DANIELS MEMORIAL HOSPITAL: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- DANIELS MEMORIAL HOSPITAL (EIN 81-6016920)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-07
- IRS object ID
- 202411289349302821
- Schema version
- 2022v5.0
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-07T14:00:41-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 105 E PINE ST UPPER FLOOR | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 816016920 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIELS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DANI | BusinessNameControlTxt |
| Phone | 4064872296 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 400 | AddressLine1Txt |
| City | SCOBEY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59263 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KODY BRINTON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4064872296 | PhoneNum |
| Signature | 2024-05-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KODY | PersonFirstNm |
| Person Last | BRINTON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAM BRUNSON CPA | PreparerPersonNm |
| PTIN | P01696998 | PTIN |
| Phone | 4067281800 | PhoneNum |
| Preparation | 2024-05-02 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIELS MEMORIAL HEALTHCARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KODY BRINTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 400 | AddressLine1Txt |
| City | SCOBEY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59263 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,643,090 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DANIELSMEMORIALHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | WE ARE DEDICATED TO ENRICHING THE HEALTH OF THOSE WE SERVE AND TO STRENGTHENING OUR COMMUNITY FOR THE FUTURE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 96 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $160,748 | PYContributionsGrantsAmt |
| CY Contributions Grants | $96,248 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,205,769 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,938,261 | CYProgramServiceRevenueAmt |
| PY Investment Income | $541 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,902 | CYInvestmentIncomeAmt |
| PY Other Revenue | $407,700 | PYOtherRevenueAmt |
| CY Other Revenue | $602,214 | CYOtherRevenueAmt |
| PY Total Revenue | $11,774,758 | PYTotalRevenueAmt |
| CY Total Revenue | $12,642,625 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,284,876 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,963,552 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $10,500 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $10,500 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,202,096 | PYOtherExpensesAmt |
| CY Other Expenses | $7,514,379 | CYOtherExpensesAmt |
| PY Total Expenses | $11,486,972 | PYTotalExpensesAmt |
| CY Total Expenses | $12,488,431 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $287,786 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $154,194 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,481,748 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,965,699 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,598,627 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,929,867 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,883,121 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,035,832 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | DMHC WILL BE AN OASIS FOR HEALTH AND HEALING AND BE RECOGNIZED NATIONALLY AS A TOP 100 CAH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,391,769 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $10,744,611 | RevenueAmt |
| Desc | PROFESSIONAL CARE PROVIDED BY A TEAM OF APPS TO INCLUDE PRIMARY CARE IN THE CLINIC SETTING, ACUTE, ER AND MENTAL HEALTH SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,023,470 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,739,397 | RevenueAmt |
