2023-05-15T10:00:36-05:00 2022-06-30 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2021-07-01 816016920 DANIELS MEMORIAL HOSPITAL DANI 4064872296 P O BOX 400 SCOBEY MT 59263 KODY BRINTON CEO 4064872296 2023-05-09 1 KODY BRINTON 999009999 SAM BRUNSON CPA P01696998 4067281800 2023-05-09 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DANIELS MEMORIAL HEALTHCARE CENTER KODY BRINTON P O BOX 400 SCOBEY MT 59263 11774758 0 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X 1956 MT TO PROMOTE THE GENERAL HEALTH CARE OF THE COMMUNITY THROUGH PROVIDING HIGH QUALITY HEALTH CARE. 9 9 99 15 0 0 2039311 160748 10093128 11205769 22645 541 475379 407700 12630463 11774758 0 0 0 0 5248250 5284876 0 0 0 4542074 6202096 9790324 11486972 2840139 287786 9757742 8481748 3162407 1598627 6595335 6883121 X TO PROVIDE A HEALTH CARE SYSTEM WITH CLINIC, ACUTE INPATIENT, EMERGENCY, OUTPATIENT, AND 25-BED CRITICAL ACCESS HOSPITAL SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 0 0 4965074 10013375 PROFESSIONAL CARE - PRIMARY, ACUTE, CRITICAL ACCESS CARE AND MENTAL HEALTH SERVICES. 1187172 1550003 CLINIC SERVICES FOR OUTPATIENT CLIENTS. 1011282 0 HOUSEKEEPING, LAUNDRY, LINEN & PLANT SERVICES - PROVIDE FOR THE HOUSEKEEPING AND BUILDING MAINTENANCE OF THE FACILTIY. 506039 50091 DIETARY SERVICES FOR ACUTE CARE PATIENTS. 506039 50091 7669567 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 5 0 99 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 4064872296 P O BOX 400 SCOBEY MT 59263 X PAUL KANNING CHAIR 2.00 X X 0 0 0 CARRIE WILSON VICE CHAIR 2.00 X X 0 0 0 JEDDA BARRON SECRETARY 2.00 X X 0 0 0 JACK PITTENGER TREASURER 2.00 X X 0 0 0 MIKE BJARKO DIRECTOR 2.00 X 0 0 0 TANNER TROWER DIRECTOR 2.00 X 0 0 0 ALYCIA NATHE DIRECTOR 2.00 X 0 0 0 JANITZIA NELSON DIRECTOR 2.00 X 0 0 0 CLIFF HAMES DIRECTOR 2.00 X 0 0 0 CAITLIN BUER DIRECTOR (THRU 11/21) 2.00 X 0 0 0 LIANA HANDRAN DIRECTOR (THRU 3/22) 2.00 X 0 0 0 MARION THOMPSON INTERIM CEO (THRU 11/21) 40.00 X 0 0 0 KODY BRINTON CEO 40.00 X 0 0 0 GREG CROWER NP 40.00 X 201655 0 32356 SHERRY GAIRRETT NP 40.00 X 194835 0 31146 DEANNA FERESTAD NP 40.00 X 158197 0 37359 SHIRLEY RELLER PT 40.00 X 158454 0 37458 JESSICA WINGE-PETERSON DON 40.00 X 123426 0 17118 836567 0 155437 6 0 1 0 BILLINGS CLINIC PO BOX 30357 BILLINGS MT 59107 MANAGEMENT, CEO, ACCOUNTING 926868 BADLANDS MEDICAL STAFFING BOX 133 UNDERWOOD ND 58576 NURSES AND CNAS 324380 SOLIANT 5550 PEACHTREE PARKWAY STE 500 PEACHTREE CORNERS GA 30092 RADIOLOGY/LAB TECH 193180 MONTANA HEALTH NETWORK 519 PLEASANT ST MILES CITY MT 59301 NURSES, CNAS, HOUSEKEEPING 185202 PRN STAFFING 2501 CADDIE LANE BRENTWOOD CA 94513 NURSES, CNAS, HOUSEKEEPING 154536 6 54902 12283 93563 160748 