FALLON MEDICAL COMPLEX INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- FALLON MEDICAL COMPLEX INC (EIN 36-3808993)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-04-29
- IRS object ID
- 202421209349302017
- 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 H
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-04-29T17:12:37-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | 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 | 363808993 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fallon Medical Complex Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FALL | BusinessNameControlTxt |
| Phone | 4067783331 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 820 | AddressLine1Txt |
| City | Baker | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59313 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David Espeland | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4067783331 | PhoneNum |
| Signature | 2024-04-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | David | PersonFirstNm |
| Person Last | Espeland | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | 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 | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2024-04-26 | 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 | See Schedule O | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David Espeland | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 820 | AddressLine1Txt |
| City | Baker | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59313 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,552,803 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.fallonmedical.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | Providing healthcare services | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 115 | TotalEmployeeCnt |
| Total Volunteers | 51 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $293,091 | PYContributionsGrantsAmt |
| CY Contributions Grants | $404,763 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,482,504 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,084,582 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$9,088 | PYInvestmentIncomeAmt |
| CY Investment Income | $31,778 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,016 | PYOtherRevenueAmt |
| CY Other Revenue | $2,681 | CYOtherRevenueAmt |
| PY Total Revenue | $11,768,523 | PYTotalRevenueAmt |
| CY Total Revenue | $10,523,804 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $40,630 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $59,617 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,985,867 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,877,869 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,222,151 | PYOtherExpensesAmt |
| CY Other Expenses | $7,373,480 | CYOtherExpensesAmt |
| PY Total Expenses | $11,248,648 | PYTotalExpensesAmt |
| CY Total Expenses | $12,310,966 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $519,875 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,787,162 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $24,617,884 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,940,603 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,008,474 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $962,346 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,609,410 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,978,257 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Fallon Medical Complex, in its innovative pursuit of Friends Healing Friends, provides comfort, compassion, and excellence in the promotion of quality of life to all individuals. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,464,691 | ExpenseAmt |
| Grant | $59,617 | GrantAmt |
| Revenue | $9,139,754 | RevenueAmt |
| Desc | Fallon Medical Complex (FMC) provides quality health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation of FMC, it is recognized that not all individuals possess the ability to purchase these essential services. It is FMC's mission to serve the surrounding area by providing health care services to all community members.FMC provides medical services to individuals who are determined unable to purchase such services through FMC's Financial Assistance policy and guidelines. In addition to free and/or subsidized care, services are also provided at below cost rates to persons covered by government programs. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. The unreimbursed value of providing care to these patients, based on established rates is $14,000 for the year ended June 30, 2023. FMC's Critical Access Hospital provides 24 hour x 7 days a week Emergency Room services, observation, Acute Care, Swing Bed services and onsite ancillary lab and diagnostic imaging services. During fiscal year ended June 30, 2023, FMC provided over 175 days of hospital services, 5,597 days of swing bed care, 889 ER visits, and over 8,088 outpatient visits. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,132,759 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $944,828 | RevenueAmt |
| Desc | FMC Community Clinic (Rural Health Clinic) operates under the same mission as FMC by providing family health care to over 4,925 patient visits per year. The three providers (one physician and two mid-levels) also provide ER coverage 24 hours, 7 days a week. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $18,007 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | One of FMC's operating philosophies states that education programs are necessary to enhance the competence of personnel in the healthcare system as well as to assist in the attainment of both personal and organizational goals. To this end, not only does the organization routinely budget $30,000 or more in continuing education for its employees, it also provides job shadowing to area students (typically 3-5 students per year) who may be interested in a healthcare career, in addition to offering routine Certified Nursing Assistant training programs (to about 5-10 prospective aides per year).FMC also hosts numerous college students seeking careers as doctors, physician assistants, and various other disciplines, such as nursing, radiology, laboratory technology, and physical therapy. FMC further believes that it is its responsibility to take a leadership role in informing the public about healthcare subjects of relevance or interest through community education. This objective is supported through a number of channels, which includes routine "Lunch and Learn" sessions provided by medical professionals (about 6 times per year), weekly public service announcements on the local radio station, and an annual health fair which is attended by people from all over the service area. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,615,457 | 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 | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 115 | 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 | 0 | QuidProQuoContributionsInd |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 | 0 | 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 | Marjorie Losing | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4067785303 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 820 | AddressLine1Txt |
| City | Baker | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 593130820 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Betty Mueller | ||||||||
| President (Jul-Dec)/Trusee (Jan-Feb) | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Doug Varner | ||||||||