| Desc | CAH SERVICES INCLUDE ACUTE CARE, SKILLED SWING BED, ISB, AND ER WITH LEVEL 4 TRAUMA DESIGNATION. ANCILLARY SERVICES INCLUDE CT AND US IMAGING, LABS, PHYSICAL THERAPY, AND SPEECH THERAPY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $974,022 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | HOUSEKEEPING, LAUNDRY, LINEN & PLANT SERVICES - PROVIDE FOR THE HOUSEKEEPING AND BUILDING MAINTENANCE OF THE FACILITY. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $575,735 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $56,467 | RevenueAmt |
| Desc | DIETARY SERVICES FOR ACUTE CARE PATIENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $575,735 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $56,467 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $7,964,996 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 96 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4064872296 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 400 | AddressLine1Txt |
| City | SCOBEY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59263 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JACK PITTENGER | |||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TANNER TROWER | |||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CARRIE WILSON | |||||||
| VICE CHAIR (THRU 11/22) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JEDDA BARRON | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JANITZIA NELSON | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MIKE BJARKO | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CLIFF HAMES | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL KANNING | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KYMBER CARNEY | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ALYCIA NATHE | |||||||
| DIRECTOR (THRU 2/23) | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CLAIRE COYNE | |||||||
| DIRECTOR (THRU 2/23) | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KODY BRINTON | |||||||
| CEO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG CROWDER | |||||||
| NP | 40.00 | $189,120 | $0 | $35,622 | Yes (X) | ||
| SHERRY GAIRRETT | |||||||
| NP | 40.00 | $130,741 | $0 | $29,690 | Yes (X) | ||
| SHIRLEY RELLER | |||||||
| PT | 40.00 | $139,779 | $0 | $35,241 | Yes (X) | ||
| DEANNA FERESTAD | |||||||
| NP | 40.00 | $147,539 | $0 | $37,730 | Yes (X) | ||
| JESSICA WINGE-PETERSON | |||||||
| DON | 40.00 | $135,191 | $0 | $15,181 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $742,370 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $153,464 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BILLINGS CLINIC | |||||
| PO BOX 30357 | BILLINGS | MT | 59107 | MANAGEMENT, CEO, ACCOUNTING, IMAGING REA | $639,686 |
| PRN STAFFING | |||||
| 2501 CADDIE LANE | BRENTWOOD | CA | 94513 | NURSES, CNAS, HOUSEKEEPING | $625,138 |
| SOLIANT | |||||
| 5550 PEACHTREE PARKWAY STE 500 | PEACHTREE CORNERS | GA | 30092 | RADIOLOGY/LAB TECH | $313,772 |
| BADLANDS MEDICAL STAFFING | |||||
| BOX 133 | UNDERWOOD | ND | 58576 | NURSES AND CNAS | $288,657 |
| MONTANA HEALTH NETWORK | |||||
| 519 PLEASANT ST | MILES CITY | MT | 59301 | NURSES, CNAS, HOUSEKEEPING | $277,922 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $36,582 | RelatedOrganizationsAmt |
| All Other Contributions | $59,666 | AllOtherContributionsAmt |
| Total Contributions | $96,248 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PROFESSIONAL CARE REVENUE | 623000 | $10,269,201 | $10,269,201 |
| CLINIC REVENUE | 623000 | $1,669,060 | $1,669,060 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,938,261 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,367 | TotalRevenueColumnAmt |
| Exclusion | $6,367 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $465 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$465 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$465 | TotalRevenueColumnAmt |
| Exclusion | -$465 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL DISTRICT TAX REVENUE | 623000 | $158,875 | $158,875 |
| 340B REVENUE | 623000 | $1,484 | $1,484 |
