CENTRAL MONTANA MEDICAL FACILITIES INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL MONTANA MEDICAL FACILITIES INC (EIN 23-7169043)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-14
- IRS object ID
- 202431359349303538
- 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 J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-14T10:40:20-05:00 | 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 | 237169043 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Facilities Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 4065387711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Perry Howell | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4065387711 | PhoneNum |
| Signature | 2024-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Perry | PersonFirstNm |
| Person Last | Howell | 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 | 2024-04-29 | 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 | Central Montana Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Cody Langbehn | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,663,513 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cmmc.health | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | The mission of CMMC is to be the leader in assuring community based quality healthcare. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 366 | TotalEmployeeCnt |
| Total Volunteers | 84 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $154,656 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,488,145 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $45,596,702 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $45,640,856 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,560,723 | PYInvestmentIncomeAmt |
| CY Investment Income | $214,470 | CYInvestmentIncomeAmt |
| PY Other Revenue | $352,074 | PYOtherRevenueAmt |
| CY Other Revenue | $259,351 | CYOtherRevenueAmt |
| PY Total Revenue | $47,664,155 | PYTotalRevenueAmt |
| CY Total Revenue | $55,602,822 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,899,576 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $25,155,946 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $173,539 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,050,886 | PYOtherExpensesAmt |
| CY Other Expenses | $22,853,504 | CYOtherExpensesAmt |
| PY Total Expenses | $45,950,462 | PYTotalExpensesAmt |
| CY Total Expenses | $48,009,450 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,713,693 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,593,372 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $46,445,765 | TotalAssetsBOYAmt |
| Total Assets EOY | $53,403,655 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,390,919 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,981,717 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $34,054,846 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $41,421,938 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Central Montana Medical Center is to be the leader in assuring community based quality healthcare. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $40,205,507 | ExpenseAmt |
| Revenue | $45,640,856 | RevenueAmt |
| Desc | Central Montana Medical Facilities, Inc. operates a 25-bed critical access hospital located in Lewistown, Montana.Hospital Inpatient Services for FY 2023:Number of beds: 25Provided 1,441 acute days of care and 850 swing bed days of care for 25.11% occupancy rate. Emergency Services for FY 2023:Provided for 5,382 Emergency visits.24-hour Physician coverage available.OB Services for FY 2023:Provided for 91 births in Central MontanaThe facilities maintain records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone for services provided under the Facilities charity care policy were approximately $1,527,240 for the fiscal year. Awards received for FY 2023 were:*PIN Quality Improvement Award for the 2022-2023 grant year (7 consecutive years)*Healthcarefirst's Home Health Honors Award*National Leader in Prevention & Wellness from Signify Health*2023 Top 100 Critical Access Hospital*CMS 5-star Overall Hospital Quality Star Rating | Desc |
| Total Program Service Expenses | $40,205,507 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | 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 | 61 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 366 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | 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 | Perry Howell | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4065357711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Ave | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Corry Arntzen | |||||||
| Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Carl Seilstad | |||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jennifer Saunders | |||||||
| Secretary/Treasurer thru Dec 2022 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ashley Morris - Member thru | |||||||
| Dec 2022/Treasurer as of Jan 2023 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ryan d'Autremont - Member thru | |||||||
| Dec 2022/Secretary as of Jan 2023 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Megan Bartel | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Keith Cook | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Christopher Goulet | |||||||
| Member as of Oct 2022 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Karen Durbin | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Marvin Mauws | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Melody Montgomery | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Dr Tamara Welsh | |||||||
