2025-05-14T18:56:38-04:00 2024-06-30 GREEN HEALTH GROUP PC 405 FOURTH AVENUE NORTH GLASGOW MT 59230 990 2023-07-01 810226578 NORTHEAST MONTANA HEALTH SERVICES NORT 4066536500 315 KNAPP STREET WOLF POINT MT 59201 THOMAS STEINER CEO 4066536500 2025-05-14 true true DANIEL GREEN P01311679 4062632615 2025-05-14 2023 2025-03-06 01:10:19Z THOMAS STEINER 315 KNAPP ST WOLF POINT MT 59201 40871086 false X WWW.NEMHS.NET X 1948 MT TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. 7 7 381 7 1433008 336587 97316 38367144 39802415 155256 576073 424391 395282 39283378 40871086 0 0 17429158 16952128 0 77488 17487610 20492418 34916768 37444546 4366610 3426540 65425409 66894795 12997522 11454944 52427887 55439851 TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. false false 31974834 39802415 PROVIDE QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO THE PATIENTS THAT WE SERVE. 31974834 true true false true false false false false false false true true false true false true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 41 0 381 true true true false false false false false false false false false false false X 7 7 false false false false false false false true true false false true true true true true true true true false X SCOTT OLANDER 4066536500 315 KNAPP ST WOLF POINT MT 59201 MICHAEL POST CEO 40.00 X 300016 0 15342 HANZ ARNSTON RN 40.00 X 186910 0 12430 NONETTE BROWN RISK MGT DIR 40.00 X 145767 0 13944 LORI COLLINS RN 40.00 X 143451 0 13898 ROGER FISHER COO 40.00 X 153608 0 3545 ELAINE LONG RN-VP NURSIN 40.00 X 140057 0 13830 TACY STRAND RN-CNO 40.00 X 137256 0 13087 DEMI WILKINSON CFO 40.00 X 96328 0 7980 MARVA CHAPMAN TRIBAL REP 1.00 X 0 0 0 SHANE GIBSON DIRECTOR 1.00 X 0 0 0 STEVE HACKLEY DIRECTOR 1.00 X 0 0 0 VICTORIA MATEJOVSKY VICE-CHAIRMA 1.00 X 0 0 0 DEBBIE MCGOWAN DIRECTOR 1.00 X 0 0 0 DAN MOUDREE TREASURER 1.00 X 0 0 0 DALLAS O'CONNOR CHAIRMAN 2.00 X 0 0 0 THOMAS STEINER CEO 0.00 X 0 0 0 1303393 94056 20 false true false KATHY WULF 51265 221ST STREET GLENWOOD IA 51534 LOCUM TENEN 326457 BARTON & ASSOCIATES INC PO BOX 417844 BOSTON MA 022417844 LOCUM TENENS 311911 BIG SKY LOCUMS PROVIDER PC PO BOX 81417 BILLINGS MT 59108 LOCUM TENENS 305699 PRN STAFFING SOLUTIONS LLC 173 AUSTRIAN ROAD VIDA MT 59274 NURSING STAFF 300030 EXPERT EASE ANESTHESIA LLC 776 HILLSIDE DRIVE GLASGOW MT 59230 CRNA 226200 7 11000 31462 54854 97316 PATIENT REVENUE 621500 36628314 36628314 RETAIL PHARMACIES 456110 3174101 1741093 1433008 39802415 576073 576073 HOSPITAL DISTRICT TAX REVENUE 900099 395282 395282 395282 40871086 39340762 1433008 X 410240 410240 14042085 11776395 2209798 55892 165833 137063 27890 880 1153391 921412 220494 11485 1180579 963703 212555 4321 10576 6926 3623 27 74323 74323 7552254 7178186 373419 649 40590 5048 35525 17 1207700 754600 452319 781 692936 550468 139973 2495 330729 269217 61512 165995 124596 41393 6 34839 23501 11337 1 188578 151029 37549 1601768 1373238 228530 534273 286535 247738 MEDICAL SUPPLIES 4590819 4548984 41835 COGS 1278726 1278726 REPAIRS & MAINTENANCE 785781 641084 143764 933 BED TAXES 587970 587970 814561 396153 418407 1 37444546 31974834 5392224 77488 14232345 2701671 6884412 13690043 10100825 14947190 1093731 1283721 356430 235426 37180310 27031444 10366332 10148866 6592203 6732251 15799131 17155627 65425409 66894795 6853744 5925272 6122641 5529672 21137 12997522 11454944 X 52396993 55388809 30894 51042 52427887 55439851 65425409 66894795 3426540 -200244 -214332 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3919 3919 false SCHEDULE C, PART IV 0.62 PERCENT OF MHA DUES PAID TO MHA, WHICH WAS 242, 32.00 PERCENT OF DUES PAID TO MHA FOR AHA, WHICH WAS 3,659, AND 1.52 PERCENT OF DUES PAID TO MHA FOR LEADINGAGE WHICH WAS 18 (3,919 COMBINED) WERE USED FOR LOBBYING EXPENSES BY MHA. 92421 92421 21350165 14631615 6718550 15737724 12399829 3337895 10148866 5580559 C BOND FUNDS 1151692 F 6732251 RECEIVABLE-WOLF POINT CLINIC ASSOC 