| INCOME/LOSS FROM INSURANCE CAPTIV | 623000 | -$38,729 | -$38,729 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $480,584 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $480,584 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $602,214 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,642,625 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,540,475 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,902 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,981,985 | TotalAmt |
| Program Services | $2,646,024 | ProgramServicesAmt |
| Management And General | $1,335,961 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,043 | TotalAmt |
| Program Services | $69,788 | ProgramServicesAmt |
| Management And General | $11,255 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,106 | TotalAmt |
| Program Services | $498,371 | ProgramServicesAmt |
| Management And General | $110,735 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,418 | TotalAmt |
| Program Services | $253,897 | ProgramServicesAmt |
| Management And General | $37,521 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,676 | TotalAmt |
| Management And General | $22,676 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,079 | TotalAmt |
| Management And General | $49,079 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,500 | TotalAmt |
| Fundraising | $10,500 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,842,731 | TotalAmt |
| Program Services | $1,377,623 | ProgramServicesAmt |
| Management And General | $2,465,108 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,873 | TotalAmt |
| Program Services | $504 | ProgramServicesAmt |
| Management And General | $31,369 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,059 | TotalAmt |
| Program Services | $19,794 | ProgramServicesAmt |
| Management And General | $27,265 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,930 | TotalAmt |
| Program Services | $226,166 | ProgramServicesAmt |
| Management And General | $39,764 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,970 | TotalAmt |
| Program Services | $21,408 | ProgramServicesAmt |
| Management And General | $47,562 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $560 | TotalAmt |
| Program Services | $560 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,886 | TotalAmt |
| Management And General | $10,886 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $358,640 | TotalAmt |
| Program Services | $358,640 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,957 | TotalAmt |
| Program Services | $3,628 | ProgramServicesAmt |
| Management And General | $127,329 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL ALLOWANCES | $1,293,468 | $1,293,468 | |
| MEDICAL SUPPLIES AND PH | $519,815 | $519,815 | |
| OTHER SUPPLIES | $285,053 | $277,047 | $8,006 |
| REPAIRS & MAINTENANCE | $202,523 | $179,531 | $22,992 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,159 | TotalAmt |
| Program Services | $218,732 | ProgramServicesAmt |
| Management And General | $165,427 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,488,431 | TotalAmt |
| Program Services | $7,964,996 | ProgramServicesAmt |
| Management And General | $4,512,935 | ManagementAndGeneralAmt |
| Fundraising | $10,500 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,038,012 | BOYAmt |
| EOY | $3,127,290 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,737 | BOYAmt |
| EOY | $744,308 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,608,208 | BOYAmt |
| EOY | $1,339,463 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,562 | BOYAmt |
| EOY | $94,933 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,339 | BOYAmt |
| EOY | $286,399 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,195 | BOYAmt |
| EOY | $89,791 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,375,687 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,236,901 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,339,046 | BOYAmt |