| V.P.(Jul-Dec)/President starting Jan | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Curt Arnell | ||||||||
| Trustee (Jul-Dec)/V.P. starting Jan | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Richard Menger | ||||||||
| Secretary (Jul-Dec) | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Evelyn Neary | ||||||||
| Secretary starting January | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Bryant Steen | ||||||||
| Trustee (Jul-Dec) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Erin Lutts | ||||||||
| Trustee starting June | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| David Kirschten | ||||||||
| Trustee starting January | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Elaine Stanhope | ||||||||
| Trustee staring September | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Alice Kay Schweigert | ||||||||
| Trustee | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| David Espeland | ||||||||
| Chief Executive Officer | 40.00 | 0.00 | Yes (X) | $164,884 | $0 | $29,990 | ||
| Marjorie Losing | ||||||||
| Chief Financial Officer | 40.00 | 0.00 | Yes (X) | $96,283 | $0 | $27,369 | ||
| Deb Wiman | ||||||||
| RN | 40.00 | 0.00 | $108,317 | $0 | $18,097 | Yes (X) | ||
| Eldon King | ||||||||
| ADON | 40.00 | 0.00 | $100,876 | $0 | $11,570 | Yes (X) | ||
| Caleb Bettenhausen PA-C | ||||||||
| PA-C | 40.00 | 0.00 | $122,701 | $0 | $1,841 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $593,061 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $88,867 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | 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 |
|---|---|---|---|---|---|
| Rural Medical Partners | |||||
| 4956 Curran Court | Grand Forks | ND | 58201 | Locum Physicians | $737,626 |
| Priorcare Staffing Solutions | |||||
| 4755 E Colorado Blvd | Spearfish | SD | 57783 | Contract Nursing | $245,223 |
| Medical Solutions LLC | |||||
| PO Box 310737 | Des Moines | IA | 50331 | Contracted Nursing and Xray | $238,329 |
| MT Health Network | |||||
| 111 S 7th St Ste 241 | Miles City | MT | 59301 | Contracted Nursing and Xray | $223,129 |
| Wilderness Medical Staffing | |||||
| 1124 W Riverside Ave | Spokane | WA | 99223 | Locum Midlevels | $212,726 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $236,067 | GovernmentGrantsAmt |
| All Other Contributions | $168,696 | AllOtherContributionsAmt |
| Noncash Contributions | $45,405 | NoncashContributionsAmt |
| Total Contributions | $404,763 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Service Revenue | 621110 | $9,568,030 | $9,568,030 |
| County Subsidy | 900099 | $419,496 | $419,496 |
| Meals on Wheels | 900099 | $71,924 | $71,924 |
| Cafeteria | 722514 | $23,252 | $23,252 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,880 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,880 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,084,582 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,778 | TotalRevenueColumnAmt |
| Exclusion | $31,778 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $31,680 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,999 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,681 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,681 | TotalRevenueColumnAmt |
| Exclusion | $2,681 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,523,804 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,084,582 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $34,459 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,617 | TotalAmt |
| Program Services | $59,617 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,120 | TotalAmt |
| Management And General | $332,120 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,287 | TotalAmt |
| Program Services | $10,287 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,620,154 | TotalAmt |
| Program Services | $3,067,914 | ProgramServicesAmt |
| Management And General | $552,240 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,427 | TotalAmt |
| Program Services | $83,003 | ProgramServicesAmt |
| Management And General | $8,424 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $533,865 | TotalAmt |
| Program Services | $447,920 | ProgramServicesAmt |
| Management And General | $85,945 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,016 | TotalAmt |
| Program Services | $233,044 | ProgramServicesAmt |
| Management And General | $56,972 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,270 | TotalAmt |
| Management And General | $5,270 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,060,811 | TotalAmt |
| Program Services | $3,772,590 | ProgramServicesAmt |
| Management And General | $288,221 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,586 | TotalAmt |
| Program Services | $11,070 | ProgramServicesAmt |
| Management And General | $15,516 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,729 | TotalAmt |
| Program Services | $419,495 | ProgramServicesAmt |
| Management And General | $68,234 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,210 | TotalAmt |
| Program Services | $173,210 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,486 | TotalAmt |
| Program Services | $108,486 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,462 | TotalAmt |
| Program Services | $14,462 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,845 | TotalAmt |
| Program Services | $8,845 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $962,232 | TotalAmt |
| Program Services | $810,815 | ProgramServicesAmt |
| Management And General | $151,417 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,981 | TotalAmt |
| Program Services | $191,981 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $577,624 | $577,624 | |
| Repairs and Maintenance | $519,955 | $415,707 | $104,248 |
| Food | $132,788 | $132,788 | |
| Bed Taxes | $58,674 | $58,674 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,827 | TotalAmt |
| Program Services | $17,925 | ProgramServicesAmt |
| Management And General | $26,902 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,310,966 | TotalAmt |
| Program Services | $10,615,457 | ProgramServicesAmt |
| Management And General | $1,695,509 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,463,534 | BOYAmt |
| EOY | $7,203,725 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,279,069 | BOYAmt |
| EOY | $3,008,839 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,345 | BOYAmt |
| EOY | $215,054 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,399 | BOYAmt |
| EOY | $198,435 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,573,175 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,598,506 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,830,268 | BOYAmt |
| EOY | $6,974,669 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,438 | BOYAmt |
| EOY | $1,853,689 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,660,831 | BOYAmt |
| EOY | $1,759,375 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $726,817 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,617,884 | BOYAmt |
| EOY | $21,940,603 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $868,597 | BOYAmt |
| EOY | $615,132 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,842 | BOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,595 | BOYAmt |
| EOY | $7,176 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,440 | BOYAmt |
| EOY | $331,459 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $440,000 | BOYAmt |
| EOY | $8,579 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,008,474 | BOYAmt |