PROFESSIONAL CARE REVENUE 623000 9697148 9697148 CLINIC REVENUE 623000 1508621 1508621 11205769 541 541 340B REVENUE 623000 138655 138655 INCOME/LOSS FROM INSURANCE CAPTIV 623000 12673 12673 256372 256372 407700 11774758 11613469 0 541 X 4177998 2875963 1302035 86611 73240 13371 716244 571031 145213 304023 256581 47442 26068 26068 38704 38704 2961723 1041439 1920284 21578 1310 20268 50384 22871 27513 231126 207146 23980 41132 10167 30965 8295 8295 294496 294496 130629 2941 127688 CONTRACTUAL ALLOWANCES 1285913 1285913 MEDICAL SUPPLIES AND PH 502835 502835 OTHER SUPPLIES 216864 202830 14034 BAD DEBT EXPENSE 111718 111718 280631 209086 71545 11486972 7669567 3817405 0 2745001 3038012 2726680 358737 1358499 1608208 129679 96562 269860 271339 88615 106195 8073896 5734850 2135119 2339046 304289 663649 9757742 8481748 1093373 662503 1496916 195757 102747 251825 469371 488542 3162407 1598627 X 6406872 6783121 188463 100000 6595335 6883121 9757742 8481748 287786 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13500 13500 4281698 3445522 836176 3336244 2270327 1065917 442454 19001 423453 2339046 SUBSCRIBERS EQUITY IN INSURANCE CAPTIVE 253691 BED TAX RECEIVABLE 99351 RESIDENT CASH 7206 DEPOSIT 700 COST REPORT SETTLEMENT RECEIVABLE 302701 663649 COST REPORT SETTLEMENT PAYABLE 324773 GUARANTEE OF PATIENT LOANS 96562 RIGHT OF USE OPERATING LEASE 60000 RESIDENT TRUST FUND 7207 488542 X 10377127 0 10377127 1397631 1397631 11774758 10089341 0 10089341 1397631 1397631 11486972 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT UNRELATED BUSINESS INCOME IN ACCORDANCE WITH THE CODE. CURRENT ACCOUNTING GUIDELINES REQUIRE AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE-LIKELY-THAN-NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. FEDERAL RETURNS FOR TAX YEARS 2018 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRACTUAL ALLOWANCES & DISCOUNTS 1,285,913. BAD DEBT EXPENSE 111,718. PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRACTUAL ALLOWANCES & DISCOUNTS 1,285,913. BAD DEBT EXPENSE 111,718. 1 1 1 X 1 X 1 1 1 0 0 181204 181204 0.01580 1843537 1843537 0.16050 2024741 2024741 0.17630 74647 39273 35374 0.00310 49262 49262 0.00430 123909 39273 84636 0.00740 2148650 39273 2109377 0.18370 1 100188 4652605 4616274 36331 X 1 1 1 1 DANIELS MEMORIAL HOSPITAL PO BOX 400 SCOBEY MT 59263 WWW.DANIELSMEMORIALHEALTHCARE.ORG X X X X RURAL HEALTH CLINIC DANIELS MEMORIAL HEALTHCARE CENTER 1 0 0 1 X X X X X X X X 21 1 0 1 1 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X 1 22 1 WWW.DANIELSMEMORIALHEALTHCARE.ORG 0 1 X 100.000000000000 400.000000000000 X X X 0 1 X X 1 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X WWW.DANIELSMEMORIALHEALTHCARE.ORG X WWW.DANIELSMEMORIALHEALTHCARE.ORG X X X X X 1 X 0 X X X X 1 0 1 DANIELS MEMORIAL HEALTHCARE CENTER PART V, SECTION B, LINE 5: FIVE KEY INFORMANT INTERVIEWS WERE CONDUCTED TO IDENTIFY IMPORTANT LOCAL HEALTHCARE ISSUES, HOW TO IMPROVE THE HEALTH OF THE COMMUNITY, AND GAPS IN HEALTH SERVICES. IN ADDITION, SURVEYS WERE PROVIDED TO 600 HOUSEHOLDS IN THE DMHC SERVICE AREA WITH 127 COMPLETED SURVEYS BEING RETURNED. DANIELS MEMORIAL HEALTHCARE CENTER PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN COOPERATION WITH THE MONTANA OFFICE OF RURAL HEALTH. DANIELS MEMORIAL HEALTHCARE CENTER PART V, SECTION B, LINE 11: THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS:GOAL 1: IMPROVE ACCESS TO HEALTHCARE SERVICES IN DANIELS COUNTY.STRATEGY 1.1: INCREASE ACCESS TO PRIMARY CARE SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER (DMHC). ACTIVITIES: CONTINUE EFFORTS TO RECRUIT A PHYSICIAN LOCALLY TO IMPROVE ACCESS TO PRIMARY CARE SERVICES; CREATE EDUCATION AND OUTREACH PLAN TO RAISE AWARENESS OF SERVICES THAT ADVANCED PRACTICE PROVIDERS CAN PROVIDE LOCALLY AND HOW DMHC IS WORKING TO EXPAND DESIRED PRIMARY CARE SERVICES; EXPLORE THE FEASIBILITY OF EXPANDING TELEHEALTH SERVICES IN PARTNERSHIP WITH BILLINGS CLINIC; CREATE A DISSEMINATION PLAN AND WORKSHOP TO EDUCATE COMMUNITY MEMBERS ON HOW TO ACCESS AND UTILIZE TELEHEALTH SERVICES; CONTINUE OUTREACH WITH LOCAL SCHOOLS TO PROMOTE HEALTH PROFESSIONS, PARTICULARLY THE CERTIFIED NURSE ASSISTANT (CNA) PROGRAM.STRATEGY 1.2: EXPLORE OPPORTUNITIES TO ENHANCE ACCESS TO SPECIALTY CARE IN DANIELS COUNTY. ACTIVITIES: DETERMINE OPPORTUNITIES TO SUSTAIN SPECIALTY SERVICES VIA TELEMEDICINE AT DANIELS MEMORIAL HEALTHCARE CENTER; IMPROVE EDUCATION AND OUTREACH TO DMHC STAFF AND THE SERVICE AREA ABOUT THE SPECIALTY SERVICES THAT ARE AVAILABLE LOCALLY VIA TELEMEDICINE; EXPLORE OPPORTUNITIES TO EXPAND CURRENT SPECIALTY SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER (I.E., ECHOCARDIOGRAMS, EXPANDED ULTRASOUND, AND WOMEN'S HEALTH, ETC.).STRATEGY 1.3: SUPPORT LOCAL TRANSPORTATION SERVICES THAT ASSIST COUNTY RESIDENTS IN ACCESSING HEALTHCARE SERVICES IN THE REGION. ACTIVITIES: CONTINUE PARTICIPATION AND SUPPORT OF THE DANIELS COUNTY PUBLIC TRANSPORTATION. CONTINUE TO FACILITATE TRANSPORTATION TO AND FROM MEDICAL APPOINTMENTS AT DMHC AND WITHIN THE REGION FOR PATIENTS WHO DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION.STRATEGY 1.4: SUPPORT AND EXPAND SERVICES THAT ASSIST DANIELS COUNTY SENIORS TO AGE IN PLACE.ACTIVITIES: CONTINUE TO PROVIDE SERVICES THAT ASSIST SENIORS TO AGE IN PLACE (I.E., VISITING NURSE, ADULT DAYCARE, LIFELINE, WHIRLPOOL, ETC.); CONTINUE TO PROVIDE ACCESS TO HEALTHY MEALS THROUGH MEALS ON WHEELS PROGRAM FOR SENIORS IN DANIELS COUNTY; CONTINUE TO PROVIDE STAFFING SUPPORT FOR THE FALL PREVENTION CLASS (I.E., STEPPING ON, ETC.).GOAL 2: ENHANCE DANIELS MEMORIAL HEALTHCARE CENTER'S SUPPORT OF AND OUTREACH FOR HEALTH AND WELLNESS IN DANIELS COUNTY.STRATEGY 2.1: SUPPORT COMMUNITY PROGRAMS AND EVENTS THAT ENCOURAGE HEALTHY BEHAVIORS AND LIFESTYLES.ACTIVITIES: CONTINUE TO SUPPORT COMMUNITY HEALTH AND WELLNESS PROGRAMS AND EVENTS THAT PROMOTE HEALTHY BEHAVIORS, ACTIVITIES, AND SHARE HEALTH EDUCATION (SPONSOR TOWER HILL WALK AND GOLF TOURNAMENT, DMHC PRESENCE VIA AN ANNUAL FAIR BOOTH, PROVIDE SPORTS PHYSICALS AT LOCAL SCHOOLS, PARTICIPATE IN COMMUNITY EVENTS SUPPORTING LOCAL VETERANS); EXPLORE NEW MODALITIES TO PROMOTE HEALTH/WELLNESS AND PROVIDE INFORMATION TO COMMUNITY (I.E., SOCIAL MEDIA, COMMUNITY OUTREACH EVENTS, ETC.).GOAL 3: IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER.STRATEGY 3.1: EXPLORE OPPORTUNITIES TO ADVANCE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES. ACTIVITIES: EXPLORE EXPANDING THE UTILIZATION OF TELEHEALTH MENTAL HEALTH SERVICES (I.E., PSYCHIATRIC NURSE PRACTITIONER); REASSESS CURRENT COMMUNITY AND REGIONAL PARTNERS/RESOURCES THAT STRENGTHEN ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES.STRATEGY 3.2: CONTINUE SUPPORT OF CURRENT MENTAL AND BEHAVIORAL HEALTH EFFORTS IN DANIELS COUNTY.ACTIVITIES: SUSTAIN DANIELS MEMORIAL HEALTHCARE CENTER'S PARTICIPATION ON THE DANIELS COUNTY LOCAL MENTAL HEALTH ADVISORY COMMITTEE. DMHC IS UNABLE TO ADDRESS THE FOLLOWING NEEDS AT THIS TIME: 1. 9.2% OF SURVEY RESPONDENTS INDICATED THEY HAD DIFFICULTY GETTING A PRESCRIPTION OR TAKING THEIR MEDICATION REGULARLY DUE TO COST IN THE LAST YEAR. IN PARTNERSHIP WITH SERVICE FAMILY PHARMACY, DANIELS MEMORIAL JOINED THE 340B PROGRAM AND ARE FINE TUNING THE DETAILS. THE 340B PROGRAM IS DESIGNED TO ASSIST IN MAKING PRESCRIPTIONS MORE AFFORDABLE FOR PATIENTS WHO ARE FINANCIALLY NEEDY. 2. 2.1% OF SURVEY RESPONDENTS WERE CONCERNED ABOUT NOT HAVING ENOUGH FOOD TO EAT IN THE LAST YEAR. DANIELS MEMORIAL HEALTHCARE CENTER PROVIDES MONETARY AND FOOD DONATIONS TO THE LOCAL FOOD PANTRY AS WELL AS REFERS COMMUNITY MEMBERS WHEN NECESSARY. PROVIDING A ROBUST STRATEGY TO ADDRESS FOOD INSECURITY IS CHALLENGING, HOWEVER DMHC IS IN PARTNERSHIP WITH THE CHAMBER OF COMMERCE AND DANIELS COUNTY PUBLIC HEALTH DEPARTMENT TO EXPLORE SOLUTIONS TO ADDRESS FOOD INSECURITY LOCALLY. DANIELS MEMORIAL HEALTHCARE CENTER PART V, SECTION B, LINE 24: PATIENT CARE WHICH IS NOT MEDICALLY NECESSARY INCLUDING ELECTIVE, COSMETIC, EXPERIMENTAL OR DEEMED TO BE GENERALLY NOT REIMBURSABLE BY TRADITIONAL INSURANCE CARRIERS AND GOVERNMENTAL PAYERS SHALL NOT BE CONSIDERED ELIGIBLE FOR CHARITY CARE. PART I, LINE 3C: THE ADMINISTRATOR CAN REVIEW ACCOUNTS ON A CASE-BY-CASE BASIS AND LOOK FOR INDICATION THAT THE FULL PAYMENT MAY CAUSE SOCIAL AND FINANCIAL HARDSHIP SO AS TO SIGNIFICANTLY HARM THE PATIENT OR THE FAMILY UNIT. PART I, LINE 7: A COST-TO-CHARGE RATIO WAS CALCULATED USING WORKSHEET 2. ALL AMOUNTS ON LINE 7 WERE CALCULATED USING THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS. PART III, LINE 2: BAD DEBT EXPENSE IS THE THE BAD DEBT EXPENSE LESS BAD DEBT RECOVERY FROM THE INCOME STATEMENT. PART III, LINE 4: SEE NOTE 1 PATIENT ACCOUNTS RECEIVABLES AND CREDIT POLICY STARTING ON PAGE 15 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE COST TO CHARGE RATIO IS USED TO DETERMINE COMMUNITY BENEFIT. THIS IS DONE BY APPLYING THE RATIO TO THE TOTAL MEDICARE REVENUE. A SHORTFALL OR OVERAGE IN ANY GIVEN YEAR IS A RESULT OF THE TIMING OF PAYMENTS FROM MEDICARE ON AN INTERIM BASIS AND WHEN FINAL SETTLEMENT IS MADE. MANAGEMENT USES ESTIMATES TO CALCULATE SUCH SETTLEMENTS BUT ACTUAL RESULTS VARY FROM THOSE ESTIMATES. ADDITIONALLY, SHORTFALLS CAN RESULT FROM VARIOUS EXPENSES THAT ARE INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE. SINCE PART OF THE COSTS ARE NOT REIMBURSED IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. ALSO MEDICARE RECIPIENTS ARE PART OF A CHARITABLE CLASS AND SO THE PROVISION OF MEDICAL CARE FURTHERS THIS CHARITABLE CLASS. PART III, LINE 9B: NOTIFICATION ABOUT THE DMHC CHARITY AVAILABILITY FORM, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY DMHC BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS. INFORMATION SHALL ALSO BE INCLUDED ON THE FACILITY WEBSITES AND IN THE CONDITIONS OF ADMISSION FORM. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY DMHC. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE DMHC STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL WORKERS, SOCIAL WORKERS, ETC. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE FOR THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 2: PRIMARILY DMHC WORKS CLOSELY WITH THE PUBLIC HEALTH DEPARTMENT AND LOCAL EMS, FIRE AND LAW ENFORCEMENT TO WORK TOGETHER TO ADDRESS ISSUES WITHIN THE COMMUNITY. PART VI, LINE 3: WE INFORM THE PUBLIC ABOUT PROGRAMS, I.E. MEDICARE/MEDICAID THROUGH ADVERTISEMENT IN PRINT AND RADIO, PAMPHLETS IN THE WAITING ROOM, AND SOCIAL SERVICE VISITS WITH PATIENTS. PART VI, LINE 4: WE ARE DESIGNATED A FRONTIER CAH. THE COUNTY HAS 1,690 PEOPLE. WE ARE FIVE HOURS AWAY FROM A TERTIARY HOSPITAL AND THREE HOURS AWAY FROM A SECONDARY HOSPITAL. PART VI, LINE 5: WE ARE GOVERNED BY A COMMUNITY BOARD REPRESENTING THE FULL SERVICES AREA. WE ALSO PARTICIPATE IN EASTERN MONTANA TELEMEDICINE AND ARE ABLE TO OFFER VISITS WITH MULTIPLE SPECIALTY PROVIDERS. 0 0 0 0 0 0 0 0 0 GREG CROWER NP 199080 0 2575 0 0 0 3025 0 29331 0 234011 0 0 0 SHERRY GAIRRETT NP 191760 0 3075 0 0 0 5603 0 25543 0 225981 0 0 0 SHIRLEY RELLER PT 155788 0 2666 0 0 0 4754 0 32704 0 195912 0 0 0 DEANNA FERESTAD NP 154422 0 3775 0 0 0 2556 0 34803 0 195556 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL HAS A MANAGEMENT AGREEMENT WITH BILLINGS CLINIC. THEY PROVIDE MANAGEMENT, IT, AND ACCOUNTING SERVICES. THE ORGANIZATION'S CURRENT CEO, KODY BRINTON, IS AN EMPLOYEE OF BILLINGS CLINIC AND COMPENSATION FOR SERVICES PROVIDED TO THE HOSPITAL INCLUDE THE FOLLOWING: BASE SALARY - $18,154 OTHER COMPENSATION - $10,000 EMPLOYER CONTRIBUTION TO MEDICAL AND DENTAL - $1,699 EMPLOYER CONTRIBUTION TO LIFE INSURANCE AND LONG-TERM DISABILITY - $47 FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE CORPORATION SHALL BE 18 YEARS OF AGE AND COMPOSED OF THE TAXPAYERS OF DANIELS COUNTY AND/OR PERSONS WHO SHALL HAVE CONTRIBUTED TO OR PATRONIZED THE DANIELS MEMORIAL HOSPITAL ASSOCIATION BY THE TIME OF THE CORPORATION'S ANNUAL MEETING. THIS IS THE ONLY CLASS OF MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A NINE OF THE TEN DIRECTORS OF THE ORGANIZATION SHALL BE ELECTED BY THE MEMBERS OF THE CORPORATION AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS AVAILABLE FOR REVIEW BY THE BOARD AFTER APPROVAL BY THE CEO. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND SIGNED BY ALL TRUSTEES AND THE CEO ANNUALLY. THE BOARD AND THE CEO MONITOR THE STATUS OF ALL TRUSTEES THROUGHOUT THE YEAR FOR CHANGES THAT COULD LEAD TO A NEW SITUATION REQUIRING DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES REVIEWS AND MAKES DECISIONS ON THE COMPENSATION PACKAGE FOR THE CEO. THE CEO COMPENSATION IS PART OF THE MANAGEMENT CONTRACT PAID TO THE OUTSIDE MANAGEMENT COMPANY. ALL MANAGERS REPORT TO THE CEO AND THE CEO REVIEWS AND MAKES DECISIONS ON THE MANAGER'S COMPENSATION. BOARD OFFICERS ARE NOT COMPENSATED. THE CEO REVIEWS MHA WAGE SURVEY INFORMATION AS WELL AS INTERNAL EQUITY TO DETERMINE COMPENSATION OF KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST STATEMENTS AND THE FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 50. MANAGEMENT AND GENERAL EXPENSES 127,903. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 127,953. CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 1,041,389. MANAGEMENT AND GENERAL EXPENSES 1,792,381. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,833,770. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. DANIELS MEMORIAL HOSPITAL FOUNDATION 105 5TH AVE SCOBEY MT 59263 363461891 COMMUNITY HEALTHCARE SUPPORT MT 501(C)(3) LINE 12D, III-O N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0