| EOY | $2,138,786 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $663,649 | BOYAmt |
| EOY | $1,144,729 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,481,748 | BOYAmt |
| EOY | $8,965,699 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $662,503 | BOYAmt |
| EOY | $945,275 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,757 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,825 | BOYAmt |
| EOY | $219,395 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $488,542 | BOYAmt |
| EOY | $765,197 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,598,627 | BOYAmt |
| EOY | $1,929,867 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,783,121 | BOYAmt |
| EOY | $6,935,832 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $100,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,883,121 | BOYAmt |
| EOY | $7,035,832 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,481,748 | BOYAmt |
| EOY | $8,965,699 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $154,194 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,483 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,500 | OtherCostOrOtherBasisAmt |
| Book Value | $13,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,234,236 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,500,778 | DepreciationAmt |
| Book Value | $733,458 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,923,604 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,691,158 | DepreciationAmt |
| Book Value | $1,232,446 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $204,347 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,965 | DepreciationAmt |
| Book Value | $159,382 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,138,786 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| COST REPORT SETTLEMENT RECEIVABLE | $600,654 |
| RIGHT OF USE ASSET | $233,730 |
| SUBSCRIBERS EQUITY IN INSURANCE CAPTIVE | $214,962 |
| BED TAX RECEIVABLE | $90,223 |
| RESIDENT CASH | $4,460 |
| DEPOSIT | $700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,144,729 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| COST REPORT SETTLEMENT PAYABLE | $397,000 |
| RIGHT OF USE OPERATING LEASE | $268,754 |
| GUARANTEE OF PATIENT LOANS | $94,933 |
| RESIDENT TRUST FUND | $4,510 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $765,197 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $11,259,625 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$1,483 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$1,483 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,261,108 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,381,517 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,381,517 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,642,625 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,106,914 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,106,914 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,381,517 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,381,517 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,488,431 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT UNRELATED BUSINESS INCOME IN ACCORDANCE WITH THE CODE. CURRENT ACCOUNTING GUIDELINES REQUIRE AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE-LIKELY-THAN-NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. FEDERAL RETURNS FOR TAX YEARS 2019 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRACTUAL ALLOWANCES & DISCOUNTS 1,293,468. BAD DEBT EXPENSE 88,049. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CONTRACTUAL ALLOWANCES & DISCOUNTS 1,293,468. BAD DEBT EXPENSE 88,049. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BANNACK GROUP LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1823 | AddressLine1Txt |
| City | BOZEMAN | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59715 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | CAPITAL CAMPAIGN | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $0 | GrossReceiptsAmt |