| EOY | $962,346 | 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 | $22,173,977 | BOYAmt |
| EOY | $20,522,602 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $435,433 | BOYAmt |
| EOY | $455,655 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,609,410 | BOYAmt |
| EOY | $20,978,257 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,617,884 | BOYAmt |
| EOY | $21,940,603 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,787,162 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $51,905 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $104,104 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $260,014 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $781 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $260,795 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $259,707 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $307 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $260,014 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $258,575 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,132 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $259,707 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $255,821 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,754 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $258,575 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $244,418 | BeginningYearBalanceAmt |
| Contributions | $10,000 | ContributionsAmt |
| Investment Earnings Or Losses | $1,403 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $255,821 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.16120 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.74020 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.09860 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $96,522 | OtherCostOrOtherBasisAmt |
| Book Value | $96,522 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,164,774 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,505,220 | DepreciationAmt |
| Book Value | $5,659,554 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,888,095 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,843,121 | DepreciationAmt |
| Book Value | $1,044,974 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $423,784 | OtherCostOrOtherBasisAmt |
| Depreciation | $250,165 | DepreciationAmt |
| Book Value | $173,619 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,974,669 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Investment in Foundation | $1,631,560 | F |
| Investment in Cooperative | $127,815 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $1,759,375 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Opearting Lease Liability | Desc |
| Amt | $8,579 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,579 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,703,542 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $51,905 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $104,104 | OtherRevenueAmt |
| Revenue Not Reported | $156,009 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,547,533 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $5,270 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | -$28,999 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$23,729 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,523,804 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,334,695 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $28,999 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $28,999 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,305,696 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $5,270 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $5,270 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,310,966 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | The organization acts as a custodian for the funds of some nursing home residents and for the auxiliary. |
| Part V, Line 4: | Friends of FMC Foundation, Inc. holds the permanently restricted funds to provide a source of income to be used for Long Term Care, and/or equipment purchases on behalf of Fallon Medical Complex, and for scholarships. The principal has been invested and the generated income (temporarily restricted) is used for said purpose. |
| Part X, Line 2: | The Hospital believes 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 Hospital 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. |
| Part XI, Line 2d - Other Adjustments: | Equity in Earnings of Affiliate recorded in revenue for financial statements 104,104. |
| Part XI, Line 4b - Other Adjustments: | Rental Expenses recorded in revenue for Form 990 -28,999. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses recorded in revenue for Form 990 28,999. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,705,446 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,259,202 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $446,244 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03620 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,371 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,178 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,193 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,734,817 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,267,380 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $467,437 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03790 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $99,226 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,860 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $59,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00480 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,899,260 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,630,873 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,268,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10300 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $837 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,999,323 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,670,733 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,328,590 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10790 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,734,140 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,938,113 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,796,027 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14580 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,193 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,193 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $996 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $996 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $165,880 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $71,924 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $93,956 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00760 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,168 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,168 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $170,237 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $71,924 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $98,313 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00800 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $466,506 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $59,713 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,765,025 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,796,619 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$31,594 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | Fallon Medical Complex Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 202 South 4th Street West | AddressLine1Txt |