10598444 RECEIVABLE-RIVERSIDE FAMILY CLINIC 6435183 WORK COMP TRUST DEPOSIT 122000 17155627 X 40670842 -200244 -200244 40871086 40871086 37444546 37444546 37444546 SCHEDULE D, PAGE 3, PART X NEMHS BELIEVES THAT THEY HAVE APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS, AND AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. SEE PAGE 11 OF THE NORTHEAST MONTANA HEALTH SERVICES, INC. AND AFFILIATES NOTES TO CONSOLIDATED FINANCIAL STATEMENTS JUNE 30, 2024 AND 2023. true true X true X false true true false false 2137 2137 0.00010 2137 2137 0.00010 3018797 2240671 778126 0.02080 3018797 2240671 778126 0.02080 3020934 2240671 780263 0.02080 true 4609108 4642891 -33783 X true true 2 1 NEMHS - TRINITY HOSPITAL 315 KNAPP STREET WOLF POINT MT 59201 WWW.NEMHS.NET X X X X 2 NEMHS - POPLAR COMMUNITY HOSPITAL 211 H STREET EAST POPLAR MT 59255 WWW.NEMHS.NET X X X X NEMHS - TRINITY HOSPITAL 1 false false true X X X X X X X X X X 21 true true false true X WWW.NEMHS.NET X X true 21 true WWW.NEMHS.NET false false true X 200.000000000000 X X X true true X X X true X WWW.NEMHS.NET X WWW.NEMHS.NET X WWW.NEMHS.NET X X X X X true X false X X X X true X false false NEMHS - POPLAR COMMUNITY HOSPITAL 2 false false true X X X X X X X X X X 21 true true false true X WWW.NEMHS.NET X X true 21 true WWW.NEMHS.NET false false true X 200.000000000000 X X X true true X X X true X WWW.NEMHS.NET X WWW.NEMHS.NET X WWW.NEMHS.NET X X X X X true X false X X X X true X false false FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 5 IN APRIL 2022, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS ALSO MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND MARKETED VIA THE FACILITY'S WEBSITE AND FACEBOOK PAGE. MAIL RETURNS AND ON-LINE SURVEYS WERE COMBINED WHICH RESULTED IN 133 SURVEYS BEING RETURNED. CONSULTATIONS WITH INDIVIDUALS WHO REPRESENTED VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, PUBLIC HEALTH, MEDICALLY UNDERSERVED, LOW INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, AND STUDENTS WERE CONDUCTED TO SOLICIT THEIR INPUT. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 6A NORTHEAST MONTANA HEALTH SERVICES - POPLAR COMMUNITY HOSPITAL. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 7D THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 11 THE PRIORITIZED HEALTH NEEDS AS DETERMINED THROUGH THE ASSESSMENT PROCESS AND WHICH THE FACILITY WILL BE ADDRESSING RELATES TO THE FOLLOWING HEALTHCARE ISSUES: 1. ACCESS TO HEALTHCARE SERVICES 2. EDUCATION AND AWARENESS OF SERVICES THE FIRST HEALTHCARE ISSUE IS TO INCREASE ACCESS TO HEALTHCARE SERVICES IN THE NEMHS SERVICE AREA. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO INCREASE ACCESS TO PRIMARY CARE SERVICES AT NEMHS BY PROVIDING LOCAL NURSE TRAINING OPPORTUNITIES AND PARTNERING WITH THE COMMUNITY COLLEGE IN FORT BELKNAP TO HOST NURSING CLINIC SITE ROTATIONS FOR STUDENTS, CONTINUING TO OFFER AND EXPLORING EXPANDING INTERNAL PAIN MANAGEMENT SERVICES WITH ON STAFF CRNA, ATTEMPTING TO RECRUIT PRIMARY CARE PHYSICIANS AND A PHYSICAL THERAPIST, ASSESSING THE FEASIBILITY OF EXPANDING OCCUPATIONAL THERAPY SERVICES(HOURS AND/OR ADDITIONAL STAFF), AND AIMING TO RECRUIT A NURSE PRACTITIONER TO ADDRESS THE INCREASED NUMBER OF PAIN MANAGEMENT PATIENTS. NEMHS HAD NURSING STUDENTS COME FROM FORT BELKNAP, IN 2023, AND DO A CLINICAL ROTATION AT BOTH THE WOLF POINT AND POPLAR CAMPUSES. DUE TO LACK OF REFERRALS FROM THE MEDICAL STAFF, WE COULD NOT EXPAND THE INTERNAL PAIN MANAGEMENT SERVICES WITH AN ON STAFF CRNA. TO RECRUIT PHYSICIANS, WE ARE NOW LOOKING AT THE POSSIBILITY OF FOREIGN WORKERS. ALSO, WE RECRUITED A NURSE PRACTITIONER TO OVERSEE THE PAIN MANAGEMENT SERVICES AND THE OVERFLOW CLINIC VOLUMES. IN FISCAL YEAR 2024, NEMHS CONTINUED TO PARTNER WITH FORT BELKNAP NURSING STUDENTS TO DO THEIR CLINICAL ROTATION AT BOTH WOLF POINT AND POPLAR HOSPITALS. WE HAVE ADDED PAIN MANAGEMENT SERVICES WITH A CRNA AND