| Retained By Contractor | $10,500 | RetainedByContractorAmt |
| Net To Organization | $0 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $10,500 | TotalRetainedByContractorsAmt |
| Licensed States | MT | LicensedStatesCd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2B, COLUMN (IV) | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL AND ITS SUPPORTING ORGANIZATION, DANIELS MEMORIAL HOSPITAL FOUNDATION, ARE CONDUCTING A CAPITAL CAMPAIGN IN WHICH THE FOUNDATION WILL COLLECT ALL CONTRIBUTIONS. THE HOSPITAL AND THE FOUNDATION ARE SPLITTING THE PROFESSIONAL FUNDRAISING FEES. THE HOSPITAL'S PORTION OF THE SHARED FEE WAS $10,500 FOR FY2023. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $134,789 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $134,789 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01080 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,162,647 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,162,647 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17320 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,297,436 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,297,436 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18400 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $82,858 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,735 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,123 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $164,707 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $164,707 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01320 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $247,565 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,735 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $203,830 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01630 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,545,001 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,735 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,501,266 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.20030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $87,721 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,527,260 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,565,868 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$38,608 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIELS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 400 | AddressLine1Txt |
| City | SCOBEY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59263 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.DANIELSMEMORIALHEALTHCARE.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIELS MEMORIAL HEALTHCARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.DANIELSMEMORIALHEALTHCARE.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.DANIELSMEMORIALHEALTHCARE.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.DANIELSMEMORIALHEALTHCARE.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.DANIELSMEMORIALHEALTHCARE.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.DANIELSMEMORIALHEALTHCARE.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DANIELS MEMORIAL HEALTHCARE CENTER | PART V, SECTION B, LINE 5: FIVE KEY INFORMANT INTERVIEWS WERE CONDUCTED TO IDENTIFY IMPORTANT LOCAL HEALTHCARE ISSUES, HOW TO IMPROVE THE HEALTH OF THE COMMUNITY, AND GAPS IN HEALTH SERVICES. IN ADDITION, SURVEYS WERE PROVIDED TO 600 HOUSEHOLDS IN THE DMHC SERVICE AREA WITH 127 COMPLETED SURVEYS BEING RETURNED. |
| DANIELS MEMORIAL HEALTHCARE CENTER | PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN COOPERATION WITH THE MONTANA OFFICE OF RURAL HEALTH. |