| City | Baker | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59313 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.fallonmedical.org | WebsiteAddressTxt |
| State License | 13128 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Outpatient Clinic - RHC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fallon Medical Complex Inc | 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 |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| 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 | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.fallonmedical.org/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://www.fallonmedical.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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.fallonmedical.org/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.fallonmedical.org/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.fallonmedical.org/financial-assistance | 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 Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Fallon Medical Complex, Inc. | Part V, Section B, Line 5: During the Community Health Needs Assessment process, Fallon Medical Complex conducted a third-party random survey of 600 people in our service area, in addition to two focus group meetings that were open to the public, and three key-informant interviews. All activities were conducted from February 2022 through May 2022 with guidance and assistance from the State Office of Rural Health (SORH). Steering committee participants were selected based on their familiarity with social conditions and healthcare needs in the community, including those who work with young children, behavioral health issues, seniors, patients with disabilities and those who are recovering from surgeries, home bound patients and those with occupational therapy needs. The steering community members were local community advocates, Fallon County Health Department personnel, and FMC personnel, including a social worker. The SORH provided demographic information and expertise regarding low-income and minority populations, as well as a compilation and an interpretation of the data derived from all of the sources. |
| Fallon Medical Complex, Inc. | Part V, Section B, Line 7d: Available in FMC's Quality Improvement Department |
| Fallon Medical Complex, Inc. | Part V, Section B, Line 11: Our Board of Trustees passed a resolution on September 7, 2022 to approve our most recent Implementation Plan, based on collective needs identified on our CHNA plan, which was completed June 29, 2022. This plan identified three goals, to be supported with a number of strategic initiatives:Goal #1: Enhance behavioral health services (mental/behavioral/SUD) in the Fallon Medical Complex service area by fostering the development and coordination of behavioral health resources.Enhance behavioral health services (mental/behavioral/SUD) in the Fallon Medical Complex service area: This is an ongoing goal from our previous Implementation Plan, wherein we are continuing to foster the development and coordination of behavioral health assistance and resources. We have sustained participation in an established integrated behavioral health grant through the Montana Health Network (MHN). Our Clinic Manager has been attending monthly steering committee meetings and leading our internal program. We are actively using our screening and intake forms to determine which patients may benefit from a visit with a behavior health specialist. MHN recently announced that they have received a second grant to find solutions for access to specialists, of which we will be a part. We are consistently looking for cost-effective training opportunities that may enhance our IBH program, and partner with other entities that may have solutions that are beneficial to our patients. For example, we agreed to support an online tool called "Credible Minds" that is offered by the county to its residents. This app allows an individual to explore behavior health topics, do self-assessments, and seek out assistance from various sources. We have not been able to research Charlie Health yet and determine how it might be of benefit to address youth crises services. We have, however, continued to provide and promote medication and needle disposal at our facility to the community.Goal #2: Improve access to health care services and the continuity of care through Fallon Medical Complex by enhancing access to primary care services and enhancing education and outreach related to available local services.Improve access to health care services and the continuity of care through Fallon Medical Complex: We have continued to partner with Intermountain Holy Rosary Healthcare to offer a regular OB/GYN outreach clinic at our facility. We also added a Podiatry outreach clinic in cooperation with Sidney Health Center, and an Orthopedic outreach clinic in cooperation with Glendive Medical Center. We have continued to seek out opportunities to expand both onsite and telemedicine specialty services. This includes maintaining and expanding our list of specialists available from Billings Clinic, as well as frequently using Avel's eEmergency and ePharmacy telemedicine systems in our hospital. We are still implementing an upgrade in our Electronic Health Record (EHR) which has proven to be challenging. We are hoping to leverage functionality within that program to develop protocols for patient appointment reminders and follow-up clinic appointments, but we are not quite there yet. We do call all patients after discharge from our Emergency Department to check on their recovery and to look for opportunities to offer enhanced care coordination. We discontinued the pursuit of offering Platelet Rich Plasma (PRP) injections, since the provider who had an interest in developing this service is no longer working for us. We take every opportunity to direct patients toward the use of telemedicine, where it makes sense. Referrals largely come from the providers on the other end, although we do put a plug in for the service when the opportunity presents itself. Billings Clinic recently upgraded their telemedicine equipment, condensing it into a smaller cabinet, so we were able to place it in one of our clinic exam rooms. It is more accessible by patients who may want a more expedient specialty visit following their primary care appointment in our clinic. And it is far closer to our check-in counter and clinic nurses, who typically accompany the patients during their visits. Our "We are Fallon Medical Complex" campaign has languished a bit on Facebook, so we are planning to roll out a new campaign called, "Do you know" to increase outreach and awareness of local providers and resources. Our third-party vendor has maintained and enhanced our redesigned website to continue making it user-friendly and patient-focused. One employee is our liaison with the website developer, constantly feeding them content and making sure that everything is up to date. We have been reluctant to actively promote our occupational and physical therapy services, since they have traditionally had a backlog of patients. One of our PT's has been trained in the use of "dry needling and is beginning to ramp up that service. In addition, our OT has built a strong practice in pediatrics. Both of these services are building their patient base largely via word of mouth, but they could benefit from the development of a local awareness plan.Goal #3: Support chronic disease