CONTINUED TO HAVE A NURSE PRACTITIONER ON STAFF AT THE CLINIC WHO SPECIALIZES IN PAIN MANAGEMENT. ALSO, WE HAVE INCREASED THERAPY STAFFING TO INCLUDE TWO OFFERS TO FOREIGN PHYSICAL THERAPISTS AND THERE IS A CONTRACT OCCUPATIONAL THERAPIST ON STAFF. THE SECOND STRATEGY IS TO INCREASE ACCESS TO SPECIALTY CARE SERVICES AT NEMHS BY BRINGING IN PODIATRY ONCE A MONTH FOR TWO OR THREE DAYS, EXPLORING INCREASING THE HOURS OF MENTAL HEALTH TELEMEDICINE, EXPANDING PHYSICAL THERAPY SERVICES TO INCLUDE PELVIC FLOOR TRAINING, EXPLORING OFFERING AQUATIC THERAPY SESSIONS, EXPLORING THE FEASIBILITY OF IMPLEMENTING A CARDIAC REHAB PROGRAM, AND CONDUCTING A FEASIBILITY STUDY REGARDING HIPAA COMPLIANCE IN THE E.R. NEMHS OFFERED PELVIC FLOOR PHYSICAL THERAPY THROUGH TRAVEL PHYSICAL THERAPISTS IN MARCH-SEPTEMBER 2023 AND APRIL-MAY 2024. THE ONSITE PHYSICAL THERAPIST WAS NOT ABLE TO GET CERTIFIED IN PELVIC FLOOR DUE TO HIGH OUTPATIENT CENSUS AND DECREASED STAFFING PREVENTING TAKING TIME OUT OF THE CLINIC TO TRAVEL TO THE REQUIRED CONTINUING EDUCATION COURSE. ALSO, A PLANNED ADDITION TO THE THERAPY CLINIC DID NOT OCCUR, SO THE THERAPY DEPARTMENT LACKS CONSISTENT ACCESS TO AN APPROPRIATE PELVIC FLOOR TREATMENT SPACE, MAKING EXPANDING INTO PELVIC FLOOR PHYSICAL THERAPY IMPRACTICAL. DUE TO LIMITATIONS OF OUR THERAPY SPACE, WE ALTERED OUR GOAL AND FOCUSED ON EXPANDING OUR PHYSICAL THERAPY SERVICES BY GETTING A THERAPIST CERTIFIED TO PERFORM DRY NEEDLING, WHICH OCCURRED IN SEPTEMBER 2023. WE EXPLORED OFFERING AQUATIC THERAPY, BUT DUE TO THE PLANNED ADDITION NOT MOVING FORWARD, PIVOTED AND INSTEAD INSTALLED AN OVERHEAD BALANCE TRACK IN NOVEMBER 2023, AS THIS CAN BE USED FOR OVER WEIGHT PATIENTS AND ALLOWS FOR GREATER FLEXIBILITY IN ITS USE THAN POOL THERAPY, ALLOWING A BROADER SCOPE OF PATIENTS TO UTILIZE IT. DUE TO NOT BEING ABLE TO EXPAND THE SPACE, A CARDIAC REHAB PROGRAM WAS NOT IMPLEMENTED. ALSO, ALL LOCATIONS INCLUDING THE EMERGENCY ROOM ARE MONITORED FOR HIPAA COMPLIANCE. IN FISCAL YEAR 2024, NEMHS CONTACTED A PODIATRIST BUT AN AGREEMENT WAS NOT REACHED. OUR CURRENT MENTAL HEALTH PRACTITIONER HAS STAFFING CONSTRAINTS SO WE ARE WORKING WITH COMMUNITY MENTAL HEALTH CRISIS SERVICES TO EXPLORE THEIR TELEMEDICINE SERVICE PLATFORM. WE HAVE CONTINUED TO OFFER DRY NEEDLING BY A CERTIFIED PHYSICAL THERAPIST AND PELVIC FLOOR PHYSICAL THERAPY THROUGH TRAVEL PHYSICAL THERAPISTS WHO UTILIZE APPROPRIATE TREATMENT SPACE IN AREAS OTHER THAN PT. A CARDIAC REHAB PROGRAM HAS NOT BEEN IMPLEMENTED DUE TO VOLUMES AND FINANCES. ALSO, WE HAVE CONTINUED TO MONITOR ALL LOCATIONS FOR HIPPA COMPLIANCE. THE SECOND HEALTHCARE ISSUE IS TO ENHANCE THE KNOWLEDGE OF SERVICES AND RESOURCES PROVIDED BY NEMHS. THE STRATEGY FOR ADDRESSING THIS ISSUE IS TO EXPAND EDUCATION AND OUTREACH EFFORTS TO IMPROVE AWARENESS OF AVAILABLE SERVICES AT NEMHS BY CONTINUING OUTREACH VIA RADIO AND SOCIAL MEDIA OUTLETS(FACEBOOK, INSTAGRAM, WEBSITE), CONTINUING TO PLACE HEALTH EDUCATION MATERIALS IN WAITING ROOMS AND HEALTH EDUCATION KIOSKS IN EXAM ROOMS, IMPROVING AWARENESS OF SLEEP STUDIES CONDUCTED BY THE FACILITY, CONTINUING TO HOST THE EMS BASH TO PROMOTE HOSPITAL AND EMS SERVICES, INCREASING COMMUNITY AWARENESS OF EMS SERVICES VIA BILLBOARD, CONTINUING TO HOST THE ANNUAL HEALTH FAIR AND GOLF TOURNAMENT, AND PARTNERING WITH REGIONAL ORGANIZATIONS TO SUPPORT STUDENT INTERESTS IN HEALTHCARE CAREERS. NEMHS CONTINUED EDUCATION AND OUTREACH EFFORTS BY DISRIBUTING SLIPS AND FALLS PREVENTION BROCHURES AND OTHER HEALTH INFORMATION TO BOTH CLINICS AND HOSPITALS, PLACING DAILY RADIO ADS AND AT LEAST THREE WEEKLY POSTS ON SOCIAL MEDIA, POSTING INFORMATION ON FACEBOOK ABOUT SLEEP AWARENESS AND SLEEP STUDIES, AND HAVING A BILLBOARD THAT WAS VISIBLE FOR EAST AND WEST BOUND DRIVERS. WE DID NOT HOST THE EMS BASH IN 2022 BECAUSE THE COST OF THE VENUE MADE IT NOT FEASIBLE. THE GOLF TOURNAMENT WAS HELD IN 2022, BUT THE ANNUAL HEALTH FAIR DID NOT HAPPEN FOR VARIOUS REASONS. IN FISCAL YEAR 2024, NEMHS CONTINUED UTILIZATION OF SOCIAL MEDIA PLATFORMS WITH FACEBOOK, INSTAGRAM AND LINKEDIN AS WELL AS LOCAL PRINT MEDIA. HEALTH EDUCATION MATERIALS ARE ROTATED THROUGHOUT THE YEAR TO COINCIDE WITH MONTHS WHERE NATIONAL EFFORTS ARE UTILIZED TO INCREASE SCREENING, SUCH AS BREAST CANCER AWARENESS, COLON CANCER, HEART, NUTRITION, MENTAL WELLNESS, ETC. EMS SERVICES ARE NOW PROVIDED BY A CONTRACT STAFFING COMPANY SO WE WERE UNABLE TO CONTINUE TO HOST THE EMS BASH AS A SPECIAL EVENT. EMS PARTICIPATES AND IS VISIBLE THROUGH OTHER VENUES SUCH AS LOCAL EVENTS, RODEO, POW WOW, ETC. ALSO, WE HELD THE GOLF TOURNAMENT IN 2023 AND WAS A CONTINUED PRESENCE IN THE LOCAL SCHOOL CAREER FAIR. THE HEALTH NEEDS IDENTIFIED BY NEMHS THAT THEY ARE UNABLE TO ADDRESS: FIRST, THERAPY SERVICES WERE IDENTIFIED AS HIGH AREAS OF CONCERN IN BOTH SURVEY AND KEY INFORMANT DATA. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. SECOND, 14% OF RESPONDENTS SAID THAT MEDICATION COSTS HAD PROHIBITED THEM FROM GETTING OR TAKING THEIR PRESCRIPTIONS REGULARLY. TRIBAL MEMBERS CAN GET THEIR MEDICATIONS THROUGH INDIAN HEALTH SERVICES FREE OF CHARGE. THE COPAY FOR THE MEDICATIONS IS DECIDED BY THE INSURANCE COMPANY OF THE PATIENT AND THERE ARE A COUPLE FACTORS FOR EACH PRESCRIPTION SUCH AS DEDUCTIBLE, PRICE OF MEDICATION, ETC. THIRD, DENTAL SERVICES WERE IDENTIFIED AS NEEDED SERVICES NOT CURRENTLY AVAILABLE FOR BOTH ADULTS AND CHILDREN. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. THERE IS ALSO A PRIVATE, LOCAL DENTIST. PROVIDING DENTAL SERVICES IS BEYOND THE SCOPE OF NEMHS AT THIS TIME. FOURTH, 28.3% OF ADULTS IN ROOSEVELT COUNTY ARE BELOW THE POVERTY LEVEL; 26% OF ADULTS ARE UNINSURED. TSHIP(TRIBAL SPONSORED HEALTH INSURANCE PROGRAM) IS AVAILABLE TO ALL MEMBERS WHO ARE UNDERINSURED OR NOT INSURED. FIFTH, THE PERCENTAGE OF SMOKING DURING PREGNANCY IN ROOSEVELT COUNTY IS 30.7% COMPARED TO 16.5% FOR THE STATE. THIS ISSUE IS BEING ADDRESSED BY NEMHS AND INDIAN HEALTH SERVICES. IT IS AN ONGOING ISSUE AND EDUCATION IS PROVIDED FOR EVERY PATIENT. SIXTH, ROOSEVELT COUNTY HAS A RATE OF 2159.2 PER 100,000 PEOPLE WITH SEXUALLY TRANSMITTED DISEASES COMPARED TO 551.6 FOR THE STATE. SEXUALLY TRANSMITTED DISEASES ARE TRADITIONALLY HIGH WITHIN ROOSEVELT COUNTY AND THE RESERVATION. SOME STEPS HAVE BEEN TAKEN TO ADDRESS THIS ISSUE; INDIAN HEALTH SERVICES HAS IMPLEMENTED A NEEDLE EXCHANGE TO HELP FIGHT THE STD CRISIS. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 5 IN APRIL 2022, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS ALSO MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND MARKETED VIA THE FACILITY'S WEBSITE AND FACEBOOK PAGE. MAIL RETURNS AND ON-LINE SURVEYS WERE COMBINED WHICH RESULTED IN 133 SURVEYS BEING RETURNED. CONSULTATIONS WITH INDIVIDUALS WHO REPRESENTED VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, PUBLIC HEALTH, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, AND STUDENTS WERE CONDUCTED TO SOLICIT THEIR INPUT. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 6A NORTHEAST MONTANA HEALTH SERVICES - TRINITY HOSPITAL. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 7D THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 11 THE PRIORITZED HEALTH NEEDS AS DETERMINED THROUGH THE ASSESSMENT PROCESS AND WHICH THE FACILITY WILL BE ADDRESSING RELATES TO THE FOLLOWING HEALTHCARE ISSUES: 1. ACCESS TO HEALTHCARE SERVICES 2. EDUCATION AND AWARENESS OF SERVICES THE FIRST HEALTHCARE ISSUE IS TO INCREASE ACCESS TO HEALTHCARE SERVICES IN THE NEMHS SERVICE AREA. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO INCREASE ACCESS TO PRIMARY CARE SERVICES AT NEMHS BY PROVIDING LOCAL NURSE TRAINING OPPORTUNITIES AND PARTNERING WITH THE COMMUNITY COLLEGE IN FORT BELKNAP TO HOST NURSING CLINIC SITE ROTATIONS FOR STUDENTS, CONTINUING TO OFFER AND EXPLORING EXPANDING INTERNAL PAIN MANAGEMENT SERVICES WITH ON STAFF CRNA, ATTEMPTING TO RECRUIT PRIMARY CARE PHYSICIANS AND A PHYSICAL THERAPIST, ASSESSING THE FEASIBILITY OF EXPANDING OCCUPATIONAL THERAPY SERVICES(HOURS AND/OR ADDITIONAL STAFF), AND AIMING TO RECRUIT A NURSE PRACTITIONER TO ADDRESS THE INCREASED NUMBER OF PAIN MANAGEMENT PATIENTS. NEMHS HAD NURSING STUDENTS COME FROM FORT BELKNAP, IN 2023, AND DO A CLINICAL ROTATION AT BOTH THE WOLF POINT AND POPLAR CAMPUSES. DUE TO LACK OF REFERRALS FROM THE MEDICAL STAFF, WE COULD NOT EXPAND THE INTERNAL PAIN MANAGEMENT SERVICES WITH AN ON STAFF CRNA. TO RECRUIT PHYSICIANS, WE ARE NOW LOOKING AT THE POSSIBILITY OF FOREIGN WORKERS. ALSO, WE RECRUITED A NURSE PRACTITIONER TO OVERSEE THE PAIN MANAGEMENT SERVICES AND THE OVERFLOW CLINIC VOLUMES. IN FISCAL YEAR 2024, NEMHS CONTINUED TO PARTNER WITH FORT BELKNAP NURSING STUDENTS TO DO THEIR CLINICAL ROTATION AT BOTH POPLAR AND WOLF POINT HOSPITALS. WE HAVE ADDED PAIN MANAGEMENT SERVICES WITH A CRNA AND CONTINUED TO HAVE A NURSE PRACTITIONER ON STAFF AT THE CLINIC WHO SPECIALIZES IN PAIN MANAGEMENT. ALSO, WE HAVE INCREASED THERAPY STAFFING TO INCLUDE TWO OFFERS TO FOREIGN PHYSICAL THERAPISTS AND THERE IS A CONTRACT OCCUPATIONAL THERAPIST ON STAFF. THE SECOND STRATEGY IS TO INCREASE ACCESS TO SPECIALTY CARE SERVICES AT NEMHS BY BRINGING IN PODIATRY ONCE A MONTH FOR TWO OR THREE DAYS, EXPLORING INCREASING THE HOURS OF MENTAL HEALTH TELEMEDICINE, EXPANDING PHYSICAL THERAPY SERVICES TO INCLUDE PELVIC FLOOR TRAINING, EXPLORING OFFERING AQUATIC THERAPY SESSIONS, EXPLORING THE FEASIBILITY OF IMPLEMENTING A CARDIAC REHAB PROGRAM, AND CONDUCTING A FEASIBILITY STUDY REGARDING HIPAA COMPLIANCE IN THE E.R. NEMHS OFFERED PELVIC PHYSICAL THERAPY THROUGH TRAVEL PHYSICAL THERAPISTS IN MARCH-SEPTEMBER 2023 AND APRIL-MAY 2024. THE ONSITE PHYSICAL THERAPIST WAS NOT ABLE TO GET CERTIFIED IN PELVIC FLOOR DUE TO HIGH OUTPATIENT CENSUS AND DECREASED STAFFING PREVENTING TAKING TIME OUT OF THE CLINIC TO TRAVEL TO THE REQUIRED CONTINUING EDUCATION COURSE. ALSO, A PLANNED ADDITION TO THE THERAPY CLINIC DID NOT OCCUR, SO THE THERAPY DEPARTMENT LACKS CONSISTENT ACCESS TO AN APPROPRIATE PELVIC FLOOR TREATMENT SPACE, MAKING EXPANDING INTO PELVIC FLOOR PHYSICAL THERAPY IMPRACTICAL. DUE TO LIMITATIONS OF OUR THERAPY SPACE, WE ALTERED OUR GOAL AND FOCUSED ON EXPANDING OUR PHYSICAL THERAPY SERVICES BY GETTING A THERAPIST CERTIFIED TO PERFORM DRY NEEDLING, WHICH OCCURRED IN SEPTEMBER 2023. WE EXPLORED OFFERING AQUATIC THERAPY, BUT DUE TO THE PLANNED ADDITION NOT MOVING FORWARD, PIVOTED AND INSTEAD INSTALLED AN OVERHEAD BALANCE TRACK IN NOVEMBER 2023, AS THIS CAN BE USED FOR OVER WEIGHT PATIENTS AND ALLOWS FOR GREATER FLEXIBILITY IN ITS USE THAN POOL THERAPY, ALLOWING A BROADER SCOPE OF PATIENTS TO UTILIZE IT. DUE TO NOT BEING ABLE TO EXPAND THE SPACE, A CARDIAC REHAB PROGRAM WAS NOT IMPLEMENTATED. ALSO, ALL LOCATIONS INCLUDING THE EMERGENCY ROOM ARE MONITORED FOR HIPPA COMPLIANCE. IN FISCAL YEAR 2024, NEMHS CONTACTED A PODIATRIST BUT AN AGREEMENT WAS NOT REACHED. OUR CURRENT MENTAL HEALTH PRACTITIONER HAS STAFFING CONSTRAINTS SO WE ARE WORKING WITH COMMUNITY MENTAL HEALTH CRISIS SERVICES TO EXPLORE THEIR TELEMEDICINE SERVICE PLATFORM. WE HAVE CONTINUED TO OFFER DRY NEEDLING BY A CERTIFIED PHYSICAL THERAPIST AND PELVIC FLOOR PHYSICAL THERAPY THROUGH TRAVEL PHYSICAL THERAPISTS WHO UTILIZE APPROPRIATE TREATMENT SPACE IN AREAS OTHER THAN PT. A CARDIAC REHAB PROGRAM HAS NOT BEEN IMPLEMENTED DUE TO VOLUMES AND FINANCES. ALSO, WE HAVE CONTINUED TO MONITOR ALL LOCATIONS FOR HIPPA COMPLIANCE. THE SECOND HEALTHCARE ISSUE IS TO ENHANCE THE KNOWLEDGE OF SERVICES AND RESOURCES PROVIDED BY NEMHS. THE STRATEGY FOR ADDRESSING THIS ISSUE IS TO EXPAND EDUCATION AND OUTREACH EFFORTS TO IMPROVE AWARENESS OF AVAILABLE SERVICES AT NEMHS BY CONTINUING OUTREACH VIA RADIO AND SOCIAL MEDIA OUTLETS(FACEBOOK, INSTAGRAM, WEBSITE), CONTINUING TO PLACE HEALTH EDUCATION MATERIALS IN WAITING ROOMS AND HEALTH EDUCATION