| Physician/Member | 40.00 | Yes (X) | $293,863 | $0 | $7,455 | ||
| Dr Michael Sura | |||||||
| Physician/Member | 40.00 | Yes (X) | $308,857 | $0 | $33,571 | ||
| Mary Albers | |||||||
| Member thru Sept 2022 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Brandon Bantz | |||||||
| Member thru Oct 2022 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Cody Langbehn | |||||||
| CEO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Perry Howell | |||||||
| CFO | 40.00 | Yes (X) | $87,615 | $0 | $8,982 | ||
| Dr Raymond Lee | |||||||
| Radiologist | 40.00 | $508,634 | $0 | $25,745 | Yes (X) | ||
| Dr Gardner Smith | |||||||
| Surgeon | 40.00 | $467,702 | $0 | $34,807 | Yes (X) | ||
| Dr Felipe Vile Martignoni | |||||||
| Family Practice Doctor | 40.00 | $402,637 | $0 | $30,154 | Yes (X) | ||
| Dr Amy A LePage | |||||||
| ER Physician | 40.00 | $353,020 | $0 | $28,810 | Yes (X) | ||
| Dr Augusto Amaral Neto | |||||||
| Family Practice Doctor | 40.00 | $346,736 | $0 | $27,420 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,769,064 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $196,944 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 34 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Billings Clinic | |||||
| PO Box 30357 | Billings | MT | 59107 | Mgmt, reading & other fees | $2,098,450 |
| Synergy Surgicalist PC | |||||
| 12396 World Trade Dr 303 | San Diego | CA | 92128 | Physician Staffing | $1,086,013 |
| Sletten Construction Company | |||||
| 1000 25th St N | Great Falls | MT | 59403 | Construction Staff | $505,400 |
| Cushing Terrell | |||||
| PO Box 30071 | Billings | MT | 59107 | Architecture-Building Services | $171,161 |
| Triage Medical Staff | |||||
| PO Box 773328 | Chicago | IL | 60677 | Medical Staffing | $143,081 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,156,408 | GovernmentGrantsAmt |
| All Other Contributions | $6,331,737 | AllOtherContributionsAmt |
| Total Contributions | $9,488,145 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 621110 | $43,029,009 | $43,029,009 |
| Special Programs | 900099 | $1,739,288 | $1,739,288 |
| Pharmacy Revenue | 456110 | $790,991 | $790,991 |
| Cafeteria | 722514 | $81,568 | $81,568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $45,640,856 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $279,143 | TotalRevenueColumnAmt |
| Exclusion | $279,143 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $424,226 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $164,875 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $259,351 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $259,351 | TotalRevenueColumnAmt |
| Exclusion | $259,351 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $830,543 | SecuritiesAmt |
| Other | $600 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $891,018 | SecuritiesAmt |
| Other | $4,798 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$60,475 | SecuritiesAmt |
| Other | -$4,198 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$64,673 | TotalRevenueColumnAmt |
| Exclusion | -$64,673 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,602,822 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,640,856 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $473,821 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $888,750 | TotalAmt |
| Program Services | $780,372 | ProgramServicesAmt |
| Management And General | $108,378 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,782 | TotalAmt |
| Program Services | $200,782 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,572,905 | TotalAmt |
| Program Services | $17,153,899 | ProgramServicesAmt |
| Management And General | $4,291,302 | ManagementAndGeneralAmt |
| Fundraising | $127,704 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $472,410 | TotalAmt |
| Program Services | $352,710 | ProgramServicesAmt |
| Management And General | $116,652 | ManagementAndGeneralAmt |
| Fundraising | $3,048 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,054,079 | TotalAmt |
| Program Services | $839,909 | ProgramServicesAmt |
| Management And General | $204,935 | ManagementAndGeneralAmt |
| Fundraising | $9,235 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $967,020 | TotalAmt |
| Program Services | $773,617 | ProgramServicesAmt |
| Management And General | $184,448 | ManagementAndGeneralAmt |
| Fundraising | $8,955 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $346,862 | TotalAmt |
| Management And General | $346,862 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,697 | TotalAmt |
| Management And General | $70,697 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,925 | TotalAmt |
| Management And General | $71,925 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,653,605 | TotalAmt |
| Program Services | $6,653,605 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,008 | TotalAmt |
| Program Services | $78,755 | ProgramServicesAmt |
| Management And General | $14,736 | ManagementAndGeneralAmt |
| Fundraising | $11,517 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,886,340 | TotalAmt |
| Program Services | $1,204,091 | ProgramServicesAmt |
| Management And General | $680,272 | ManagementAndGeneralAmt |
| Fundraising | $1,977 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,126,327 | TotalAmt |
| Program Services | $890,788 | ProgramServicesAmt |