prevention and management efforts throughout Fallon Medical Complex's service area by sustaining chronic disease prevention and management outreach through FMC.Support chronic disease prevention and management efforts throughout Fallon Medical Complex's service area: We have continued participation in the Chronic Care Management (CCM) HRSA grant offered by the Montana Health Network (MHN). As the grant winds down, we have agreed to continue participating in the program by purchasing services from MHN. We have not been a part of implementing Community Health Workers to assist with patient management, since there are duplicative services offered in our community. Furthermore, we continue to offer Lunch & Learns on relevant topics, most recently "the anti-inflammatory approach to heart health and other chronic conditions" by our dietician. We continue to offer outreach materials for patient distribution on chronic care management as developed by the MHN HRSA grant, and we are beginning to explore the development of video clips that endorse the service and provide patient testimonials. Our primary annual community wellness program is offered through a collaboration with Intermountain Holy Rosary Healthcare, called "Healthy Lifestyles." They also provide a dietician to support our dietary department, who is also available to individually consult with patients upon request or referral. We offer wellness programs for our employees, but have not been able to develop a community-wide event, such as a 5k run, yet. We hoping to do something along that line in collaboration with our foundation.FMC chose not to address the following needs identified during the CHNA process:1) 10.6% of survey respondents indicated they had difficulty getting a prescription or taking their medication regularly due to cost in the last year. We do not own a retail pharmacy or have an ownership interest in the local store, so it cannot set rates or provide medications under our financial assistance program. Nevertheless, we can recommend qualified patients for significantly discounted medications in collaboration with Baker Rexall Drug through the federal HRSA 340(b) program. This government program requires drug manufacturers to provide outpatient drugs to eligible patients at significantly reduced prices. We act as a gatekeeper for access to the program which is based on a patient's financial ability to pay for healthcare services. While this program provides financial assistance with many routine medications, drug manufacturers can choose which ones they are willing to offer to program participants. For this reason, not all prescriptions are offered at discount prices.2) Focus group and key informant interview participants shared challenges among community members in accessing resources such as Medicaid and Supplemental Nutrition Assistance Program (SNAP) benefits. We do provide assistance in helping our long-term care residents pull together the information they need to qualify for Medicaid in an institutional setting. However, we do not have staff trained, and certified by the state, to provide assistance to people seeking community Medicaid or SNAP benefits. Those types of workers are required to be state employees. Fallon County Council on Aging assists seniors with Medicare, including Part D, and Social Security. Our county hosted a public assistance office for many years, but the State of Montana consolidated offices to save money, shutting down our local office. |
| Fallon Medical Complex, Inc. | Part V, Section B, Line 13h: All applicants are required to pursue alternative sources of payment, such as government health care benefit programs, and provide proof of being ineligible for any assistance. |
| Fallon Medical Complex, Inc. | Part V, Section B, Line 16j: FMC provides a summary of the financial assistance policy to patients upon admission. FMC also attaches a summary of the policy to billing invoices and posts a plain language summary in the facility's emergency and waiting rooms, admissions offices, public health, courthouse, and senior citizen center. |
| Fallon Medical Complex, Inc. | Part V, Section B, Line 20e: Offered an appeals process with respect to FAP determinations. |
| Fallon Medical Complex, Inc. | Part V, Section B, Line 24: Services excluded under the FAP include cosmetic procedures, DOT/ICC/FAA physical exams, marijuana eligibility exams, and any FMC Long Term or Intermediate Swing Bed care. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Community Clinic | ||||
| 202 South 4th Street West | Baker | MT | 59313 | Outpatient Clinic - RHC |
| 2 - Wibaux Clinic | ||||
| 710 Drake Street | Wibaux | MT | 59353 | Outpatient Clinic |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | We do not include an asset test to determine eligibility for applicants who have family income up to 200% of FPG; those with family income that exceeds 200% of FPG but not more than 250% may be asked to complete a net asset test. All applicants are required to pursue alternative sources of payment, such as government health care benefit programs, and provide proof of being ineligible for any other assistance.Anyone at or below 150% qualifies for free care. Anyone with family income above 150% and below 200% qualifies for a discount of 50% of their account balance. Those with family income that exceeds 200% of FPG but not more than 250% are eligible to receive a discount of 15%. |
| Part I, Line 7: | Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Cost of other means tested government programs, community health improvement services and community benefit operations, and cash and in-kind contributions to community groups are based on costs recorded in the general ledger and estimated costs. Medicaid and Subsidized health services are determined based on costing methods used to prepare the cost report. |
| Part II, Community Building Activities: | FMC participates in community building activities to improve our community. Our Foundation Coordinator has been a member of the local housing board, searching for ways to address our community's chronic housing shortage by facilitating the construction of new housing and the renovation of existing housing. She is also actively involved with a local group that is working to develop a community daycare facility.From an economic development standpoint, our Foundation Director has also been a board member of our local Southeastern Montana Revitalization Team which is dedicated to revitalizing the economic climate in the area. They are focused on building community infrastructure, as well as attracting new businesses and finding ways to provide housing for incoming workers and their families. In addition, in an effort to help keep local commerce alive, our Foundation Coordinator actively participates in Baker Chamber of Commerce meetings and events, including hosting their monthly meeting on a rotating basis. One of the Chamber's primary events, the Fall Festival, is coordinated by FMC staff, who also participate in the Chili Cook-off event every year.To further support the community, a number of FMC employees frequently participate in disaster preparedness meetings and events through the Fallon County Local Emergency Preparedness Committee (LEPC). This group meets regularly to discuss disaster preparedness activities, to review the response of similar groups to disasters across the nation, to determine ways to enhance the effectiveness of disaster response in our area and to conduct table top exercises that simulate potential local disasters. We have also dedicated