARE BUT CANNOT AFFORD THE SERVICES. RHCC IS A MEDICAID PROVIDER FOR NURSING HOME SERVICES. MEDICAID'S REIMBURSEMENT FOR THESE SERVICES IS ABOUT 80% OF THE ACTUAL COST TO CARE FOR A PERSON IN THE NURSING HOME. PART VI, LINE 6: ROSEBUD HEALTH CARE CENTER IS NOT AN AFFILIATE OF ANY OTHER HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES MT X X X X 0 0 0 0 0 0 0 0 0 MINDY PRICE CEO 147263 0 2700 0 9428 0 5091 0 27969 0 192451 0 0 0 SHELLEY RICKETT PHYSICIAN ASSISTANT 146968 0 2103 0 300 0 4766 0 20982 0 175119 0 0 0 JEANNE MACIAG DIRECTOR/DON 131431 0 2840 0 1175 0 4229 0 17694 0 157369 0 0 0 DERRICK WOODS PHYSICIAN ASSISTANT 131086 0 2301 0 776 0 2188 0 20982 0 157333 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE 990 IS PROVIDED TO THE CEO FOR REVIEW PRIOR TO FILING AND THE DRAFT COPY IS GIVEN TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE FACILITY HAS A YEARLY READING AND SIGNATURE OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. WE ALSO MONITOR VOTING MEMBERS WHERE ANY CONFLICT COULD EXIST. THE CONFLICT OF INTEREST POLICY APPLIES TO ALL OFFICERS, BOARD MEMBERS, AND EMPLOYEES. IF A CONFLICT EXISTS, THE FOLLOWING WILL OCCUR: THE CONFLICTING INTEREST IS FULLY DISCLOSED; THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTIONS; A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS; AND THE BOARD OR DULY CONSTITUTED COMMITTEE THEREOF WILL DETERMINE IF THE TRANSACTION IS IN THE BEST INTERESTS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 CEO COMPENSATION: AN INDEPENDENT CONSULTING FIRM WITHOUT CONFLICT WAS CONTRACTED TO PERFORM COMPENSATION ANALYSIS OF COMPARABLE REGIONS AND FACILITIES. UPON PRESENTATION OF RESULTS, THE BOARD OF DIRECTORS VOTED ON ACCEPTANCE/REJECTION OF THE PROPOSED COMPENSATION PROGRAM, WHICH WAS DOCUMENTED IN THE BOARD MINUTES. OTHER OFFICERS AND KEY EMPLOYEES: A COMPENSATION STUDY IS USED TO DETERMINE INITIAL COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,322,152. MANAGEMENT AND GENERAL EXPENSES 487,429. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,809,581. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 208,303. MANAGEMENT AND GENERAL EXPENSES 384,472. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 592,775.