| DANIELS MEMORIAL HEALTHCARE CENTER | PART V, SECTION B, LINE 11: THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS:GOAL 1: IMPROVE ACCESS TO HEALTHCARE SERVICES IN DANIELS COUNTY.STRATEGY 1.1: INCREASE ACCESS TO PRIMARY CARE SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER (DMHC). ACTIVITIES: SINCE LAST YEAR, WE HAVE BEEN ABLE TO STABILIZE OUR MEDICAL STAFF BY ADDING THREE NEW PROVIDERS, THUS IMPROVING ACCESS TO PRIMARY CARE SERVICES. CREATE EDUCATION AND OUTREACH PLAN TO RAISE AWARENESS OF SERVICES THAT ADVANCED PRACTICE PROVIDERS CAN PROVIDE LOCALLY AND HOW DMHC IS WORKING TO EXPAND DESIRED PRIMARY CARE SERVICES. WE CONTINUE TO WORK WITH BILLINGS CLINIC AND ITS SPECIALTY PROVIDERS TO EXPAND OUR TELEHEALTH/TELEMEDICINE SERVICES. OUR TEAM HAS BEEN WORKING DILIGENTLY WITH THE LOCAL SCHOOL DISTRICT TO INTRODUCE HEALTH PROFESSIONS TO HIGH SCHOOL STUDENTS, STARTING DURING THE SOPHOMORE AND JUNIOR YEAR OF HIGH SCHOOL. OUR CNA PROGRAM CONTINUES TO HAVE AT LEAST ONE TO THREE ENROLLEES EVERY YEAR. STRATEGY 1.2: EXPLORE OPPORTUNITIES TO ENHANCE ACCESS TO SPECIALTY CARE IN DANIELS COUNTY. ACTIVITIES: DETERMINE OPPORTUNITIES TO SUSTAIN SPECIALTY SERVICES VIA TELEMEDICINE AT DANIELS MEMORIAL HEALTHCARE CENTER; IMPROVE EDUCATION AND OUTREACH TO DMHC STAFF AND THE SERVICE AREA ABOUT THE SPECIALTY SERVICES THAT ARE AVAILABLE LOCALLY VIA TELEMEDICINE; EXPLORE OPPORTUNITIES TO EXPAND CURRENT SPECIALTY SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER (I.E., ECHOCARDIOGRAMS, EXPANDED ULTRASOUND, AND WOMEN'S HEALTH, ETC.). OVER THE LAST YEAR, WE HAVE WORKED WITH OUR PSYCHIATRIC NURSE PRACTITIONER, AND OUR VARIOUS REHABILITATION THERAPISTS TO OFFER TELEMEDICINE/TELEHEALTH VISITS. WE HAVE SEEN AN IMPACT IN OUR ABILITY TO SERVE PEOPLE AND ACCOMMODATE THEIR SCHEDULES THROUGH THIS TELEHEALTH OFFERING.STRATEGY 1.3: SUPPORT LOCAL TRANSPORTATION SERVICES THAT ASSIST COUNTY RESIDENTS IN ACCESSING HEALTHCARE SERVICES IN THE REGION. ACTIVITIES: CONTINUE PARTICIPATION AND SUPPORT OF THE DANIELS COUNTY PUBLIC TRANSPORTATION. CONTINUE TO FACILITATE TRANSPORTATION TO AND FROM MEDICAL APPOINTMENTS AT DMHC AND WITHIN THE REGION FOR PATIENTS WHO DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION. DANILES COUNTY TRANSPORTATION IS CONTINUOUSLY LOOKING FOR QUALIFIED, INTERESTED DRIVERS TO FURTHER PROVIDE TRANSPORTATION SERVICES TO THOSE IN OUR COMMUNITIES, INCLUDING BUT NOT LIMITED TO THOSE 60 YEARS OF AGE AND UP. WORKING WITH MONTANA DEPARTMENT OF TRANSPORTATION, OUR TRANSPORTATION PROGRAM WILL BE PURCHASING A NEW VAN THIS UPCOMING YEAR.STRATEGY 1.4: SUPPORT AND EXPAND SERVICES THAT ASSIST DANIELS COUNTY SENIORS TO AGE IN PLACE.ACTIVITIES: CONTINUE TO PROVIDE SERVICES THAT ASSIST SENIORS TO AGE IN PLACE (I.E., VISITING NURSE, ADULT DAYCARE, LIFELINE, WHIRLPOOL, ETC.); CONTINUE TO PROVIDE ACCESS TO HEALTHY MEALS THROUGH MEALS ON WHEELS PROGRAM FOR SENIORS IN DANIELS COUNTY. OUR STAFF MEMBERS ALSO VOLUNTEER WITH THE STEPPING UP PROGRAM, SPONSORED THROUGH THE COUNTY PUBLIC HEALTH DEPARTMENT, THAT PROVIDES FALL PREVENTION CLASSES TO MEMBERS OF OUR COMMUNITY.GOAL 2: ENHANCE DANIELS MEMORIAL HEALTHCARE CENTER'S SUPPORT OF AND OUTREACH FOR HEALTH AND WELLNESS IN DANIELS COUNTY.STRATEGY 2.1: SUPPORT COMMUNITY PROGRAMS AND EVENTS THAT ENCOURAGE HEALTHY BEHAVIORS AND LIFESTYLES.ACTIVITIES: THIS LAST YEAR, OUR COMMUNITY RELATIONS MANAGER SPEARHEADED OUR FIRST ANNUAL COMMUNITY HEALTH FAIR AT OUR FACILITY. THE EVENT WAS WELL ATTENDED. THIS EVENT ALLOWED VARIOUS HEALTH FOCUS ORGANIZATIONS TO PARTICIPATE. THE COMMUNITY WAS ABLE TO TOUR THE HOSPITAL, VISITING EACH BOOTH LEARNING ABOUT THE DIFFERENT HEALTH SERVICES OUR FACILITY OFFERS, AS WELL AS THE COMMUNITY OFFERS. THEY WERE EVEN ABLE TO HAVE OUR LOCAL FIRE DEPARTMENT AND EMS CREW HAVE AN AMBULANCE AND A FIRE RESPONSE VEHICLE SO COMMUNITY MEMBERS COULD VIEW AND LEARN MORE ABOUT THEIR FIRST RESPONSE PROGRAMS. WE CONTINUE TO SUPPORT COMMUNITY HEALTH AND WELLNESS PROGRAMS AND EVENTS THAT PROMOTE HEALTHY BEHAVIORS, ACTIVITIES, AND SHARE HEALTH EDUCATION (SPONSOR TOWER HILL WALK AND GOLF TOURNAMENT, DMHC PRESENCE VIA AN ANNUAL FAIR BOOTH AND PROVIDE SPORTS PHYSICALS AT LOCAL SCHOOLS). GOAL 3: IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER.STRATEGY 3.1: EXPLORE OPPORTUNITIES TO ADVANCE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES.ACTIVITIES: EXPLORE EXPANDING THE UTILIZATION OF TELEHEALTH MENTAL HEALTH SERVICES (I.E., PSYCHIATRIC NURSE PRACTITIONER); REASSESS CURRENT COMMUNITY AND REGIONAL PARTNERS/RESOURCES THAT STRENGTHEN ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES.STRATEGY 3.2: CONTINUE SUPPORT OF CURRENT MENTAL AND BEHAVIORAL HEALTH EFFORTS IN DANIELS COUNTY.ACTIVITIES: DUE TO THE ORIGINATING MEMBERS IN THE COMMUNITY WHO SERVED ON THE DANIELS COUNTY MENTAL HEALTH ADVISORY COMMITTEE NO LONGER LIVING IN THE COUNTY, THIS LOCAL COMMITTEE CURRENTLY DOES NOT EXIST. THERE ARE PLANS TO REVITALIZE THIS COMMITTEE IN THE NEAR FUTURE.DMHC IS UNABLE TO ADDRESS THE FOLLOWING NEEDS AT THIS TIME: 1. 