KIOSKS IN EXAM ROOMS, IMPROVING AWARENESS OF SLEEP STUDIES CONDUCTED BY THE FACILITY, CONTINUING TO HOST THE EMS BASH TO PROMOTE HOSPITAL AND EMS SERVICES, INCREASING COMMUNITY AWARENESS OF EMS SERVICES VIA BILLBOARD, CONTINUING TO HOST THE ANNUAL HEALTH FAIR AND GOLF TOURNAMENT, AND PARTNERING WITH REGIONAL ORGANIZATIONS TO SUPPORT STUDENT INTERESTS IN HEALTHCARE CAREERS. NEMHS CONTINUED EDUCATION AND OUTREACH EFFORTS BY DISTRIBUTING SLIPS AND FALLS PREVENTION BROCHURES AND OTHER HEALTH INFORMATION TO BOTH CLINICS AND HOSPITALS, PLACING DAILY RADIO ADS AND AT LEAST THREE WEEKLY POSTS ON SOCIAL MEDIA, POSTING INFORMATION ON FACEBOOK ABOUT SLEEP AWARENESS AND SLEEP STUDIES, AND HAVING A BILLBOARD THAT WAS VISIBLE FOR EAST AND WEST BOUND DRIVERS. WE DID NOT HOST THE EMS BASH IN 2022 BECAUSE THE COST OF THE VENUE MADE IT NOT FEASIBLE. THE GOLF TOURNAMENT WAS HELD IN 2022, BUT THE ANNUAL HEALTH FAIR DID NOT HAPPEN FOR VARIOUS REASONS. IN FISCAL YEAR 2024, NEMHS CONTINUED UTILIZATION OF SOCIAL MEDIA PLATFORMS WITH FACEBOOK, INSTAGRAM AND LINKEDIN AS WELL AS LOCAL PRINT MEDIA. HEALTH EDUCATION MATERIALS ARE ROTATED THROUGHOUT THE YEAR TO COINCIDE WITH MONTHS WHERE NATIONAL EFFORTS ARE UTILIZED TO INCREASE SCREENING, SUCH AS BREAST CANCER AWARENESS, COLON CANCER, HEART, NUTRITION, MENTAL HEALTH, ETC. EMS SERVICES ARE NOW PROVIDED BY A CONTRACT STAFFING COMPANY SO WE WERE UNABLE TO CONTINUE TO HOST THE EMS BASH AS A SPECIAL EVENT. EMS PARTICIPATES AND IS VISIBLE THROUGH OTHER VENUES SUCH AS LOCAL EVENTS, RODEO, POW WOW, ETC. ALSO, WE HELD THE GOLF TOURNAMENT IN 2023 AND WAS A CONTINUED PRESENCE IN THE LOCAL SCHOOL CAREER FAIR. THE HEALTHCARE NEEDS IDENTIFIED BY NEMHS THAT THEY ARE UNABLE TO ADDRESS: FIRST, THERAPY SERVICES WERE IDENTIFIED AS HIGH AREAS OF CONCERN IN BOTH SURVEY AND KEY INFORMANT DATA. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. SECOND, 14% OF RESPONDENTS SAID THAT MEDICATION COSTS HAD PROHIBITED THEM FROM GETTING OR TAKING THEIR PRESCRIPTIONS REGULARLY. TRIBAL MEMBERS CAN GET THEIR MEDICATIONS THROUGH INDIAN HEALTH SERVICES FREE OF CHARGE. THE COPAY FOR THE MEDICATIONS IS DECIDED BY THE INSURANCE COMPANY OF THE PATIENT AND THERE ARE A COUPLE FACTORS FOR EACH PRESCRIPTION SUCH AS DEDUCTIBLE, PRICE OF MEDICATION, ETC. THIRD, DENTAL SERVICES WERE IDENTIFIED AS NEEDED SERVICES NOT CURRENTLY AVAILABLE FOR BOTH ADULTS AND CHILDREN. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. THERE IS ALSO A PRIVATE, LOCAL DENTIST. PROVIDING DENTAL SERVICES IS BEYOND THE SCOPE OF NEMHS AT THIS TIME. FOURTH, 28.3% OF ADULTS IN ROOSEVELT COUNTY ARE BELOW THE POVERTY LEVEL; 26% OF ADULTS ARE UNINSURED. TSHIP(TRIBAL SPONSORED HEALTH INSURANCE PROGRAM) IS AVAILABLE TO ALL MEMBERS WHO ARE UNDERINSURED OR NOT INSURED. FIFTH, THE PERCENTAGE OF SMOKING DURING PREGNANCY IN ROOSEVELT COUNTY IS 30.7% COMPARED TO 16.5% FOR THE STATE. THIS ISSUE IS BEING ADDRESSED BY NEMHS AND INDIAN HEALTH SERVICES. IT IS AN ONGOING ISSUE AND EDUCATION IS PROVIDED FOR EVERY PATIENT. SIXTH, ROOSEVELT COUNTY HAS A RATE OF 2159.2 PER 100,000 PEOPLE WITH SEXUALLY TRANSMITTED DISEASES COMPARED TO 551.6 FOR THE STATE. SEXUALLY TRANSMITTED DISEASES ARE TRADITIONALLY HIGH WITHIN ROOSEVELT COUNTY AND THE RESERVATION. SOME STEPS HAVE BEEN TAKEN TO ADDRESS THIS ISSUE; INDIAN HEALTH SERVICES HAS IMPLEMENTED A NEEDLE EXCHANGE TO HELP FIGHT THE STD CRISIS. 2 WOLF POINT CLINIC ASSOCIATION 301 KNAPP STREET WOLF POINT MT 59201 RURAL HEALTH CLINIC RIVERSIDE FAMILY CLINIC PO BOX 629 POPLAR MT 59255 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7G THERE WAS NO BAD DEBT EXPENSE TO REMOVE FROM THE COMMUNITY BENEFIT IN COLUMN C. PHYSICIAN CLINIC COSTS ARE NOT INCLUDED IN SUBSIDIZED HEALTHCARE SERVICES. SCHEDULE H, PART I, LINE 7 USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX EXPENSE. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. SCHEDULE H, PART II THE STAFF AT NEMHS DESIGNATES TIME FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. THESE ACTIVITIES/INITIATIVES OFTEN TARGET ENVIRONMENTAL STRATEGIES, ECONOMIC DEVELOPMENT AND LEADERSHIP, ADVOCACY AND SUPPORT THAT INDIRECTLY AFFECT THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, LINE 2 THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT EXPENSE, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES, NOT INCLUDING IMPLICIT PRICE CONCESSIONS, TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS AND IMPLICIT PRICE CONCESSIONS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF IMPLICIT PRICE CONCESSIONS OR BAD DEBT, WHICH REDUCE IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. PATIENT OBLIGATIONS WHICH QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT RECORDED AS IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 4 THERE IS NO BAD DEBT EXPENSE RECORDED AND THEREFORE NO RELATED BAD DEBT FOOTNOTE. AFTER ADOPTING THE NEW REVENUE RECOGNITION GUIDANCE IN FASB ASU 2014-09, MOST TRANSACTIONS THAT PREVIOUSLY WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE ARE NOW RECORDED AS IMPLICIT PRICE CONCESSIONS, WHICH ARE REDUCTIONS OF REVENUE VERSUS BAD DEBT EXPENSE. NOTE 9 TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS DISCUSSES IMPLICIT PRICE CONCESSIONS ON PAGES 18 AND 19. SCHEDULE H, PART III, LINE 8 THERE IS A MEDICARE SHORTFALL SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE, LESS THE 2 PERCENT SEQUESTRATION ADJUSTMENT. THIS MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT SINCE THE ORGANIZATION IS PROVIDING MEDICARE PATIENT CARE SERVICES AT LESS THAN THE COST. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE COSTS BASED ON THE AMBULANCE COST-TO-CHARGE RATIO ON THE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE REVENUE FROM THE MEDICARE PS&R REPORT. SCHEDULE H, PART III, LINE 9B THE ORGANIZATION WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE APPLICABLE SERVICES WILL BE DISCOUNTED BY 100%, SO THERE IS NO COLLECTIONS EFFORT. SCHEDULE H, PART VI, LINE 2 PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, NEMHS ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT AND AN IMPLEMENTATION PLAN DURING FISCAL YEARS 2022, 2019 AND 2016 (TAX YEARS 2021, 2018 AND 2015). THESE ARE A CONTINUATION AND EXPANSION OF WHAT WE ARE ALREADY DOING TO BETTER SERVE OUR COMMUNITY. WE ARE DILIGENTLY TRACKING LOCAL TRENDS IN HEALTH CARE NEEDS THROUGH AN CUSTOM SURVEY SOLUTIONS PATIENT SATISFACTION SURVEY GIVEN TO ALL INPATIENTS AS WELL AS THE USE OF OUR INTERNAL BALANCED SCORE CARD. A SELECTED TEAM OF MANAGERS MEET QUARTERLY TO DISCUSS OUTCOMES FROM OUR SURVEY REPORTS AND BALANCED SCORE CARD FINDINGS. SCHEDULE H, PART VI, LINE 3 NORTHEAST MONTANA HEALTH SERVICES EMPLOYS TWO SOCIAL SERVICE EMPLOYEES TO ASSIST PATIENTS WITH THEIR FINANICAL NEEDS AND OPTIONS. COMMUNITY ADVERTISEMENT IS USED TO EDUCATE PATIENTS AND SUPPORT IS GIVEN ON A ONE-ON-ONE BASIS TO ASSIST COMMUNITY MEMBERS. PATIENTS ARE NOTIFIED BY THE BILLING DEPARTMENT OF OUR POLICY FOR FINANCIAL ASSISTANCE AND ARE SENT A SIMPLE APPLICATION. OUR WEBSITE PROVIDES DETAILS OF OUR FINANCIAL ASSISTANCE POLICY AND THE FINANCIAL ASSISTANCE AVAILABLE. THE PATIENT INVOICES INCLUDE A STATEMENT ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO FIND FURTHER INFORMATION. SCHEDULE H, PART VI, LINE 4 THE ORGANIZATION OPERATES ON THE FORT PECK RESERVATION. GEOGRAPHICALLY THIS IS A REMOTE LOCATION WHERE ACCESS TO OTHER HEALTH FACILITIES IS AT LEAST 50 MILES AWAY. WITH SEVERE WEATHER CONDITIONS OFTEN RESULTING IN BLIZZARDS AND IMPASSABLE ROADS, NORTHEAST MONTANA HEALTH SERVICES IS THE FRONTLINE OF CARE FOR THE COMMUNITY. THE POPULATION OF SIOUX AND ASSINIBOINE TRIBAL MEMBERS MAKE UP OUR HIGHEST CONCENTRATION OF PATIENTS WITH DISPARITIES THAT INCLUDE CULTURAL BARRIERS, LOW HOUSEHOLD INCOME, HIGH UNEMPLOYMENT RATES, HIGHER RATES OF TOBACCO, ALCOHOL AND ILLEGAL DRUG USE, AS WELL AS HIGHER THAN AVERAGE RATES OF HEART DISEASE, DIABETES, FETAL ALCOHOL SYNDROME, AND SUICIDE. AS WE CONTINUE OUR EFFORTS TO SERVE THE PUBLIC THROUGH HEALTHCARE AND EDUCATION, THERE IS PROGRESS BEING MADE TO IMPROVE THE QUALITY OF LIFE FOR COMMUNITY MEMBERS. SCHEDULE H, PART VI, LINE 5 NORTHEAST MONTANA HEALTH SERVICES IS GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY MEMBERS REPRESENTING THE GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. OUR HOSPITALS PROVIDE 24/7 EMERGENCY SERVICE COVERAGE TO TREAT PATIENTS, INCLUDING THOSE THAT ARE UNABLE TO PAY. SCHEDULE H, PART VI, LINE 6 TWO AFFILIATED RURAL HEALTH CLINICS, WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC, PROVIDE PROFESSIONAL PHYSICIAN AND OTHER PRACTITIONER SERVICES WHILE NORTHEAST MONTANA HEALTH SERVICES PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND SKILLED NURSING SERVICES. THE TWO RURAL HEALTH CLINICS ARE OPERATED, AND SUBSIDIZED IF NEEDED, BY NORTHEAST MONTANA HEALTH SERVICES. SCHEDULE H, PART VI PART V: WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC ARE RURAL HEALTH CLINICS THAT ARE OPERATED AND SUBSIDIZED IF NEEDED BY NORTHEAST MONTANA HEALTH SERVICES. THEIR REVENUES AND EXPENSES ARE NOT INCLUDED ON NORTHEAST MONTANA HEALTH SERVICES' FORM 990. X X X X false false false false false false false false false MICHAEL POST CEO 300016 1275 14067 315358 HANZ ARNSTON RN 186910 1402 11028 199340 NONETTE BROWN RISK MGT DIRECTOR 145767 2916 11028 159711 LORI COLLINS RN 143451 2870 11028 157349 ROGER FISHER COO 153608 3545 157153 ELAINE LONG RN-VP NURSING 140057 2802 11028 153887 TACY STRAND RN-CNO 137256 2059 11028 150343 A MT FACILITY FINANCE AUTHORITY BONDS 364615155 2017-01-31 9820000 REFUNDING OF 2007B REVENUE BONDS false false false A 9820000 794798 8827353 196400 1449 2017 true false true true A false false false false false false true A false false false false false false false false false A false PURPOSE OF ISSUE DESCRIPTION MT FACILITY FINANCE AUTHORITY BONDS REFUNDING OF 2007B REVENUE BONDS FORM 990, PAGE 1, PART I, LINE 6 BOARD MEMBERS FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED AND APPROVED BY MANAGEMENT AND IS DISTRIBUTED TO THE GOVERNING BOARD FOR REVIEW PRIOR TO BEING FILED. FORM 990, PAGE 6, PART VI, LINE 12C THE MEMBERS OF THE GOVERNING BOARD SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY IN WHICH THEY ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT DOES EXIST, THE BOARD CHAIRMAN WILL REMIND MEMBERS AND ASK THEM TO ABSTAIN FROM VOTING. THESE CONFLICTS ARE DULY NOTED IN THE MINUTES. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD APPROVES THE WAGES OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS IN THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 15B THE CEO APPROVES THE WAGES OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE AVAILABLE FROM CFO UPON REQUEST. FORM 990, PART IX, LINE 11G PURCH SVCS & CONTRACT STAFF 3,184,573 364,888 649 CONTRACT NURSING STAFF 1,866,378 8,531 0 CONTRACT LAB STAFF 948,508 0 0 CONTRACT PHARMACY SERVICES 698,271 0 0 CONTRACT PHYSICIANS 480,456 0 0 TOTAL 7,178,186 373,419 649 RIVERSIDE FAMILY CLINIC PO BOX 629 POPLAR MT 59255 810474760 CLINIC MT 501C3 3 NEMHS true WOLF POINT CLINIC ASSOCIATION 301 KNAPP STREET WOLF POINT MT 59201 810386812 CLINIC MT 501C3 3 NEMHS true NEMHS CHARITABLE FOUNDATION INC PO BOX 341 POPLAR MT 59255 383732814 SUPPORT MT 501C3 7 N/A false NE MT STAT AIR AMB COOP 81 AIRPORT ROAD GLASGOW MT 59230 204748673 AIR AMBUL MT 501C3 12B N/A false FAITH LUTHERAN HOME FOUNDATION INC 1000 6TH AVE N WOLF POINT MT 59201 810483586 SUPPORT MT 501C3 PF N/A false false false true false false false false false false false false false false false true false false true false NEMHS CHARITABLE FOUNDATION O 69647 DIRECT EXPENSE FAITH LUTHERAN HOME FOUNDATION C 11000 CASH GIFTS RIVERSIDE FAMILY CLINIC R 833511 INCREASE IN RECEIVABLE WOLF POINT CLINIC ASSOCIATION R 522985 INCREASE IN RECEIVABLE