2023-05-12T18:21:59-04:00 2022-06-30 GREEN HEALTH GROUP PC 405 FOURTH AVENUE NORTH GLASGOW MT 59230 990 2021-07-01 810226578 NORTHEAST MONTANA HEALTH SERVICES NORT 4066536500 315 KNAPP STREET WOLF POINT MT 59201 MICHAEL POST CEO 4066536500 2023-05-11 true MICHEAL POST XXX-XX-XXXX DANIEL GREEN P01311679 4062632615 2023-05-12 2021 2023-04-26 12:10:37Z MICHAEL POST 315 KNAPP STREET WOLF POINT MT 59201 37124169 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. 8 7 447 5 1192070 10676677 571024 34360492 36296589 301801 -114554 306535 364062 45645505 37117121 0 0 17247225 17844854 0 65255 13113170 15011357 30360395 32856211 15285110 4260910 60858718 64200147 16873885 15954577 43984833 48245570 TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. false false 28860184 36296589 PROVIDE QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO THE PATIENTS THAT WE SERVE. 28860184 true true false true false false false false false false true true false true false true false true false false false false false false true 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 34 0 447 true true true false false false false false false false false false false false X 8 7 false false false false false false false true true false false true true true true true true true true false X JAMES BACON 4066536500 315 KNAPP ST WOLF POINT MT 59201 X MARGARET NORGAARD CEO 40.00 X 181688 0 32050 LORI COLLINS RN 40.00 X 184679 0 14505 MARK ZILKOSKI MD MEDICAL STAF 1.00 40.00 X 0 184485 1845 HANZ ARNSTON RN 40.00 X 158191 0 11998 ELAINE LONG RN-VP NURSIN 40.00 X 149618 0 13799 DEMI WILKINSON CFO 40.00 X 134990 0 15300 STEPHEN TRIMBLE RN 40.00 X 134173 0 13633 ROGER FISHER COO 40.00 X 146453 0 1142 NONETTE BROWN RN 40.00 X 130315 0 13418 SHANE GIBSON DIRECTOR 1.00 X 0 0 0 STEVE HACKLEY CHAIRMAN 2.00 X 0 0 0 VICTORIA MATEJOVSKY DIRECTOR 1.00 X 0 0 0 STEPHANIE MCGOWAN TREASURER 1.00 X 0 0 0 DAN MOUDREE DIRECTOR 1.00 X 0 0 0 DALLAS O'CONNOR VICE-CHAIRMA 1.00 X 0 0 0 STACEY SUMMERS TRIBAL REP 1.00 X 0 0 0 MICHAEL POST CEO 0.00 X 0 0 0 1220107 184485 117690 23 false true false KATHY WULF 51265 221ST STREET GLENWOOD IA 51534 LOCUM TENEN 346969 BARTON & ASSOCIATES INC PO BOX 417844 BOSTON MA 022417844 LOCUM TENENS 266825 DRAGE FAMILY EMERGENCY INC 1912 E HICKORY POINT CIRCLE SANDY UT 84092 LOCUM TENENS 248172 SOUTHERN MT ANESTHESIA 430 FLESHMAN CREED RD LIVINGSTON MT 59047 CRNA 202671 EXPERT EASE ANESTHESIA LLC 776 HILLSIDE DRIVE GLASGOW MT 59230 CRNA 188391 10 12350 97448 414890 46336 571024 PATIENT REVENUE 621500 32531163 32531163 RETAIL PHARMACIES 446110 3765426 2573356 1192070 36296589 -114554 -114554 7588 12350 7048 540 HOSPITAL DISTRICT TAX REVENUE 900099 365146 365146 LOSS ON SALE OF ASSETS 900099 -1624 -1624 363522 37117121 35353487 1192070 X 480020 480020 14804979 12971584 1779981 53414 156053 128599 27149 305 1223434 1015643 203782 4009 1180368 992761 183034 4573 14501 14501 61250 61250 4417488 4326817 90546 125 97853 97853 689435 469662 219410 363 347625 277926 68378 1321 339484 275833 63651 110041 101707 8330 4 26042 19473 6561 8 217771 174326 43445 1726906 1487703 239203 285921 228880 57041 MEDICAL SUPPLIES 4247378 4182840 64538 COGS 841125 841125 REPAIRS & MAINTENANCE 691698 546094 144516 1088 BED TAXES 523764 523764 373075 295447 77583 45 32856211 28860184 3930772 65255 17548530 18351089 3875254 3849520 7490035 8631934 847522 1100895 357591 341714 34844225 23686177 11710022 11158048 6759041 6597985 12270723 14168962 60858718 64200147 9008555 8992770 327964 111455 7256670 6700609 280696 149743 16873885 15954577 X 43944868 48201161 39965 44409 43984833 48245570 60858718 64200147 X 4260910 -107558 107385 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2764 2764 false SCHEDULE C, PART IV 0.83 PERCENT OF MHA DUES PAID TO MHA, WHICH WAS 286, 26.47 PERCENT OF DUES PAID TO MHA FOR AHA, WHICH WAS 2,449, AND 2.93 PERCENT OF DUES PAID TO MHA FOR LEADINGAGE WHICH WAS 29 (2,764 COMBINED) WERE USED FOR LOBBYING EXPENSES BY MHA. 60058 60058 20177175 12970631 7206544 14606992 10715546 3891446 11158048 5549896 C BOND FUNDS 1048089 F 6597985 RECEIVABLE-WOLF POINT CLINIC ASSOC 9254507 RECEIVABLE-RIVERSIDE FAMILY CLINIC 4792455 WORK COMP TRUST DEPOSIT 122000 14168962 X 37016611 -107558 -107558 37124169 -7048 -7048 37117121 32863259 32863259 -7048 -7048 32856211 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, 2022 AND 2021. SCHEDULE D, PAGE 4, PART XI, LINE 4B FUNDRAISING EXPENSES NETTED AGAINST REVENUE -7,048 SCHEDULE D, PAGE 4, PART XII, LINE 4B FUNDRAISING EXPENSES NETTED AGAINST REVENUE -7,048 EMS FUNDRAISER 19938 12350 7588 1471 1454 750 3373 19938 12350 7588 1471 1454 750 3373 7048 540 true true X true X true X true true true false false 595374 595374 0.01810 595374 595374 0.01810 5429985 2987248 2442737 0.07430 5429985 2987248 2442737 0.07430 6025359 2987248 3038111 0.09250 99442 99442 0.00300 99442 99442 0.00300 true 6680444 6555174 125270 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 150.000000000000 400.000000000000 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 150.000000000000 400.000000000000 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. 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. 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. 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. NEMHS HAS A SLIDING-FEE SCALE THROUGH WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC. 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. 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. 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. 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. NEMHS HAS A SLIDING-FEE SCALE THROUGH WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC. 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 AND WORKFORCE DEVELOPMENT 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. PART II, LINE 8: NEMHS IS LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA AND SPENT 99,442 TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS NEEDED IN THE COMMUNITY. THE COST IS COMPRISED OF PAYMENTS TO RECRUITING FIRMS, NEWSPAPER AND PERIODICALS ADVERTISING, LEGAL FEES FOR FOREIGN PROFESSIONALS, AND TRAVEL AND LODGING FOR SITE VISITS. 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 10 TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS DISCUSSES IMPLICIT PRICE CONCESSIONS ON PAGES 19 AND 20. SCHEDULE H, PART III, LINE 8 THERE IS A MEDICARE SURPLUS SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE AND THE 2 PERCENT SEQUESTRATION ADJUSTMENT WAS REINSTATED IN APRIL 2022. 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 USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, AND ALSO A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS FINANCIAL ASSISTANCE UNLESS THE PATIENT QUALIFIES FOR DISCOUNTED CARE AND THEN DEFAULTS ON THE PAYMENT PLAN ON THE BALANCE OF THE ACCOUNT. THIS IS A SPECIFIC POLICY FOR PATIENTS QUALIFYING FOR FREE OR DISCOUNTED CARE. 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 PROVIDER 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 false true false false false false false false false MARGARET NORGAARD CEO 181688 3634 28416 213738 LORI COLLINS RN 184679 3693 10812 199184 MARK ZILKOSKI MD MEDICAL STAFF REP 184485 1845 186330 HANZ ARNSTON RN 158191 1186 10812 170189 ELAINE LONG RN-VP NURSING 149618 2987 10812 163417 DEMI WILKINSON CFO 134990 4488 10812 150290 SCHEDULE J, PAGE 1, PART I, LINE 4 MARK ZILKOSKI, MD 0 -209,253 0 SCHEDULE J, PART III MARK ZILKOSKI, MD PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED PLAN IN TAX YEAR 2021, BUT THE VALUE OF THE RELATED INVESTMENTS DECLINED IN TAX YEAR 2021 RESULTING IN A CONTRA-EXPENSE OF 209,253. THE COMPENSATION OF MARK ZILKOSKI, MD IS AN EXPENSE OF WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY. 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 VOLUNTEERS ASSIST WITH RESIDENT ACTIVITIES AT FAITH LUTHERAN HOME 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 VII THE MEDICAL STAFF REPRESENTATIVE ON THE GOVERNING BOARD, MARK ZILKOSKI, M.D., IS EMPLOYED BY WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY, AS A FULL TIME PHYSICIAN WHICH IS INCLUDED AT 40 HOURS PER WEEK. FORM 990, PART IX, LINE 11G PURCH SVCS & CONTRACT STAFF 2,925,196 90,546 125 CONTRACT NURSING STAFF 1,130,151 0 0 CONTRACT LAB STAFF 271,470 0 0 TOTAL 4,326,817 90,546 125 FORM 990, PART XI, LINE 9 FUNDRAISING EXPENSES NETTED AGAINST REVENUE 7,048 FUNDRAISING EXPENSES NETTED AGAINST REVENUE -7,048 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 59012 DIRECT EXPENSE FAITH LUTHERAN HOME FOUNDATION C 10500 CASH GIFTS RIVERSIDE FAMILY CLINIC R 927761 INCREASE IN RECEIVABLE WOLF POINT CLINIC ASSOCIATION R 943478 INCREASE IN RECEIVABLE NEMHS CHARITABLE FOUNDATION C 86948 CASH GIFTS