9.2% OF SURVEY RESPONDENTS INDICATED THEY HAD DIFFICULTY GETTING A PRESCRIPTION OR TAKING THEIR MEDICATION REGULARLY DUE TO COST IN THE LAST YEAR. IN PARTNERSHIP WITH SERVICE FAMILY PHARMACY, DANIELS MEMORIAL JOINED THE 340B PROGRAM AND ARE FINE TUNING THE DETAILS. THE 340B PROGRAM IS DESIGNED TO ASSIST IN MAKING PRESCRIPTIONS MORE AFFORDABLE FOR PATIENTS WHO ARE FINANCIALLY NEEDY. 2. 2.1% OF SURVEY RESPONDENTS WERE CONCERNED ABOUT NOT HAVING ENOUGH FOOD TO EAT IN THE LAST YEAR. DANIELS MEMORIAL HEALTHCARE CENTER PROVIDES MONETARY AND FOOD DONATIONS TO THE LOCAL FOOD PANTRY AS WELL AS REFERS COMMUNITY MEMBERS WHEN NECESSARY. PROVIDING A ROBUST STRATEGY TO ADDRESS FOOD INSECURITY IS CHALLENGING, HOWEVER DMHC IS IN PARTNERSHIP WITH THE CHAMBER OF COMMERCE AND DANIELS COUNTY PUBLIC HEALTH DEPARTMENT TO EXPLORE SOLUTIONS TO ADDRESS FOOD INSECURITY LOCALLY. |
| DANIELS MEMORIAL HEALTHCARE CENTER | PART V, SECTION B, LINE 24: PATIENT CARE WHICH IS NOT MEDICALLY NECESSARY INCLUDING ELECTIVE, COSMETIC, EXPERIMENTAL OR DEEMED TO BE GENERALLY NOT REIMBURSABLE BY TRADITIONAL INSURANCE CARRIERS AND GOVERNMENTAL PAYERS SHALL NOT BE CONSIDERED ELIGIBLE FOR CHARITY CARE. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ADMINISTRATOR CAN REVIEW ACCOUNTS ON A CASE-BY-CASE BASIS AND LOOK FOR INDICATION THAT THE FULL PAYMENT MAY CAUSE SOCIAL AND FINANCIAL HARDSHIP SO AS TO SIGNIFICANTLY HARM THE PATIENT OR THE FAMILY UNIT. |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO WAS CALCULATED USING WORKSHEET 2. ALL AMOUNTS ON LINE 7 WERE CALCULATED USING THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS. |
| PART III, LINE 2: | BAD DEBT EXPENSE IS THE THE BAD DEBT EXPENSE LESS BAD DEBT RECOVERY FROM THE INCOME STATEMENT. |
| PART III, LINE 4: | SEE NOTE 1 PATIENT ACCOUNTS RECEIVABLES AND CREDIT POLICY STARTING ON PAGE 14 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE COST TO CHARGE RATIO IS USED TO DETERMINE COMMUNITY BENEFIT. THIS IS DONE BY APPLYING THE RATIO TO THE TOTAL MEDICARE REVENUE. A SHORTFALL OR OVERAGE IN ANY GIVEN YEAR IS A RESULT OF THE TIMING OF PAYMENTS FROM MEDICARE ON AN INTERIM BASIS AND WHEN FINAL SETTLEMENT IS MADE. MANAGEMENT USES ESTIMATES TO CALCULATE SUCH SETTLEMENTS BUT ACTUAL RESULTS VARY FROM THOSE ESTIMATES. ADDITIONALLY, SHORTFALLS CAN RESULT FROM VARIOUS EXPENSES THAT ARE INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE. SINCE PART OF THE COSTS ARE NOT REIMBURSED IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. ALSO MEDICARE RECIPIENTS ARE PART OF A CHARITABLE CLASS AND SO THE PROVISION OF MEDICAL CARE FURTHERS THIS CHARITABLE CLASS. |
| PART III, LINE 9B: | NOTIFICATION ABOUT THE DMHC CHARITY AVAILABILITY FORM, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY DMHC BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS. INFORMATION SHALL ALSO BE INCLUDED ON THE FACILITY WEBSITES AND IN THE CONDITIONS OF ADMISSION FORM. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY DMHC. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE DMHC STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL WORKERS, SOCIAL WORKERS, ETC. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE FOR THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. |
| PART VI, LINE 2: | PRIMARILY DMHC WORKS CLOSELY WITH THE PUBLIC HEALTH DEPARTMENT AND LOCAL EMS, FIRE AND LAW ENFORCEMENT TO WORK TOGETHER TO ADDRESS ISSUES WITHIN THE COMMUNITY. |