| Management And General | $233,739 | ManagementAndGeneralAmt |
| Fundraising | $1,800 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,535 | TotalAmt |
| Program Services | $55,235 | ProgramServicesAmt |
| Fundraising | $300 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,355 | TotalAmt |
| Program Services | $111,227 | ProgramServicesAmt |
| Fundraising | $128 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,906 | TotalAmt |
| Program Services | $126,258 | ProgramServicesAmt |
| Management And General | $38,648 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,908,671 | TotalAmt |
| Program Services | $1,469,246 | ProgramServicesAmt |
| Management And General | $439,425 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $719,540 | TotalAmt |
| Program Services | $719,540 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| Medical Supplies | $6,673,011 | $6,672,999 | $12 | |
| Equipment Rental and Ma | $644,908 | $636,045 | $8,863 | |
| Taxes and Licenses | $52,234 | $15,751 | $36,483 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,262,580 | TotalAmt |
| Program Services | $1,470,678 | ProgramServicesAmt |
| Management And General | $791,902 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,009,450 | TotalAmt |
| Program Services | $40,205,507 | ProgramServicesAmt |
| Management And General | $7,630,404 | ManagementAndGeneralAmt |
| Fundraising | $173,539 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,217,869 | BOYAmt |
| EOY | $13,278,114 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,065,167 | BOYAmt |
| EOY | $5,047,999 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,055,451 | BOYAmt |
| EOY | $8,193,325 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $996,694 | BOYAmt |
| EOY | $995,026 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $210,140 | BOYAmt |
| EOY | $367,805 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,135,971 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $36,646,278 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,912,212 | BOYAmt |
| EOY | $13,489,693 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,686,638 | BOYAmt |
| EOY | $5,117,907 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,301,594 | BOYAmt |
| EOY | $6,913,786 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,445,765 | BOYAmt |
| EOY | $53,403,655 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,274,876 | BOYAmt |
| EOY | $4,807,096 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,921,316 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,236,672 | BOYAmt |
| EOY | $3,105,547 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,547,300 | BOYAmt |
| EOY | $2,094,758 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $410,755 | BOYAmt |
| EOY | $1,974,316 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,390,919 | BOYAmt |
| EOY | $11,981,717 | 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 | $24,460,383 | BOYAmt |
| EOY | $27,356,640 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,594,463 | BOYAmt |
| EOY | $14,065,298 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,054,846 | BOYAmt |
| EOY | $41,421,938 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,445,765 | BOYAmt |
| EOY | $53,403,655 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,593,372 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $310,615 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$536,895 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $123,009 | OtherCostOrOtherBasisAmt |
| Book Value | $123,009 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,979,484 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,899,510 | DepreciationAmt |
| Book Value | $8,079,974 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,220,454 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,467,966 | DepreciationAmt |
| Book Value | $3,752,488 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,813,024 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,278,802 | DepreciationAmt |
| Book Value | $1,534,222 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,489,693 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Long-Term Prepaid Expenses | $585,898 |
| Due from Foundation | $3,152,401 |
| Other Receivables | $1,263,887 |
| Finance Lease ROU Asset | $57,546 |
| Operating Lease ROU Asset | $20,181 |
| ERC Receivable | $1,833,873 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,913,786 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Estimated Third-Party Payor Settlements | $1,893,966 |
| Operating Lease Liability | $20,181 |
| Finance Lease Obligation | $60,169 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,974,316 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $56,078,312 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $310,615 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $310,615 | RevenueNotReportedAmt |
| Revenue Subtotal | $55,767,697 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$164,875 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$164,875 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $55,602,822 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $48,174,325 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $164,875 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $164,875 | ExpensesNotReportedAmt |
| Expenses Subtotal | $48,009,450 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $48,009,450 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Facilities believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Facilities would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
| Part XI, Line 4b - Other Adjustments: | Rental Expenses Reported in Revenue for Tax Purposes -164,875. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses Reported in Revenue for Tax Purposes 164,875. |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $740,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $740,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01540 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,253,427 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,179,922 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $73,505 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,993,427 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,179,922 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $813,505 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01690 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 14727 | PersonsServedCnt |
| Total Community Benefit Expns | $55,989 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $55,989 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 20 | PersonsServedCnt |
| Total Community Benefit Expns | $135 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $135 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,313,011 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,312,073 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,000,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12500 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 1175 | PersonsServedCnt |
| Total Community Benefit Expns | $3,260 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,260 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 17 | ActivitiesOrProgramsCnt |
| Persons Served | 15922 | PersonsServedCnt |
| Total Community Benefit Expns | $14,372,395 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,312,073 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,060,322 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12630 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 17 | ActivitiesOrProgramsCnt |
| Persons Served | 15922 | PersonsServedCnt |
| Total Community Benefit Expns | $18,365,822 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,491,995 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,873,827 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14320 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 300871 | PersonsServedCnt |
| Total Community Benefit Expns | $17,568 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,568 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 300871 | PersonsServedCnt |
| Total Community Benefit Expns | $17,568 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,568 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,662,159 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,868,976 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,884,271 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$15,295 | 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 | Central Montana Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendall Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cmmc.health | WebsiteAddressTxt |
| State License | 12894 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Home Health / Hospice | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Facilities 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 | https://www.cmmc.health/resources/reports/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.cmmc.health/resources/reports/ | 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | 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 | See Part V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V | 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 |
| 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 5: In January 2022, surveys were mailed out to the residents in Fergus County, Montana. Survey respondents had the ability to complete the survey mailed to them, or via an online survey hosted at Montana State University's HELPS Lab web portal. The survey was based on a design that has been used extensively in the states of Washington, Wyoming, Alaska, Montana, and Idaho. The survey was designed to provide each facility with information from local residents regarding: -Demographics of respondents -Hospitals, primary care providers and specialists used, plus reasons for selection -Local healthcare provider usage -Services preferred locally -Perception and satisfaction of local healthcare Key informant interviews and focus groups were conducted to identify important local healthcare issues, how to improve the health of the community, and gaps in health services. It was intended that this research would help determine the awareness of local programs and services, as well as the level of satisfaction with local services, providers, and facilities. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 11: In the most recent CHNA conducted the following needs were identified:1. Health concerns including expanding access to mental and behavioral health services through CMMC2. Increasing access to healthcare services at CMMC3. Improving the health and wellness of Central MontanaThe organization will not address the need identified for affordable housing. This is a challenging issue to tackle alone. As time allows in the future, CMMC would be open to engaging with community partners for discussions related to housing affordability and accessibility.In the current year the facility has taken the following actions to address the needs in the most recent CHNA:1. Health concerns including expanding access to mental and behavioral health services through CMMC-We added an RN Behavioral Health Care Navigator to our behavioral health department. -We continue to recruit for a full-time LCSW or LCPC, but have not been successful in that effort to date.2. Increasing access to healthcare services at CMMC:-Hired a financial navigator-Completed a comprehensive review of all charges to ensure pricing accuracy and consistency-Added option for online bill pay-Improved timeliness of patient statements and standardized the billing process-Added pediatric after hours hotline-Participated in community wide health fair-Upgraded phone system to allow community members more efficient access to services & added diabetes & stroke support group. 3. Improving the health and wellness of Central Montana:-We participated in the community wide health fair.-Started a diabetes support group & stroke group-Started fundraising for a comprehensive Cancer Care Center.-Got accredited by ADCES to provide Diabetes Self-management education and support-Purchased a new high tech MRI machine |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 13h: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 16j: A summary of the financial assistance policy is also posted in the hospital facility's emergency room, waiting rooms, and admissions offices. |
| Part V, Line 16a, FAP Website: | https://www.cmmc.health/for-patients/billing-and-financial-assistance/ |
| Part V, Line 16b, FAP Application Website: | https://www.cmmc.health/for-patients/billing-and-financial-assistance/ |
| Part V, Line 16c, FAP Plain Language Summary Website: | https://www.cmmc.health/for-patients/billing-and-financial-assistance/ |
| 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 - Central Montana Medical Center - DME | ||||
| 202 4th Avenue South | Lewistown | MT | 59457 | HME/DME Services |
| 2 - Central Montana Medical Center-Clinic | ||||
| 410 Wendell Ave | Lewistown | MT | 59457 | Physician Clinic |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. |
| Part I, Line 7: | The Organization used an average overall ratio of costs to gross charges which addresses all patient segments in order to calculate charity care. Community health improvement services, health professions education and cash and in kind contributions were based on expenses recorded in the general ledger. Medicaid and subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare cost report. |
| Part II, Community Building Activities: | Community Building activities promote the health of the communities served by providing services and donations for a healthy, active, and educated public. Central Montana Medical Center staff donated time to several Community Boards, including the Chamber of Commerce, Kiwanis, the Lewistown Downtown Association, and other meetings with volunteers servicing our community. CMMC participated in community events including Cancer Center town hall meetings, the local Youth Challenge, and the Central Montana Fair. CMMC also participated in a food drive. By contributing in these different ways, CMMC staff provide a range of knowledge to the community members with a foundation on health and medical needs. All these programs benefit central Montana and promote health and wellness. |
| 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 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. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. |
| Part III, Line 9b: | On every patient statement it states that the Hospital financial assistance application is available upon request. Applications received prior to 120 days are reivewed and accounts are not referred to a collection agency. Any application received from day 120-240 will have the account immediately returned from any collection agency for the application to be processed. Applications are available upon request and on the website for clients to access. |
| Part VI, Line 2: | Currently, CMMC assesses the health care needs of the community by the number of responses to ads and articles released through the local media. Also tracked were the kinds of support requested of CMMC such as children's safety, wellness initiatives and healthcare assessments. In FYE 2022 CMMC completed a Community Health Needs Assessment with the help of Montana State University. Mail and phone surveys were completed and "town hall" type meetings were held in Lewistown. |
| Part VI, Line 3: | CMMC has financial assistance signage posted in the admissions areas and the ER waiting area. A pamphlet explaining our financial assistance program, the application process and contact information is available at all hospital registration areas. The Charity Care policy and application along with a checklist and contact information is posted on our website on the internet. Prior to discharge someone from discharge planning discusses with the patient the availability of various government benefits, such as Medicaid, and assists the patient with qualifications for such programs, where applicable. Assistance with filling out the Charity Care application is also provided at this time. Private Pay in-patients are informed of Charity Care either prior to scheduled admission by physician referral or prior to discharge from the facility. We also send out information with first time statements. All other patients are informed upon inquiry. |
| Part VI, Line 4: | Lewistown is an agricultural community and the county seat for Fergus County Montana. Lewistown is located in the center of Montana and is surrounded by five mountain ranges: the Snowies, the Judiths, the Moccasins, the Belts and the Highwoods. Lewistown's elevation is 3,963 feet with 3,194 people per square mile (average).The city of Lewistown and the surrounding rural towns are supported by one hospital, Central Montana Medical Center. Fergus County is located in a federally designated medically underserved area.As of the census of 2022, the population of Lewistown MT is 6,076 (2,879 female and 3,197 male). The county's population was 11,872 and there are 2.73 persons per square mile.March 2022 cost of living index in our zip code (59457) is 87.4%, U.S. average is 100.Real estate property taxes paid for housing units with mortgages in 2022 was $1,765. Renter-occupied apartments were 35% compared to the state average of 31%.The median resident age for this zip code is 48.1 years old with an average household size of 2.2 people.The population 25 years and over in 59457 shows High school or higher: 93.3%, Bachelor's degree or higher: 23.0%, Graduate or professional degree: 4.2%, Unemployed:6.0%Information obtained from www.city-data.com/city/Lewistown-Montana.html |
| Part VI, Line 5: | The CMMC Governing Board consisted of 12 volunteer community members including members from surrounding communities and 1 member from our affiliate, Billings Clinic.CMMC extends medical staff privileges to qualified physicians based upon community needs.Surplus funds, when available, are applied to patient care needs, equipment and building maintenance and medical education requirements. The expenditure of these funds is approved by the Governing Board which meets on a monthly basis.Community care and services are also provided through the many reduced-price services and free clinics, fairs, and programs offered throughout the year. Care and services provided this year includes but is not limited to the following (all costs are estimates):Services provided for fiscal year 22-23:*Concussion Testing: - 536 students tested-Established baseline cognitive functioning for all area schools' athletic programs (Lewistown High School and Junior High, Winifred, Roy, Hobson, and Moore)-Educated on importance of brain health and injury prevention-Estimated Cost: $5,690*Sports Physical Clinics:-Provided 251 sports physical exams to area students that included a musculoskeletal exam by CMMC Rehab department: Donated proceeds back to individual school athletic programs-Estimated cost: $8,612*CPR / First Aid:-99 students taught at Fergus High School: 7 day class / 6 class periods per day-Educated on 9-1-1 emergency calls; basic adult / infant CPR; AED training; seizure care; allergic reactions and training in use of an Epi-pen; Stop the Bleed training; diabetic s/sx and response to abnormal issues; total of 118 staff hours-Estimated cost: $2,710*Rural EMS volunteer services:-2 volunteer EMTs served.-Respirator fit testing, TB testing & immunization assessment completed-Estimated cost: $181*Volunteer Services: -110 volunteers served-Lab testing, COVID and flu vaccines, TB testing-4 staff and supplies used -Estimated cost: $2,108 (does not include staff time)*Student Services:-176 students served (Nursing Resident, FHS EMT, etc)-Drug testing, Lab testing, COVID and flu vaccines, TB testing, Respirator Fit testing-4 staff used and supplies used-Estimated cost: $2,802*Hospice Annual Volunteer Training: - 13 volunteers served-Educated on immunizations; appropriate PPE, and Covid precautions / symptoms for Covid-Estimated cost: $90 |
| Part VI, Line 6: | CMMC is part of an affiliated health care system with Billings Clinic. Central Montana Medical Center is involved in promoting community health by participating in Population Health programs offered by Medicare and other third party insurers. Billings Clinic and CMMC collaborate on Population Health and Care Coordination initiatives that are provided to the community. CMMC has an independent Care Coordination department focused on promoting the health of the individuals in our community. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Raymond Lee | ||||||||||||||
| Radiologist | $508,634 | $0 | $0 | $0 | $0 | $0 | $17,208 | $0 | $8,537 | $0 | $534,379 | $0 | $0 | $0 |
| Dr Gardner Smith | ||||||||||||||
| Surgeon | $467,702 | $0 | $0 | $0 | $0 | $0 | $9,111 | $0 | $27,089 | $0 | $503,902 | $0 | $0 | $0 |
| Dr Felipe Vile Martignoni | ||||||||||||||
| Family Practice Doctor | $402,637 | $0 | $0 | $0 | $0 | $0 | $6,833 | $0 | $23,320 | $0 | $432,790 | $0 | $0 | $0 |
| Dr Amy A LePage | ||||||||||||||
| ER Physician | $353,020 | $0 | $0 | $0 | $0 | $0 | $5,489 | $0 | $23,320 | $0 | $381,829 | $0 | $0 | $0 |
| Dr Augusto Amaral Neto | ||||||||||||||
| Family Practice Doctor | $346,736 | $0 | $0 | $0 | $0 | $0 | $4,100 | $0 | $23,320 | $0 | $374,156 | $0 | $0 | $0 |
| Dr Michael Sura | ||||||||||||||
| Physician/Member | $308,857 | $0 | $0 | $0 | $0 | $0 | $10,250 | $0 | $23,320 | $0 | $342,427 | $0 | $0 | $0 |
| Dr Tamara Welsh | ||||||||||||||
| Physician/Member | $293,863 | $0 | $0 | $0 | $0 | $0 | $7,455 | $0 | $1,393 | $0 | $302,711 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fergus County Montana | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 816001358 | BondIssuerEIN |
| CUSIP | 000000000 | CUSIPNum |
| Bond Issued | 2014-05-01 | BondIssuedDt |
| Issue Price | $4,500,000 | IssuePriceAmt |
| Purpose | Emergency and laboratory expansion and remodel of existing facility | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,394,453 | RetiredAmt |
| Total Proceeds | $4,500,000 | TotalProceedsAmt |
| Capital Expenditures | $4,500,000 | CapitalExpendituresAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Amie D'Autremont | |||
| Sister of board member, Ryan D'Autremont | $74,452 | Employee compensation | 0 |
| Amy D'Autremont | |||
| Wife of board member, Ryan D'Autremont | $104,942 | Employee compensation | 0 |
| Amy Howell | |||
| Wife of CFO, Perry Howell | $21,388 | Employee compensation | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1a | The Executive Committee includes the President or Chair, Vice President or Vice Chair, Secretary and Treasurer and 2 members-at-large and their authority is similar to that of the full governing board. |
| Form 990, Part VI, Section A, line 3 | Cody Langbehn is a contract employee of Billings Clinic as of August 31, 2020. Central Montana Medical Center became affiliated with Billings Clinic and Cody serves as the CEO. Billings Clinic was paid a total of $346,862 for Cody's services during calendar year 2022. Compensation: $286,510 Benefits: $60,352 The organization pays Billings Clinic a management fee of $32,023.81 per month for our affiliation. |
| Form 990, Part VI, Section A, line 6 | The organization has two classes of membership: Class A general membership and Class B membership, with the sole member of the Class B Membership being Billings Clinic. Class A Membership in the Corporation shall consist of residents of Central Montana residing within the counties of Fergus, Judith Basin and Petroleum who are at least eighteen (18) years of age and who have or shall indicate their interest in the maintenance of adequate medical facilities and high standards of medical care in the area, served by CMMC, and who indicate a willingness and desire to be a member of the Corporation by attending and signing the register at the Corporation's annual meeting. |
| Form 990, Part VI, Section A, line 7a | The board has two classes of directors. Class A Directors are elected by the Class A Members and Class B Directors are appointed by the Billings Clinic. There shall be at last nine but no more than thirteen Class A Directors. There shall be at least one but no more than two Billings Clinic Directors, as determined by Billings Clinic from time to time. Each Class A Director must reside within the counties of Fergus, Judith Basin or Petroleum. Two Class A Directors must be physicians holding privileges on CMMC's active Medical Staff. Further, so long as the Corporation remains obligated for the repayment of any long-term tax-exempt financing, underwritten through Fergus County, Montana, one Class A Director shall be selected from the Fergus County Commissioners. The Board and Billings Clinic shall communicate concerning the appointment of Billings Clinic Directors with the objective of selecting individuals who will work cooperatively with the Class A Directors for the benefit of CMMC. |
| Form 990, Part VI, Section A, line 7b | Any amendment to the bylaws affecting the voting rights and powers of membership, must be approved by both a two-thirds majority of the board present at any regular or special meeting of the board and Billings Clinic. Additionally, Billings Clinic must consent to any amendment of the bylaws relating to CMMC's purpose, the membership, the members of the board, including but not limited to the number of directors, the composition of the board, the term of office of directors or the method or way in which directors are elected or selected. |
| Form 990, Part VI, Section B, line 11b | A draft copy of the Form 990 is reviewed by the CFO and Board of Directors prior to its filing. |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by discussing at the Board of Director Meetings and obtaining signed statements from members. All officers, board members, and key employees are covered by the policy. The board determines whether conflicts exist and all potential conflicts are reviewed by the board. Any person with a conflict is not allowed to vote on conflicted issues. |
| Form 990, Part VI, Section B, line 15a | Cody Langbehn, CEO, is employed by Billings Clinic. Billings Clinic provided market data to the Board and the Board takes action annually to set his compensation level. CFO compensation was determined by the CEO after looking at market data from MHA and consulting with a recruitment company about market data for the CFO pay range. The specific pay rate was then set based on the market range and relevant experience. These processes take place on an annual basis. |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. A copy may be requested by calling, emailing, walk-in or via mail. |
| Form 990, Part IX, line 11g | Medical/Professional Fees: Program service expenses 83,384. Management and general expenses 0. Fundraising expenses 0. Total expenses 83,384. Service Contracts: Program service expenses 749,051. Management and general expenses 0. Fundraising expenses 0. Total expenses 749,051. Purchased Services: Program service expenses 5,821,170. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,821,170. |
| Form 990, Part XI, line 9: | Change in Interest in Central Montana Foundation -536,895. |