staff time and resources to acquiring knowledge in the Hospital Emergency Incident Command System (HEICS), a nationally recognized and practice program in incident management.In an effort to assist with leadership development, a number of staff members routinely provide assistance with youth leadership programs. For instance, one of our Physical Therapists has acted as a 4H leader for a number of years, participating in youth developmental programs that provide hands-on learning activities to youth. In addition, our CEO, and other employees, provide judging for our local Business Professionals of America (BPA) chapter, which teaches basic and advanced business skills to high school students. Our CEO, and other employees, have also acted as judges for local Speech and Drama events, which helps high school students gain valuable skills in public speaking and performing.FMC participates in coalition building by contributing to collaborative efforts that address health and safety issues, including LEPC and HEICS mentioned earlier, with other healthcare entities and emergency service providers. To further provide continuity across our service area, our Chief of the Medical Staff is the County Health Officer and County Ambulance Medical Director, routinely attending their meeting and providing medical control and guidance on relevant issues.One of our larger efforts to assist with community health improvement is to take an active role in offering, serving and significantly subsidizing noon meals to seniors. FMC collaborates with our local Council on Aging to serve 2,884 meals each year to seniors in our facility dining room as well as an additional 3,061 meals through Meals on Wheels. This program promotes health and well-being of our seniors by providing nutritious meals to those who might otherwise not receive them, especially those who are home bound.FMC's workforce development support is largely focused on healthcare careers. We annually work with the local school system to offer "Medical Explorers," which allows students to ask medical professionals questions about their job and learn about the myriad of healthcare careers. Some years we are able to secure a patient simulator to give students a real-life experience. Additionally, we allow students of all levels to request an opportunity to job shadow a healthcare professional. In the past, students have observed lab techs, radiology techs, physical and occupational therapists, nurses, doctors and mid-levels in their daily activities of providing care for patients. Our CEO and Foundation Director serve on two Montana healthcare-related scholarship committees. Their participation on these committees promotes healthcare-related careers by helping to fund college educations. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. |
| Part III, Line 3: | The estimated amount of implicit price concessions attributable to patients eligible under the organization's charity care policy is 12.8% (based upon US Census Bureau Quickfacts for percent of citizens below the poverty level in Fallon County). Fallon Medical Complex is estimating the amount of implicit price concessions to be charity care based on the percentage of demographics below charity care income/asset levels. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on pages 13-14 of the attached audited financial statements. |
| 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 Centers for Medicare and Medicaid Services.All of the Medicare shortfall should be treated as a community benefit. The Organization treats individuals regardless of the ability to pay. It is a community benefit to be able to treat all individuals at the local hospital and clinic. |
| Part III, Line 9b: | Once a patient has been determined by FMC to be eligible for financial assistance, that patient shall not receive any future bills based upon undiscounted gross charges on approved account balances. Requests for financial assistance shall be processed promptly. FMC shall notify the patient in writing within 30 days of receipt of a completed application. Collection activity will be suspended while a financial assistance application is under review. Normal collection efforts will resume if the application is not returned in a timely fashion or after the write-off is complete and the patient owes a balance. |
| Part VI, Line 2: | We have traditionally received input about unmet community health care needs from a number of sources: a) citizens, board members, patients, and residents expressing an idea or a concern, b) suggestions from consultants who were hired to provide a study of our operations, c) the county or state health department providing observations or data regarding the health status of our specific population, d) staff members gleaning information from an education program or from reviewing professional journals and periodicals regarding the latest equipment or trends in patient and resident care, e) suggestions from the public posted on our website, etc. We have completed a formal Community Health Services Development assessment through Montana State University, the result of which is available on our website, www.fallonmedical.org. Subsequent to the CHNA, we developed a 3 year implementation plan to address the most important health needs in our community. This plan is also published on our website. Information from all of these sources is analyzed on a case by case basis by the department manager who would be responsible for implementing the program. The manager determines the program's merit relative to our stated mission as well as what resources would be necessary to implement the program. The manager submits the analysis to our internal Operational Review Committee, which looks at its impact facility-wide and its feasibility. If it progresses past this committee, it is then evaluated by our management team, who analyzes the finer details. Ultimately, it is discussed at the Board of Trustees level to seek their input and approval, if necessary. |
| Part VI, Line 3: | We notify our patients of our financial assistance program through a number of methods; (1) we post the charity care policy, or a summary thereof, and financial assistance contact information in admissions areas, emergency rooms, facility website, other areas of our facility in which eligible patients are likely to be present, public health department, senior citizen center and courthouse; (2) we make available a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process; (3) we provide a copy of the policy, or a summary thereof, and financial assistance contact information to patients with discharge materials; (4) we include the policy, or a summary thereof, along with financial assistance contact information, in patient bills; and/or (5) we discuss with the patient the availability of various government benefits, such as Medicaid or state programs, and assist the patient with qualification for such programs, where applicable. |