| PART VI, LINE 3: | WE INFORM THE PUBLIC ABOUT PROGRAMS, I.E. MEDICARE/MEDICAID THROUGH ADVERTISEMENT IN PRINT AND RADIO, PAMPHLETS IN THE WAITING ROOM, AND SOCIAL SERVICE VISITS WITH PATIENTS. |
| PART VI, LINE 4: | WE ARE DESIGNATED A FRONTIER CAH. THE COUNTY HAS 1,690 PEOPLE. WE ARE FIVE HOURS AWAY FROM A TERTIARY HOSPITAL AND THREE HOURS AWAY FROM A SECONDARY HOSPITAL. |
| PART VI, LINE 5: | WE ARE GOVERNED BY A COMMUNITY BOARD REPRESENTING THE FULL SERVICES AREA. WE ALSO PARTICIPATE IN EASTERN MONTANA TELEMEDICINE AND ARE ABLE TO OFFER VISITS WITH MULTIPLE SPECIALTY PROVIDERS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREG CROWDER | ||||||||||||||
| NP | $185,895 | $0 | $3,225 | $0 | $0 | $0 | $0 | $0 | $35,622 | $0 | $224,742 | $0 | $0 | $0 |
| DEANNA FERESTAD | ||||||||||||||
| NP | $143,814 | $0 | $3,725 | $0 | $0 | $0 | $0 | $0 | $37,730 | $0 | $185,269 | $0 | $0 | $0 |
| SHIRLEY RELLER | ||||||||||||||
| PT | $139,554 | $0 | $225 | $0 | $0 | $0 | $0 | $0 | $35,241 | $0 | $175,020 | $0 | $0 | $0 |
| SHERRY GAIRRETT | ||||||||||||||
| NP | $130,591 | $0 | $150 | $0 | $0 | $0 | $0 | $0 | $29,690 | $0 | $160,431 | $0 | $0 | $0 |
| JESSICA WINGE-PETERSON | ||||||||||||||
| DON | $134,966 | $0 | $225 | $0 | $0 | $0 | $0 | $0 | $15,181 | $0 | $150,372 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOSPITAL HAS A MANAGEMENT AGREEMENT WITH BILLINGS CLINIC. THEY PROVIDE MANAGEMENT, IT, AND ACCOUNTING SERVICES. THE ORGANIZATION'S CURRENT CEO, KODY BRINTON, IS AN EMPLOYEE OF BILLINGS CLINIC AND COMPENSATION FOR SERVICES PROVIDED TO THE HOSPITAL INCLUDE THE FOLLOWING: BASE SALARY - $123,061 EMPLOYER CONTRIBUTION TO MEDICAL AND DENTAL - $21,333 EMPLOYER CONTRIBUTION TO LIFE INSURANCE AND LONG-TERM DISABILITY - $481 |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OF THE CORPORATION SHALL BE 18 YEARS OF AGE AND COMPOSED OF THE TAXPAYERS OF DANIELS COUNTY AND/OR PERSONS WHO SHALL HAVE CONTRIBUTED TO OR PATRONIZED THE DANIELS MEMORIAL HOSPITAL ASSOCIATION BY THE TIME OF THE CORPORATION'S ANNUAL MEETING. THIS IS THE ONLY CLASS OF MEMBERSHIP. |
| FORM 990, PART VI, SECTION A, LINE 7A | NINE OF THE TEN DIRECTORS OF THE ORGANIZATION SHALL BE ELECTED BY THE MEMBERS OF THE CORPORATION AT THE ANNUAL MEETING. THE 10TH POSITION IS THE REPRESENTATIVE FROM THE HOSPITAL DISTRICT. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS AVAILABLE FOR REVIEW BY THE BOARD AFTER APPROVAL BY THE CEO. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND SIGNED BY ALL TRUSTEES AND THE CEO ANNUALLY. THE BOARD AND THE CEO MONITOR THE STATUS OF ALL TRUSTEES THROUGHOUT THE YEAR FOR CHANGES THAT COULD LEAD TO A NEW SITUATION REQUIRING DISCLOSURE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF TRUSTEES REVIEWS AND MAKES DECISIONS ON THE COMPENSATION PACKAGE FOR THE CEO. THE CEO COMPENSATION IS PART OF THE MANAGEMENT CONTRACT PAID TO THE OUTSIDE MANAGEMENT COMPANY. ALL MANAGERS REPORT TO THE CEO AND THE CEO REVIEWS AND MAKES DECISIONS ON THE MANAGER'S COMPENSATION. BOARD OFFICERS ARE NOT COMPENSATED. THE CEO REVIEWS MHA WAGE SURVEY INFORMATION AS WELL AS INTERNAL EQUITY TO DETERMINE COMPENSATION OF KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST STATEMENTS AND THE FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 560. MANAGEMENT AND GENERAL EXPENSES 89,050. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 89,610. CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 1,377,063. MANAGEMENT AND GENERAL EXPENSES 2,376,058. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,753,121. |
| FORM 990, PART XII, LINE 2C: | THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIELS MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 105 5TH AVE | AddressLine1Txt |
| City | SCOBEY | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59263 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363461891 | EIN |
| Primary Activities | COMMUNITY HEALTHCARE SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12D, III-O | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |