2024-08-15T09:47:10-05:00 2023-09-30 390758449 WIPFLI LLP 105 E PINE ST UPPER FLOOR MISSOULA MT 59802 990 2022-10-01 810236460 MADISON VALLEY HOSPITAL INC MADI 4066826862 305 NORTH MAIN STREET ENNIS MT 59729 ALLEN ROHRBACK CEO 4066826862 2024-08-08 1 1 SAM BRUNSON CPA P01696998 4067281800 2024-08-08 2022 2024-08-08 14:25:15Z MADISON VALLEY MEDICAL CENTER ALLEN ROHRBACK 305 NORTH MAIN STREET ENNIS MT 59729 16650037 0 X MVMEDCENTER.ORG X 1948 MT THE MISSION OF MADISON VALLEY MEDICAL CENTER IS TO INSPIRE AND PROMOTE HEALTH AND WELLNESS FOR EACH PATIENT THROUGH EXCELLENCE IN HEALTHCARE. 5 5 154 31 667105 0 884060 780283 11849758 13342895 210871 336535 1990312 2153421 14935001 16613134 0 0 0 0 7656343 8641041 0 0 0 6025830 7283683 13682173 15924724 1252828 688410 18792434 20773464 6396471 7521407 12395963 13252057 X THE MISSION OF MADISON VALLEY MEDICAL CENTER IS TO INSPIRE AND PROMOTE HEALTH AND WELLNESS FOR EACH PATIENT THROUGH EXCELLENCE IN HEALTHCARE. 1 0 13687264 0 14827081 THE MADISON VALLEY MEDICAL CENTER PROVIDES HEALTHCARE AND HOSPITAL SERVICES TO THE LOCAL COMMUNITY AND SURROUNDING AREA. THE PROVIDERS IN THE CLINIC HAD 8,550 VISITS. THE OBSERVATION, INPATIENT, AND SWING BED DAYS FOR THE HOSPITAL TOTAL 939 FOR FY2023.ON MAY 1, 2021, THE CITY COMMISSION OF ENNIS, MONTANA CONVEYED ITS AMBULANCE RELATED ASSETS TO THE HOSPITAL IN RETURN FOR THE HOSPITAL'S COMMITMENT TO CONTINUE TO PROVIDE EMERGENCY AMBULANCE TRANSPORTATION SERVICES IN THE ENNIS COMMUNITY. IN FY2023, THE AMBULANCE SERVICE RESPONDED TO 477 CALLS, WITH 151 OF THOSE CALLS BEING NON-BILLABLE.ON FEBRUARY 16, 2022, MADISON VALLEY MEDICAL CENTER OPENED A RETAIL PHARMACY TO BETTER SERVE THE ENNIS COMMUNITY. IN FY2023, THE RETAIL PHARMACY FILLED OVER 23,811 PRESCRIPTIONS.MADISON VALLEY MEDICAL CENTER ADDED PAIN MANAGEMENT PROCEDURES IN JULY 2023. 13687264 1 1 0 0 0 0 0 1 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 53 0 154 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 0 1 1 1 0 X ALICIA NICHOLSON 4066826862 305 NORTH MAIN STREET ENNIS MT 59729 MARRY OLIVER CHAIR 5.00 X X 0 0 0 JIM HAGEMAN VICE CHAIR 5.00 X X 0 0 0 BRYANT HARP SECRETARY 5.00 X X 0 0 0 DOTTIE FOSSEL FORMER CHAIR 5.00 X 0 0 0 KAREN MCMULLIN TRUSTEE 1.25 X 0 0 0 JEFF MONTAG TRUSTEE 5.00 X 0 0 0 ALLEN ROHRBACK CEO 40.00 X 223177 0 11553 ALICIA NICHOLSON CFO 40.00 X 99419 0 8975 MAURA DAVENPORT MD, CHIEF OF STAFF 40.00 X 249587 0 11529 RD MARKS MD 40.00 X 154542 0 11350 MARTIN DEGROOT PA 40.00 X 139228 0 7513 SEAN SIMMONS PA 40.00 X 116925 0 39 SAMUEL RIORDAN PHARMACIST 40.00 X 120939 0 6039 1103817 0 56998 10 0 1 0 CARDINAL HEALTH 13651 DUBLIN CT STAFFORD TX 77477 RETAIL PHARMACY CONSULTING & PHARMACIST 326225 ONE STAFF MEDICAL PO BOX 3544 OMAHA NE 68103 NURSING TRAVELERS 304816 BILLINGS CLINIC LOCUM PO BOX 30357 BILLINGS MT 59101 LOCUM ER AND CLINIC PROVIDERS 167694 MONIDA SHARED IMAGING 1200 S RESERVE STE H MISSOULA MT 59801 MRI SERVICES 120800 4 544464 229650 6169 780283 PATIENT SERVICE REVENUE 621110 11329192 10662087 667105 CLINIC 621110 1585196 1585196 340B REVENUE 621110 290636 290636 OTHER PROGRAM SERVICE REVENUE 900099 137871 137871 13342895 349577 349577 2130 0 2130 2130 2130 23861 36903 -13042 -13042 -13042 TAX LEVY REVENUE 900099 2151291 2151291 2151291 16613134 14827081 667105 338665 X 373286 303746 69540 6891876 5607977 1283899 114719 93347 21372 726497 636827 89670 534663 440141 94522 28800 28800 2542816 2266110 276706 62234 14775 47459 156644 49174 107470 225808 143039 82769 5983 5385 598 21770 20116 1654 165229 163560 1669 1037190 1026818 10372 227971 225691 2280 MEDICAL SUPPLIES 1573537 1573537 SUPPLIES & MINOR EQUIPM 607456 589634 17822 BAD DEBT EXPENSE 256049 256049 DUES & SUBSCRIPTIONS 88467 54083 34384 283729 217255 66474 15924724 13687264 2237460 0 671197 61370 1368701 1846166 2598455 3374185 488812 546084 153357 199788 16334576 9452569 7097435 6882007 6096932 6429280 317545 1434584 18792434 20773464 1136324 1161709 217752 0 5042395 4740454 0 1619244 6396471 7521407 X 12395963 13252057 12395963 13252057 18792434 20773464 688410 167684 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 376209 376209 11406022 6707476 4698546 4536542 2745093 1791449 15803 15803 6882007 ASSETS FINANCED WITH SUBSCRIPTION-BASED LIABILITIES 1430332 INSURANCE SSA 4252 1434584 SUBSCRIPTION-BASED LIABILITIES 1619244 1619244 16522639 167684 167684 16354955 258179 258179 16613134 15666545 0 15666545 258179 258179 15924724 PART III, LINE 1A: THE HOSPITAL DOES NOT RECOGNIZE CONTRIBUTIONS OF WORKS OF ART, HISTORICAL TREASURES, AND SIMILAR ASSETS WHEN THE COLLECTION ITEMS ARE HELD FOR PUBLIC EXHIBITION AND ARE PROTECTED, KEPT UNENCUMBERED, CARED FOR, AND PRESERVED. PART III, LINE 4: CURRENT COLLECTIONS INCLUDE A SCULPTURE AND ARTWORK DONATED FOR DISPLAY IN THE HOSPITAL BUILDING. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 256,049. RENT INCOME NETTED W/ EXPENSE 2,130. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 256,049. RENT INCOME NETTED W/ EXPENSE 2,130. 1 1 1 X 1 X 1 1 1 0 1 1 143440 143440 0.00900 1521556 1175394 346162 0.02170 4547 0 4547 0.00030 1669543 1175394 494149 0.03100 359547 359547 0.02260 310038 310038 0.01950 3614396 3230959 383437 0.02410 28232 28232 0.00180 4312213 3230959 1081254 0.06800 5981756 4406353 1575403 0.09900 71058 12768 58290 0.00370 71058 12768 58290 0.00370 1 279874 120346 4879516 4962060 -82544 X 1 1 1 1 MADISON VALLEY MEDICAL CENTER 305 NORTH MAIN STREET ENNIS MT 59729 WWW.MVMEDCENTER.ORG X X X RURAL HEALTH CLINIC MADISON VALLEY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X MVMEDCENTER.ORG/COMMUNITY/HEALTH-RESOURCES X 1 23 1 WWW.MVMEDCENTER.ORG 0 1 X 100.000000000000 250.000000000000 X X 1 1 X X X X 1 X MVMEDCENTER.ORG/PATIENT-INFORMATION/BILLING-FINANCIAL-SERVICES X MVMEDCENTER.ORG/PATIENT-INFORMATION/BILLING-FINANCIAL-SERVICES X MVMEDCENTER.ORG/PATIENT-INFORMATION/BILLING-FINANCIAL-SERVICES X X X X X 1 X 0 X X X X 1 X 0 1 MADISON VALLEY MEDICAL CENTER PART V, SECTION B, LINE 5: A STEERING COMMITTEE WAS CONVENED TO ASSIST MADISON VALLEY MEDICAL CENTER IN CONDUCTING CHSD. A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY (EX. PUBLIC HEALTH, ELDERLY, YOUNG FAMILIES, UNINSURED) CAME TOGETHER IN APRIL 2023. SEE APPENDIX A FOR A LIST OF ALL STEERING COMMITTEE MEMBERS AND THEIR AFFILIATIONS. THE STEERING COMMITTEE MET TWICE DURING THE CHSD PROCESS; FIRST TO DISCUSS HEALTH CONCERNS IN THE COMMUNITY AND OFFER THEIR PERSPECTIVE IN DESIGNING THE SURVEY INSTRUMENT, AND AGAIN, TO REVIEW THE CHNA RESULTS AND TO ASSIST IN THE PRIORITIZING HEALTH NEEDS. MADISON VALLEY MEDICAL CENTER PART V, SECTION B, LINE 11: BASED ON THE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE MADISON VALLEY MEDICAL CENTER BOARD OF DIRECTORS, LEADERSHIP TEAM AND MEDICAL PROVIDERS IDENTIFIED THE MOST IMPORTANT HEALTH NEEDS. THE GROUPS DETERMINED WHICH NEEDS COULD BE ADDRESSED WHILE CONSIDERING MADISON VALLEY MEDICAL CENTER'S RESOURCES AND LIMITATIONS. THE NEEDS WERE PRIORITIZED USING THE ORGANIZATION'S MISSION, VISION AND VALUES. THESE STRATEGIC INITIATIVES ARE PUBLISHED IN OUR CURRENT IMPLEMENTATION PLAN. GOAL 1: IMPROVE ACCESS TO HEALTHCARE SERVICES THROUGHOUT MADISON COUNTY.STRATEGY 1.1: EXPAND ACCESS TO SPECIALTY CARE SERVICES LOCALLY TO ENHANCE ACCESS AND REDUCE TRAVEL BURDEN.1.1.1. CONTINUE GROWTH OF CARDIOLOGY SERVICES (I.E., ONSITE CARDIAC STRESS TEST, ECHO STRESS TEST) TO ENHANCE ACCESS TO CARDIAC SERVICES IN MADISON COUNTY.1.1.2. EXPLORE FEASIBILITY TO EXPAND AVAILABLE SPECIALTY SERVICES SUCH AS CARDIOLOGY, RHEUMATOLOGY, DERMATOLOGY, ONCOLOGY, GASTRO-INTESTINAL AND GYNECOLOGY.1.1.3. EXPLORE THE FEASIBILITY OF OFFERING CHIROPRACTIC SERVICES. DETERMINE NEEDED WORKFORCE AND SPACE.1.1.4. DEVELOP OUTREACH CAMPAIGN FOR NEW SERVICES AND PROVIDERS TO INCREASE KNOWLEDGE AND ACCESS TO SERVICES.STRATEGY 1.2: EXPAND ACCESS TO PRIMARY CARE SERVICES LOCALLY.1.2.1. DETERMINE FEASIBILITY TO EXPAND URGENT CARE SERVICES TO IMPROVE AVAILABILITY AND ENHANCE ACCESS.1.2.2. DETERMINE FEASIBILITY TO FURTHER EXPAND PRIMARY CARE SERVICES AT MVMC BY BRINGING ON AN INTERNAL MEDICINE PHYSICIAN.1.2.3. ENHANCE COORDINATION BETWEEN CLINIC AND COMMUNITY INTEGRATED HEALTH (CIH) SERVICES TO FOSTER COORDINATION AND IMPROVE HEALTH OUTCOMES.STRATEGY 1.3: EXPAND HEALTHCARE SERVICES IN BIG SKY.1.3.1. CONTINUE TO OFFER PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES IN BIG SKY.1.3.2. DETERMINE FEASIBILITY TO EXPAND ACCESS TO OTHER HEALTHCARE SERVICES IN BIG SKY.1.3.3. REACH OUT TO BIG SKY HEALTHCARE PARTNERS TO DISCUSS NEEDS AND OPPORTUNITIES FOR ENHANCE ACCESS TO NEEDED SERVICES AND PARTNER COLLABORATION.GOAL 2: IMPROVE ACCESS TO MENTAL HEALTH AND BEHAVIORAL HEALTH SERVICES THROUGHOUT MADISON COUNTY.STRATEGY 2.1: CONTINUE TO ENHANCE MENTAL HEALTH OUTREACH AND EDUCATION THROUGHOUT THE SERVICE AREA.2.1.1. SUPPORT LOCAL PUBLIC HEALTH DEPARTMENT'S COUNTY-WIDE BEHAVIORAL HEALTH NEEDS ASSESSMENT. EXPLORE OPPORTUNITIES FOR COLLABORATION.2.1.2. PROVIDE MVMC STAFF TO PARTICIPATE IN LOCAL MENTAL HEALTH ADVISORY COUNCIL WHICH HELPS TO COORDINATE MENTAL HEALTH RESOURCES IN MADISON COUNTY.2.1.3. EXPLORE FEASIBILITY TO EXPAND ACCESS TO TELE-MENTAL HEALTH SERVICES TO REDUCE TRAVEL, STIGMA AND ENHANCE ACCESS TO BEHAVIORAL HEALTH SERVICES.2.1.4. PARTNER WITH LOCAL SCHOOLS TO DEVELOP MENTAL HEALTH, SUICIDE RISK, AND SUBSTANCE ABUSE EDUCATION PROGRAMS IN THE SCHOOLS.GOAL 3: IMPROVE THE AWARENESS OF RESOURCES AND SERVICES AVAILABLE IN MADISON COUNTY THROUGH ENHANCEMENTS TO COMMUNITY OUTREACH AND EDUCATION.STRATEGY 3.1: CHAMPION OPPORTUNITIES TO ENHANCE COUNTY-WIDE HEALTH EDUCATION AND WELLNESS THROUGH PROGRAMMING AND COMMUNITY PARTNERSHIPS.3.1.1. CONTINUE TO OFFER AND PROVIDE HEALTH AND WELLNESS EDUCATION (DIABETES, CARDIAC HEALTH, FALL RISK). EXPLORE OPPORTUNITIES TO ENHANCE OFFERED PROGRAMMING.3.1.2. MEET WITH COMMUNITY SOCIAL ORGANIZATIONS TO ENHANCE COMMUNITY KNOWLEDGE AND ACCESS TO LOCAL HEALTH ENHANCING SERVICES (EX. CHAMBER OF COMMERCE, SENIOR CENTER, WOMEN'S CLUB, LION'S CLUB)3.1.3. ENHANCE ACCESS AND KNOWLEDGE OF HEALTHCARE SERVICES THROUGH DEVELOPMENT AND IMPLEMENTATION OF A SOCIAL MEDIA CAMPAIGN.3.1.4. EXPLORE RELAUNCH OF MVMC'S ANNUAL HEALTH FAIR WITH COMMUNITY PARTNERS TO PROVIDE HEALTH, PREVENTION AND EDUCATION OF SERVICES AND PROGRAMS.3.1.5. CONTINUE TO SUPPORT COMMUNITY EVENTS THAT PROMOTE HEALTH, WELLNESS, AND PREVENTION IN MADISON COUNTY. IDENTIFIED HEALTH NEEDS UNABLE TO ADDRESS BY MVMC:1.1 80.3% OF SURVEY RESPONDENTS DO NOT FEEL THERE IS ADEQUATE AND AFFORDABLE HOUSING IN THE AREA. ADDITIONALLY, 49.0% OF SURVEY RESPONDENTS FEEL ACCESS TO AFFORDABLE HOUSING WAS AN IMPORTANT COMPONENT OF A HEALTHY COMMUNITY. MVMC ALONG WITH A FEW OTHER BUSINESSES AND THE COUNTY HAVE COME TOGETHER TO START THIS CONVERSATION. RIGHT NOW THERE IS NOT AN IMMEDIATE SOLUTION IDENTIFIED, INSTEAD WE (MVMC) HAVE 9 HOUSING UNITS THAT WE USE FOR NEW AND UNDER DIFFERENT CIRCUMSTANCES CURRENT EMPLOYEES. ALTHOUGH THERE HAS NOT BEEN A SOLUTION FOR AFFORDABLE HOUSING IN MADISON COUNTY, WE CONTINUE TO WORK ON THIS AS WE KNOW THIS IS A BIG REASON RETENTION OF EMPLOYEES CONTINUES TO BE A STRUGGLE FOR ALL OF MADISON COUNTY. THIS IS NOT BEING ADDRESSED IN OUR 2023 CHNA, BUT IT STILL BEING WORKED ON BEHIND THE SCENES.2.1 46.9% OF SURVEY RESPONDENTS INDICATED "AFFORDABLE HEALTHCARE" WAS THE TOP COMPONENT OF A HEALTHY COMMUNITY. INSURANCE NOT COVERING SERVICES WAS A REASON THAT 22.6% OF RESPONDENTS DELAYED OR DID NOT RECEIVE CARE, AND 30.0% OF RESPONDENTS SAID THEY ARE NOT AWARE OF HEALTHCARE COST ASSISTANCE PROGRAMS.3.1 TO HELP OFFSET SOME OF THE FINANCIAL BURDEN THAT COMES ALONG WITH NEEDING TO USE HEALTHCARE, MVMC OFFERS THE FOLLOWING TO ALL PATIENTS THAT QUALIFY:FINANCIAL ASSISTANCEPAYMENT PLANS340B PROGRAMHEALTH FAIR LABS MADISON VALLEY MEDICAL CENTER PART V, SECTION B, LINE 24: PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE MAY BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES FOR PROCEDURES AND SUPPLIES THAT ARE DETERMINED TO BE ELECTIVE OR NON-MEDICALLY NECESSARY. PART I, LINE 6A: MADISON VALLEY MEDICAL CENTER FOUNDATION PART I, LINE 7: THE HOSPITAL USED WORKSHEET 2 TO DETERMINE A COST-TO-CHARGE RATIO OF 1.10 USED IN THE CALCULATION OF PART I, LINE 7A AND LINE 7C. PART I, LINE 7G: THE RURAL HEALTH CLINIC AND EMERGENCY DEPARTMENT OPERATE AT A LOSS CALCULATED BY TAKING THE ALLOWABLE COSTS TO OPERATE FROM THE MEDICARE COST REPORT AND OFFSETTING REVENUES. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL OFFERS ANNUAL HEALTH FAIR LABS THROUGHOUT THE YEAR WHICH PROMOTES THE HEALTH OF THE COMMUNITY BY ENCOURAGING CITIZENS TO RECEIVE LAB TESTS AT A NOMINAL FEE, AND AT A DATE THAT'S CONVENIENT FOR THEM. PART III, LINE 2: CALCULATED BASED ON THE TOTAL BAD DEBT OF THE FACILITY FOR FISCAL YEAR 2023 (FOUND IN THE FACILITY'S 2023 AUDITED FINANCIAL STATEMENTS) MULTIPLIED BY THE COST-TO-CHARGE RATIO CALCULATED ON WORKSHEET 2 OF THE 2022 SCHEDULE H. PART III, LINE 3: CALCULATED BASED ON THE ASSUMPTION THAT A LARGE PORTION OF PRIVATE PAY PATIENTS SENT TO BAD DEBT WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE HAD THEY APPLIED. MADISON VALLEY MEDICAL CENTER ESTIMATES THAT 43% OF PRIVATE PAY ACCOUNTS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR EXPANDED MEDICAID HAD THEY BEEN WILLING TO APPLY. THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE IS CALCULATED AS THE FACILITY'S TOTAL BAD DEBT EXPENSE MULTIPLIED BY THE COST-TO-CHARGE RATIO CALCULATED ON WORKSHEET 2 OF THE 2022 SCHEDULE H AND THE ESTIMATED PORTION OF BAD DEBT ACCOUNTS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT CAN BE FOUND ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THIS AMOUNT REFLECTS THE ACTUAL AMOUNT RECEIVED FROM MEDICARE RELATED TO MEDICARE SERVICES BILLED. THE COSTING METHODOLOGY USED WAS THE STANDARD ALLOWABLE COST FROM THE MEDICARE COST REPORT 2552-10. PART III, LINE 9B: TO RECEIVE ASSISTANCE, PATIENTS MUST COMPLETE AN APPLICATION ACCOMPANIED BY PROOF OF INCOME AND A WRITTEN STATEMENT OF NON-QUALIFICATION FOR GOVERNMENT ASSISTANCE. THE APPLICATION IS REVIEWED AND A WRITTEN DETERMINATION IS PROVIDED TO THE PATIENT. THE PATIENT MAY QUALIFY FOR A DISCOUNT OF UP TO 100% ON THEIR BILL BASED ON CURRENT FEDERAL POVERTY GUIDELINES. IF THE PATIENT HAS A BALANCE REMAINING, A PAYMENT PLAN MAY BE SET UP AT THIS TIME, USING GUIDELINES FOR PRIVATE PAY PATIENTS. PART VI, LINE 2: THE ORGANIZATION UTILIZES THE SURVEY INFORMATION CONTAINED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED EVERY THREE YEARS TO DETERMINE THE HEALTH CARE NEEDS IN EACH COMMUNITY WE SERVE. THE SURVEY IDENTIFIES MAJOR HEALTH CONCERNS, ACCESS TO CURRENT SERVICES, ADDITIONAL SERVICES NEEDED, QUALITY RATINGS IN EACH SERVICE LINE, AND WHAT WOULD IMPROVE COMMUNITY ACCESS TO HEALTHCARE, INCLUDING BEHAVIORAL HEALTH AND PREVENTIVE CARE. PATIENT ACCESS IS ALSO MEASURED REGULARLY THROUGH PATIENT REGISTRATION AND SCHEDULING TO DETERMINE OPTIMAL PROVIDER STAFFING LEVELS. IN ADDITION, IPADS ARE LOCATED OUTSIDE THE LAB AND CLINIC TO ALLOW FOR QUICK PATIENT SATISFACTION SURVEY RESPONSES FROM PATIENTS. SURVEY RESPONSES AND COMMENTS SPECIFIC TO DEPARTMENTS ARE DISTRIBUTED TO DEPARTMENT MANAGERS FOR CORRECTIVE ACTION WHEN NECESSARY. PART VI, LINE 3: PATIENTS ARE NOTIFIED OF OUR FINANCIAL ASSISTANCE PROGRAM BOTH VERBALLY AND IN WRITING AT THE TIME OF SERVICE, BY TELEPHONE WHEN INITIATING OR RESPONDING TO PATIENT SELF-PAY COLLECTIONS, AND ALSO BY WRITTEN NOTICE ON STATEMENTS ON EACH PATIENT ACCOUNT. PART VI, LINE 4: THE GEOGRAPHIC AREA THE ORGANIZATION SERVICES IS APPROXIMATELY 80 MILES NORTH TO SOUTH, AND 30 MILES EAST TO WEST. THE PRIMARY SERVICE AREA IS COMPRISED OF THE ENNIS, BIG SKY, NORRIS, MCALLISTER, CARDWELL, CAMERON, VIRGINIA CITY, AND ALDER COMMUNITIES. THE POPULATION OF THIS AREA IS APPROXIMATELY 4,800 WITH A LARGE INCREASE IN RESIDENTS AND VISITORS TO OVER 6,000 FROM MAY TO SEPTEMBER. MEDICARE AGE POPULATION IS SLIGHTLY ABOVE MONTANA STATE AND NATIONAL AVERAGES. PART VI, LINE 5: THE HOSPITAL OFFERS DISCOUNTED "HEALTH FAIR LABS" THROUGHOUT THE YEAR FOR A NOMINAL FEE WHICH PROMOTES PREVENTIVE CARE AND OVERALL HEALTH IN OUR COMMUNITY, AS WELL AS, FREE COMMUNITY INTEGRATED HEALTH VISITS FROM OUR EMS STAFF, AND DIABETIC EDUCATION AND FALL PREVENTION CLASSES. X X 0 0 0 0 0 0 0 0 0 MAURA DAVENPORT MD, CHIEF OF STAFF 248587 0 1000 0 0 0 5125 0 6404 0 261116 0 0 0 ALLEN ROHRBACK CEO 199177 0 24000 0 0 0 5209 0 6344 0 234730 0 0 0 RD MARKS MD 154292 0 250 0 0 0 5311 0 6039 0 165892 0 0 0 FORM 990, PART III, LINE 2 MADISON VALLEY MEDICAL CENTER ADDED PAIN MANAGEMENT PROCEDURES IN JULY 2023. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS WHO CONSIST OF ALL REGISTERED VOTERS OF THE TAX DISTRICT. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED BY THE FINANCE COMMITTEE BEFORE FILING ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY APPLIES TO ALL MEMBERS OF THE BOARD OF TRUSTEES. ALL POTENTIAL CONFLICTS SHOULD BE DISCLOSED TO THE BOARD OR COMMITTEE OF THE BOARD FOR REVIEW AND DETERMINATION OF WHETHER A CONFLICT EXISTS. THE BOARD MEMBER WITH THE CONFLICT IS EXCUSED FROM ALL DISCUSSION CONCERNING THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS THE CEO'S GOALS AND PRODUCTON FOR PRIOR YEAR AND FROM THIS PROCESS THEY DETERMINE THE ANNUAL SALARY/WAGES INCREASE FOR ALL ORGANIZATION STAFF. THE PROCESS INCLUDES THE USE OF SURVEY INFORMATION FROM COMPARABLE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 1,943,947. MANAGEMENT AND GENERAL EXPENSES 276,706. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,220,653. MEDICAL CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 322,163. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 322,163. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MADISON VALLEY MEDICAL CENTER FOUNDATION PO BOX 993 ENNIS MT 59729 810453395 RAISES FUNDS TO SUPPORT THE CENTER AND ITS RELATED PROGRAMS MT 501(C)(3) LINE 12B, II N/A 0 MADISON VALLEY HOSPITAL DISTRICT 305 NORTH MAIN ENNIS MT 59729 HOSPITAL DISTRICT MT N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 MADISON VALLEY MEDICAL CENTER FOUNDATION C 544464 MADISON VALLEY HOSPTIAL DISTRICT S 2151291