| Part VI, Line 4: | Fallon Medical Complex (FMC) is a sole community health care provider for a rural population in excess of 7,200 people spread over seven counties. In addition to serving Fallon County, located in southeastern Montana, FMC also provides health care for three bordering Montana counties (Carter, Wibaux, and part of Custer) and three adjacent North Dakota counties (Slope, Golden Valley, and part of Bowman). Considered "frontier" by the Montana Department of Public Health and Human Services, this region boasts less than two residents per square mile. FMC operates a Critical Access Hospital, a Rural Health Clinic, and a home care and personal care services agency.Although Carter County operates a Critical Access Hospital and a Rural Health Clinic in Ekalaka, MT (35 miles to the south), facilities offering the next highest level of care are over 80 miles from Baker, necessitating a drive of nearly two hours in inclement weather. Two mid-levels (physician assistants and/or family nurse practitioners) practice full time in Baker and see patients one day a week in our satellite clinic in Wibaux, MT. FMC also utilizes three primary care locum physicians to work in the clinic and see patients in our Emergency Room. We also employ one part-time DO who provides DOT and FAA physicals. These physicians supervise mid-level providers at FMC. All in all, the DHHS Bureau of Primary Health Care has designated FMC's service area as a Health Professional Shortage Area (HPSA) due to: a) a high population-to-physician ratio (greater than 3,500:1), b) the extreme remoteness of this facility, c) sparseness of our service area, and d) excessive distances to alternative providers.The majority of patients in FMC's service area are Caucasian (95%), with a median age of 35.1, and have graduated from high school (96.5%). The median income is $61,855 per year (compared to $66,341 for all of Montana), the median household income is $83,750 (compared to $72,980) and the unemployment rate is 1.4% (compared to 3.0%). About 12.8% of the population is below the Federal Poverty Level (compared to the national average of 12.6%) and roughly 8.2% of the population does not have health insurance. Of those with health insurance, 12.1% are covered by Medicare, 16.5% are covered by Medicaid, and 50.9% are covered by their employer. In all, according to a Robert Wood Johnson Foundation study, Fallon County is ranked 10 out of 47 (1 is best) for "health factors," based on health behaviors, clinical care, social and economic factors, and physical environment.FMC's service area economy is largely based on oil and gas exploration and extraction, as well as construction services that accompany that industry. Many residents are employed by large energy exploration and drilling companies or smaller energy-related service companies. The other major contributor is agriculture. Wheat and barley are major farm crops and cattle and sheep dominate the local livestock production. The area has been delving into the alternative energy arena with wind farms and solar farms cropping up across the wind-swept prairie. |
| Part VI, Line 5: | All members of the FMC Board of Trustees reside in our primary service area and are not employees or contractors of FMC. None have family members who are employed by FMC. They are not compensated for their participation on the board and must be interested in, and willing to work towards, the best interests of healthcare in our service area. The board strives to find trustee candidates from all corners of FMC's service area, as well as do their best to embrace diversity in gender and occupations. The Board is comprised of individuals who work as educators, ranchers, small business employees or owners, retirees, and oil company managers.One of the board's responsibilities is to maintain and oversee FMC's Medical Staff. As such, they are responsible for granting privileges to qualified physicians and mid-level providers based on education and skills confirmed through a structured credentialing process. The board extends medical staff privileges to all qualified providers that have an interest in providing services to our patients and who complete our formal application process. This process includes conducting due diligence through background checks, verification of education and credentials, and personal and professional reference checks. Providers may offer their services directly in our community or remotely via telemedicine systems.Given the isolated rural location of FMC as well as its limited-service area population, the facility typically does not generate surplus funds from operations. A delicate balance exists between forecasting an anticipated revenue stream and attempting to match up operational expenses. Given that no revenue is guaranteed, adjustments must be made throughout each fiscal year to ensure the facility's ongoing solvency. Accordingly, FMC has not realized a net profit from operations for over 30 years. Most "surplus" funds are derived from gifts, grants, and fundraising efforts, all of which are generally focused on acquiring capital for the acquisition of patient care equipment. Some of these purchases are meant to upgrade equipment that has reached the end of its useful life cycle, in which case we strive to leverage design or technology improvements to provide greater comfort and effectiveness for the benefit of our patients. And in some cases, we use the funding to start a new service which was identified through our various needs assessments.FMC is predominantly a sole community "primary care" provider for its service area. Its system, or complex, of health care services was created out of necessity due to its remoteness. FMC lacks the resources and service area population to offer specialized medical services and/or conduct formal medical education and medical research. For the most part, we have striven to incrementally improve and enhance our core service offerings in an effort to increase the overall health status of our patients and residents. Accordingly, we strive to excel at primary care, offering family practice and preventative health outpatient services, routine hospital and fully digital diagnostic services, 24-hour emergency care (available to all regardless of ability to pay), long-term care, home-based skilled and personal care, and physical and occupational therapy. Our ER includes a telemedicine connection to the Avel eCare network which offers on-demand board certified physicians on call 24-hours a day and pharmacy consultation services.In an effort to provide comprehensive medical care to the community, various providers from neighboring communities routinely offer services to patients at FMC. For instance, chiropractic, dental, and hearing aid clinics are held regularly in Baker. In addition, FMC's primary medical care is augmented by visiting physicians such as an Obstetrician, a Podiatrist, and an Orthopedic Surgeon. Our telemedicine system is routinely used by participants in Healthy Lifestyles classes in conjunction with Intermountain Holy Rosary Healthcare, allowing participants to interact with others in neighboring communities without having to drive more than an hour each way multiple times each month. Telemedicine is also used to connect our patients with specialists located at Billings Clinic.Although we are not a formal teaching facility, we have hosted multiple students annually who are seeking careers in healthcare-related disciplines. This includes high school students who would like to job shadow, and medical students who are completing a primary care rural rotation. We have a number of cooperative agreements with colleges and universities across the nation that allow students a variety of clinical experiences, from observation of care by a trained professional to providing limited patient services under direct supervision. In the past few years, we have hosted students pursuing careers as nurses, lab techs, radiology techs, physician assistants, occupational therapists, physical therapists and physicians coming from Pennsylvania, Washington State, Florida, Utah and Montana.In addition, FMC's Hospital Helpers organization has 15 members who volunteer their time by fundraising for various projects, while working in our long term care area -- operating a beauty shop, visiting with residents, and providing assistance with activities -- and managing a small gift shop in the hospital. All of the money raised by this group is gifted to the facility for the purchase of essential furniture, fixtures, and equipment, and for providing scholarships to students being educated in a healthcare-related field. The community also provides 36 specialty volunteers who offer their talents to our facility. For example, various music groups provide events throughout the year and clergy from surrounding churches hold regular church services and help with special needs. Volunteers also read newspapers and books, hold bible study classes, and decorate rooms and hallways for our residents.FMC is the sole beneficiary of a foundation that exists to attract and manage funds from donors who would like to provide financial support in the furtherance of FMC's mission. This separate charitable non-profit entity is governed by its own Board of Directors, which raises the funds, manages the investments, and determines how the funds should be spent. One of their most actively managed efforts is the awarding of scholarships to students from our service area seeking healthcare careers.We also encourage our staff to be involved in community-related boards and programs. For instance, our Foundation Coordinator has been a member of a local housing board, searching for ways to address our community's chronic housing shortage, as well as a county-supported economic revitalization team, and the local chamber of commerce. Furthermore, a number of employees participate in disaster preparedness meetings through the Local Emergency Preparedness Committee and provide leadership roles in Boy Scouts, 4H, Business Professionals of America, Medical Explorers and Speech and Drama.Lastly, FMC participates in many government-sponsored health care programs, including Medicare, Medicaid, Champus/Tricare, CHIP, VA Choice, and the expanded Medicaid program (HELP) offered in Montana. We have also embraced participation in a number of voluntary government-sponsored programs that focus on quality assurance and process improvement, both independently as well as through collaborative efforts with other Montana hospitals and associations (such as the Montana Health Network, the Montana Hospital Association, the Mountain-Pacific Quality Health Foundation and the Hospital Improvement Innovation Network). |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Friends of FMC Foundation Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 820 | AddressLine1Txt |
| City | Baker | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59313 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 431975486 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $0 | CashGrantAmt |
| Non Cash Assistance | $59,617 | NonCashAssistanceAmt |
| Valuation Method Used | Cost | ValuationMethodUsedDesc |
| Purpose Of Grant | In kind donation of wages and supplies | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The organization pays for the salaries and wages of the Foundation Director for Friends of FMC Foundation, a related organization, as well as small amounts of supplies. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David Espeland | PersonNm |
| Title | Chief Executive Officer | TitleTxt |
| Base Compensation Filing Org | $164,884 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $7,047 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $22,955 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $194,886 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Darryl Espeland | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Employee and brother of CEO | RelationshipDescriptionTxt |
| Transaction | $10,287 | TransactionAmt |
| Transaction | Compensation | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | Genexpert Cepheid Molecular Analyzer | 1 | $26,430 | Cost |
| Yes (X) | Unitrends backup unit for IT | 1 | $18,975 | Replacement Cost |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The members of the Corporation shall consist of all trustees and those individuals who apply for membership and fulfill the qualifications for membership which are established by the Board of Trustees. |
| Form 990, Part VI, Section A, line 7a | Elections for Trustees shall be held at the annual membership meeting, or by written ballot if authorized by the Board of Trustees. |
| Form 990, Part VI, Section A, line 8b | The organization does not have a committee that acts on behalf of the governing board. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is emailed to the Board of Trustees for their review and they are allowed to comment prior to filing. |
| Form 990, Part VI, Section B, line 12c | The organization's policy requires a duty to disclose any conflicts annually as well as during discussions. The conflict of interest policy covers all members of the board, officers and employees. Board Members, officers and employees complete a questionnaire annually addressing potential areas of conflicts. Conflicts are determined by each individual. Conflicts are determined by each individual, but reviewed at the board level. If a conflict arises, the board member abstains from voting on matters that gave rise to the conflict. |
| Form 990, Part VI, Section B, line 15 | The Montana Hospital Association (MHA) publishes its compensation data for all classifications of healthcare workers annually. The data pertaining to facilities comparable in size is used to determine executive and officer compensation. The Board may also choose to call their peers in other facilities to substantiate the MHA data and to confirm the appropriateness of any proposed compensation. The board votes and approves the compensation for officers such as the CEO and CFO. The decisions are documented on an annual basis when salaries are approved. The process last took place at the end of fiscal year 06/30/23 and the board approval of the budget for FY2024 was at the 06/07/2023 board meeting. |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy and financial statements are available for inspection at the corporation's place of business upon request. |
| Form 990, Part IX, line 11g | Contract Labor: Program service expenses 2,090,813. Management and general expenses 155,468. Fundraising expenses 0. Total expenses 2,246,281. Professional Services: Program service expenses 1,652,580. Management and general expenses 114,587. Fundraising expenses 0. Total expenses 1,767,167. Other Fees: Program service expenses 29,197. Management and general expenses 18,166. Fundraising expenses 0. Total expenses 47,363. |
| Form 990, Part XI, line 9: | Equity in Earnings of Affiliate recorded in Revenue for Financial Statement 104,104. |
| Form 990, Page 1, Line C: | Fallon Medical Complex, Inc. is doing business under the following names: Community Clinic, Home Care Services, Fallon Memorial Hospital, and Wibaux Clinic. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Friends of FMC Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 820 | AddressLine1Txt |
| City | Baker | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59313 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431975486 | EIN |
| Primary Activities | Foundation/Fundraising | PrimaryActivitiesTxt |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 7 | 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 | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |